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Communication interventions for minimally verbal children with autism : a sequential multiple assignment randomized trial . OBJECTIVE This study tested the effect of beginning treatment with a speech-generating device ( SGD ) in the context of a blended , adaptive treatment design for improving spontaneous , communicative utterances in school-aged , minimally verbal children with autism . METHOD A total of 61 minimally verbal children with autism , aged 5 to 8 years , were randomized to a blended developmental/behavioral intervention ( JASP+EMT ) with or without the augmentation of a SGD for 6 months with a 3-month follow-up . The intervention consisted of 2 stages . In stage 1 , all children received 2 sessions per week for 3 months . Stage 2 intervention was adapted ( by increased sessions or adding the SGD ) based on the child 's early response . The primary outcome was the total number of spontaneous communicative utterances ; secondary measures were the total number of novel words and total comments from a natural language sample . RESULTS Primary aim results found improvements in spontaneous communicative utterances , novel words , and comments that all favored the blended behavioral intervention that began by including an SGD ( JASP+EMT+SGD ) as opposed to spoken words alone ( JASP+EMT ) . Secondary aim results suggest that the adaptive intervention beginning with JASP+EMT+SGD and intensifying JASP+EMT+SGD for children who were slow responders led to better posttreatment outcomes . CONCLUSION Minimally verbal school-aged children can make significant and rapid gains in spoken spontaneous language with a novel , blended intervention that focuses on joint engagement and play skills and incorporates an SGD . Future studies should further explore the tailoring design used in this study to better understand children 's response to treatment . Clinical trial registration information-Developmental and Augmented Intervention for Facilitating Expressive Language ( CCNIA ) ; http : //clinicaltrials.gov/ ; NCT01013545 .
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Intervention_Educational
Communication interventions
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Intervention_Educational
speech-generating device ( SGD )
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Intervention_Educational
blended developmental/behavioral intervention ( JASP+EMT ) with or without the augmentation of a SGD
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Intervention_Educational
adding the SGD )
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Intervention_Educational
blended behavioral intervention that began by including an SGD ( JASP+EMT+SGD )
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Intervention_Educational
spoken words alone ( JASP+EMT ) .
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Intervention_Educational
JASP+EMT+SGD
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Intervention_Educational
JASP+EMT+SGD
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Intervention_Educational
SGD
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Outcome_Mental
spontaneous , communicative utterances
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Outcome_Mental
total number of spontaneous communicative utterances ; secondary measures were the total number of novel words and total comments from a natural language sample .
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Outcome_Mental
spontaneous communicative utterances , novel words , and comments
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Outcome_Mental
spoken spontaneous language
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Participant_Age
children
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Participant_Condition
autism
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Participant_Age
school-aged ,
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Participant_Condition
autism
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Participant_Sample-size
61
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Participant_Age
children
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Participant_Age
aged 5 to 8 years
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Participant_Age
school-aged children