Week 11 Update

Whoa, last post. Interesting. I'm not quite done with my analysis, so I'm actually going to keep going in to ASU for the next next week, but here's a link to my slideshow. It's not finalized. I'll update it later. Thanks and goodbye.

Week 10 Update

The stuff I did this week was pretty similar to what I've been talking about for a while now (analyzing Quince's speech sample at ASU and going to Quince's therapy sessions). So instead of repeating myself, I'm going to give you guys an update on how Quince is doing and what sort of progress he has been making in the last month or so.

My parents have been coodinating a lot of medical stuff for Quince, which I'm not really going to talk about. Essentially, Quince's speech is significantly affected by how healthy he is at that time, so every time he gets sick, his speech deteriorates. It's not just that his throat hurts so he talks less, but his pronunciation becomes way more garbled. Anyways, the medical stuff I was talking about seems to be working pretty well, because his speech is very clear and more spontaneous than usual.

But the most exciting thing that's been happening with him recently is that he seems to be more aware and less scattered. When he was one and a half, Quince used to grab my calculator, hold it up to his ear, and babble like he was talking on the phone. But after his regression, we haven't seen any pretend play at all (for nearly four years). Not engaging in pretend play is very common among children with autism. However, in the past couple of weeks, Quince has carried around an orange bucket that he puts on his head and says 'hat'. We also saw him trying to make his stuffed bear ride his bicycle. This may seem kind of insignificant, but it's actually very exciting for us to see because it shows he's making progress.

Something else that indicates a lot of progress for Quince is his improved attention span. My mom, a pediatrician, has described him as having the most severe case of ADHD she has ever seen. He usually doesn't stay at one task voluntarily for more than a few seconds, and he spends most of his free time (when he's not in therapy or working with someone) running around the house from one object to another. This is why watching him is so much more exhausting than a regular child. Ok, I'm getting sidetracked but this might be kind of interesting, so I'm going to describe a typical five minutes when I'm babysitting him. We'll probably start in his playroom. He'll grab a toy, throw it, run across the room, run back, and then bolt out into the living room. He'll dive onto one of the couches (on the other side of the house), then climb onto a windowsill. After I haul him down, he runs into the kitchen, grabs a lemon from the counter, and if I can't catch him, bites a chunk out of the rind. While I'm getting that out of his mouth, he'll reach over, grab the dropped lemon, and throw it down the sink. Then he would probably run back to the playroom, run back to the kitchen, pull a box of cereal out of the pantry, dump it on the floor, run into the bathroom, spread shampoo all over the bathroom and himself, turn on the bath, run out to the kitchen and grab the lemon again... That's probably only about two minutes actually but you guys can see where this is going. So anyways, you can see there's very little coherence or planning in that. Anyways, the cool part is that lately Quince has been doing things that are still kind of difficult to manage, but that involve multiple steps and a sort of planning. For example, yesterday, he climbed up the pantry shelves somehow, and my mom found him perched on the top shelf, pouring quineoa onto the floor about eight feet down. Usually, he wouldn't do this because it would require him to take at least a couple minutes focused on climbing, not to mention pretty good motor control to climb those shelves, and a sort of intent that he hasn't displayed very often. Basically, Quince had to think something like "I want to pour quinoua off the top shelf of the pantry" (he loves pouring things and the feeling of grains and stuff) and then proceed to work towards this goal for far longer than he would have ever stayed focused before.

So that was pretty cool for me, but it might have been one of those you had to be there things so sorry if I bored you. Anyways, thats's what's been going on.

Week 9 Update

Hey guys. Sorry that this post is late. I was on the East Coast visiting some colleges and to be honest I completely forgot about it. Also I am now writing this on my phone on the plane so this may not be my highest quality post either. Anyways, during the precious little time last week that I was in town and could work on my project, I actually figured out some pretty interesting things. I'm not sure how much I'm supposed to tell you guys because I don't know how much I'm supposed to save for my presentation. Are my conclusions supposed to be a surprise? Maybe I'll just tell you guys what analysis I did but not what I'm concluding from it. I'm almost done with my analysis, which is really good because this project is almost over. Yay.

