An evaluation of a multi-component intervention for loud speech in children with autism spectrum disorder

Idiosyncratic patterns of speech are common in ASD and greatly affect an individual’s level of functioning, and as a result, the extent of their social and educational inclusion. Although there is a large body of literature detailing and evaluating interventions for a variety of verbal behaviors in ASD, there is a relative dearth of research describing interventions for idiosyncratic characteristics of communicative speech (e.g., atypical prosody) and even less focused specifically on loud speech. To address this gap in the literature, the current study presents and evaluates a treatment package implemented with three children with ASD and a history of loud speech (i.e., ≥ 70 db). A concurrent multiple baselines across participants design was used to determine whether a multi-component intervention (i.e., an antecedent modification, a differential reinforcement of other behavior (DRO) procedure, and in-vivo feedback) effectively reduced participants’ rates of loud speech. The results suggest it is possible to decrease rates of loud speech in children with ASD to near-zero levels by consistently implementing a relatively simple combination of behavioral strategies. The present study extends the literature on speech prosody in ASD, and fills a gap in the treatment literature by detailing an effective intervention for loud speech. This research could also inform future investigations into this nuanced yet crucial aspect of social communication, including appropriate methods for addressing issues with speech loudness in individuals with ASD.