Background and aims We introduce the Assessment of Phase of Preschool Language (APPL), a rating form that characterizes children’s language according to a well-established framework recommended by Tager-Flusberg et al. (2009). The language benchmarks framework defines children’s language as falling at one of the Pre-verbal, First Words, Word Combinations, Sentences, or Complex Language phases for phonology, vocabulary, grammar, pragmatics, and overall language. The APPL is a flexible assessment tool that allows assessors to determine language phase using a range of assessment sources: natural language samples, standardized measures, and/or parent rating forms. Using the APPL, we examined language profiles in four- and five-year-olds with autism spectrum disorder and explored language development during a community-based Naturalistic Developmental Behavioral Intervention program. Methods Community speech-language pathologists completed the APPL with 95 four- and five-year-olds at the beginning of the treatment. The APPL was re-administered after a mean of 10 months of intervention (SD = 2 months) for 46 of these children. Children received treatment for up to 15 h per week in their homes and/or community childcare centers. Pivotal Response Treatment was the main form of intervention. The Picture Exchange Communication System or other augmentative and alternative communication systems were also used with many pre-verbal children. Results At the beginning of intervention, the most common language phase was Word Combinations (44%), followed by Pre-verbal (26%), Sentences (20%), and then First Words (10%). Only 24% of children had even profiles (i.e. phonology, vocabulary, grammar, and pragmatics skills at the same level). Phonology was a common area of relative strength, and pragmatics was a common area of relative weakness. Ten months of intervention was associated with gains in overall language phase for 37% of children. Approximately half gained at least one phase in Grammar (57%), Vocabulary (51%), and Phonology (46%), while Pragmatics improved for 33%. Gains varied based on initial language phase. Inclusion of skills using augmentative and alternative communication enhanced interpretation of change during intervention. Conclusions Four- and five-year-olds with autism spectrum disorder in this sample tended to have uneven skills across expressive language domains. Community-based Naturalistic Developmental Behavioral Intervention was associated with gains in language phase in older preschoolers with autism spectrum disorder. Gains varied across language domains and were influenced by initial language phase. Implications The Assessment of Phase of Preschool Language is a useful tool to support consistent application of the language benchmarks framework. It is important to consider all language domains when characterizing language skills and treatment impact in children with autism spectrum disorder.

中文翻译：

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学龄前语言阶段的评估：应用语言基准框架来描述四到五岁自闭症谱系障碍儿童的语言特征和变化

背景和目的我们介绍学龄前语言阶段评估（APPL），这是一种根据Tager-Flusberg等人推荐的完善框架，描述儿童语言特征的评级表。（2009）。语言基准框架将儿童的语言定义为语音，词汇，语法，语用和整体语言的前言，第一词，单词组合，句子或复杂语言阶段之一。APPL是一种灵活的评估工具，允许评估人员使用一系列评估来源来确定语言阶段：自然语言样本，标准化度量和/或父级评估表。使用APPL，我们研究了自闭症谱系障碍的四岁和五岁儿童的语言概况，并在基于社区的自然发展行为干预计划中探索了语言发展。方法社区言语病理学家在治疗开始时用95岁的4岁和5岁儿童完成了APPL。在平均10个月的干预（SD = 2个月）之后，对这些儿童中的46名进行了APPL的重新给药。儿童在家中和/或社区儿童保育中心每周接受长达15小时的治疗。关键反应治疗是干预的主要形式。图片交换通信系统或其他补充性和替代性通信系统也与许多言语前儿童一起使用。结果干预开始时，最常见的语言阶段是单词组合（44％），其次是前言（26％），句子（20％），然后是第一词（10％）。只有24％的儿童甚至拥有个人简介（即，同级别的语音，词汇，语法和语用技能）。语音学是相对优势的常见领域，而语用学是相对劣势的常见领域。十个月的干预与37％的儿童在总体语言阶段的进步有关。大约一半的人在语法（57％），词汇（51％）和语音学（46％）至少达到了一个阶段，而语用学则提高了33％。收益根据初始语言阶段而有所不同。使用补充性和替代性沟通来融合技能，可以增强干预过程中对变化的理解。结论本样本中的4岁和5岁自闭症谱系障碍者在跨表达语言领域的技能往往不均衡。基于社区的自然主义发展行为干预与自闭症谱系障碍的学龄前儿童语言阶段的获得有关。收益因语言领域而异，并受初始语言阶段的影响。启示学龄前语言阶段评估是一个有用的工具，可支持语言基准框架的一致应用。在描述自闭症谱系障碍儿童的语言技能和治疗效果时，重要的是要考虑所有语言领域。基于社区的自然主义发展行为干预与自闭症谱系障碍的学龄前儿童语言阶段的获得有关。收益因语言领域而异，并受初始语言阶段的影响。启示学龄前语言阶段评估是一个有用的工具，可支持语言基准框架的一致应用。在描述自闭症谱系障碍儿童的语言技能和治疗效果时，重要的是要考虑所有语言领域。基于社区的自然主义发展行为干预与自闭症谱系障碍的学龄前儿童语言阶段的获得有关。收益因语言领域而异，并受初始语言阶段的影响。启示学龄前语言阶段评估是一个有用的工具，可支持语言基准框架的一致应用。在描述自闭症谱系障碍儿童的语言技能和治疗效果时，重要的是要考虑所有语言领域。