Improving Language Comprehension via Hand Gestures in Children with Autism Spectrum Disorders and/or Language Impairment in Rural Montana

Modyanova, N., Bolton, A. P., Storrusten, C., & McCrory, B. (2024). Improving Language Comprehension via Hand Gestures in Children with Autism Spectrum Disorders and/or Language Impairment in Rural Montana. Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 13(1), 191-196. https://doi.org/10.1177/2327857924131012

Publication date: 1 Jun 2024 Added to AutiHub: 8 Aug 2026 Type: Other Article language: English

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Authors

Publication authors
4
Publication authors identified as autistic
1 / 4 (25.0%)

Abstract

Background: Developmental Language Disorder (DLD) and Autism Spectrum Disorder (ASD) are lifelong challenges, dramatically impairing communicative abilities with long term impacts on outcomes. Children with DLD and/or ASD benefit from interventions to improve language skills, but those are hard to reach in rural areas. Caregiver hand gestures can improve comprehension of content words in DLD/ASD via multimodal processing. However, little is known about how gestures affect comprehension of grammatical determiners (e.g., “ the” or “ an”). Methods: We investigate whether combining determiner phrases (e.g., “ the apple” or “ another apple”) with specific gestures (signs for [same] or [different] from American Sign Language) can improve language comprehension in hearing children with DLD/ASD, compared to TD controls. Operating Gazepoint or Tobii eye tracking at participants’ homes or a university space, we use a constrained act-out task presented via a custom-made interactive computer game with pre-recorded video prompts, or a toy and paper version, using a pretest-training-test-posttest protocol. Results: After evaluating 35 participants with ASD, DLD, and TD, ages 2-31, we identified three subgroups (across diagnoses) based on their knowledge of determiners at pretest. 51% of participants showed good (adult-like) knowledge across determiners and tests. 26% of participants were unable to complete our interactive game. However, 23% of participants showed initial poor knowledge of “ the”, followed by improvements in the comprehension of “ the” with gestures in the test, which were mostly retained in the posttest. Eye tracking demonstrated consistency between children’s attention to gestures and answers and their behavioral responses. Conclusion: Hand gestures can improve language comprehension in some children with DLD/ASD and TD. Our findings may lead to designing an inclusive intervention, for both children and their caregivers, to improve communication using multiple modalities – both speech and simple gestures which emphasize the main points of the spoken message, thereby supporting rural & underserved families.

