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JOURNAL OF APPLIED BEHAVIOR ANALYSIS 1988)

NUMBER4 (wiNm
1988,21,391-400

TRAINING PARENTS TO USE THE NATURAL LANGUAGE


PARADIGM TO INCREASE THEIR AUTISTIC CHILDREN'S
SPEECH
KAREN E. LASKI
CLAREMONT GRADUATE SCHOOL

MARJORIE H. CHmuuop
CLAREMONT MCKENNA COLLEGE

LAURA SCHREIBMAN
UNIVERSITY OF CALIFORNIA, SAN DIEGO

Parents of four nonverbal and four echolalic autistic children were trained
to increase their children's speech by using the Natural Language
Paradigm (NLP), a loosely structured procedure conducted in a play
environment with a variety of toys. Parents were initially trained to use
the NLP in a clinic setting, with subsequent parent-child speech
sessions occurring at home. The results indicated that following training,
parents increased the frequency with which they required their children
to speak (i.e., modeled words and phrases, prompted answers to
questions). Correspondingly, all children increased the frequency of
their verbalizations in three nontraining settings. Thus, the NLP appears
to be an efficacious program for parents to learn and use in the home to
increase their children's speech.
DESCRIPTORS: parent training, natural language paradigm, autistic children, speech
Health.
The authors Chris Kimball and
thank
Jeffrey Yasuda for their graphics and Sandy
Sullivan, Julie McDonald, Nora Tann, John
One of the most debilitating and
Teeples, Joanna Kirshner, Trish Kurtz,
difficult to treat characteristics of Janice Milstein, Jerry Silliman, and Lori
autistic children is their severe Robles for their assistance in data collection
speech deficit (Rutter, 1978). and analysis.
Reprints may be obtained from Karen E.
Although researchers have reported
Laski, Affiliated Counselors &
success in increasing appropriate
Psychotherapists, 9530 E. Imperial Hwy.,
speech using clinic-based operant Suite L, Downey, California 90242, or
training proce Marjorie H. Charlop, Psy chology
dures (e.g., Lovaas, Koegel, Department, Claremont McKenna College,
Simmons, & Long, 1973), Clare mont, California 9171 1.
generalized improvement in
functional speech has been
disappointing (Fay & Schuler,
1980). One strategy used to enhance
generalization has been to train
parents to deliver the speech
therapy; however, problems still
remain. Some

This was a dissertation submitted by the


first author to Claremont Graduate School in
partial fulfillment for a Doctor of
Philosophy Degree in Psychology. The
research was sup ported by U.S.P.H.S.
research grants 39434 (Laura Schreib man,
Principal Investigator), 28210 (Robert L.
Koegel, Prin cipal Investigator), and 41706
(Marjorie H. Charlop, Principal Investigator)
from the National Institute of Mental
generalization and maintenance of
parent-training results (e.g.,
Harris, Wolchik, &
Weitz, 1981).
To address the problems associated
with tradi tional operant language
training procedures, re searchers
have explored the use of more
natural and loosely structured
language procedures such as
incidental teaching (Hart & Risley,
1968, 1974, 1975, 1980),
mand-model (Rogers-Warren &
Warren, 1980), and time delay
(Charlop, Schreib man, &
Thibodeau, 1985; Halle, Baer, &
Spradlin, 1981). Recendy, another
natural language proce dure, the
Natural Language Paradigm (NLP),
was designed for use with autistic
children in a clinic setting
(Koegel, O'Dell, & Koegel, 1987).
The NLP is similar to the
mand-model, in which teach ers
systematically prompt
verbalizations with mands, model
verbalizations if necessary, and
provide re inforcement following
appropriate verbalizations during
the children's play and preschool
activities. However, the NLP
studies suggest that traditional
operant language procedures are procedures differ from other natural
difficult and time consuming for language programs by combining
several
parents (e.g., Culatta & Horn,
1981); this perhaps accounts for poor

391
392 al.

KAREN E. LASKI et
tocol designed to increase
of the positive features of both motivation by varying tasks
traditional operant procedures and (Dunlap, 1984), increase responding
natural language procedures. Play by pro viding direct reinforcers
sessions are specifically presented, (Koegel & Williams, 1980), and
during which massed opportunities enhance generalization through loose
are provided for the child to use structure
speech, and all verbal attempts are and multiple exemplars (Stokes &
reinforced even though they may not Baer, 1977). The present study
be as elaborate or dear as expands upon the results of Koegel
previously emitted. A rapid et al. (1987), who initially
exchange of the toys continues demonstrated the efficacy of this
between the child and therapist promising language program. Their
while a wide variety of words and data suggested that, when used in a
phrases are modeled for the child. clinic setting with trained
Thus, the NLP is a child-initiated therapists, the NLP produced more
pro generalized speech for two autistic
children than did traditional
operant procedures. The pres ent
study was designed to enhance the
effects of the NLP on increasing
generalization of speech by teaching
parents to use the procedures in the
home. In our study, parents of 8
autistic children were trained to use
the NLP, and the effects of training
on parent-child verbal interactions
were examined in three
generalization settings.

