Background and aims:Prior work has examined how children and adolescents with autism spectrum disorder who are minimally verbal use their spoken language abilities during interactions with others. However, social communication includes other aspects beyond speech. To our knowledge, no studies have examined how minimally verbal children and adolescents with autism spectrum disorder are using their gestural communication during social interactions. Such work can provide important insights into how gestures may complement their spoken language abilities.Methods:Fifty minimally verbal children and adolescents with autism spectrum disorder participated (Mage = 12.41 years; 38 males). Gestural communication was coded from the Autism Diagnostic Observation Schedule. Children (n = 25) and adolescents (n = 25) were compared on their production of gestures, gesture–speech combinations, and communicative functions. Communicative functions were also assessed by the type of communication modality: gesture, speech, and gesture–speech to examine the range of communicative functions across different modalities of communication. To explore the role gestures may play the relation between speech utterances and gestural production was investigated.Results:Analyses revealed that (1) minimally verbal children and adolescents with autism spectrum disorder did not differ in their total number of gestures. The most frequently produced gesture across children and adolescents was a reach gesture, followed by a point gesture (deictic gesture), and then conventional gestures. However, adolescents produced more gesture–speech combinations (reinforcing gesture-speech combinations) and displayed a wider range of communicative functions. (2) Overlap was found in the types of communicative functions expressed across different communication modalities. However, requests were conveyed via gesture more frequently compared to speech or gesture–speech. In contrast, dis/agree/acknowledging and responding to a question posed by the conversational partner was expressed more frequently via speech compared to gesture or gesture–speech. (3) The total number of gestures was negatively associated with total speech utterances after controlling for chronological age, receptive communication ability, and nonverbal IQ.Conclusions:Adolescents may be employing different communication strategies to maintain the conversational exchange and to further clarify the message they want to convey to the conversational partner. Although overlap occurred in communicative functions across gesture, speech, and gesture–speech, nuanced differences emerged in how often they were expressed across different modalities of communication. Given their speech production abilities, gestures may play a compensatory role for some individuals with autism spectrum disorder who are minimally verbal.Implications:Findings underscore the importance of assessing multiple modalities of communication to provide a fuller picture of their social communication abilities. Our results identified specific communicative strengths and areas for growth that can be targeted and expanded upon within gesture and speech to optimize social communication development.

Difficulties understanding spoken language are associated with several social and academic risks in school-age children and adolescents with developmental language disorder (DLD). Still, interventions for this group have received little attention, and there are no reviews focusing on oral language comprehension interventions in school-age children and adolescents. The objective of this systematic scoping review was to identify interventions targeting oral language comprehension in school-age children and adolescents with DLD. Further, the aim was to examine the focus of intervention, efficacy, and level of evidence of the identified interventions. The present review is the second part of a larger search on oral language comprehension interventions. The first review examined the same factors in children 8 years and younger. A systematic scoping review of eight databases was conducted. Of the 2399 sourced articles, 12 met the inclusion criteria. Another 8 articles were identified through reference lists of sourced articles. In these 20 articles, containing 21 studies, 1661 children aged 5-16 years participated. The data were extracted and analysed, and the intervention focus, efficacy, and level of evidence were examined.Main contribution: In the interventions intended for school-age children and adolescents with DLD, three intervention foci were identified that targeted aspects of language and language processing, as well as modifying the communicative environment. Of the included studies, 57% reported positive results, 14% reported mixed results, and 29% reported no effects on oral language comprehension. The level of evidence varied. One can have high confidence in the results of 19%, moderate in 38%, and indicative confidence in 43% of the included studies. Results of the present review suggest that there are a few interventions providing high confidence on the efficacy of improving oral language comprehension difficulties in school-age children and adolescents with DLD. Most interventions indicating efficacy provide moderate or indicative confidence in the results. More research with a high level of evidence is urgently needed. Most of the interventions indicating efficacy focused directly on language skills or modified the communicative environment. The results suggest that the therapy techniques focusing on improving language processing skills indicate efficacy only when they aim at compensating current language processing skills, not trying to improve them.Implications: The findings on different therapy techniques, their focus of intervention, efficacy, and level of evidence provide information for clinical practice and direct future investigations in this sparsely researched topic.

[This corrects the article DOI: 10.1177/23969415211010419.].

Background & Aims:The development of communicative competence requires both language and social skills. The ability to repair following a communication breakdown is critical for continued conversational interchange and to ensure comprehension of bids for communication. Repair demonstrates adequate language and social skills. Children with Fragile X Syndrome (FXS) have difficulty with language development and social skills, which may result in delays or deficits in repair. Repair may be additionally impaired in children with FXS and co-morbid autism. This study examined the development of repair in children with FXS from toddlerhood into middle childhood.Methods:Fifty-five children with FXS and their biological mothers participated. Data were collected during in-home visits approximately every 18 months. Videotaped mother-child interactions were collected, as well as standardized assessments of language, social skills, and autism symptomology.Results:Children with FXS acquired the ability to repair at 90% mastery by three-and-a-half years of age. Multilevel logistic regressions predicting probability of repair indicated marginally significant effects of mean length of utterance and number of different words, and significant effects of global social skills and autism symptomology. Effect sizes were small to moderate.Conclusions:Ability to repair was measured in a naturalistic setting, which allowed children with FXS to utilize repairs in their daily interactions. Although children with FXS may have delayed development of repair relative to typically developing expectations, in general they nonetheless catch up and demonstrate a robust ability to repair by three-and-a-half years of age. However, this study provides evidence that individual differences in language and social skills may influence ability to repair in children with FXS. Finally, the relationship between autism symptoms and repair remains unclear, necessitating further exploration.Implications:Given the noted delay in repair in young children with FXS, clinicians working with this population should target development of this skill as early as possible to maximize successful social interactions. This may be particularly necessary for children with FXS and co-morbid autism.