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Semin Speech Lang. 1998;19(4):329-52; quiz 353; 424.

Understanding the continuum of discrete-trial traditional behavioral to social-pragmatic developmental approaches in communication enhancement for young children with autism/PDD.

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Center for Human Development, Brown University, Providence, Rhode Island, USA.


Clinicians are faced with the challenge of making informed decisions amidst heated debates over the most effective treatment approaches for young children with autism. This article provides a more specific focus to this debate by considering the practice of enhancing spontaneous language and related social-communicative abilities of young children with autism/pervasive developmental disorder (PPD). First, a historical perspective of the evolution of different approaches for enhancing communication and related abilities is presented, followed by a description of characteristics of the approaches. The approaches are described along a continuum from massed discrete trial, traditional behavioral to social-pragmatic, developmental. The current state of knowledge regarding the effectiveness of early services for children with autism/PDD is examined and conclusions are presented with consideration of the need for more meaningful outcome measures than are currently used for the next generation of outcome research.

[Indexed for MEDLINE]

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