Ok, so my goal for this project has evolved a lot from my original proposal, but what I hoped to learn from it has stayed the same. I always wanted to gain some insight into Quince's speech patterns, and that's what I did, so that's pretty cool (with a lot of help from Dr. Ingram). At some point, I was trying to compare Quince and Reilley, but I think for my presentation I'm just going to focus on Quince because 1. I have more data available for Quince, such as pronunciations and contextual information, and 2. it's really hard to compare them because they're both at very different cognitive stages that is kind of reflected in their language but not completely. Quince is a lot older, and has a lot more words he attempts, but Reilley's words are more functional and stuff.

I looked at two specific aspects of Quince's language acquisition: vocabulary development (in both his expressive and receptive language) and speech development (in only his expressive language. For vocabulary development, I looked at how many words he had, and which semantic categories they were in FOR EACH CATEGORY. This is where the whole comprehension versus production (receptive versus expressive) thing comes into play. So basically, I was seeing how the words Quince could say differed from the words he could understand but not say.

For speech development, I examined Quince's pronunciation, so I obviously was only looking at which words he could produce. I looked at whole word complexity, using the PMLU scores, and I also analyzed his phonetic inventory of consonants and his phonetic inventory of vowels. This is where the really interesting stuff was, and the stuff that I'm saving for the presentation. But in general, when you analyze a phonetic inventory, you're looking at what speech sounds the subject can produce.

So anyways, this last week I was mostly doing my phonetic inventory analysis (this is also where Dr. Ingram had to help me a lot because you have to be able to recognize patterns in speech samples really well, so basically you have to have a lot of experience and I have little to none) and polishing up the rest of my stuff too. Sorry again that it's so late.

Week 8 Update

This week, Dr. Ingram had me do a reliability check on all my data so far. This is basically fixing all the errors in my spreadsheets, which takes a really long time and is pretty tedious. He pointed out some mistakes that I was making consistently while typing up the word shapes that were causing my PMLU calculations to be kind of off. Just to remind you guys, I’m using the PMLU values as a measure of word complexity. For a refresher on what exactly the PMLU values are and we figure out the shape of the word, check out my week five update (I think? I’d check but I don’t have access to the Internet right now. I’ll fix it later. If you guys are reading this, it means I didn’t proofread this post. Whoops.) Besides the random human errors that happened while I was typing things in, there were three main types of mistakes that I was making in my word shape transcriptions. First, I was considering ‘er’ as VC (vowel followed by consonant) instead of V (just vowel) like I was supposed to. This seems kind of confusing at first, but if you think about it, when you say a word like ‘teacher’, the ‘r’ at the end changes how you say the ‘e’ that precedes it, but it doesn’t really stand alone as its own unit of sound. Second, I was counting each complex vowel, or diphthong, as multiple vowels when I was supposed to count them as only one.  For example, the vowel unit in the word ‘boy’ is a dipthong, consisting of two sounds, the ‘o’ as in bowl and the ‘ee’ as in sheep. Even though there are two sounds, the shape of the word ‘boy’ should still be written as CV (one consonant and one vowel). Third, I was counting the consonant sounds ‘ch’ as in cheese and ‘j’ as in judge as two consonants instead of one. I thought that because the IPA transcription of these sounds had two symbols, I should consider them as two consonants each, but this is actually not true.

To be honest, none of these mistakes are very likely to affect the total average PMLUs of any categories. Since I made the errors consistently, they re probably equally likely to be in either the produced or comprehended category. If not, that's actually an important part of my results, because that means certain aspects of words are prevalent in a certain category.

Next week I’m supposed to do the same thing for my semantic categories, which is going to be pretty interesting I guess.

Week 7 Update

This week, I got my first very rough look at some results, which is cool. I looked at the average PMLU scores for Quince’s produced speech, Quince’s comprehended speech, Reilley’s produced speech, and Reilley’s comprehended speech. Weirdly enough, all of these numbers were within about 0.2 of each other (with standard deviations of around 2.5), so right now it’s not looking good for the whole complexity-decides-which-words-kids-say hypothesis. But that’s ok, because 1. Dr. Ingram was explaining to me that we have a lot of work to do on the analysis of this part to fix it by eliminating outliers and stuff and 2. I have two other hypotheses to test before I have to start getting worried.  Also, this might maybe help me prepare for the AP Statistics mock that I’ll be taking soon. That should be interesting.

