title: A language programme to increase the verbal production of a child dually diagnosed with Down syndrome and autism.
abstract: BACKGROUND
  The incidence of children dually diagnosed with Down syndrome and autism is estimated to be as high as 11%. There is a paucity of research investigating linguistic treatment interventions for such children. This single-subject experiment examined a programme designed to increase the language production and verbal behaviour of a 9-year-old dually diagnosed boy who had been receiving a 15-h/week home-based applied behaviour analysis (ABA) programme.
  
  
  METHODS
  Training principles were derived from previously empirically validated research in discrete trail learning and natural environment teaching, as well as modified incidental teaching procedures. The crux of the language programme involved withholding reinforcement until a spoken request was made.
  
  
  RESULTS
  Language production noticeably increased for each target area after the introduction of the language programme and was maintained at a 9-month follow-up session.
  
  
  CONCLUSIONS
  A combined treatment approach incorporating direct instruction, natural environment teaching and incidental teaching can be effective in increasing and maintaining responsive and spontaneous speech in a child with Down syndrome diagnosed with autism. Replication studies are needed with such multiple dually diagnosed children to further evaluate the effectiveness and generalizability of this combined language programme.
authors.affiliation: Division of Developmental Disabilities, The Kelly O'Leary Center for Autism Spectrum Disorders, Cincinnati Children's Hospital Medical Center, OH 45229, USA. Kimberly.Kroeger-Geoppinger@cchmc.org
authors.forename: K A
authors.initials: KA
authors.lastname: Kroeger
authors.forename: W M
authors.initials: WM
authors.lastname: Nelson
mesh_terms: D001321:Autistic Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy; D002648:Child; D003131:Combined Modality Therapy; D015897:Comorbidity; D004314:Down Syndrome / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007805:Language Development Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D007808:Language Therapy; D008297:Male; D012055:Reinforcement Schedule; D013068:Speech Production Measurement; D014040:Token Economy; D014705:Verbal Behavior