A language programme to increase the verbal production of a child dually diagnosed with Down syndrome and autism

• Published in: Journal of intellectual disability research 2006-02, Vol.50 (2), p.101-108
• Main Authors: Kroeger, K. A., Nelson III, W. M.
• Format: Article
• Language: English
• Subjects: applied behaviour analysis design; Autism; Autistic Disorder - complications; Autistic Disorder - diagnosis; Autistic Disorder - psychology; Autistic Disorder - therapy; Behavior Rating Scales; Behavior Therapy; Biological and medical sciences; Child; Child development; Combined Modality Therapy; Communication Strategies; Comorbidity; Delayed Speech; Developmental Disabilities; Direct Instruction; Down Syndrome; Down Syndrome - complications; Down Syndrome - diagnosis; Down Syndrome - psychology; Down Syndrome - therapy; Down's syndrome; dual diagnoses; Educational Facilities Improvement; Educational programmes; Expressive Language; Grade 2; Humans; Intellectual Disability; Language Acquisition; Language Development Disorders - complications; Language Development Disorders - diagnosis; Language Development Disorders - psychology; Language Development Disorders - therapy; Language instruction; language programme; Language Skills; Language Therapy; Linguistics; Mainstreaming; Male; Medical diagnosis; Medical sciences; Pragmatics; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reinforcement Schedule; Replication (Evaluation); Semantics; Single case studies; Socialization; Special education. Orthophony; Speech; Speech Production Measurement; Speech therapy; spontaneous language; Teaching Methods; Token Economy; Treatments; Verbal Behavior; Verbal Communication; Verbal communication skills; Verbal learning
• ISSN: 0964-2633; 1365-2788
• DOI: 10.1111/j.1365-2788.2005.00734.x

Background  The incidence of children dually diagnosed with Down syndrome and autism is estimated to be as high as 11%. There is a paucity of research investigating linguistic treatment interventions for such children. This single‐subject experiment examined a programme designed to increase the language production and verbal behaviour of a 9‐year‐old dually diagnosed boy who had been receiving a 15‐h/week home‐based applied behaviour analysis (ABA) programme. Methods  Training principles were derived from previously empirically validated research in discrete trail learning and natural environment teaching, as well as modified incidental teaching procedures. The crux of the language programme involved withholding reinforcement until a spoken request was made. Results  Language production noticeably increased for each target area after the introduction of the language programme and was maintained at a 9‐month follow‐up session. Conclusions  A combined treatment approach incorporating direct instruction, natural environment teaching and incidental teaching can be effective in increasing and maintaining responsive and spontaneous speech in a child with Down syndrome diagnosed with autism. Replication studies are needed with such multiple dually diagnosed children to further evaluate the effectiveness and generalizability of this combined language programme.