Some more stuff I’ve been doing at ASU involves typing out the IPA transcription of every single one of Quince’s produced words, fixing all the errors I’ve been finding in my spreadsheets, and performing more analysis on my data with semantic categories.

The transcriptions took forever since I had to prompt Quince to say the word into my phone so I could record it, listen to his pronunciation a ton of times, figure out the sounds that make up his pronunciation, translate those sounds to IPA, type them using this IPA symbol thing, and copy the final transcription into my spreadsheet. Even though this whole process was pretty tedious, it was definitely worth it. I always knew Quince had a limited range of sounds, but I never really realized that he essentially only has ONE vowel. His consonants are actually not even close to as restricted as his vowels are. For each word, he puts a consonant in front of, behind, or sandwiched between the ə sound, which is pronounced like the u in up, and then puts these consonant-vowel units together in different combinations. Dr. Ingram mentioned that vowel problems are very common in apraxia, so this definitely makes sense for Quince’s diagnosis. And the most exciting thing is that I don’t think anyone realized just how limited Quince’s vowels are, so if we focus on getting more vowel sounds in his speech therapy, we can hopefully improve his comprehensibility significantly.

Most of the errors I’ve been fixing in the spreadsheets have to do with excel auto-filling cells with things I typed in the first time, like replacing the word butter with butterfly because I wasn’t paying attention and had entered butterfly in an earlier cell. I also somehow managed to switch the produced and comprehended columns of words in some but not all of the spreadsheets, so I had to go through and check that all of those were in the right spot.

For the semantic analysis, I looked at a textbook that Dr. Ingram gave me (and also is the author of, so that’s cool). I broke my word lists into five categories: specific nominal, general nominal, action words, modifiers, and personal-social. I can go into more detail if anyone wants, but basically the most important things to know are that general nominals are most nouns and personal-socials are the words we use to relate to different states and social expressions like hi, bye, or thank you. There are two general kinds of kids, expressive and referential. Expressive kids tend to have a vocabulary that has a higher percentage of personal-social words than receptive kids, who tend to have more general nomials in their category.  We aren’t exactly sure why this is. Maybe it has something to do with personality, like more outgoing people using more personal-socials, or upbringing, if a child’s parents try to name everything they see to expand their child’s vocabulary or something. Anyways, I looked at my sample of Quince’s and Reilley’s vocabularies and calculated the proportions of each category in them. Right now, it looks like both Quince and Reilley fall somewhere in the middle of these two categories, but after Dr. Ingram helps me account for all the error and stuff this could easily change.

Week 6 Update

A couple of interesting things happened this week. First of all, I have been analyzing the CDI of another kid, Reilley. Dr. Ingram actually has three different CDIs of Reilley's, at 1;11, 2;2, and 2;5. (Everyone probably knows this already, but I didn't so I'll explain it anyways. 1;11 is a way to write the child's age. The first number is years and the second number is months, so 1;11 means Reilley was one year and eleven months old when the first CDI was done.) Even though Reilley was so much younger than Quince when this data was taken, they are at similar places in terms of vocabulary as Reilley's language developed normally. This allows me to see in what ways Quince's speech is unusual.

Right now, Dr. Ingram and I are trying to figure out why Quince and Reilley say some words but not others. For example, Quince says pajamas but not shirt. We have a few hypotheses for this right now: 1. The words that the children don't say are generally more complex in structure than the words they do, so they are avoiding the more complex, harder-to-produce words. 2. There are specific sounds within the words that the children don't say that are especially difficult for the children to produce.  3. The words that the children don't say are ones that they aren't exposed to or aren't interested in, so they simply don't need them. 

