We work with minimally and low-verbal autistic children.

To participate in any of the below studies, please contact us at (617) 726-2405.

Autism Spectrum Auditory Perception (ASAP)

We want to understand how minimally and low-verbal autistic children perceive speech sounds. Is speech perception related to their own speech production and expressive language abilities? We hypothesize that, if some children can’t hear the difference between similar-sounding words like “ball” and “doll”, maybe they can’t learn to pronounce words accurately and this interferes with their being able to learn spoken language. 

We created a tablet-based video game to help us answer these questions, where children sort pictures into categories. It includes a purely visual version of the task as well as an auditory version, so that we can tell if children have auditory processing issues only or whether their challenges also extend to visual stimuli. We’re looking for 26 participants, between the ages of 5 and 12, to participate. 

Inclusion criteria: 

  1. The main language of the child’s family (spoken >50% of the time) is English. 
  2. Child meets criteria for ASD on a gold-standard diagnostic instrument (can submit documentation of previous ADOS assessment). 

Exclusion criteria:

  1. Children with conditions that might explain their verbal status (e.g., known hearing impairment, Down syndrome) are not eligible.
  2. Children with visual impairments who can’t see the visual stimuli in standardized tests or experimental tasks are not eligible. 
  3. If child is eligible for COVID-19 vaccine and has not received at least the first dose.
     

Prospective participants will be assessed in our lab in Charlestown with a variety of measures that document their speech, language, social, and nonverbal IQ skills. They will then be given the tablet game to play. The visits will be broken down into two 2-hour visits. All assessments and game play will be audio-and videotaped for later analysis.

During the visits, children’s parents will also be asked to complete a series of questionnaires that document demographics, developmental history, and current levels of community functioning. Parents will also be asked to participate in an hour-long interview either in person or by zoom, whichever is most convenient for the parent. 

Families will receive $25 for completion of the assessments and an additional $50 once they have completed the whole study. We can also provide a summary report on request. Parking is paid for each visit to our Charlestown lab location. Please inquire about payment for Uber rides or about alternate assessment locations. 

Childhood Apraxia of Speech Intelligibility Therapy for Autism (CASITA)

We suspect that some minimally verbal autistic children also have a motor speech disorder called “childhood apraxia of speech” or CAS. If this is so, does CAS treatment, appropriately modified for minimally verbal autistic children, improve their speech? Instead of being primarily drill-based, therapy will be embedded in a social, play-based context to provide ecologically valid feedback and help children generalize their skills as much as possible. We’re looking for up to 20 children with ASD and CAS, between the ages of 5 and 18, to participate. 

Inclusion criteria include:

  1. Child meets criteria for ASD on a gold-standard diagnostic instrument (can submit documentation of previous ADOS assessment).
  2. Minimally verbal status (child spontaneously, non-imitatively produces no more than 20 different words, and no multi-word phrases, during a language sample). 
  3. Meets criteria for CAS by showing at least 5 signs of CAS during language sample and speech imitation tasks.
  4. The ability to correctly repeat at least two syllables. 
  5. The child lives in a primarily English-speaking environment (i.e., is exposed to at least 50% English). 

Exclusion criteria include:

  1. Poorly controlled seizure disorder.
  2. Other factors, such as blindness or deafness, that might contribute to a child’s minimally verbal status.
  3. The child lives in an environment where English is not the primary language. 
  4. Behavioral challenges that make it impossible for the child to participate in the study. 
  5. If child is eligible for COVID-19 vaccine and has not received at least the first dose. 
     

Prospective participants will be assessed in our lab in Charlestown with a variety of measures that document their speech, language, social, and nonverbal IQ skills. During the speech tasks only (estimated to last approximately 30 minutes), children will wear reflective markers, 2-3 millimeters in size, on their faces. Our multiple camera system will track the movements of these markers as children attempt to repeat a series of syllables and simple words. Baseline assessments are conservatively estimated to last approximately 4 hours, scheduled as two 2-hour visits. All assessments will be audio- and videotaped for later analysis. 

