Publications by authors named "Andrea Barton-Hulsey"

16 Publications

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Augmentative and Alternative Communication Supports for Language and Literacy in Preschool: Considerations for Down Syndrome and Autism Spectrum Disorder.

Semin Speech Lang 2021 Aug 26;42(4):345-362. Epub 2021 Jul 26.

School of Communication Science and Disorders, Florida State University, Tallahassee, Florida.

Children with Down syndrome and children with autism spectrum disorder have a range of speech abilities during preschool that impacts access to both language and literacy instruction. It is the responsibility of the speech-language pathologist to advocate for and provide intervention using augmentative and alternative communication (AAC) through individualized assessment. This article provides a review of the literature supporting the use of AAC during preschool for both language and literacy development in children with Down syndrome and children with autism spectrum disorder who have limited speech. A small scale exploratory report is discussed to highlight differences in early literacy skills found in children in each group. Implications for AAC intervention during preschool to support both language and literacy are discussed.
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http://dx.doi.org/10.1055/s-0041-1730996DOI Listing
August 2021

Reading Skills in Down Syndrome: Implications for Clinical Practice.

Semin Speech Lang 2021 Aug 26;42(4):330-344. Epub 2021 Jul 26.

School of Communication Science and Disorders at Florida State University, Tallahassee, Florida.

Though children with Down syndrome can learn to read, they may have difficulty developing some component skills, including phonological awareness and word decoding. Given reading's foundation in language, speech-language pathologists (SLPs) should play a central role in supporting access to and providing reading instruction for children with Down syndrome. This article reviews the available research on reading in Down syndrome and offers guidance for SLPs working with this population. We start by reviewing the Down syndrome phenotype, highlighting physical features and cognitive and linguistic patterns of strength and weakness that impact reading development. Next, we define different reading subskills and outline typical reading development, including stages of prereading, learning to read, and transitioning to using reading as a tool for learning. We then use these stages to review what is known about reading in Down syndrome, including relevant intervention work. We also incorporate considerations for clinical practice. In particular, we encourage SLPs to advocate for supporting reading development in children with Down syndrome, to work with families to develop rich home literacy environments, and to work with educators to promote phonological awareness and decoding skills. Lastly, we note limitations in our current knowledge and include a call for more research.
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http://dx.doi.org/10.1055/s-0041-1730991DOI Listing
August 2021

Maternal Input and Child Language Comprehension During Book Reading in Children With Down Syndrome.

Am J Speech Lang Pathol 2020 08 28;29(3):1475-1488. Epub 2020 May 28.

Waisman Center, University of Wisconsin-Madison.

Purpose Communication interactions between parents and children during shared book reading impact a child's development of both language and literacy skills. This study examined maternal language input and child expressive communication during a shared book reading activity in children with Down syndrome (DS) and children with typical development (TD). Additionally, children's receptive language was examined to understand the relationship between maternal language input and child receptive language ability. Method Participants included 22 children with DS and 22 children with TD between 22 and 63 months of age and their mothers. Each mother-child dyad participated in a 7-min naturalistic shared book reading activity. Results Compared to mothers of children with TD, mothers of children with DS used significantly more utterances with less grammatical complexity, but a similar range of vocabulary diversity. Mothers of children with DS used more questions, descriptions, gestures, and labels, whereas mothers of children with TD used nearly half of their utterances to read directly from books. Children with DS communicated at a similar frequency compared to their peers with TD; however, they produced significantly fewer spoken words. Conclusions This study reveals important differences between early shared book reading interactions and provides implications for future research targeting parent-coached intervention strategies that may enhance children's learning during shared book reading by providing access to expressive language and print instruction.
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http://dx.doi.org/10.1044/2020_AJSLP-19-00156DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893527PMC
August 2020

Grammatical judgment and production in male participants with idiopathic autism spectrum disorder.

Clin Linguist Phon 2020 12 3;34(12):1088-1111. Epub 2020 Feb 3.

Waisman Center, University of Wisconsin-Madison , Madison, Wisconsin, USA.

This study examined grammatical judgment and production in 22 male participants with idiopathic autism spectrum disorder (ASD) who had a range of nonverbal IQ from 44 to 111 (mean = 72.23) and were between 9.42 and 16.75 years of age (mean = 13.45). Relationships between grammatical judgment and production and nonverbal IQ were examined. Participants completed the Test of Early Grammatical Impairment (TEGI) to describe relative strengths and weaknesses in their ability to judge and produce grammatical tense. Participants also completed the Leiter-R to assess the relationship between nonverbal IQ and grammatical judgment and production. Relative strengths were found across participants in judging correct use of subject-verb agreement in sentences, and correctly producing verbs that linked sentences (e.g., auxiliaries and copulas of " she resting?"). Participants had the greatest difficulty judging the correctness of a sentence using a dropped verb tense marker (e.g., "He happy now") and producing irregular verb tense markers. Nonverbal IQ did not contribute to the variance in performance on any tasks of grammaticality judgment or production. Grammatical markers that mark tense in past tense verbs as well as the production of auxiliary may be an important focus of language intervention for boys with ASD.
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http://dx.doi.org/10.1080/02699206.2020.1719208DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396296PMC
December 2020

Executive Functioning and Narrative Language in Children With Dyslexia.

