Paul Yoder

Vanderbilt University, Special Education, Faculty Member

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University of Kansas

Missouri Western State University

Ruth Berman

Lindsay Pennington

Newcastle University

Louise Cummings

The Hong Kong Polytechnic University

Bruno Estigarribia

Itam Hogan

University Of Lagos Akoka

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Papers by Paul Yoder

Early Effects of Responsivity Education/Prelinguistic Milieu Teaching for Children With Developmental Delays and Their Parents

Journal of Speech, …, 2006

Purpose: To evaluate the efficacy of a 6-month course of responsivity education/ prelinguistic mi... more Purpose: To evaluate the efficacy of a 6-month course of responsivity education/ prelinguistic milieu teaching (RE/PMT) for children with developmental delay and RE/ PMT's effects on parenting stress in a randomized clinical trial. Method: Fifty-one children, age 24-33 months, with no more than 10 expressive words or signs, were randomly assigned to treatment/no-treatment groups. Thirteen children in each group had a diagnosis of Down syndrome. Results: In 1 of 2 multivariate comparisons, the RE/PMT group exhibited superior gains in communication compared with the no-treatment group. The treatment effect for overall use of intentional communication acts in the child-examiner context was significant (d = .68, 95% confidence interval = 0.12-1.24). There were no effects on child outcomes due to presence or absence of Down syndrome. RE/PMT led to modest increases in recoding of child acts by parents of children who did not have Down syndrome. There were no effects on parenting stress associated with the intervention or the presence or absence of Down syndrome. Conclusions: RE/PMT may be applied clinically with the expectation of mediumsize effects on the child's rate of intentional communication acts after 6 months of intervention. The approach warrants further investigation with modifications, such as delivery at higher intensity levels.

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Indirect Effect of Impact Intervention on Expressive Communication in Infant Siblings of Children with ASD

Initial MLU Predicts the Relative Efficacy of Two Grammatical Treatments in Preschoolers With Specific Language Impairments

Purpose—We sought to confirm predictions based on past findings that pre-treatment mean length of... more Purpose—We sought to confirm predictions based on past findings that pre-treatment mean length of utterance (MLU) would predict which of two grammatical treatments would best facilitate generalized and maintained grammatical development in preschoolers with specific language impairment (SLI). Method—The participants were 57 preschoolers with specific language impairment (SLI). A randomized group experiment was used. The two grammatical treatments were Broad Target Recasts (BTR) and Milieu Language Teaching (MLT). MLU was assessed at Time 1 in two conversational language samples. Growth rate of productive grammar was quantified using growth curve modeling on the Index of Productive Syntax (IPSyn) from two conversational language samples at each of 6 measurement periods. Results—Predictions were confirmed for children with initially low MLU, but not for children with initially high MLUs. MLT facilitated growth of grammar better than BTR in children who were initially in Brown’s stage ...

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A Multisite Randomized Controlled Trial Comparing the Effects of Intervention Intensity and Intervention Style on Outcomes for Young Children With Autism

Journal of the American Academy of Child & Adolescent Psychiatry

OBJECTIVE This randomized, multisite, intent-to-treat study tested the effects of two levels of t... more OBJECTIVE This randomized, multisite, intent-to-treat study tested the effects of two levels of treatment intensity (number of hours) and two treatment styles on progress of young children with autism spectrum disorder (ASD). We predicted that initial severity of developmental delay or autism symptoms would moderate the effects of intensity and style on progress in four domains: autism symptom severity, expressive communication, receptive language, and nonverbal ability. METHOD Eighty-seven children with ASD, mean age 23.4 months, were assigned to one of two intervention styles (naturalistic developmental-behavioral or discrete trial teaching), each delivered for either 15 or 25 hours per week of 1:1 intervention for 12 months by trained research staff. All caregivers received coaching twice monthly. Children were assessed at four timepoints. Examiners and coders were naive to treatment assignment. RESULTS Neither style nor intensity had main effects on the four outcome variables. In terms of moderating effects of initial severity of developmental delay and of autism symptom severity, neither moderated the effects of treatment style on progress in any of the four domains. In terms of treatment intensity, initial severity moderated effect of treatment intensity on only one domain - change in autism symptom severity, and in a secondary analysis, this effect was found in only one site. CONCLUSION Neither treatment style or intensity had overall effects on child outcomes in the four domains examined. Initial severity did not predict better response to one intervention style than another. We found very limited evidence that initial severity predicted better response to 25 versus 15 hours per week of intervention in the domains studied.

