Simplified Language for Autism

(PALS Trial)

Overseen By Courtney Venker, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Michigan State University

Disqualifiers: Genetic conditions, Cerebral palsy, Brain injury, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

104 Participants Needed

Trial Summary

What is the purpose of this trial?

The long-term study goal is to experimentally evaluate the components (and likely active ingredients) of early language interventions for young children with ASD. The overall objective is to determine how single-word and telegraphic simplification affects real-time language processing and word learning in young children with ASD (relative to full, grammatical utterances). The proposed project will investigate three specific aims: 1) Determine how single-word and telegraphic simplification affects language processing. 2) Determine how single-word and telegraphic simplification affects word learning. 3) Evaluate child characteristics that may moderate the effects of linguistic simplification on language processing and word learning. Aim 1 will test the hypothesis that children with ASD will process full, grammatical utterances faster and more accurately than single-word or telegraphic utterances. Aim 2 will test the hypothesis that full, grammatical utterances will support word learning better than telegraphic or single-word utterances. Aim 3 will test the hypothesis that language and cognitive skills significantly moderate the effects of linguistic simplification on language processing and word learning in young children with ASD.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Simplified Language for Autism?

The pilot study on Expressive Language Sampling (ELS) suggests that parents can effectively learn and administer language tasks at home, which may help improve language skills in children with autism. This indicates that simplified language input, like the treatment in the trial, could be beneficial for enhancing communication in autistic individuals. ^{1 2 3 4 5}

How does the treatment 'Simplified Language for Autism' differ from other treatments for autism?

The 'Simplified Language for Autism' treatment is unique because it uses telegraphic simplification, which involves using short, simple phrases to help children with language delays understand and communicate better. This approach is different from other treatments that may focus on more complex language structures or different therapeutic methods. ^{6 7 8 9 10}

Eligibility Criteria

This trial is for young children aged 1-4 who have been diagnosed with autism spectrum disorder or are suspected to have it, confirmed through ADOS-2. They must primarily speak English. Children with genetic conditions like Down syndrome, brain injuries, cerebral palsy, or uncorrected vision/hearing issues cannot participate.

Inclusion Criteria

I am between 1 and 4 years old.

Existing or suspected autism spectrum disorder, confirmed through ADOS-2

English as primary language

Exclusion Criteria

Cerebral palsy

I have vision or hearing problems that haven’t been corrected.

Acquired brain injury

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Experimental Manipulation

Participants are exposed to all utterance types to evaluate language processing and word learning

Varies per task

Multiple sessions (in-person)

Assessment

Gaze location is assessed during Looking-While-Listening tasks and Fast Mapping tasks

Less than 10 minutes per task

Single assessment per task

Follow-up

Participants are monitored for any changes in language processing and word learning post-intervention

4 weeks

Treatment Details

Interventions

• Linguistic simplification

Trial Overview The study is testing how simplifying language in different ways affects the ability of young autistic children to process and learn new words. It compares full sentences to single-word and short phrases (telegraphic speech) to see which supports better understanding and learning.

Participant Groups

Group I: Utterance Type Experimental Treatment 1 Intervention

This study uses a within-participant experimental manipulation. All participants will be exposed to all utterance types (across trials).

Who Is Running the Clinical Trial?

Michigan State University

Lead Sponsor

Trials

202

Recruited

687,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Findings from Research

A pilot study demonstrated that native English-speaking and native Spanish-speaking parents can effectively learn to administer the Expressive Language Sampling (ELS) narrative task at home, with 16 out of 19 parents successfully completing the training.

The ELS-N procedures showed strong test-retest reliability and minimal practice effects over a 4-week period, indicating that this method can provide reliable measures of expressive language skills in youth with autism spectrum disorder (ASD).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using telehealth-delivered procedures to collect a parent-implemented expressive language sampling narrative task in monolingual and bilingual families with Autism Spectrum Disorder: A pilot study. Soriano, LDH., Bullard, L., Alvarez, CH., et al.[2023]

The study analyzed language samples from 49 autistic youth aged 6-21 who used fewer than 200 words, revealing that those with a higher number of different words (NDW) did not produce more nouns and verbs, indicating a unique lexical profile.

However, youth with higher NDW demonstrated significantly longer mean lengths of utterance and more frequent use of early developing morphosyntactic structures, suggesting that their morphosyntactic abilities align more closely with their spoken vocabulary level.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lexical and Morphosyntactic Profiles of Autistic Youth With Minimal or Low Spoken Language Skills. Butler, LK., Shen, L., Chenausky, KV., et al.[2023]

In a study involving 21 children with autism and 22 typically developing peers, it was found that children with autism showed significantly less sensitivity to grammatical errors, particularly in third person singular and present progressive forms.

