The Effects of a Developmental, Social–Pragmatic Language Intervention on the Production of Expressive Language Skills in Young Children with Autistic Spectrum Disorders

The developmental, social–pragmatic model is a naturalistic strategy for teaching social-communication skills to young at-risk children and children with disabilities. Our aim was to assess the effect of a developmental, social–pragmatic language intervention on expressive language skills production in young children with autistic spectrum disorders. We used the experimental method in this study, we administered PLS-5 twice on two children, whose comprehension and expressive language ages were delayed associated with autism spectrum disorder as a baseline assessment and a post-treatment assessment. Our findings after comparing the baseline assessment scores and post-treatment assessment scores, there is a better improvement in auditory comprehension and expressive communication skills of both participants by using DSP language intervention strategies. We concluded that the child who takes language therapy using DSP language intervention will get better improvement in their language skills. Developmental social-pragmatic language intervention is more effective for children with autism than the other interventions.

Developmental Language Disorder (DLD) is a common and heterogeneous neuro-developmental disorder that occurs during childhood and affects 3% to 7% of children. The term applies to significant difficulties in one or more language domains, in expressive and/or receptive language that affects communication and learning without an associated biomedical condition.

Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first 2 years of life. Common types of behaviors in people diagnosed with ASD are Making little or inconsistent eye contact, Appearing not to look at or listen to people who are talking, Infrequently sharing interest, emotion, or enjoyment of objects or activities (including infrequent pointing at or showing things to others), Not responding or being slow to respond to one’s name or to other verbal bids for attention, Having difficulties with the back and forth of conversation, Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond, Displaying facial expressions, movements, and gestures that do not match what is being said, Repeating certain behaviors or having unusual behaviors, such as repeating words or phrases (a behavior called echolalia), Having a lasting intense interest in specific topics, such as numbers, details, or facts, Showing overly focused interests, such as with moving objects or parts of objects, Becoming upset by slight changes in a routine and having difficulty with transitions, etc. Not all people with ASD will have all behaviors, but most will have several of the behaviors.

Pragmatic language deficits are a core feature of ASD regardless of language level or age. Also, children with DLD may manifest difficulties in this language domain throughout childhood. These difficulties have a negative impact on learning, socialization, and mental health and may persist into adulthood. Therefore, early, effective, evidence-based interventions are crucial to minimizing the long-term impacts of pragmatic language impairments.

There are several intervention programs mentioned in the literature to improve children's pragmatic language. Some of these programs are Social Scripts, Social Stories, Comic Strip Conversations, Social Use of Language Program, Score Skills Strategy, Social Thinking, Social Communication Intervention Project (SCIP), Building Blocks Program, JASPER, Mind Reading, and Pragmatic Intervention Program.

The developmental, social–pragmatic model is a naturalistic strategy for teaching social communication skills to young at-risk children and children with disabilities (Prizant, Wetherby, & Rydell, 2000). This model has also been referred to as the interactive model (Tannock & Girolametto, 1992) or the child-oriented approach (Fey, 1986).

The Developmental, social–pragmatic (DSP) model is derived from research on typical child development that indicates a relationship between caregivers’ responsivity and their child’s level of social communication development (Bornstein, Tamis-LeMonda, & Haynes, 1999; Hoff-Ginsberg & Shatz, 1982; Mahoney & Perales, 2003; Prizant et al., 2000). The DSP model is based on the theory that language develops within strong, affection interactions between the child and the adult, and it emphasizes the function of the child’s communication (i.e., requesting, protesting, sharing, commenting, etc.) over the form (i.e., eye gaze, gestures, vocalizations, facial expressions, body postures, language; Bates, 1976; Bates & Mac Whinney, 1979; Prizant & Wetherby, 1998; Prizant et al., 2000).

DSP interventions share several common characteristics (Prizant et al., 2000). First, teaching follows the child’s lead or interest; the adult engages in child-initiated interactions that are based on the child’s interests and attention. Second, the adult arranges the environment to encourage initiation from the child. Common strategies include playful obstruction (i.e., briefly interrupting an activity the child is doing), sabotage (i.e., omitting necessary items needed for an activity), violating familiar routines (i.e., changing the way a child likes to do things), and in sight–out of reach (i.e., displaying desired items so that the child cannot access them himself).

Participants

In the present study, two children (Ajay & Deva- names were changed for this study) have participated. The children were diagnosed with an autistic spectrum disorder by a professional using CARS (Childhood Autism Rating Scale). All participants were administered the standardized language assessment by a speech–language pathologist and a developmental assessment by a clinical psychologist associated with this research (see Table 1 for participant characteristics) and children were recruited randomly from a list of children who are undergoing speech–language therapy services at a Blooming Buds Child Development Center (Banjara Hills Hyderabad) which is specializing in intervention for children with communication disorders. Ajay was 4 years had a diagnosis with an autistic spectrum disorder. Initially, Ajay's language was delayed and it consisted of immediate echolalia, poor eye contact, jargon speech, stubborn behavior, and some basic concepts (colours, shapes, fruits, vegetables, animals, birds).

Results

The results of this study showed that there is a better improvement in auditory comprehension and expression skills in both participants by taking speech-language therapy using DSP intervention strategies.

These results provide support for the effectiveness of a DSP language intervention for young children with ASD. In this study, two of the children had gains in their use of spontaneous language with the therapist that began at the onset of treatment.

Especially Deva, the nonverbal child, made gains in his use of language using this approach. Several researchers have suggested that children with autism who are nonverbal may require a more structured approach to learn prerequisite skills such as verbal imitation before receiving a less structured approach (e.g., Greenspan & Wieder, 1998). The nonverbal child in this study made gains in spontaneous language, which suggests that DSP interventions may be appropriate for nonverbal children with ASD.

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Greenspan, S. I., & Wieder, S. (1998). The child with special needs. Reading, MA: Addison-Wesley. Hart, B. M., & Risley, T. R. (1968). Establishing the use of descriptive adjectives in the spontaneous speech of disadvantaged preschool children. Journal of Applied Behavior Analysis, 1, 109–120.

Thyagarajan, R. & Mone, A.S. (2023). The Effects of a Developmental, Social–Pragmatic Language Intervention on the Production of Expressive Language Skills in Young Children with Autistic Spectrum Disorders. International Journal of Indian Psychology, 11(2), 110-130. DIP:18.01.289.20231102, DOI:10.25215/1102.289