The effect of early autism intervention on parental sense of efficacy in a randomized trial depends on the initial level of parent stress

Autism

This study examined whether style or intensity of child-focused intervention had a secondary effe... more This study examined whether style or intensity of child-focused intervention had a secondary effect on parental sense of efficacy and whether these effects varied by baseline level of parent stress. We randomized 87 children with autism, age 13–30 months, into one of four conditions: 15 versus 25 intervention hours crossed with 12 months of Early Intensive Behavioral Intervention versus Early Start Denver Model. Baseline parent stress was the putative moderator. Parent sense of efficacy, collected at baseline and the end of treatment, was the dependent variable. Analyses used generalized linear mixed model with full information maximum likelihood estimation. We tested main effects and interactions involving time, treatment intensity and style, and baseline parent stress to test moderation effects. Changes in parent efficacy across 12 months were related to intervention intensity but not style; this effect was moderated by level of parent stress at baseline. Parents with higher stres...

A randomized controlled trial of Hanen’s ‘More Than Words’ in toddlers with early autism symptoms

Journal of Child Psychology and Psychiatry, Jul 1, 2011

Background: This randomized controlled trial compared Hanen's 'More than Words'(HM... more Background: This randomized controlled trial compared Hanen's 'More than Words'(HMTW), a parent-implemented intervention, to a 'business as usual'control group. Methods: Sixty-two children (51 boys and 11 girls; M age= 20 months; SD= 2.6) who met criteria for autism spectrum disorders (ASD) and their parents participated in the study. The HMTW intervention was provided over 3.5 months. There were three measurement periods: prior to randomization (Time 1) and at 5 and 9 months post enrollment (Times 2 and 3). Children's ...

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Social-Communication Outcomes in Preschoolers With Autism Spectrum Disorders: A Best-Evidence Review

PsycEXTRA Dataset, 2000

A recent review concluding that brief music therapy is the most effective treatment for preschoolers with ASD is not credible

Evidence-Based Communication Assessment and Intervention

Rationale for blindness to treatment assignment in between-group experiments testing generalized communication and language

Evidence-Based Communication Assessment and Intervention

Partial-Interval Estimation of Count: Uncorrected and Poisson-Corrected Error Levels

Journal of Early Intervention

A simulation study that used 3,000 computer-generated event streams with known behavior rates, in... more A simulation study that used 3,000 computer-generated event streams with known behavior rates, interval durations, and session durations was conducted to test whether the main and interaction effects of true rate and interval duration affect the error level of uncorrected and Poisson-transformed (i.e., corrected) count as estimated by partial-interval recording. For both count estimates, shorter intervals and lower true rates resulted in less error than longer intervals and higher rates. For all conditions tested, Poisson-corrected estimates were more accurate than uncorrected estimates. Therefore, using Poisson-corrected estimates and short intervals are recommended when partial-interval recording is used to estimate counts. Generality of results might be restricted to events that are about 1-s long. A URL was provided to aid in the computation of corrected counts.

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Comparing Auditory-Only and Audiovisual Word Learning for Children with Hearing Loss

Journal of deaf studies and deaf education, Jan 15, 2018

Although reducing visual input to emphasize auditory cues is a common practice in pediatric audit... more Although reducing visual input to emphasize auditory cues is a common practice in pediatric auditory (re)habilitation, the extant literature offers minimal empirical evidence for whether unisensory auditory-only (AO) or multisensory audiovisual (AV) input is more beneficial to children with hearing loss for developing spoken language skills. Using an adapted alternating treatments single case research design, we evaluated the effectiveness and efficiency of a receptive word learning intervention with and without access to visual speechreading cues. Four preschool children with prelingual hearing loss participated. Based on probes without visual cues, three participants demonstrated strong evidence for learning in the AO and AV conditions relative to a control (no-teaching) condition. No participants demonstrated a differential rate of learning between AO and AV conditions. Neither an inhibitory effect predicted by a unisensory theory nor a beneficial effect predicted by a multisenso...

