Characterizing social communication among minimally verbal children with autism: An application of item response theory.
Andrew Schlink, Connie Kasari
PMID 39152613WHAT IT FOUND
Reaching for an object is the easiest social gesture for minimally verbal autistic children.
Showing an object is the hardest. Joint attention gestures are generally more difficult than requesting behaviors. This hierarchy helps clinicians select initial intervention targets for children with limited communication skills.
Key findings
01Behavior regulation reaches (requesting) were the easiest gestures to exhibit, while joint attention shows were the most challenging.
02Joint attention gestures were more difficult to exhibit than behavior regulation gestures, with behavior regulation eye contact being a notable exception as the third most difficult.
03The five easiest gestures identified were behavior regulation reaches, behavior regulation gives, joint attention eye contact, behavior regulation language, and behavior regulation eye contact.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a secondary analysis of baseline data, so it describes a cross-sectional snapshot of ability rather than tracking development over time. The sample included a wide age range (3 to 11 years), which may mask age-specific differences in gesture difficulty. The study assumed a single underlying social communication ability, which may oversimplify the distinct developmental paths of requesting versus joint attention. The results are based on statistical modeling of existing data, not direct clinical observation of intervention outcomes.
Declared interests
The study was supported by the National Institute on Deafness and Other Communication Disorders (N.I.H.). No other conflicts of interest were reported.
The easy way to misread this
Do not interpret this difficulty ranking as evidence that a specific therapy works. This study analyzes the inherent challenge of gestures for this population. It informs goal selection but does not prove that targeting the 'easiest' gestures will lead to better language outcomes compared to other approaches.