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Cited references
38
Total cited references integrated for this publication.
Cited references with an identified autistic author
1 / 38 (2.6%)
Cited author occurrences identified as autistic
1 / 139 (0.7%)
Among occurrences linked to AutiHub author records: 1 / 10 (10.0%). Distinct cited authors identified as autistic: 1 / 133 (0.8%).
Cited author occurrences linked to AutiHub author records
10 / 139 (7.2%)
Distinct linked cited authors: 9 / 133 (6.8%)
Linked cited-author occurrences not identified as autistic
9 / 10 (90.0%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 9 / 139 (6.5%). Distinct linked cited authors not identified as autistic: 8 / 9 (88.9%).
  1. (2011). The Processing and Acquisition of Reference . The MIT Press.
    OpenAlex
  2. Geoff Lindsay , Steve Strand (2016). Children with Language Impairment: Prevalence, Associated Difficulties, and Ethnic Disproportionality in an English Population . Frontiers in Education, 1. Frontiers Media SA.
    Crossref OpenAlex OpenCitations
  3. JEANNETTE SCHAEFFER , MEREL VAN WITTELOOSTUIJN , AVA CREEMERS (2018). Article choice, theory of mind, and memory in children with high-functioning autism and children with specific language impairment . Applied Psycholinguistics, 39(1), 89-115. Cambridge University Press (CUP).
    Crossref OpenAlex OpenCitations
  4. Nadezhda Modyanova *Autistic author. Learn more… (2009). Semantic and pragmatic language development in typical acquisition, autism spectrum disorders, and Williams syndrome with reference to developmental neurogenetics of the latter . DSpace@MIT (Massachusetts Institute of Technology).
    Type: Dissertation OpenAlex: https://openalex.org/W1556544030
    OpenAlex
  5. Jon Baio , Lisa Wiggins , Deborah L. Christensen , Matthew J Maenner , Julie Daniels , Zachary Warren et al. (2018). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014 . MMWR. Surveillance Summaries, 67(6), 1-23. Centers for Disease Control MMWR Office.
    Crossref OpenAlex OpenCitations
  6. Cécile De Cat (2012). Explaining children’s over-use of definites in partitive contexts . First Language, 32(1-2), 137-150. SAGE Publications.
    Crossref OpenAlex OpenCitations
  7. Emily M. Lund (2014). Social Communication Questionnaire . Encyclopedia of Special Education. Wiley.
    OpenAlex
  8. H. ‐C. Steinhausen , C. Mohr Jensen , M. B. Lauritsen (2016). A systematic review and meta‐analysis of the long‐term overall outcome of autism spectrum disorders in adolescence and adulthood . Acta Psychiatrica Scandinavica, 133(6), 445-452. Wiley.
    Crossref OpenAlex OpenCitations
  9. Susan Goldin-Meadow , Diane Brentari (2017). Gesture, sign, and language: The coming of age of sign language and gesture studies . Behavioral and Brain Sciences, 40, e46-e46. Cambridge University Press (CUP).
    Crossref OpenAlex OpenCitations
  10. John C. Trueswell , Irina Sekerina , Nicole M. Hill , Marian L. Logrip (1999). The kindergarten-path effect: studying on-line sentence processing in young children . Cognition, 73(2), 89-134. Elsevier BV.
    Crossref OpenAlex OpenCitations
  11. Janet Y. Bang , Aubrey S. Adiao , Virginia A. Marchman , Heidi M. Feldman (2020). Language nutrition for language health in children with disorders: a scoping review . Pediatric Research, 87(2), 300-308. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  12. Lucy A. Henry , David J. Messer , Gilly Nash (2012). Executive functioning in children with specific language impairment . Journal of Child Psychology and Psychiatry, 53(1), 37-45. Wiley.
    Crossref OpenAlex OpenCitations
  13. Livia Colle , Simon Baron-Cohen , Jacqueline Hill (2007). Do Children with Autism have a Theory of Mind? A Non-verbal Test of Autism vs. Specific Language Impairment . Journal of Autism and Developmental Disorders, 37(4), 716-723. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  14. Enrica Donolato , Enrico Toffalini , Kristin Rogde , Anders Nordahl-Hansen , Arne Lervåg , Courtenay Norbury et al. (2023). Oral language interventions can improve language outcomes in children with neurodevelopmental disorders: A systematic review and meta‐analysis . Campbell Systematic Reviews, 19(4), e1368-e1368. SAGE Publications.
    Type: Article DOI: 10.1002/cl2.1368 OpenAlex: https://openalex.org/W4389070121
    Crossref OpenAlex OpenCitations