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Predicting Receptive-Expressive Vocabulary Discrepancies in Preschool Children With Autism Spectrum Disorder

Journal of speech, language, and hearing research : JSLHR, Jan 15, 2018

Correlates of receptive-expressive vocabulary size discrepancies may provide insights into why la... more Correlates of receptive-expressive vocabulary size discrepancies may provide insights into why language development in children with autism spectrum disorder (ASD) deviates from typical language development and ultimately improve intervention outcomes. We indexed receptive-expressive vocabulary size discrepancies of 65 initially preverbal children with ASD (20-48 months) to a comparison sample from the MacArthur-Bates Communicative Development Inventories Wordbank (Frank, Braginsky, Yurovsky, & Marchman, 2017) to quantify typicality. We then tested whether attention toward a speaker and oral motor performance predict typicality of the discrepancy 8 months later. Attention toward a speaker correlated positively with receptive-expressive vocabulary size discrepancy typicality. Imitative and nonimitative oral motor performance were not significant predictors of vocabulary size discrepancy typicality. Secondary analyses indicated that midpoint receptive vocabulary size mediated the asso...

A meta-analysis of the association between vocalizations and expressive language in children with autism spectrum disorder

Research in developmental disabilities, 2018

Targeting the frequency or complexity of prelinguistic vocalizations might improve the language t... more Targeting the frequency or complexity of prelinguistic vocalizations might improve the language trajectory of children with autism spectrum disorder (ASD) who exhibit continued expressive language deficits. This meta-analysis evaluates the strength of the association between various measures of vocalizations and expressive language in young children with ASD and five putative moderators of that association to inform prelinguistic intervention development: consonant-centricity, communicativeness, concurrent versus longitudinal research design, risk for correlated measurement error, and publication status. We systematically searched databases and other sources for correlations between vocalizations and expressive language in children with ASD less than 9 years old. Using robust variance estimation, we calculated the weighted mean effect size and conducted moderator analyses. Nine studies (19 reports), which included 362 participants and 109 unique effect sizes, met inclusion criteria....

Word Processing in Children With Autism Spectrum Disorders: Evidence From Event-Related Potentials

Journal of speech, language, and hearing research : JSLHR, Jan 20, 2017

This investigation was conducted to determine whether young children with autism spectrum disorde... more This investigation was conducted to determine whether young children with autism spectrum disorders exhibited a canonical neural response to word stimuli and whether putative event-related potential (ERP) measures of word processing were correlated with a concurrent measure of receptive language. Additional exploratory analyses were used to examine whether the magnitude of the association between ERP measures of word processing and receptive language varied as a function of the number of word stimuli the participants reportedly understood. Auditory ERPs were recorded in response to spoken words and nonwords presented with equal probability in 34 children aged 2-5 years with a diagnosis of autism spectrum disorder who were in the early stages of language acquisition. Average amplitudes and amplitude differences between word and nonword stimuli within 200-500 ms were examined at left temporal (T3) and parietal (P3) electrode clusters. Receptive vocabulary size and the number of experi...

Longitudinal associations across vocabulary modalities in children with autism and typical development

Autism : the international journal of research and practice, 2018

We examined differences between children with autism spectrum disorder and typically developing c... more We examined differences between children with autism spectrum disorder and typically developing children over an 8-month period in: (a) longitudinal associations between expressive and receptive vocabulary and (b) the extent to which caregiver utterances provided within an "optimal" engagement state mediated the pathway from early expressive to later receptive vocabulary. In total, 59 children (28-53 months at Time 1) comprised the autism spectrum disorder group and 46 children (8-24 months at Time 1) comprised the typically developing group. Groups were matched on initial vocabulary sizes. Results showed that the association between early expressive and later receptive vocabulary was moderated by group. A moderated mediation effect was also found, indicating linguistic input provided within an optimal engagement state only mediated associations for the autism spectrum disorder group.

Sequential Associations Between Caregiver Talk and Child Play in Autism Spectrum Disorder and Typical Development

Child development, Jan 26, 2017

This study examined sequential associations between child play and caregiver talk in 98 caregiver... more This study examined sequential associations between child play and caregiver talk in 98 caregiver-child dyads (Mmental age = 14 months). Fifty dyads included a child with autism spectrum disorder (ASD). Analyses revealed sequential associations between child play and caregiver follow-in (FI) utterances (utterances related to the child's attentional focus) were stronger in the ASD as compared to the typically developing (TD) group. FI utterances were more likely to elicit functional play than caregiver-focused utterances, and more so in the ASD group. Across groups, FI directives were more likely to elicit functional play than FI comments. These findings have important implications for research involving caregiver-child play as an early intervention context for children with ASD.