Personally, I think that it's a combination of these reasons, and probably some others as well. Off the top of my head, I can think of examples from Quince's CDI for all three. For the first one, Quince calls orangutans monkeys, even though he can make all the sounds within the word orangutan, because it's very complicated. For the second one, Quince uses the word pop instead of soda because he can't make the 's' sound. And for the third one, Quince never says the word brother because he doesn't have any. But still, I'm interested in seeing which reasons are more prominent than others.

I'm testing these hypotheses by looking at the data from the CDIs in different ways. To test complexity, I’m calculating the PMLU scores for each of the words. Dr. Ingram actually invented the PMLU score as a way to measure word complexity based on word shape. Each vowel unit (not individual letter) is assigned one point, and each consonant gets two. The higher the score, the more complex the word is. I haven’t started on the specific sounds yet, but I’m probably going to try to identify patterns of particularly prevalent sounds and conspicuous absences in the list of produced words. For the situational part, I’m dividing the words into categories such as foods, clothing items, actions, etc. I’m not really going to be able to look at the exact details, like Quince not saying brother because he doesn’t have one, because I don’t have these details for the other subjects.

Something I'm realizing about this field is that it's a lot more subjective than what I'm used to in the research I’ve done, which is mostly physics/engineering kind of stuff. First of all, how can we define exactly which words the child understands and which the child says (which is what these CDIs are based on)? You can try to test comprehension by putting objects in front of the child and asking them to identify one, but a correct response could be produced through random guessing, or process of elimination using already known objects. And where do you draw the line for ability to produce a word? If the child can repeat it? If the child can respond to a question with it? If the child can label something with it? If the child can use it spontaneously without any prompting? 

This uncertainty is very frustrating for me. I can’t tell what criteria were used to fill out Reilley’s CDIs, so the data might not even be comparable. But I guess it’s good for me to get used to doing this kind of thing too? 

Finally, I’ve been trying to record a lot of Quince’s speech, and I noticed something very interesting. When I record what he says and play it back for him, he listens and tries to correct his own recording. The corrections are clearer and more coherent. This is very exciting for us, as it presents a new technique we might be able to incorporate into his treatment.

Here is an example recording I took of my mom working with Quince. In it, my mom is trying to get Quince to say "mow." On the third try, he manages to get the right vowel sound, and then says "I did it." (I repeated "I did it" afterwards to translate for my mom, because she didn't recognize what he said at first.)

Quince's speech exercise (this is a link, you can click on it)

My mom: Mow
Quince: Ma-me
My mom: Mow
Quince: Ma-me-me
My mom: Mow
Quince: Ma-mo, I dee ee
Me: I did it, ok 

Week 5 Update

I took my spring break last week.

Week 4 Update

I'm going to make this update pretty short because I already posted something this week, my project hasn't changed much, and I'm exhausted. Mostly, I've just been going through the dissertation I mentioned before, working on analyzing the CDI data, and studying more phonetics. I got really tired of going through all of the words and individually assigning them a PMLU score, so I've been working on writing a program that will do it for me. So far, I've been completely and utterly unsuccessful with that.

One interesting thing that I figured out this week happened when I found an old photo album filled with pictures of Quince as a baby (birth to about six months). I decided to try and get Quince to talk about stuff in these pictures, because he's really tired of the ones we are using now and actually so am I so I wanted to change things up. He got really excited and was able to focus on the new pictures for a lot longer, probably about ten minutes straight. When I asked him who the infant in the pictures was, he said 'baby' (actually, he pronounces this more buh-buh, or sometimes buh-bee if it's especially good), and he also could identify 'Daddy', 'Casey', 'Mommy', and 'Kiele'. Elke and Mary have changed so much in the past five years that he couldn't recognize them. Clearly, he is getting bored with being quizzed on the same things over and over, and actually seems to be doing better when I switch things around and introduce new stuff.

On a completely separate note, Rachel gave me permission to add this picture to my post, since I haven't had any for the past couple. It's not really related but I guess it adds color or something (see Rachel's blog at rachel-lincoln.blogspot.com for more color-related things).