  15. M. Mary Konstantareas (1984). Sign language as a communication prosthesis with language-impaired children . Journal of Autism and Developmental Disorders, 14(1), 9-25. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  16. Reshmi L. Singh , Eric J. Moody , Bethany Rigles , Elyssa B. Smith (2019). What it Takes to Raise Children with Autism in a Rural State . Advances in Neurodevelopmental Disorders, 3(1), 17-28. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  17. Chiara Cantiani , Naseem A. Choudhury , Yan H. Yu , Valerie L. Shafer , Richard G. Schwartz , April A. Benasich (2016). From Sensory Perception to Lexical-Semantic Processing: An ERP Study in Non-Verbal Children with Autism . PLOS ONE, 11(8), e0161637. Public Library of Science (PLoS).
    Crossref OpenAlex OpenCitations
  18. Angeliek van Hout , Kaitlyn Harrigan , Jill de Villiers (2010). Asymmetries in the acquisition of definite and indefinite NPs . Lingua, 120(8), 1973-1990. Elsevier BV.
    Crossref OpenAlex OpenCitations
  19. Vasiliki Chondrogianni , Theodoros Marinis (2015). Production of definite and indefinite articles in typically developing English-speaking children and children with SLI . Lingua, 155, 9-28. Elsevier BV.
    Crossref OpenAlex OpenCitations
  20. Vallotton. (n.d.). Signing with Babies & Children: A Summary of Research Findings for Parents & Professionals.
    Type: Other
    Crossref
  21. Jeannette Schaeffer , Muna Abd El-Raziq , Elena Castroviejo , Stephanie Durrleman , Sandrine Ferré , Ileana Grama et al. (2023). Language in autism: domains, profiles and co-occurring conditions . Journal of Neural Transmission, 130(3), 433-457. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  22. Schumacher H. (2020). Is this the most powerful word in the English language? Is this the most powerful word in the English language?.
    Type: Other
    Crossref
  23. Modyanova N. (2009). Semantic and Pragmatic Language Development in Typical Acquisition, Autism Spectrum Disorders, and Williams Syndrome with Reference to Developmental Neurogenetics of the latter. Ph. D. Dissertation at MIT
    Type: Other
    Crossref
  24. Michelle M. Hughes , Kelly A. Shaw , Monica DiRienzo , Maureen S. Durkin , Amy Esler , Jennifer Hall-Lande et al. (2023). The Prevalence and Characteristics of Children With Profound Autism, 15 Sites, United States, 2000-2016 . Public Health Reports®, 138(6), 971-980. SAGE Publications.
    Crossref OpenAlex OpenCitations
  25. Rudolph F. Martin , Elizabeth Carrow (1977). Test for Auditory Comprehension of Language . The Modern Language Journal, 61(8), 427. Wiley.
    Type: Article DOI: 10.2307/325936 OpenAlex: https://openalex.org/W2320743384
    OpenAlex
  26. Florian Schwarz (2019). Definites, Domain Restriction, and Discourse Structure in Online Processing . In Studies in Theoretical Psycholinguistics (pp. 187-208). Springer International Publishing.
    Crossref OpenAlex OpenCitations
  27. Wexler K. (2003). The Processing and Acquisition of Reference . The Processing and Acquisition of Reference.
    Type: Other
    Crossref
  28. Ahn D. (2020). bibr18-2327857924131012 BUCLD, 44.
    Type: Other
    Crossref
  29. for the IBIS Network , N Marrus , L P Hall , S J Paterson , J T Elison , J J Wolff et al. (2018). Language delay aggregates in toddler siblings of children with autism spectrum disorder . Journal of Neurodevelopmental Disorders, 10(1), 29-29. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  30. Dorothy Bishop (2013). Children’s Communication Checklist (CCC-2) . In Encyclopedia of Autism Spectrum Disorders (pp. 614-618). Springer New York.
    OpenAlex
  31. (2018). Peabody Picture Vocabulary Test . The SAGE Encyclopedia of Educational Research, Measurement, and Evaluation. SAGE Publications, Inc..
    OpenAlex
  32. Rutter M. (2003). Social communication questionnaire . Social communication questionnaire.
    Type: Other
    Crossref
  33. Kaufman (2004). Kaufman Brief Intelligence Test, Second Edition (KBIT-2) . British Psychological Society.
    Crossref OpenAlex
  34. Dunn D. M. (2019). Peabody Picture Vocabulary Test . Peabody Picture Vocabulary Test.
    Type: Other
    Crossref
  35. Colarusso R. (2015). Motor-Free Visual Perception Test-4 (MVPT-4) . Motor-Free Visual Perception Test-4 (MVPT-4).
    Type: Other
    Crossref
  36. Carrow-Woolfolk E. (2014). Test for Auditory Comprehension of Language . Test for Auditory Comprehension of Language.
    Type: Other
    Crossref
  37. Bishop D. V. (2003). The Children’s Communication Check-list: CCC-2. London: Harcourt Assessment. https://www.ers.usda.gov/data-products/rural-urban-commuting-area-codes/
    Type: Other
    Crossref
  38. Dink J. W., Ferguson B. (2015). EyetrackingR: An R Library for Eye-tracking Data Analysis. http://www.eyetrackingr.com
    Type: Other
    Crossref