Developing expressive language outcome measures for autism clinical trials

  • Awarded: 2015
  • Award Type: Targeted: Novel Outcome Measures for ASD Clinical Trials
  • Award #: 383660

One of the most important objectives of autism spectrum disorder (ASD) interventions is to improve spoken communicative language skills. Across all ages and levels of language, quantitative changes in the amount of intelligible speech, the length of speaker turns and better conversational turn-taking are key measures of advances in spoken language. Changes in these measures not only signify that a treatment is effective in improving language itself, but also leads to improvements in social communication.

There are a number of significant challenges in measuring these language outcomes. One of these challenges is that gold-standard approaches depend on expert transcription and coding that is time and cost intensive. Another issue is that recent attempts to utilize automated data collection, coding and analysis (e.g., Language ENvironment Analysis [LENA]) do not work reliably across all speakers, languages and settings and provide limited measures of language and communication. Helen Tager-Flusberg and her team at Boston University propose to develop novel approaches to the collection and analysis of spoken language from children and adolescents with ASD who are likely to be enrolled in future clinical trials.

The project has three specific aims: (1) Test the feasibility and reliability of collecting spoken language from children and adolescents with ASD in a range of settings, including school and home, using smartphone technology and enticing materials to stimulate the participants’ motivation to communicate in different social contexts. (2) Test a novel real-time system for coding the language samples collected by naïve listeners to yield measures of language and communication that can serve as reliable outcome measures. (3) Evaluate the reliability and validity of the novel assessment and measures developed in this project.

The data will be collected in a pre- and post-test design from 50 children and adolescents attending two schools serving the ASD population. The key intervention will be a comparison of two different tablet-based apps that target cognitive/linguistic skills, which will be provided to the families recruited through the schools for a period of three months. Both school- and home-based measures will be collected and analyzed in the course of this intervention study.

Whether or not the interventions are effective in significantly changing the individuals’ language and communication abilities, the project will yield new, reliable and valid low-cost methods for measuring clinically meaningful improvements in expressive language that can be readily implemented in both short- and long-term clinical trials involving large numbers of participants across multiple settings.

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