Article Link

Since a couple people seem to be interested, here is a link to the article I mentioned in my previous post. For everyone who is too lazy to open it, I'll summarize it.

https://drive.google.com/open?id=0BzYV_fxDrzE_aXRmTUtTQVQ3WUE

Gibson, the first author, observed her son (who had language delays) from when he was about two and a half to about age four. She kept a detailed log of all the words he comprehended, and later, all the words he spoke or signed. Along with Ingram, she analyzed this data, and found that even though the onset of language comprehension and production was significantly delayed (Graeme, the subject, was nearly three when he understood his 50th word, while in a study by Benedict of developing children, the mean age at which the 50th word was understood was about one), the rate of acquisition once certain milestones were hit were relatively normal. Specifically, Graeme underwent "word spurts" similar to those experienced by most children that were merely occurred later than usual.

Dr. Ingram informed me that today, Graeme would most likely be diagnosed with autism spectrum disorder, just like Quince. This paper was published in 1983, when far fewer children were diagnosed with the disorder. However, I don't believe that Graeme's process of language acquisition is very similar to Quince's, which demonstrates the diversity within the autism community. Quince's comprehension is far more advanced than his production, and his production rate is far slower and more steady than Graeme's spurts of progress. This is probably because Quince doesn't struggle with the concept of producing words to communicate and label objects, but rather the physical production of the words themselves, especially in muscle coordination.

Even though the article isn't particularly applicable to Quince specifically, it was still interesting to read and very informative. Right now, I am working my way through Gibson's dissertation, which is over 400 pages of analysis, background, and further research centering on the same diary study analyzed by the previously-described article. This dissertation is even more interesting than the paper; written almost thirty years later, it is significantly more recent and relevant to the field.

Week 3 Update

Tuesday was another lab day with Dr. Ingram. I was excited because I got to start working on a project using data from a survey my mom filled out about Quince's language. This survey is called the Macarthur-Bates communicative Development Inventory (CDI). It lists ten pages of phrases and words, with an option to indicate that the child understands, says, or signs each one. The part of the survey I am interested in is the vocabulary checklist. In this section, there are 396 different words in 19 different categories (sound effects and animal sounds, animal names, vehicles, toys, food and drink, clothing, body parts, furniture and rooms, small household items, outside things and places to go, people, games and routines, action words, words about time, descriptive words, pronouns, question words, prepositions and locations, and quantifiers). Specifically, I am going to be looking at the difference between comprehending and producing certain words, and trying to establish whether the complexity of a word determines if it is both understood and spoken or just understood. 

The first step in doing this was to type out each of the words into an excel spreadsheet, which was extremely tedious but a good exercise for improving typing speed (at least that's what I told myself). I then made columns for "Comprehends" and "Produces" and filled them out, with a 1 in each column if the survey indicated that Quince could comprehends/produce each word, and a 0 if he could not. I did not include the signing option as he doesn't sign anything beyond "all done" and "more". I'm planning on further categorizing each word by whether it is monosyllabic or polysyllabic and whether or not it contains a cluster (two or more consecutive vowels). Hopefully, these categories will allow me to determine the complexity of each word, so that when I analyze this spreadsheet, I will be able to see if there is a correlation between complexity and lack of production. 

On Wednesday, I once again took Quince swimming for the last hour of ABA. Admittedly, I'm not really sure why we bring his therapist along instead of simply ending his session early, since I am the only one who gets in the water with him. We did some more speech work, similar to last week, but at the pool near his therapy location, Quince is limited to a small, shallow rectangle of the pool, which is very distracting since he always tries to escape into the lap lanes. Afterwards, we went to speech, where he was unfortunately pretty unfocused. Still, it was interesting to see how his therapists manage to keep his attention on how they are forming words.

I spent most of Thursday working on the spreadsheet of Quince's CDI and practicing phonetics at ASU. Also, Dr. Ingram sent me an article that he cowrote with his graduate student. It analyzes the daily speech diary of a child with language delay (kept by the mother). This is pretty relevant because I've been considering doing this for Quince to keep track of exactly what words he says, but it seems like a lot of work and I'm not with him all the time.

