The effect of cue type on directive-following in children with moderate to severe autism spectrum disorder

Abstract

For this study, 11 children with moderate to severe autism spectrum disorder (ASD) were given directives containing prepositions in three cue conditions: (a) spoken alone, (b) a short video clip along with spoken cues, and (c) a sequence of three graphic symbols accompanied by spoken cues. Participants followed directives significantly more accurately with the video clip than with spoken cues only, and significantly more accurately with spoken cues only relative to the sequence of graphic symbols. Results suggest that the short video clip along with spoken cues may be an optimal mode for enhancing learners’ ability to follow directives containing prepositions. In addition, results reveal three statistically significant correlations between participants’ preexisting skills and directive-following accuracy: a positive correlation between spoken preposition preassessment total score and accuracy in the spoken-alone condition; a positive correlation between spoken noun preassessment total score and accuracy in the video-clip condition; and a positive correlation between ASD severity and the need for repetition in the video-clip condition. Results also suggested that, for children with more severe ASD symptoms, the video clips require repetitions so that the relationships illustrated within it can gain more semantic salience. Implications for clinical practice and future research are discussed.

Keywords:

• Aided language
• augmentative and alternative communication (AAC)
• augmented input
• autism spectrum disorder
• receptive language

Author contributions

The manuscript was completed as part of the requirements for the first author’s doctoral dissertation at MGH Institute of Health Professions.

The authors thank Amanda O’Brien, Christina Yu, and Jenny Abramson for their assistance with recruitment; Nicole Choe and Indigo Young for their assistance with data collection; Annie Fox-Galalis for her assistance with data analysis; Meryl Alper, Nicole Choe, Suzanne Flynn, Maria Galassi, Loren Fields McMahon, Paul Simeone, Leigh Anne White, and Christina Yu for their input on the manuscript; Emily Laubscher, Gregg Lof, and Meghan O’Brien for insights that helped define the topic; and anonymous reviewers for their helpful comments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 iPad, iPhone, and iOS Camera app are products of Apple Computers Inc., Cupertino, CA, www.apple.com

2 Gumby and Pokey are products of Prema Toy Company.