1. Effects of Conversational Recasting with Imitation on the Acquisition of Linguistic Structures in Children with Autism  
GREGORY LYONS, Lynn Koegel, Robert Koegel
Presentation for Recent Advances in Autism Research
University of Wisconsin - Madison
Research Conducted at:
University of California, Santa Barbara
My project is entitled “Improving the Acquisition of Target Linguistic Skills in Young Children with Autism” and is essentially concerned with grammar rules, and as such I hope that all of the tenses I use in this presentation are accurate…and if not, a simple recast should help me out.

2. Introduction CHILDREN WITH AUTISM: Are delayed in language development
(Lord & Paul, 1997; Menyuk & Quill, 1985; Paul & Alforde, 1993; Swisher & Demetras, 1985)
Frequently omit morphemes
(Bartolucci, Pierce, & Streiner, 1980; Howlin, 1984; Roberts, Rice & Tager-Flusberg, 2004)
May have atypical order of acquisition of morphemes
(Bartolucci, Pierce, & Streiner, 1980; Menyuk & Quill, 1985; Paul & Alforde, 1993; Swisher & Demetras, 1985)
Language development in children with autism is not well understood, however it has been the interest of many researchers over the years
The findings, although indicating heterogeneity in language development within the diagnosis of autism, point to certain generalizations. Specifically, children with autism are typically delayed in the onset of language acquisition, they frequently omit morphemes, and when they do develop morphemes, they are often acquired in an atypical order.
Studies show that up to 75% have a language disorder (Roberts, Rice, Tager-Flusberg)

3. Introduction (cont.) SUGGESTED INTERVENTIONS:
Analog elicited imitation
Naturalistic conversational (sentence) recasting
(Fey & Proctor Williams, 2000)
Given that there exists a subpopulation that has difficulty with syntax, the literature suggests a variety of possible interventions. Two that are particulalry noteworthy are “analog elicited imitation” and “naturalistic sentence recasting”

4. Introduction (cont.) ANALOG ELICITED IMITATION:
Follows the operant conditioning model (S-R-C)
Child is presented with an adult-chosen imitative stimulus  a model of the linguistic skill is presented  the child is required to imitate the model prior to reinforcement (Connell, 1987; Fey & Proctor-Williams, 2000; Lovaas, 1987 )
Non-natural stimuli and environments
Flashcards = “imitative stimulus”
“Decontextualized” (Connell, 1987)
Analog elicited imitation follows an operant conditioning model (stimulus-response-consequence) and argues that individuals who do not learn language naturally, learn best through the de-contextualized presentation of grammar coupled with imitation practice.

5. Introduction (cont.) NATURALISTIC SENTENCE RECASTING:
Is when an adult repeats the general utterance of the child, but expands upon it or corrects it (Nelson & Camarata, 1992)
Child is not required to imitate the recast (Fey & Proctor-Williams, 2000)
Is contextualized- natural environments/stimuli
Creates an optimal context grammar learning (Fey & Proctor-Williams, 2000)
Focuses child attention on specific grammatical features (cues)
Is successful in facilitating correct and generalized language use with different populations, but has not been addressed with children with autism (Nelson, Camarata, Welsh, & Butkovsky, 1996; Fey, Cleave, Long, & Hughes, 1993; Farrar, 1990)
Has become the preferred mode of treatment by speech therapy practitioners and researchers.

