Preface

This was a very opportune time to put together a special journal related to infants and toddlers with disabilities. Several issues of critical importance are facing all professionals who serve these young children and their families. As two recent studies by the Centers for Disease Control have documented, the prevalence of Autism Spectrum Disorders (ASD) has increased over the past 30 years and many more children with these disorders are being served in the early intervention system.[1] Given that two of the major defining features of ASD are deficits in social interaction and communication skills, speech-language pathologists (SLPs) should be central to any team of professionals serving young children with ASD. The SLP can provide valuable information related to the communication skills and needs of the child and can work closely with the family and other professionals to maximize the development of these skills. The ideal situation for screening, diagnosing, and providing intervention services to young children with or suspected of having ASD is within an interdisciplinary context. However, at times, SLPs may be the only service provider available to a family. The recent American Speech-Language-Hearing Association Guidelines indicate[2] “The SLP who has been trained in the clinical criteria for ASD, as well as in the use of reliable and valid diagnostic and assessment tools for individuals with ASD, and who is experienced in diagnosis of developmental disorders, may be qualified to diagnose these disorders as an independent professional.” Therefore, SLPs who provide services to young children with ASD must have the most up-to-date information to guide their work and decision-making processes in collaboration with the family and other available professionals.

Two of the articles in this volume should be beneficial to SLPs working with infants and toddlers with ASD (or who appear at risk for ASD). One is focused on early identification of these young children (Crais, Watson, Baranek, and Reznick) and the other (Yoder and McDuffie) targets using nonverbal and play behaviors to facilitate spoken language. Crais and colleagues provide compelling evidence for the early identification of young children at risk for ASD and suggest that these children are already showing behaviors that distinguish them from typically developing children by 12 months of age. Yoder and McDuffie offer advice for clinicians in selecting therapy goals as well as approaches for working with young prelinguistic or early linguistic children with autism.

An additional issue facing SLPs in current practice is the difficulty of identifying which late-talking 2-year-olds will eventually “normalize” their language and which ones will continue to have difficulties well into the preschool and school years. Given that morphosyntactic deficits are a characteristic of preschool children with specific language impairment,[3] [4] the article by Hadley identifies areas of grammatical development that can be incorporated into risk-factor assessment models for toddlers between the ages of 2 and 3. Hadley then provides examples for how these behaviors can be measured in a time-efficient way.

A third major issue facing SLPs relates to their ever-increasing amount of interaction with young English-language learners and the need to make diagnostic decisions and recommendations regarding linguistic differences in addition to disorder. With the rapidly changing demographics in this country, SLPs are challenged to gain new skills in working with children and families whose linguistic and cultural backgrounds differ from their own. Moore and Perez provide an insightful discussion of some of the myths and issues surrounding the provision of services to these young children and their families. They have developed two creative strategies for assessing and then providing language enrichment opportunities for the children and families, at the same time that they provide preparation for their students in working with families from diverse backgrounds.

Finally, Olswang, Pinder, and Hanson address the early communication skills of young children with severe motor disabilities and the challenges they and their caregivers face. They discuss an individualized treatment approach used with three young children between the ages of 14 and 21 months and their families. This approach focuses on teaching caregivers to facilitate their child's communication production of early signals of communication. In light of the current movement toward provision of services in children's natural environments and enhancing parent-professional collaboration, this methodology has great promise for future use with young children with motor disabilities.

In sum, we are excited about the contribution the current authors have made toward a greater understanding of the role of the SLP in assessing and intervening with infants and toddlers with disabilities. We hope you will learn from and enjoy what we have brought together for you.

REFERENCES

• 1 Centers for Disease Control and Prevention . Mental health in the United States: parental report of diagnosed autism in children aged 4-17 years-United States, 2003-2004.  MMWR Morb Mortal Wkly Rep. 2006;  55 481-486
• 2 American Speech-Language-Hearing Association .Guidelines for speech-language pathologists in diagnosis, assessment, and treatment of autism spectrum disorders across the life span. 2006. Available at: http://www.asha.org/members/deskref-journal/deskref/default Accessed
• 3 Rescorla L. Language and reading outcomes to age 9 in late-talking toddlers.  J Speech Lang Hear Res. 2002;  45 360-371
• 4 Thal D. Early identification of language impairment: what are the best strategies?. Presented at: American Speech-Language-Hearing Association Annual Convention 2005 San Diego, CA