Recent studies indicate that children with ASD have a significantly higher risk of co-occurring speech sound disorders than typically developing children. Early atypical speech development may be a critical yet overlooked bottleneck hindering their language improvement. Given the unique phonetic features of Mandarin, it is essential to investigate speech development in Mandarin-speaking children with ASD. This study aims to construct developmental trajectories and establish early identification and prognosis prediction models for this population.
1. Procedures. This study plans to enroll 60 children with autism spectrum disorder (ASD group) and 60 typically developing children (TD group), aged 18-60 months, matched by age and sex. At baseline, both groups will undergo assessments of development, language, and parent-child interaction, as well as fNIRS; the ASD group will additionally receive clinical diagnostic evaluations. Subsequently, a one-year follow-up will be conducted, with both groups completing language and parent-child interaction assessments at 3, 6, 9, and 12 months, and undergoing repeated developmental and fNIRS evaluations at the final 12-month visit. 2. Demographic questionnaire and clinical data. The demographic questionnaire is completed by the child's primary caregiver, detailing child's name, gender, date of birth, height, weight, heart rate. Clinical data will be ascertained from the medical records, including information about DSM-5 diagnosis and comorbid conditions. 3. Sample size. This study ultimately determined a sample size of 120 participants (60 in the ASD group and 60 in the TD group). The estimation was based on the minimum sample size required to analyze the "group × time" interaction effect using a mixed-effects model (88 participants, achieving 85% power), and fully considered the following factors: ① Meeting the analytical requirements for both the main effects of group and time; ② The need to increase the sample size to 110 participants if multiple comparison corrections (Bonferroni correction, α=0.0083) are applied to the six speech indicators; ③ Considering practical operational challenges such as the long follow-up period, multiple repeated measurements, and anticipated dropout rates, the sample was ultimately expanded to 120 participants to ensure the robustness of the study. 4. Statistical analysis. SPSS 25.0 software (SPSS Inc) was used for statistical analysis for the scale data, The speech development trajectories of the two groups can be analyzed using longitudinal methods such as mixed-effects models. Repeated measures ANOVA will compare speech characteristics between the ASD and TD groups at five time points (baseline, 3, 6, 9, and 12 months). Correlation analysis (Pearson or Spearman, depending on normality) will assess the relationship between speech development and core ASD symptoms. ANOVA/MANOVA will examine group differences in speech perception tasks, and exploratory factor analysis will identify underlying factors influencing speech perception.All statistical analyses were conducted with a statistical threshold P-value of \<0.05. The data collected through fNIRS will be performed via NirSpark analysis software. 5. Ethical matters and data protection. The children participated in the study will sign the informed consent (obtained from the guardian). And this study was approved by the local ethics committee. children's name will be abbreviated and the research data will be assigned a code then to provide to the researcher. The authorization from parents on the children's health information remains valid until the study is completed. After that, researchers will delete private information from the study record.
Study Type
OBSERVATIONAL
Enrollment
120
The intervention methods for children in the ASD group will be documented in detail (through telephone or online follow-ups, based on parental reports, with records including the location, time, frequency, and main content of the interventions); children in the TD group did not receive any intervention.
The language ability of ASD group and TD group by Dream-it
The participants will be assessed using the Dream-it, which consists of two separate scales developed for children aged 0-18 months and 18-36 months, respectively. The assessment is conducted via parent report and completed on an iPad. The evaluation covers four domains: language comprehension, language expression, cognitive play, and social communication.The researchers will calculate the participants' scale scores across four dimensions and compare them at different time points.
Time frame: Baseline enrollment;3 months ,6 months ,9 months and 12 months after follow-up
The language ability of ASD group and TD group by free-play session with one parent
The participants will be engage in a 15-minute semi-structured free-play session with one parent, which will be video-recorded for later coding of behavioral and vocalization measures. The investigators will collect the participant's naturalistic language. Indicators such as the diversity of syllables, the number of vowels, and the number of consonants will be calculated and compared at various time points.
Time frame: Baseline enrollment; 3 months, 6 months, 9 months and 12 months after follow-up
The changes in degree of ASD disorder by Autism Diagnostic Observation Schedule-2
The participants in ASD group will be accepted the ADOS assessment.The Autism Diagnostic Observation Schedule-2 (ADOS-2) is adopted to assess the changes in the degree of ASD disorder. The Autism Diagnostic Observation Schedule-2 (ADOS-2) is a standardized observational assessment. The assessment includes abilities in four areas: social interaction, stereotypical behavior, verbal communication, emotion, and abnormal behavior. The participants in the study will be administered a module 1 for children with little or no phrase speech or Module 2, for children who use phrase speech but are not yet fluent. Standardized ADOS scores in the domains of social affect (SA) and restricted repetitive behaviors (RRB) were calculated as indicators of ASD severity.
Time frame: Baseline enrollment; 12 months after follow-up
The developmental level in ASD group and TD group
The participants will be assessed using the Gesell Developmental Schedule (GESELL) .The Gesell assessment is a developmental evaluation tool for young children, typically used from birth to age six, to measure skills across fine motor, gross motor, adaptive, language, and personal-social domains.Scores for the five domains (gross motor, fine motor, adaptive, language, and personal-social) will be calculated and compared between groups.
Time frame: Baseline enrollment; 12 months after follow-up
The changes of brain function detection indicators
To assess speech perception, two groups of participants will be completed a task-based paradigm while being monitored with functional near-infrared spectroscopy (fNIRS).All participants will undergo an approximately 10-minute speech perception task, during which concentrations of oxygenated hemoglobin in different brain regions and functional connectivity will be recorded.
Time frame: Baseline enrollment;12 months after follow-up
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