Sorry, I'm pretty sure that's the third time I've forgotten to get a video of Quince at speech. I'll try to remember for next week, but to be honest, at this point it's probably a lost cause.

Week 2 Update (Part II)

Sorry, I didn't manage to get the video of Quince's speech programs since he has been sick and thus not attending his therapy sessions these past few days. I'll work on that for next week.

Thursday was another lab day for me, so I went in to ASU with my dad that morning. Since I had already worked with Dr. Ingram for two days before, I had a better idea of what was going on and what exactly I was doing. Specifically, I entered the analysis I performed on Tuesday from the tests on children with cleft palates into a spreadsheet, and started looking at transcribing their language in IPA. Also, Dr. Ingram showed me an intriguing case of a child with abnormal language development. This child could produce some more difficult sounds such as r and l, but not sounds that children generally acquire first such as s and sh. Dr. Ingram hypothesized that this might be due to an auditory deficit, since r and l are both generally louder sounds than s or sh.

As I mentioned before, Quince has been pretty sick, so he didn't go to any therapy sessions on Friday. Instead, my mom and I took him to the zoo. One of the things we've been working on with him is the names of different animals and the sounds they make. I tried to keep track of what he said while we were there, and to practice my phonetics, I have listed both the words and a transcription of how Quince pronounced it in IPA below. For words with prompting, I counted responses to questions that my mom or I asked him, such as "what animal is that?", as well as echoing. For example, if Quince repeated the word "monkey" after my mom said "this is a monkey," I would count that as an echoed response. Spontaneous words occur when he says something without anyone encouraging him to do so. An example of this is when he got tired of walking, Quince grabbed my hand and said "up."

Words with prompting:

• Zoo (zu)
• Lion (leɪə)
• Roar (wʌ)
• Monkey (mʌnkʌ)
• Giraffe (gʌræf)
• Pig (pʌ)
• Otter (ɒtʌ)
• Lizard (lɪzə)

Spontaneous words:

• Up (ʌp)
• Casey (kʌkʌ)
• Hi (hʌ)
• Pop (pɑp)
• Bye (bʌbʌ)

While I was transcribing these words, I noticed something interesting. In many cases, Quince seems to be saying the first consonant sound followed by ʌ (pronounced like the u in cup) instead of the actual word. This is probably ʌ is a relatively easy sound to shape, and his apraxia makes motor control of his mouth difficult. 

Here is a video that provides an example of how I interact with Quince. In this scenario, he is eating cake and an apple core, and I am trying to get him to talk to me. Usually, I ask him some question and/or make some commentary on what he's doing, leaving long pauses in between to catch anything he might say. If he does say something, I respond so that any attempts to talk are recognized. In the video, I persist in trying to make him say bye-bye, because I know that's something he can say easily. 

Week 2 Update (Part I)

I'm going to see if I can get a video of someone doing some sort of speech exercise with Quince for you guys, since it's pretty hard to understand what his speech is like unless you can hear it. In the meantime, here is the first part of my weekly update.

On Tuesday, I went with my dad to ASU to meet Dr. Ingram for my first lab day of actually doing things other than introductions. I sorted through and organized a bunch of files that were part of a study on the language development of children with cleft palates. At first, I didn't really understand what this had to do with my project, but I soon realized that even though the language delays were different, the tools used to track the children's progress was the same. Specifically, each child was tested using a Profile of Early Expressive Phonological Skills (PEEPS) twice, once around the age of two and once six to ten months later. On these tests, the administrators had recorded the child's phonetic pronunciations of each word, which was interesting for me to see as I have been trying to learn a bit of the IPA (International Phonetic Alphabet) so that I can record my brother's speech. The IPA looks something like this: 

http://ipa-paradise.weebly.com/ipa.html

We also tried to work out a way for me to do the CITI HIPAA training, but we couldn't get around the request for an ASU email address, which I do not have. I think they're going to look into seeing if their department can get me a temporary one or something.

--

Five hours of work in a small office would be hard on anyone, but for a hyperactive five year old, it's especially tough. On Wednesday, my mom and I decided to let Quince have a break for the last hour of his ABA, so I took him swimming, dragging his therapist along too. Quince is very stimulated by water and loves anything to do with it: surfing, swimming, even bath time.