During the baseline visits, children’s parents will also be asked to complete a series of questionnaires that document demographics, developmental history, and current levels of community functioning. 

After analysis of baseline data (documenting that participants meet criteria for ASD, minimally verbal status, and CAS), children who meet inclusion criteria will be invited to receive treatment. A set of 6 one- or two-syllable words will be selected for each child, identified from their baseline tests to specifically involve the speech movements that are found to be disordered in their speech (i.e., stimuli will consist of words that the child can attempt to say but which are not pronounced perfectly). 

Treatment will consist of 15 hour-long sessions over 3 weeks and may take place in our lab or at a child’s home or school, and will be video- and audio-recorded for later analysis. 

During treatment sessions, children will practice each target multiple times, divided into separate practice blocks and interspersed with practice on the other targets. A “scaffolding” hierarchy will be employed to help children learn the correct speech movements for each target. Specific scaffolding activities that the therapist will provide include (1) producing the target slowly, (2) producing it in unison with the therapist, (3) gradually fading out this assistance as the child learns to produce the targets correctly on their own, and (4) providing tactile or visual cues to help children remember the correct oral movements for each target. 

Practice will occur in a naturalistic, developmentally-informed framework, which involves embedding speech tasks within social interactions organized around play or social activities that are matched to the child’s developmental level and that incorporate the child’s target words. For example, if a child has difficulty saying the consonant /k/, the word “cookie” might be selected as a target. This word could be practiced during an activity where therapist and child pretend to feed a stuffed animal cookies or where they actually decorate and eat cookies as a snack. The aim is for children to learn correct speech production at the same time that they engage in positive and rewarding social interactions that promote skill generalization, rather than for them to simply respond to therapist prompts. 

After treatment is completed, children will be invited back to the lab to have their speech production analyzed, using the same procedures as at baseline. They may also re-enroll to receive an additional series of 15 treatment sessions if desired. 

For their time, participants will receive $50 for completion of the baseline testing and $100 upon completion of the post-treatment testing. We can also provide a summary report on request. Parking is paid for each visit to our Charlestown lab location. Please inquire about payment for Uber rides or about alternate treatment locations. 
 

Speech and Motor Assessment Remote Protocol (SMART)

Post-pandemic, so much healthcare-related assessment is taking place remotely. This can be much more convenient for families with a child who has a complex neurodevelopmental disorder, but we need to know how the information from a remote assessment compares to an in-person one. 

This project aims to do just that: Compare how a child performs on a series of speech, language, and motor assessments in our lab and remotely, at home. We hypothesize that children will perform at least as well when they are in a familiar place like their home. We're looking for children with neurodevelopmental or genetic diagnoses between the ages of 2 and 18, to participate.

Inclusion criteria include:

  1. Child has a diagnosis of a neurodevelopmental or genetic condition from a qualified professional.
  2. Child is between the ages of 2 and 18. 
  3. The main language of the child’s family (spoken >50% of the time) is English. 

Exclusion criteria include:

  1. Poorly controlled seizure disorder.
  2. Inability to participate in testing. 
     

Families will come to the Motor Development Lab at Boston University for a 2-hour in-person visit where children will participate in a series of motor and spoken-language assessments. Motor assessments will include walking back and forth on our “magic carpet”, which records each of their footsteps, playing a “flamingo game” by balancing on one leg, and putting coins into a piggy bank. Spoken language assessments will include watching a preferred video while we record children’s facial movements, attempting to repeat a set of 8 syllables, a picture-naming task, and trying some tongue-twisters. The specific spoken-language tasks for each child will be selected based on their verbal ability, so everyone has a just-right challenge. The in-person and remote assessments will be audio- and videotaped for later analysis. 

At the end of the in-person assessment, families will receive $25, and we’ll make two Zoom appointments. One will be for parents to complete a set of questionnaires about their child’s history and current skills, and the other will be to complete the same spoken-language and motor tasks they just finished at home, via Zoom. Once the two remote sessions are complete, families will receive another $75 and a personalized report if they would like. Parking will be free for the in-person session.