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Do you speak my language? Are behavior analysts considering the needs of learners on the autism spectrum?

One of the domains most commonly affected by autism spectrum disorders (ASD) is communication (American Psychiatric Association, 2000). Language deficits in children with ASD can be as severe as to warrant a label as nonverbal, or characterized by difficulties with the functions of communication. Additionally, deficits in language for children with ASD often manifest in a number of maladaptive behaviors, such as stereotypic responses, tantrums, or aggression. In fact, the majority of aberrant behaviors commonly exhibited by children with ASD relate to the need to develop or increase their language repertoire. Numerous language-based interventions for treating communication deficits and functionally related undesired behaviors have been researched. Some of the most efficacious interventions include verbal behavior approaches (e.g., Pistoljevic & Greer, 2006), functional communication training (FCT) (e.g., Richmond, 2006), and naturalistic interventions (Connell, Kane, & Pellecchia, 2010). Pieces of these methodologies are based on the principles of applied behavior analysis (ABA), a science that has proven effective on countless occasions for children with ASD (e.g., Eikeseth, 2009; Howard, Sparkman, Cohen, Green, & Stanislaw, 2005).

While a great deal of research has been devoted to language-inducing treatments for children with ASD, these studies have paid very little attention to the diverse characteristics of the children treated. This is a concern, as changing demographics in many countries mean greater diversity in learners (Cartledge & Kourea, 2008). Some general recognition of culturally and linguistically diverse (CLD) students with ASD has begun to emerge in the literature, as demonstrated in an article by Rodriguez (2009). However, this beginning acknowledgment of linguistically diverse populations with ASD has thus far failed to reach the empirically validated language interventions provided through in-home behavior analytic services.

Language Learning Needs of Linguistically Diverse Atypical Learners

The realms of research have only generically addressed meeting the language learning needs of linguistically diverse and atypical populations. These strategies have often related to the areas of needs analysis and second language acquisition. Needs analysis involves collecting information about the learner's background and the intended uses of the targeted language for that learner (Benesch, 1996). Some young children with ASD may not be able to participate actively in the needs analysis process. However, strategies applied in the classroom to determine a student's language learning needs can be logically transposed to the home environment for such children. The needs analysis would involve surveying the child's home setting, interacting with the parents to determine their commonly used communication nuances, and looking at the most typical functions language will serve for the child and his or her familial communicative partners--ultimately strategizing through dissecting the social contexts surrounding the child (Tarone, 1989). Such an analysis would likely drive the curriculum development for the child's language instruction, focusing on individualization at the local level. While some may argue that instruction at such a local level for already delayed learners will further hinder their acquisition of English as a second language, research on second language acquisition disagrees. Targeting instruction at the native language level should create links usable at the later second language level (Littlewood, 1981). Research shows that even atypical learners use interrelated processes when learning their native language and later a second language, and transfer skills from one language to another (Gutierrez-Clellen, 1999).

For young children from linguistically diverse backgrounds who have been diagnosed with ASD, a needs analysis is likely to reveal a home environment where a language other than English is most commonly used. Therefore, it appears logical that language instruction for such children be based in their native language. This would allow for access to the social contexts in which they are immersed. It would also align with the intervention research focusing on contextual fit, or a family-centered approach, which strives to recognize the impact of an intervention on the family and their natural routine (Albin, Luchyshyn, Horner, & Flannery, 1996). However, only minimal attempts have been made at considering local language needs when applying language strategies for children with ASD or other disabilities.

Kohnert, Yim, Nett, Kan, and Duran (2005) summarized the focus of many professionals, including bilingual experts, on the need to use home languages for interventions with children with speech and language impairments. Perozzi (1985) validated this in a study with six children with language delays. All children took part in two conditions. One condition involved vocabulary instruction in their native language, followed by instruction in English for the same vocabulary words. The other condition was reversed, with the English instruction occurring prior to the native language instruction. The results of the study revealed that the children learned the English words at a quicker rate when instruction was first targeted in their native language. These improved rate of acquisition results spanned across both languages, with the condition where instruction first began in the native language resulting in words acquired more quickly in both languages. A later study by Perozzi and Chavez-Sanchez (1992) corroborated these results. Five 1st-grade children learning prepositions and pronouns were rotated across two conditions, English only and Spanish (their native language) followed by English. In the condition where instruction was first targeted in their native language, the children learned twice as quickly.