Quince and someone (probably me, but possibly one of my other sisters) surfing.

We actually managed to fit in some speech work during this time. Here are some examples of how we can get him to practice talking at the pool:

Prompt: "Quince, where are we going?" 

Expected response: "Pool" (puh) or "Swimming" (fuh-fuh)

Prompt: Standing on the edge of the pool, about to jump it. "Ready, set, ..."

Expected response: "Go" (go or guh, it varies)

Prompt: "Are you all done swimming or do you want more?"

Expected response: "All done" (ah dun) or "More" (muh or muh-muh, this also varies). Whatever he says here, we always follow through, unless he seems to want the opposite, in which case we usually ask him again.

After swimming, we headed straight to speech. My mom and I were hoping Quince would be more focused and less hyper after using up all his energy in the pool, but this did not seem to be the case. In speech, one of the main things they have been working on is showing Quince a set of pictures and getting him to say the sounds the objects pictured make. This picture set is very focused on specific sounds that we want Quince to say, such as the long o sound. 

The aforementioned picture set

This time, when the therapist got out the picture set, she pointed to the cow and asked him what it said. Instead, he pointed to the horse and said "neigh neigh" very clearly, which was definitely good because it was spontaneous and well-pronounced. However, it was pretty clear that he was avoiding the long o sound of "moo moo" that we are trying to help him develop.

One thing I'm learning from the speech therapists is to adapt my programs to Quince's attention span, not my own. At speech, they move between exercises and breaks quickly, nearly too fast for me to follow, but it helps to prevent Quince from getting bored or frustrated.

In the next post, I will explain what I did the rest of the week, and hopefully I will be able to show you a sample of Quince's speech as well.

Week 1 Update

First of all, here's Quince (and I) hanging out at the beach:

Since this week is the first week of my project, I have been adjusting to my new schedule. I am realizing that my project can really be broken into three separate segments. In this post, I will describe these three segments. Then, I will explain what I did this week.

The first part consists of shadowing Quince's ABA therapists, both at the CARD office and in our home. I am paying particularly close attention to the exercises that focus on verbal communication, since my project focuses on this aspect of therapy. These exercises are usually what CARD calls echoics. In Quince's version of echoics, his therapist holds up a picture (out of a pile of pictures that we have taken of items and people he encounters regularly) and names what is in the picture. Then they pause and wait for Quince to repeat what they named. If he doesn't say anything or says something wrong, they will prompt him again with the name. If he repeats it correctly, they reward him with praise, a token on his token board*, or sometimes even a treat like a piece of candy. An example echoic program might go something like this:

Therapist: Quince, look. (Holds up picture)

Therapist: This is Dada. Can you say 'Dada'?

Quince: Dada

Therapist: That's right, Dada. Good job Quince. High five!

Since Quince struggles with the clarity of his speech (which we believe is due to his apraxia), sometimes what he says doesn't sound anything like the prompt. For example, he can't pronounce the letter 's', so for him, Casey is 'cuh-cuh.' Because of this, it's very difficult to decipher what he is saying, particularly if you aren't familiar with him. Quince just switched CARD locations, which means he has an entirely new team of therapists. Thus, it is particularly useful for me to shadow them for the next couple months, as I can identify what he's saying for them until they become more accustomed to his vocabulary. Quince's ABA sessions are extremely long, usually four hours in the morning and sometimes two or three hours in the afternoon as well. In these sessions, his therapists are trying to reinforce all kinds of functional behaviors, including but not limited to this type of verbal communication. 

The second part of my project is centered more specifically on speech. It consists of accompanying my mom to Quince's speech therapy sessions at Pediatric Speech and Language Associates. These sessions are half an hour, four times a week, usually right after his morning ABA. Since they are only with Quince for a short amount of time, the speech therapists have to be focused and fast-paced. They do a lot of flash cards, and books interspersed with breaks for toys, tickles, and jumping. Quince's attention span is extremely short (sometimes a span of seconds) so these breaks have to happen often. Although to me this initially seemed similar to what CARD does, I soon realized that they do emphasize how Quince should be producing the speech. For example, they will model a word, and then prompt him both verbally and physically with a touch on the throat or the chin, depending on the sound they want him to produce. This seems like a really good idea, since forming speech is one of the hardest things for Quince, and is something I'm looking forward to learning more about. 