Am J Speech Lang Pathol 2019 08 13;28(3):1127-1138. Epub 2019 Jun 13.

Department of Psychology, Georgia State University, Atlanta.

Purpose Children with dyslexia often struggle with nonphonological aspects of language and executive functioning. The purpose of this study was to investigate the impact of executive functioning on language abilities at both structural (e.g., grammar in sentences) and functional (e.g., narrative) levels in 92 third- and 4th-grade students with dyslexia. Additionally, we asked if working memory updating contributed a significant amount of variance in narrative language ability beyond what would be expected by students' structural language skills alone. Method Students' language and executive functioning skills were evaluated using a range of language and cognitive measures including the Clinical Evaluation of Language Fundamentals-Fourth Edition (Semel, Wiig, & Secord, 2003), the Peabody Picture Vocabulary Test-Fourth Edition (Dunn & Dunn, 2007), the Test of Narrative Language (Gillam & Pearson, 2004), the Delis-Kaplan Executive Function Scale (Kaplan, Kramer, & Delis, 2001), and the Corsi Block-Tapping Test (WISC-IV Integrated; Kaplan, Fein, Kramer, Delis, & Morris, 2004). Results Low correlations between the language measures suggested that each of these assessments captures a unique element of language ability for children with dyslexia. Hierarchical regression analysis indicated that working memory updating accounted for a significant amount of unique variance in oral narrative production beyond what would be expected by structural language ability. Conclusions The range of performance found across language measures suggests that it may be important to include a variety of language measures assessing both structural and functional language skills when evaluating children with dyslexia. Including cognitive measures of executive functioning may also be key to determine if deficits in working memory updating are contributing to functional expressive language difficulties.
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http://dx.doi.org/10.1044/2019_AJSLP-18-0106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802918PMC
August 2019

Visual-graphic symbol acquisition in school age children with developmental and language delays.

Augment Altern Commun 2018 12 4;34(4):265-275. Epub 2018 Dec 4.

a Georgia State University.

Augmented language systems have become both an integral component of communication intervention programs for children with severe communicative impairments and spurred research on their language and communication development. This study examined intrinsic and extrinsic factors that may influence the language development process for children with developmental disabilities, by exploring the relationship between varying degrees of symbol arbitrariness and extant speech comprehension skills in the discrimination, learning, and use of symbols for communication. For the study, 13 school-aged participants (M = 8.24 [years; months]), with both developmental and language delays, were provided experience with iconic Blissymbols and an arbitrary symbol set of lexigrams via observational computerized experience sessions. There was a modest difference in their ability to learn arbitrary versus iconic symbols. There were no differences if the vocabulary item was unknown prior to the symbol learning experience. These findings suggest that iconicity of a symbol may not be a critical factor in learning a symbol-referent relationship if a target referent is not yet known in comprehension.
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http://dx.doi.org/10.1080/07434618.2018.1522547DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673660PMC
December 2018

Adapting and translating the Mullen Scales of Early Learning for the South African context.

S Afr J Commun Disord 2018 Mar 8;65(1):e1-e9. Epub 2018 Mar 8.

Centre for Augmentative and Alternative Communication, University of Pretoria.

Background:  South African speech-language therapists have identified the need for culturally valid and sensitive assessment tools that can accommodate multiple languages and cover a reasonable age range. The Mullen Scales of Early Learning (MSEL) extend from birth to 68 months, contain five separate subscales including receptive language, expressive language, gross motor, fine motor and visual reception scale, are straightforward to administer and have been successfully used in other African countries, such as Uganda. It also identifies a child's strengths and weaknesses and provides a solid foundation for intervention planning.

Objectives:  This research aimed to demonstrate the appropriateness and usefulness of the translated and culturally and linguistically adapted MSEL across four South African languages (Afrikaans, isiZulu, Setswana and South African English) through two sub-aims: (1) to describe differences, if any, in MSEL performance across language groups and (2) to describe differences, if any, in MSEL performance between age groups.