6. Introduction (cont.)
Literature indicates sentence recasting might be effective for children with autism:
Similarities to children with SLI (Roberts, Rice, Tager-Flusberg, 2004)
Naturalistic (Delprato, 2001; Koegel, O’Dell, Koegel, 1987)
However, autism specific characteristics may limit effectiveness:
Low levels of motivation (Koegel & Koegel, 1995; Koegel & Mentis, 1985)
Attentional differences (Swettenham, et al. , 1998; Lovaas, Koegel, Schreibman, 1979)
Possible modification to sentence recasting?
Imitation (Camarata & Nelson, 1992; Fey & Proctor-Williams, 2000)
Given that the literature has suggested a similar profile to children with SLI, and given the shift in treatment paradigms toward more naturalistic procedures, sentence recasting would seem to be a useful intervention in remediating syntactical language difficulties in chidlren with autism.
However, autrism specific charateristics in the realms of motivation and attention might conflict with the hypothesized mechanism of recasting discussed in the prior slide.
Despite this, some researchers suggest that (for some children) imitation and sentence recasting can effectively complement each other.
Camarata and Nelson (1992) have speculated that imitation might have a role in helping some children first attend to the target structure in the input (i.e., the recast) and subsequently practice producing it. Other researchers, such as Fey and Proctor Williams argue that imitation can complement recasting to maximize effectiveness and efficiency of grammatical interventions.

7. Introduction (cont.) AREA IN NEED OF RESEARCH:
The use of sentence recasting with children with autism
The role of imitation of the linguistic structure contained in the recast
(Koegel, Carter, & Koegel, 2003; Fey & Proctor-Williams, 2000; Camarata & Nelson, 1992; Kaiser, Yoder, & Keetz, 1992; Koegel, O’Dell, & Koegel, 1987; Culatta & Horn, 1982; Hedge & Gierut, 1979; Hester & Hendrickson, 1977)
And so it follows that the following areas are in need of research:
The use of sentence recasting in children with autism
2) The role of imitation of the recast has not been assessed, nor specified in the literature

8. Research Questions
Is typical sentence recasting effective for improving target linguistic structures in children with autism?
Is incorporating an imitation component within a naturalistic recast procedure for children with autism (who exhibit difficulties with syntax) effective?
And so I asked:

9. Methods
Child 1
3.5-years-old at the start of the study; male Brazilian-American diagnosed with autism
Vineland Adaptive Behavior Scale showed delay in communication
Used some spontaneous language
Started with an MLU of 2+ words
Language samples revealed missing linguistic structures appropriate for language-age at time of intervention for that bahavior:
progressive [–ing], did/do reversal, past tense during conversation
Child 2
2.6-years-old at the start of the study; male European-American diagnosed with autism
Vineland Adaptive Behavior Scale showed delay in communication
Used some spontaneous language
Started with an MLU of 2+ words
Language samples revealed missing linguistic structures appropriate for language-age at time of intervention for that behavior:
progressive [–ing], plural [-s], possessive [-’s]
Child 1…and data was collected longitudinally over a period of 2 years;
Child 2….and data was collected longitudinally over a period of 1.5 years.

10. Methods
DESIGN
A non-concurrent multiple baseline design across behaviors and participants, with a control for order effects, was employed (Bailey & Burch, 2002)
PROCEDURE
Baseline -
Semi-structured language samples where the participants were provided 20 opportunities (asked questions or given leading statements) in order to evoke the target linguistic skills
No Recasts Delivered
In order to answer my research questions, I used a…
There is a total of 6 tiers, with 3 tiers per child and there were three condtions in my study for the first 2 tiers for each child: a) baseline, followed by recast alone, followed by recast with imitation

11. Methods Intervention Conditions -
Recast alone – children were NOT prompted to imitate the recasted syntactic structure prior to continuing play/interaction.
Example: Child says “Train go”, Adult recasts “Train’s going”, & Child is NOT prompted to imitate recast and can continue playing with trains.
Recast with Imitation- children were prompted to imitate the recasted syntactic structure prior to continuing play/interaction.
Example: Child says “Train go” , Adult recasts “Train’s going” & Child is prompted to imitate the recast, “Train is going” prior to continuing to play with the trains.

12. Methods PROCEDURE (cont.) Generalization Probes -
Semi-structured language samples in novel setting where adults naïve to the purpose of the study and provided 20 opportunities (asked the participants questions and gave leading statements) in order to elicit the target linguistic skill
Dependent Measure -
Percent Correct Target Linguistics Skills Used - number of
correct spontaneous target linguistic skill responses divided by the sum of correct and incorrect spontaneous target skills responses, multiplied by 100%

13. Example: Recasting Alone
Child: “What did you did?”
Adult recast: “What did you DO?”
Child: “uh huh”
And continues to not use the grammar.