The third part of my project involves the work I am doing at ASU with Dr. Ingram. There, I am studying phonetics and will be learning to analyze speech samples. I will then apply what I learn to specifically analyze Quince's language. 

This week, on Monday, I shadowed at CARD for Quince's morning ABA session. It was very rewarding to see how excited he was that I was coming with him. I soon saw how I could help to provide consistency among therapists and also between CARD and our family by interpreting his speech. For example, one of Quince's echoics is a picture of a lollipop, and in our family, that's what we call it. However, his therapist was asking him to say sucker, which was confusing him. By letting the therapist know that we say lollipop instead, I was able to prevent this confusion. After the morning session, I accompanied Quince to speech, where he produced the long e sound on command three times. This was an enormous accomplishment for him, since this is a particularly difficult thing for him to say. 

Unfortunately, on Tuesday, I came down with strep throat, and was unable to work with Quince at all for the next couple of days. Quince tends to get sick easily as his immune system doesn't always work properly, so I had to avoid him. By the time I was recovered, on Thursday, I went with my dad to ASU, where I had my first lab day with Dr. Ingram. In preparation, I had studied some basic phonetics and taken a brief inventory of Quince's language to show him. Once I was there, we talked a lot about my project and Dr. Ingram's expectations and training that I'll have to complete in order to work with human data. Then, he introduced me to Dr. Beate Peter, an expert in apraxia, which was very exciting. 

On Friday, Quince had clinic at CARD. Clinic is where my mom meets with Quince's head therapist to review his goals and progress on them. I accompanied my mom to clinic, and played with Quince during the meeting. After clinic, Quince had two more hours of CARD, and then it was time for an hour of music therapy. His music therapy isn't very focused on language development, so I probably won't talk about it a lot here after this, but I'll provide a rough overview. His music therapist, Mary, plays the guitar and sings to Quince while he drums. Sometimes she plays the piano and he jumps on a trampoline. It's less demanding and thus more enjoyable for Quince, so he looks forward to these sessions. 

Sorry for the lengthy post. I'll try to break it up next week.

*Quince's token board is a piece of laminated paper with ten velcro circles on it. His tokens are laminated pictures of surfboards (because Quince loves to surf) with the opposite velcro circle. When Quince is working on a program, if the token board is being used, every time he gets a trial right, they give him a token to put on the token board. Once the board is full, Quince knows he is 'all done', meaning he gets to take a break and run around. They use this board so that he can visualize the reward and exactly how much more he has to do to get it.

Introduction

Hello, my name is Casey Calhoun and I am a senior at BASIS Scottsdale. Instead of attending the last trimester of school, I will be participating in a research project from February to May. Specifically, my project investigates the language development of children with autism, and the effects of different therapy techniques on their speech.

My interest in language development is largely due to my five-year-old brother, Quince. Quince was diagnosed with autism at two, when he rapidly lost nearly all of his speech. For the past four years, we have been trying to improve his ability to communicate through therapy. I have learned that the variation within the autism diagnosis is immense, and that in particular the evolution of each autistic child's speech can be wildly different.

For example, there is another boy with autism at Quince's therapy who is roughly the same age. He speaks clearly and in complete phrases, but usually through echolalia (repetition of the words said to him). On the other hand, Quince's words are individual and garbled, nearly incomprehensible to everyone except my mother, but more frequent and spontaneous. I have always wondered how the same therapy techniques could help two completely different children.

For the next few months, I will be working with ASU professor Dr. David Ingram to track the language development of children with autism as they progress through speech therapy. My goal is to see if children with varying communication challenges respond differently to therapy techniques. I will also be shadowing Quince's therapists at CARD, his ABA (applied behavioral analysis) therapy site. Each week, this blog will be updated with my progress.