Method:  A total of 198 typically developing children between the ages of 21 and 68 months spread across the four language groups were individually assessed with the culturally and linguistically adapted and translated MSEL.

Results:  A one-way analysis of variance (ANOVA) showed no statistically significant differences between the four language groups for total MSEL scores. A Welch's one-way ANOVA showed that the total MSEL scores were significantly different between age groups.

Conclusion:  The translation and adaptation of the MSEL was successful and did not advantage or disadvantage children based on their home language, implying that linguistic equivalence was achieved. The MSEL results differed between age groups, suggesting that the measure was also successful in differentiating the performance of children at different developmental levels.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843936PMC
http://dx.doi.org/10.4102/sajcd.v65i1.571DOI Listing
March 2018

The Relationship Between Speech, Language, and Phonological Awareness in Preschool-Age Children With Developmental Disabilities.

Am J Speech Lang Pathol 2018 05;27(2):616-632

Department of Communication, Georgia State University, Atlanta.

Purpose: A number of intrinsic factors, including expressive speech skills, have been suggested to place children with developmental disabilities at risk for limited development of reading skills. This study examines the relationship between these factors, speech ability, and children's phonological awareness skills.

Method: A nonexperimental study design was used to examine the relationship between intrinsic skills of speech, language, print, and letter-sound knowledge to phonological awareness in 42 children with developmental disabilities between the ages of 48 and 69 months. Hierarchical multiple regression was done to determine if speech ability accounted for a unique amount of variance in phonological awareness skill beyond what would be expected by developmental skills inclusive of receptive language and print and letter-sound knowledge.

Results: A range of skill in all areas of direct assessment was found. Children with limited speech were found to have emerging skills in print knowledge, letter-sound knowledge, and phonological awareness. Speech ability did not predict a significant amount of variance in phonological awareness beyond what would be expected by developmental skills of receptive language and print and letter-sound knowledge.

Conclusion: Children with limited speech ability were found to have receptive language and letter-sound knowledge that supported the development of phonological awareness skills. This study provides implications for practitioners and researchers concerning the factors related to early reading development in children with limited speech ability and developmental disabilities.
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http://dx.doi.org/10.1044/2017_AJSLP-17-0066DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105119PMC
May 2018

Language Assessment for Children With a Range of Neurodevelopmental Disorders Across Four Languages in South Africa.

Am J Speech Lang Pathol 2018 05;27(2):602-615

University of Pretoria, South Africa.

Purpose: The purpose of this study is (a) to examine the applicability of a culturally and linguistically adapted measure to assess the receptive and expressive language skills of children with neurodevelopmental disorders (NDDs) in South Africa and then (b) to explore the contributions of 2 additional language measures.

Method: In Part 1, 100 children with NDD who spoke Afrikaans, isiZulu, Setswana, or South African English were assessed on the culturally and linguistically adapted Mullen Scales of Early Learning (MSEL). Clinicians independently rated the children's language skills on a 3-point scale. In Part 2, the final 20 children to be recruited participated in a caregiver-led interaction, after which the caregiver completed a rating scale about their perceptions of their children's language.

Results: Performance on the MSEL was consistent with clinician-rated child language skills. The 2 additional measures confirmed and enriched the description of the child's performance on the MSEL.

Conclusions: The translated MSEL and the supplemental measures successfully characterize the language profiles and related skills in children with NDD in multilingual South Africa. Together, these assessment tools can serve a valuable function in guiding the choice of intervention and also may serve as a way to monitor progress.
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http://dx.doi.org/10.1044/2017_AJSLP-17-0035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105121PMC
May 2018

Gaze avoidance and perseverative language in fragile X syndrome and autism spectrum disorder: brief report.

Dev Neurorehabil 2018 Feb 15;21(2):137-140. Epub 2018 Jan 15.

b University of Wisconsin-Madison, Waisman Center , Madison , WI , USA.

Gaze avoidance and perseverative language impact pragmatics in autism spectrum disorder (ASD) and fragile X syndrome (FXS). We examined these features during conversation samples in boys with ASD (n = 10) and boys with FXS and ASD (FXS+ASD; n = 10). Both groups had similar high rates of gaze avoidance and topic and conversation device perseverations, yet these features were not correlated with one another. Boys with FXS+ASD produced a higher proportion of single utterance perseverations. Results from this study highlight the need for future research to identify potential mechanisms influencing the presence of language perseverations and gaze avoidance.
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http://dx.doi.org/10.1080/17518423.2018.1424264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236677PMC
February 2018

Challenges and Opportunities in Reading Instruction for Children with Limited Speech.

Semin Speech Lang 2017 09 11;38(4):253-262. Epub 2017 Sep 11.

