Alternative receptive language assessment modalities and stimuli for autistic children who are minimally verbal

Abstract

The primary aim of this study was to evaluate and compare alternative modalities and stimuli used to measure receptive vocabulary skills in autistic children who are minimally verbal. This study systematically compared participants’ outcomes on three different receptive vocabulary assessment conditions: a low-tech assessment that used a stimulus book, a touchscreen assessment, and an assessment that used real-object stimuli. A secondary aim of this study was to examine how individual characteristics such as nonverbal cognition, maladaptive behavior, and autism symptomology impact performance on assessment conditions. Participants were 27 autistic students between the ages of 3 and 12 who had minimal verbal skills. Participants responded to 12 items in 3 assessment conditions (972 total items). Results from a crossed random effects model showed that participants’ scores in the real-object assessment condition were significantly higher than in the low-tech book condition and marginally higher than scores in the touchscreen assessment condition. Nonverbal cognition accounted for 44% of the variance in participants’ scores.

Lay abstract

It is difficult to measure language comprehension abilities in autistic children who have limited expressive language skills. Results from available assessments may underestimate autistic children’s receptive language skills. The primary purpose of this study was to compare alternative modalities and stimuli used to measure receptive vocabulary skills in autistic children who are minimally verbal. This study compared participants’ outcomes on three different receptive vocabulary assessment conditions: an assessment that used a low-tech stimulus book, a touchscreen assessment, and an assessment that used real-object stimuli. Twenty-seven students between the ages of 3 and 12 who had minimal verbal skills and a diagnosis of autism spectrum disorder participated in this study. Results showed that participants’ scores in the real-object assessment condition were significantly higher than in the low-tech condition and marginally higher than scores in the touchscreen condition. These results suggest real-object stimuli may provide a more robust measure of autistic children’s receptive vocabulary skills than traditional low-tech picture stimuli. Although many direct standardized assessments use picture stimuli to measure word understanding, when assessing autistic individuals who have limited expressive language, real objects can be used in replacement of, or in addition to, picture stimuli.