Those serving linguistically diverse learners with ASD are beginning to recognize the need to consider the findings of language interventions for children with language delays who are also linguistically diverse. Petersen, Marinova-Todd, and Mirenda (2012) compared the native language of Chinese and the second language of English with 14 bilingual preschool-age children with ASD. The comparison showed that the children had no significant differences between their two repertoires of language. They were additionally compared to a matched monolingual group of English-only children with ASD. That comparison showed that the bilingual children had larger vocabularies than that of their English-only peers, thus demonstrating the ability for children with ASD to function successfully as bilingual individuals and opposing the notions of parents and professionals who believe that bilingual approaches for children with ASD are harmful (Hambly & Fombonne, 2009).

In what appears to be the earliest study in a peer-reviewed journal looking at language intervention in the native language of a bilingual child with ASD, Seung, Siddiqi, and Elder (2006) followed a Korean-English child with autism over the course of 24 months. During the first 12 months of the longitudinal study, language intervention was provided in the child's native language of Korean. The intervention then gradually transitioned to include English, ultimately becoming English-only in nature. The child excelled in many areas of language in both linguistic repertoires.

While research addressing the linguistically diverse needs of children with ASD is beginning to surface in the arenas of speech-language therapy and special education services, integration into the field of behavior analysis has been nearly non-existent. A keyword search of the prominent behavior analytic journal, Journal of Applied Behavior Analysis, for terms related to culturally and linguistically diverse practices was devoid of relevant hits. Additionally, a 2011 issue of the Journal of Behavioral Education was one of the first journal issues prominently focusing on addressing the needs of CLD learners with moderate to severe needs, including ASD diagnoses. A few articles in that issue looked at using strategies grounded in the principles of ABA to address such linguistic diversity. A study by Lang and colleagues (2011) looked at the use of Discrete Trial Training (DTT) with a 4-year-old child with autism assessed at the same competency level in both her native language of Spanish and the target language of English. The study compared the DTT training across the conditions of Spanish and English instruction. Results showed an increase in correct responses, and a decrease in aberrant behaviors, when presented with the intervention in Spanish, as opposed to English. This provides additional support for the consideration of native language usage in the intervention services of children with ASD.

Rispoli and colleagues (2011) conducted a modified functional analysis procedure with a Spanish-speaking child with a severe intellectual disability. The behavior assessment procedure was conducted in both English and Spanish, across all conditions of the analysis. When the assessment was conducted in English, the child emitted more maladaptive behaviors when demands were placed in the escape/ demand condition of the assessment. While this does not necessarily imply that her language responses would increase when instruction is targeted in her native language, it does provide implications regarding the need for cultural competency in the assessment and intervention protocols for linguistically diverse children with moderate disabilities.

Jones and colleagues (2011) addressed the linguistic diversity of their student population diagnosed with autism when applying an intensive, ABA-based intervention in Wales. The team worked to translate all student-programming resources into Welsh, the students' native language. They also worked to translate the terminology associated with the intervention to train the interventionists. However, student outcomes were not measured in this study. Rather, an anecdotal report was provided on the obstacles and successes met in providing services to the linguistically diverse student population in their first language, with an emphasis on the value of embracing a multilingual approach. While this is a promising start in the consideration of language needs at the local level for children with ASD, the lack of tangible outcomes does little to advance the field of behavior analysis. It is promising, but very basic.

Verbal Behavior Approach to Teaching Language

The verbal behavior approach to teaching language employs Skinner's theory of the function of language, the role of the listener and speaker, and the environmental controls surrounding language (Skinner, 1957 /1992). The approach provides a behavioral formulation of communication skills, where the development of language is based on experiences and contact with reinforcement (Greer & Ross, 2008). When embracing the view of language as generative, these experiences can be taught and are done so using many different procedures (Bondy, Esch, & Sundberg, 2010). Regardless of the strategies employed, instruction typically revolves around teaching the verbal operants (learned types of communicative interactions), such as echoics (e.g., saying "ball" when you hear someone else say "ball"), mands (e.g., saying "ball" when you want someone to bring you the ball), tacts (e.g., saying "ball" when you see the ball), and intraverbals (e.g., saying "ball" when asked "What do you throw?"). Tacts are language emissions used frequently by typically developing children as they begin to label the items around them, and are met with praise and attention from others. Children with autism are often lacking a bank of tacts (words to use as labels), and thus lack a vital foundation skill for the development of more complex communicative responses (Pistoljevic & Greer, 2006).