14. Examples: Recasting with Imitation
Child: “What did you DID?”
Adult recast: “What did you DO?”
Child: “What did you DO?”
Adult: “I went to the movies.”
…next opportunity…
Adult: “I did something fun.”
The nice thing about that first clip:
1) Is you see the change taking place between opportunities
2) And you also see that he is not just using a rote response “what did you do?” in fact I found him using the correct did/verb combinations within a variety of sentence constructions- even in statements (would be interesting to look at novel use of the skills/rules in future studies)
Second clip- you will not only see that he’s a bit sassy in the clip, but that he is self-correcting nicely
Third clip- generalization clip, and we see that he ios nicely generalizing the new skill

15. Recast with imitation Recast with Imitation Recast with Imitation
Baseline

16. Recast with Imitation
Recast with Imitation

17. Discussion
Recast with imitation resulted in improved acquisition and generalization in contrast to a recasting procedure that did not incorporate imitation.
The results have implications for understanding the roles of imitation and contingent reinforcement in the recast mechanism as it pertains to teaching children with autism linguistic skills
Underlying variables addressed: motivation & attention
It helped focus the child’s attention on relevant cue (i.e., the new grammar cues)
* Role of imitation
2) It motivated the child to initially attend to the adult’s recast
* Role of contingent reinforcement
3) It motivated the child to imitate the recast and subsequently use the target syntax

18. Mechanisms for Recast with Imitation Condition
Intervention Variable
Related Mechanism
Related
Characteristic of Autism
Related Observations
Contingent Reinforcement:
Child’s access/continuation in play interrupted
Motivated the child to initially attend to the recast.
Motivation
Children typically ignored the recast in the recast alone condition.
Only an attempt at accurate use led to the natural reinforcer
Motivated the child to imitate the recast and use the correct linguistic skill.
Operant conditioning
1) Rarely imitated during recast alone (ignored or said “uh huh”).
2) Children began imitating and self-correcting.
Imitation:
Child attempted to imitate the recast with the target linguistic skill
Focuses child’s attention onto the relevant cue (i.e., the differing grammar)
Selective Attention
(i.e., overselectivity; e.g., Koegel, Dunlap, Richman, & Dyer, 1981; Koegel, Shirotova, & Koegel, 2009)
1) If the child repeated their utterance in recast alone, typically omitted the new linguistic skill.
2) When the children first attempted imitating, they again omitted the new grammar.
So it turns out, that simply getting the children to imitate the recast, several parameters of the recast alone intervention are altered, and thus may be implicated in the intervention mechanism.
The role of contingent reinforcement is necessarily implicated.
Related characteristics of autism being operated on is:
The most interesting variable to me is the role of imitation and its potential effect on selective attention. Interestingly, this relates to a study by KOegel, Dunlap, Richman, & Dyer which showed that by getting children with autism to say the specific relevant orienting cue, there was improved performance in discrimination tasks. For example, in a two-step instruction, first touch the dog then touch the bunny, at baseline the non-specific orienting might have been “look at me” instead the specific orienting cue would be to have them say that instruction.

19. Future Studies Response generalization Tease out treatment mechanisms
Do children start generalizing the grammar rules to novel words/responses?
Need to systematically assess
Tease out treatment mechanisms
Is imitation necessary?
Limited application to children with autism who:
Have an MLU of 2+ words
-Necessary? First word acquisition?
2) Use language spontaneously (have demonstrated social communicative intent)
Do children who display frequent use of echolalia improve under recast alone? (interesting control for imitation v. functional use)
What is more crucial?

20. In conclusion:
The current results suggest that stimulus control variables, specifically overselectivity (Lovaas, Koegel, & Schreibman, 1979), and other variables such as contingent reinforcement, may be important aspects of a mechanism by which children with autism effectively and efficiently acquire target linguistic structures in natural settings.