Characterizing social communication among minimally verbal children with autism: An application of item response theory.
Reaches emerge first and joint-attention shows or gives are last—sequence your gesture targets in that order.
01Research in Context
What this study did
Schlink et al. (2024) looked at 453 minimally verbal kids with autism. They used item-response theory on ESCS play videos. The goal was to rank each gesture by how hard it is to produce.
What they found
Reaches for items came first. Joint-attention shows and gives were almost never seen. Behavior-regulation gestures sat in the middle. The team built a clear difficulty ladder you can follow.
How this fits with other research
Dimitrova et al. (2017) seems to disagree. Their verbal kids with autism understood pointing just fine. The gap is explained by verbal level: the 2017 group could talk, the 2024 group could not.
Chiang (2008) came first. That pilot simply listed the gestures kids used. Andrew’s team added numbers and order, turning a list into a roadmap.
Garwood et al. (2021) also gave us a new way to sample language. Their ELSA protocol captures spoken turns; IRT now ranks the gestures that come before words.
Why it matters
Start with easy reaches for behavior regulation. Save joint-attention shows and gives for later targets. The ladder keeps therapy realistic and shows parents why some skills take longer.
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02At a glance
03Original abstract
Minimally verbal children constitute a portion of the autism spectrum. The paucity of proper measurement tools that sensitively and accurately assess behaviors has been one limiting factor in the improved knowledge of these children. Short of creating and validating a new measurement tool for this subpopulation, this study took an alternative and more immediate approach: conduct a secondary data analysis and examine an existing social communication measure, the Early Social Communication Scales (ESCS), with item response theory. The final sample consisted of 453 minimally verbal children culled from four different completed studies. The IRT models analyzed the frequency of social communication gestures from the ESCS and returned an objective difficulty hierarchy regarding initiations of joint attention and behavior regulation gestures. The best-fitting and final model was a zero-inflated negative binomial model (ZINBM), which determined that joint attention gestures were, on average, more difficult than behavior regulation gestures. Joint attentional shows and gives were essentially absent in the children's repertoire, and behavior regulation reaches were the easiest gestures for this sample. The ZINBM separately modeled children with some gestures and children who did not present with any gestures and determined that behavior regulation reaches and gives were likely the first gestures a child will eventually exhibit among children with no gestures. Methodological contributions and potential future applications of IRT are discussed.
Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1139/h93-017