Tact instruction has proven effective in increasing the language of children with autism. Woods (1984) conducted one of the earliest studies of tact training for children with autism. Woods' seminal study not only demonstrated the value of tact training, but also compared two different tact training conditions, one using a more contrived condition where antecedents were vocal (e.g., "What do you see there?") and one using a more naturalistic approach. While the children did have a faster rate of tact acquisition in the contrived condition, generalization was substantially better under the naturalistic condition. Woods' results certainly inspired continued research in the area of tact instruction for children with ASD, with a broadening focus on instructional teaching procedures and outcomes that span beyond the teaching environment.

Barbera and Kubina (2005) were able to explore transfer procedures for teaching tacts to a 7-yearold child on the spectrum, which resulted in vast increases in tact acquisition over baseline. The procedure involved two- and three-syllable words for the tact targets, and used a receptive-to-echoic-to-tact transfer procedure. The targets and procedure were developed as a result of evaluating the child's current language usage and language needs in the classroom. The instructional procedure took into consideration his functional language needs, moving beyond the focus of acquisition for the sake of acquisition.

In a study by Pistolijevic and Greer (2006), a teaching procedure that involved the intensive presentation of tact opportunities to 3- and 4-year-old children with autism had promising results, and aimed for more functional and generalizable outcomes. The increased tact-specific language intervention involved the presentation of two-dimensional stimuli of common objects presented throughout the school day for the participants to vocally label. Eighty items were targeted for the instruction, spanning common categories, with 100 tact opportunities presented daily. The intensive intervention resulted in the increase of mand and tact responses in the generalized, non-instructional setting. Delgado and Oblak (2007) replicated this study with preschool children diagnosed with developmental delays, with congruent results. With a further replication by Lydon, Healy, Leader, and Keohane (2009), two early intervention age children with autism participated in the intensive tact intervention, with favorable results.

A study by May, Hawkins, and Dymond (2013) also reported on the benefits of tact instruction in regard to greater communicative application. The teaching procedure in their study involved using a stimulus equivalence paradigm. The participants were taught one type of tact response, and then later probed for the emission of a corresponding untaught intraverbal response. In this study involving adolescents with autism, an increase in tact responses occurred as well as an increase of untaught responses, intraverbals in this case. The results of this study provided support for the use of tact instruction on higher-level language acquisition.

The above studies are only a few examples of successful verbal behavior-based tact interventions for children with autism. It is valuable to consider how these successful interventions have striven to meet the needs of children beyond increases in spoken words. The learners' communicative needs were taken into account. Tact targets were developed based on common items with which the learners had contact, with the Barbera and Kubina (2005) case even assessing the target child's peers to find words that they knew, but he did not, for targeted instruction. The value of generalization to more advanced communication responses and naturalistic environments was clear as well.

The verbal behavior approach's apparent focus on considering the functional needs of a language learner in the analysis prior to developing an intervention echoes the theory of needs assessment and family-centered planning. Yet research needs to be done linking these areas, especially in the realm of linguistically diverse learners with ASD.

Linking Language Needs

It has been stated that children with an ASD diagnosis who come from homes where English is not the first language spoken should be provided with instruction in their native language (Wilder, Dyches, Obiakor, & Algozzine, 2004). The use of such a native language strategy is also supported by research on the needs analysis of language learning, second language acquisition, and a family-centered approach. Unfortunately, little research discusses the utility of applying such a native language approach (even more specifically, a verbal behavior approach to teaching language) to already empirically validated in-home language interventions for such children. So where is the integration of behavior analytic practices and native language instruction? With evidence building for both pieces of that puzzle, behavior analysts need to face their ethical obligations to target really socially significant behaviors. Verbal behavior-based language interventions need to begin with a needs analysis that will make the already targeted goals of generalization more attainable. When providing services to linguistically diverse learners, and aiming to embrace Skinner's philosophy of language, behavior analysts must ask themselves how the listener and speaker play complementary roles in a setting where two different languages are spoken. Additionally, it must be remembered that truly expanding a child with ASD's access to positive reinforcement means giving him or her tools to communicate effectively in his or her environment, whatever language may be spoken there.


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Sheri Kingsdorf is Solve It! Research Assistant and a doctoral student, Department of Teaching and Learning, University of Miami, Coral Gables, Florida.
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Title Annotation:Review of Research
Author:Kingsdorf, Sheri
Publication:Childhood Education
Article Type:Report
Geographic Code:1USA
Date:Mar 1, 2014
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