The ability to detect grammatical errors was influenced by sentence length and was associated with the onset of speech development and the severity of autistic symptoms, suggesting that language skills in autism are more complex than previously assumed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Grammaticality judgments in autism: deviance or delay. Eigsti, IM., Bennetto, L.[2023]

Language impairments in autism are more extensive than previously thought, affecting semantic, syntactic, and pragmatic skills, with some individuals also experiencing phonological deficits.

Neurophysiological studies indicate that both low-level perceptual difficulties and abnormal high-level processing in specific brain regions contribute to these language impairments, suggesting that early sensory issues and atypical neural connectivity play a significant role in language acquisition challenges in autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The phenotype and neural correlates of language in autism: an integrative review. Groen, WB., Zwiers, MP., van der Gaag, RJ., et al.[2022]

The study involved 90 participants across three age groups (children, teenagers, and adults) who used picture communication symbols to construct utterances, revealing that simpler utterances resulted in more consistent responses than complex ones.

Children found it particularly challenging to convey complex sentences, especially subject relative constructions, indicating that tasks involving graphic symbol use may require advanced metalinguistic skills beyond basic language transfer.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Construction of graphic symbol utterances by children, teenagers, and adults: the effect of structure and task demands. Trudeau, N., Sutton, A., Dagenais, E., et al.[2007]

Icono is a new language that uses icons to represent words, making it more intuitive and reader-friendly, especially for individuals with learning difficulties like dyslexia and autism.

The structure of sentences in Icono is visually represented before reading, which can enhance comprehension and speed up writing on digital devices compared to traditional alphabetic languages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Icono: a universal language that shows what it says. Kramer, P.[2023]

The Minimalist program suggests that the human language system is an optimal solution for connecting sound and meaning, aiming to simplify earlier complex models of language.

Recent research has focused on reducing the number of linguistic levels and deriving syntactic constraints from principles of economy and computational simplicity, highlighting a shift towards a more streamlined understanding of language structure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The minimalist program in syntax. Lasnik, H.[2019]

A significant majority of speech-language pathologists (82%) use telegraphic input when working with young children with language delays, particularly for prompting verbal imitations.

Despite the high usage of telegraphic input, only 30% of SLPs found it useful, indicating a need for more thoughtful decision-making regarding language simplification strategies in therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Telegraphic Input With Children With Language Delays: A Survey of Speech-Language Pathologists' Practices and Perspectives. Venker, CE., Yasick, M., McDaniel, J.[2020]

In a study involving 115 children aged 4-8, those with autism spectrum disorder (ASD) exhibited a higher ratio of content to filler disfluencies compared to typically developing (TD) children, indicating different patterns of speech disfluency.

The study established a reliable classification schema for disfluencies, which showed that while ASD children had similar rates of repetitions, revisions, and false starts as TD children, they produced fewer cued disfluencies, suggesting differences in pragmatic language use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Quantitative analysis of disfluency in children with autism spectrum disorder or language impairment. MacFarlane, H., Gorman, K., Ingham, R., et al.[2019]

A study involving 93 speech-language pathologists (SLPs) found that those who did not see telegraphic speech as useful preferred to use grammatical utterances when communicating with children who have language delays.

The results suggest that using grammatical input is more beneficial for children with language delays, as telegraphic speech may hinder their ability to learn proper language structures, unless further evidence supports the use of telegraphic input.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech-Language Pathologists' Ratings of Telegraphic Versus Grammatical Utterances: A Survey Study. Venker, CE., McDaniel, J., Yasick, M.[2021]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Using telehealth-delivered procedures to collect a parent-implemented expressive language sampling narrative task in monolingual and bilingual families with Autism Spectrum Disorder: A pilot study. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Lexical and Morphosyntactic Profiles of Autistic Youth With Minimal or Low Spoken Language Skills. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Grammaticality judgments in autism: deviance or delay. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

The phenotype and neural correlates of language in autism: an integrative review. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Construction of graphic symbol utterances by children, teenagers, and adults: the effect of structure and task demands. [2007]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Icono: a universal language that shows what it says. [2023]

7. England pubmed.ncbi.nlm.nih.gov

The minimalist program in syntax. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Using Telegraphic Input With Children With Language Delays: A Survey of Speech-Language Pathologists' Practices and Perspectives. [2020]

9. United States pubmed.ncbi.nlm.nih.gov

Quantitative analysis of disfluency in children with autism spectrum disorder or language impairment. [2019]

10. United States pubmed.ncbi.nlm.nih.gov

Speech-Language Pathologists' Ratings of Telegraphic Versus Grammatical Utterances: A Survey Study. [2021]