A Path Model of Expressive Vocabulary Skills in Initially Preverbal Preschool Children with Autism Spectrum Disorder

Journal of autism and developmental disorders, Apr 1, 2017

We examined direct and indirect paths involving receptive vocabulary and diversity of key consona... more We examined direct and indirect paths involving receptive vocabulary and diversity of key consonants used in communication (DKCC) to improve understanding of why previously identified value-added predictors are associated with later expressive vocabulary for initially preverbal children with autism spectrum disorder (ASD; n = 87). Intentional communication, DKCC, and parent linguistic responses accounted for unique variance in later expressive vocabulary when controlling for mid-point receptive vocabulary, but responding to joint attention did not. We did not confirm any indirect paths through mid-point receptive vocabulary. DKCC mediated the association between intentional communication and expressive vocabulary. Further research is needed to replicate the findings, test potentially causal relations, and provide a specific sequence of intervention targets for preverbal children with ASD.

Predicting Intentional Communication in Preverbal Preschoolers with Autism Spectrum Disorder

Journal of autism and developmental disorders, Jun 4, 2017

Intentional communication has previously been identified as a value-added predictor of expressive... more Intentional communication has previously been identified as a value-added predictor of expressive language in preverbal preschoolers with autism spectrum disorder. In the present study, we sought to identify value-added predictors of intentional communication. Of five theoretically-motivated putative predictors of intentional communication measured early in the study (at study entry and 4 months after), three had significant zero-order correlations with later intentional communication (12 months after study entry) and were thus added to a linear model that predicted later intentional communication scores controlling for initial intentional communication scores at study entry. After controlling for initial intentional communication, early motor imitation was the only predictor that accounted for a significant amount of variance in children's later intentional communication.

Pursuing Precision Speech-Language Therapy Services for Children with Down Syndrome

Seminars in Speech and Language, 2016

The behavioral phenotype of individuals with Down syndrome (DS) offers one avenue for developing ... more The behavioral phenotype of individuals with Down syndrome (DS) offers one avenue for developing speech-language therapy services that are tailored to the individual&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s characteristics that affect treatment response. Behavioral phenotypes are patterns of behavioral strengths and weaknesses for specific genetic disorders that can help guide the development and implementation of effective interventions. Nonetheless, individual differences within children with DS must be acknowledged and addressed because behavioral phenotypes are probabilistic, not deterministic. Developing precision speech-language therapy services to maximize learning opportunities and outcomes for children with DS calls for increased collaboration among clinicians and researchers to address the needs, challenges, and opportunities on three interconnected themes: (1) moving effective interventions from research to practice, (2) making evidence-based, child-specific treatment intensity decisions, and (3) considering child motivation and temperament characteristics. Increased availability of intervention materials and resources as well as more specific recommendations that acknowledge individual differences could help narrow the research-practice gap. Clear descriptions of disciplined manipulations of treatment intensity components could lead to more effective intervention services. Last, addressing motivation and temperament characteristics, such as the personality-motivation orientation, in children with DS may help maximize learning opportunities. Focused attention and collaboration on these key themes could produce substantial, positive changes for children with DS and their families in the coming decade.

An Evaluation of a Behaviorally Based Social Skills Group for Individuals Diagnosed with Autism Spectrum Disorder

Journal of Autism and Developmental Disorders, 2016

In this study we evaluated a social skills group which employed a progressive applied behavior an... more In this study we evaluated a social skills group which employed a progressive applied behavior analysis model for individuals diagnosed with autism spectrum disorder. A randomized control trial was utilized; eight participants were randomly assigned to a treatment group and seven participants were randomly assigned to a waitlist control group. The social skills group consisted of 32, 2 h sessions. Teachers implemented a variety of behaviorally based procedures. A blind evaluator measured participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; behavior immediately prior to intervention, immediately following intervention, and during 16 and 32-week maintenance probes. Results of the study demonstrated that participants made significant improvements with their social behavior (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001) following intervention, and the results were maintained up to 32 weeks after intervention had concluded.

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