Waisman Center, University of Wisconsin, Madison, Wisconsin.

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http://dx.doi.org/10.1055/s-0037-1604273DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387684PMC
September 2017

Narrative Language and Reading Comprehension in Students With Mild Intellectual Disabilities.

Am J Intellect Dev Disabil 2017 09;122(5):392-408

Andrea Barton-Hulsey, Rose A. Sevcik, and MaryAnn Romski, Georgia State University.

Past research shows positive correlations between oral narrative skill and reading comprehension in typically developing students. This study examined the relationship between reading comprehension and narrative language ability of 102 elementary students with mild levels of intellectual disability. Results describe the students' narrative language microstructure and relative strengths and weaknesses in narrative macrostructure. Students' narrative macrostructure accounted for significant variance in reading comprehension beyond what was accounted for by narrative microstructure (i.e., mean length of utterance in morphemes, number of different words, total utterances). This study provides considerations for measuring narrative quality when characterizing the functional language skills of students with mild levels of intellectual disability. Measurement tools that quantify the quality of language provide important information regarding targets of intervention beyond grammar and vocabulary.
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http://dx.doi.org/10.1352/1944-7558-122.5.392DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043286PMC
September 2017

Comparing the Effects of Speech-Generating Device Display Organization on Symbol Comprehension and Use by Three Children With Developmental Delays.

Am J Speech Lang Pathol 2017 May;26(2):227-240

Department of Psychology, Georgia State University, Atlanta.

Purpose: Three children ages 3;6 to 5;3 with developmental and language delays were provided experience with a traditional grid-based display and a contextually organized visual scene display on a speech-generating device to illustrate considerations for practice and future research in augmentative and alternative communication assessment and intervention.

Method: Twelve symbols were taught in a grid display and visual scene display using aided input during dramatic play routines. Teaching sessions were 30 minutes a day, 5 days a week for 3 weeks. Symbol comprehension and use was assessed pre and post 3 weeks of experience.

Results: Comprehension of symbol vocabulary on both displays increased after 3 weeks of experience. Participants 1 and 2 used both displays largely for initiation. Participant 3 had limited expressive use of either display.

Conclusions: The methods used in this study demonstrate one way to inform individual differences in learning and preference for speech-generating device displays when making clinical decisions regarding augmentative and alternative communication supports for a child and their family. Future research should systematically examine the role of extant comprehension, symbol experience, functional communication needs, and the role of vocabulary type in the learning and use of grid displays versus visual scene displays.
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http://dx.doi.org/10.1044/2016_AJSLP-15-0166DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253965PMC
May 2017

Early Intervention and AAC: What a Difference 30 Years Makes.

Augment Altern Commun 2015 8;31(3):181-202. Epub 2015 Jul 8.

Department of Communication, Georgia State University , Atlanta , Georgia.

This article provides an overview of early intervention and AAC over the 30-year period since the founding of the journal Augmentative and Alternative Communication in 1985. It discusses the global context for early intervention and addresses issues pertaining to young children from birth to 6 years of age. It provides a narrative review and synthesis of the evidence base in AAC and early intervention. Finally, it provides implications for practice and future research directions.
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http://dx.doi.org/10.3109/07434618.2015.1064163DOI Listing
May 2016

Using a speech-generating device to enhance communicative abilities for an adult with moderate intellectual disability.

Intellect Dev Disabil 2008 Oct;46(5):376-86

Department of Communication, Georgia State University, Atlanta, Georgia 30302-4000, USA.

For adults with disabilities who are unable to speak, the literature recommends that intervention include augmentative and alternative communication (AAC) to improve communication and interactions with others. Some adults with moderate intellectual disabilities who exhibit limited functional speech are often overlooked as candidates for AAC interventions because they have some speech abilities. The perception is that they are too old to improve their language and communication skills. This article presents a case report of a 30-year-old woman with a moderate intellectual disability and a severe expressive language disorder who uses a speech-generating device as a compensatory strategy to facilitate her communicative abilities, independence, and self-determination.
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http://dx.doi.org/10.1352/2008.46:376-386DOI Listing
October 2008

Early intervention, AAC, and transition to school for young children with significant spoken communication disorders and their families.

Semin Speech Lang 2008 May;29(2):92-100

Georgia State University, Atlanta, Georgia, USA.

This article presents an overview of the integration of augmentative and alternative communication (AAC) strategies into very early language intervention. Included is a brief discussion of the myths that exist about using AAC with very young children and the evidence against these myths. It also examines the transition to school for children who will use AAC. This examination includes issues that must be considered for a child's transition to school using AAC to be successful.
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http://dx.doi.org/10.1055/s-2008-1079123DOI Listing
May 2008
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