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Purpose: This randomized group experiment compared the efficacy of 2 communication interventions (Responsive Education and Prelinguistic Milieu Teaching [RPMT] and the Picture Exchange Communication System [PECS]) on spoken communication in 36 preschoolers with autism spectrum disorders (ASD).
Method: Each treatment was delivered to children for a maximum total of 24 hr over a 6-month period. Spoken communication was assessed in a rigorous test of generalization at pretreatment, posttreatment, and 6-month follow-up periods.
Results: PECS was more successful than RPMT in increasing the number of nonimitative spoken communication acts and the number of different nonimitative words used at the posttreatment period. Considering growth over all 3 measurement periods, an exploratory analysis showed that growth rate of the number of different nonimitative words was faster in the PECS group than in the RPMT group for children who began treatment with relatively high object exploration. In contrast, analogous slopes were steeper in the RPMT group than in the PECS group for children who began treatment with relatively low object exploration.
KEY WORDS: autism, intervention, spoken language
The Interagency Autism Coordinating Committee "roadmap" set a long-term goal of helping 90% of children with autism spectrum disorders (ASD) to achieve useful speech by elementary school age (Department of Health and Human Services, 2004). The broad goal of "achieving speech" is probably based on results of several retrospective reports that identify "useful speech by age 5" as a consistently strong predictor of later adaptive functioning in individuals with ASD (DeMyer et al., 1973; Gillberg & Steffenburg, 1987; Kobayashi, Murata, & Yoshinaga, 1992; Rutter & Lockyer, 1967). "Useful speech" has been defined by some as "at least 5 communicative words used daily" (Venter, Lord, & Schopler, 1992). Others have required that the word use be "habitual" (DeMyer et al., 1973) and "nonimitative" (DeMyer et al., 1973; Kobayashi et al., 1992). Therefore, it is clear that useful speech has come to mean speech that is frequent, communicative, nonimitative, and referential.
For speech to be communicative, it must be used for the purpose of conveying a message to a social partner. The spoken words must also be linked to specific referents (e.g., objects, actions, ideas) that are generally understood by adults in the culture. For communicative speech to be functional, however, it must...