Development And Application Of The Prelinguistic Communication Assessment Tool For Children With Autism Spectrum Disorder

Autism spectrum disorder(ASD)is a neurodevelopmental disorder in which social communication is one of the core impairments.A large number of children with ASD exhibit minimal to no verbal language,remaining in the prelinguistic stage for a long time.In the prelinguistic stage,the ability to use nonverbal communication forms or modalities such as eye gaze,gestures,and vocalizations to communicate with others is called prelinguistic communication skills.Numerous studies have shown that prelinguistic communication skills predict language development.However,the prelinguistic communication skills of children with ASD are impaired to varying degrees.The aims of this study are: To develop a tool to assess the prelinguistic communication skills of children with ASD.To explore the characteristics of prelinguistic communication skills of children with ASD and their prediction of language.To design and validate intervention strategies for prelinguistic communication skills in children with ASD.Study 1 developed an assessment tool for prelinguistic communication skills in children with ASD.First,we designed 14 semi-structured play interaction tasks,and finally identified 10 tasks that best elicited the initiation of prelinguistic communication behaviors in children with ASD.Second,we constructed a five-level communication scale for the prelinguistic communication skills of children with ASD through five steps.Third,we tested the validity and reliability of the five-level communication scale.The results showed that expert content validity showed strong Spearman correlation coefficients(rs > 0.8),while validity showed a moderate Spearman correlation coefficient(r > 0.4).The study also found that retest reliability showed a strong Spearman correlation coefficient(r = 0.9),as did rater reliability(rs > 0.8).Study 2 explored the characteristics of communication behaviors of different communication modalities and their prediction of language.First,the study found that 92 children with ASD had corresponding skills at each level of the scale,which demonstrated that the scale could distinguish children with ASD who had different prelinguistic communication skills.Second,the results indicated that children with ASD had an advantage in behavioral regulation of communicative behaviors compared to joint attention behaviors.Children with ASD had impairments in both unimodal and multimodal communication behaviors related to eye gaze.However,gestural unimodality,gesture and vocalization multimodality are advantageous communication behaviors for children with ASD.The results of the effects of preverbal communication skills on language development showed that gestural unimodality in behavioral regulation function failed to predict,while gesture and vocalization multimodality,gesture combine vocalization and eye gaze multimodal communication behaviors predicted expressive vocabulary after 12 months.Canonical syllables and consonant inventory predicted expressive vocabulary after 12 months,but vowels did not.Study 3 designed and verified an intervention strategy for prelinguistic communication skills.First,the study designed the graded intervention strategy for prelinguistic communication skills by combining theoretical foundations,five-level communication behaviors,and intervention methods such as contingent response and dyadic song interaction.Second,we implemented an intervention to test the effectiveness of the graded intervention strategy.The results showed that the strategy increased the prelinguistic communication skill levels,frequency of intentional communication behaviors,and number of consonant types in children with ASD.The innovation and contribution of this study are mainly reflected in three aspects: First,the five-level communication scale for children with ASD was developed.The scale reasonably distinguished the communication skills of children with ASD,and provided a reference for the formulation of intervention goals.Second,we explored the characteristics of different modality communication behaviors and their impact on language development,and identified key prelinguistic communication behaviors.Third,a graded intervention strategy for prelinguistic communication was designed and its effectiveness was verified through the intervention study.