METHOD
Subjects
Participants were 7 autistic boys
and 1 autistic like girl (ages 5 to
9.6 years old) and their primary
caretakers. The children were
diagnosed by two independent
agencies according to the criteria es
tablished by National Society for
Autistic Children (Ritvo & Freeman,
1978).
The nonverbal children (Children
1 through 4) were 5.8, 5.9, 5, and
9.6 years old with mental ages of
2.7, 3.10, 1.7, and 2.9 years.
Children 1, 2, and 4 could imitate
only sounds and a few words upon
request, rarely initiated speech, and
had re
ceptive vocabularies under
approximately 15 words. Child 3 was
functionally mute and had no
receptive vocabulary. The 4
echolalic children (Children 5

through 8), aged 6.2, 8.11, 5.4, and


6.2 years old with mental ages of
3.10, 3.7, 4.7, and 6.6 years,
respectively, had larger vocabularies
and occasion ally used short phrases. adjacent to the parent.
However, they rarely spoke Over successive 1 5-min individual
spontaneously and their speech parent-train ing sessions, parents
repertoires consisted received (a) a discussion of the NLP
primarily of highly specific, procedures, (b) two observations of
previously trained re sponses. All therapists conducting the NLP with
children were deficient in academic the child (one through a one-way
skills and social and play behaviors, mirror and one in the therapy room),
and engaged in self-stimulatory and (c) in vivo training. The
behaviors. experimenter was in the room during
To control for maturation, 6 the first two or three in vivo
nonhandicapped children and their training sessions and subsequently
mothers served as comparison observed through
subjects. The children, aged 2.2, a one-way mirror and provided
2.7, 3.9, 5.7, 6.7, and 9.8 years, feedback by inter com. Parents
were selected to match approxi received a minimum of five and a
mately the chronological and mental maximum ofnine training sessions
age range of the autistic children. until they reached the preestablished
The younger siblings (ages 2.8, 3.9, criterion (described below) for
and 3.10 years) of 3 autistic boys conducting the NLP. Parent behaviors
also participated to permit were scored during a 10-min NLP
assessment of generalization of session using a 10-s contin uous
parent behavior. partial interval scoring procedure
along the four basic criteria of the
Parent Training NLP. Assessment of par ents'
Parent training in NLP procedures proficiency in conducting the NLP
was con ducted in a small (2.9 by began in the fourth training session
2.9 m) therapy room equipped with and continued until par ents met
criterion in two consecutive training
a table and two small chairs. Parent
ses sions. All parents met criterion
and child participants sat facing
within nine sessions. NLP criterion.
each other at the side of the table
with toys placed on the floor Four key components of the

TRAINING PARENTS TO 393


INCREASE SPEECH
as direct reinforcement for the vo
NLP were used as criteria to assess calization. To meet criterion,
parents were required to reinforce
parents' NLP proficiency and to
establish when training was com 85% or more of their child's com
plete. Criterion levels were
municative attempts.
previously derived from careful (b) Turn-taking with the
observations of clinical staff stimulus material. During an NLP
conducting the NLP and from those session, control of the stimulus
material passes frequently between
used in Koegel et al. (1987). (A
the parent and the child. Thus, the
manual detailing the procedures for
parent takes a turn with the toy and
training parents can be obtained
models a target response (a
from the first author upon request.)
verbalization about that toy), the
(a) Direct reinforcement of
child receives the toy (for ap
verbal attempts. With the NLP, the proximately 10 s) following a
object or activity and praise are
verbal or commu nicative attempt,
used to reinforce all of the child's
and then the parent has another
verbal at tempts even if they are
turn or models another word or
not as dear or accurate as previous
attempts. For example, if the parent phrase. To meet criterion, control
models "throw ball" and the child of the stimuli was required to pass
responds "ba," he re ceives the ball between parent and child in at least
50% of the intervals.
(c) Task variation and multiple
exemplars. The NLP uses a variety
of tasks to illustrate the meaning
of a given word or activity.
Identical words are paired with
different referents (e.g., one can
"turn on" the music box or "take
turns"; and one can "open" a box
or "open" the door) and different
actions are paired with identical
referents (e.g., one can "blow"
and/or "pop" bubbles). Parents were
required to change stimulus
materials and/or the words modeled
in at least 50% of the intervals.
(d) Shared control. Shared control
occurs when the child is given the
opportunity to select a new toy,
when a change in the play activity
occurs fol lowing the child's verbal
request or gesture to do so, and
when the parent allows the child to
change the target word or phrase.
For example, the parent models
"blow bubbles," the child changes
the

phrase to "pop bubbles," and the


parent acknowl edges by repeating
"pop bubbles." Shared control
needed to occur at least five times
during the ses sion. training) located at the clinic, a
free-play setting in the child's
Parent-Child NLP Training home, and the clinic break room
where parents and therapists observe
Sessions After the second NLP
children during treat ment and
parent-training session, parents
where children usually take periodic
were instructed to conduct 15-min
breaks from their ongoing behavior
NLP sessions in the home four times
therapy. Parent-child verbal
per week. Thus, for several weeks,
interaction probes for the siblings
parents simultaneously received NLP
and non handicapped comparison
training at the clinic and conducted
group were taken only in the clinic
NLP sessions at home. Once parents play room.
met the NLP cri terion, parent-child
A variety of age-appropriate toys
NLP sessions took place only in the (e.g., puppets, balls, blocks) were
home (usually in the child's used during all NLP training
bedroom or in the living room). sessions and generalization probes.
Additionally, parents were asked to Behavioral definitions. Three
maintain a self-report log of the categories of be havior were
dates, times, and duration of NLP observed during the generalization
sessions and to note any problems probes and were based in part on
they were having for later those used by Koegel et al. (1987).
discussion.
The first, parent ver balizations,
occurred when the parent provided a
Baseline and Posttreatment discriminative stimulus for speech
Generalization Probes by requesting any kind of
Settings and materials. vocalization. This induded the
parent modeling word(s) to be
Generalization mea sures of
imitated (e.g., "I want car," "Block
parent-child verbal interactions for
is big") and asking a question
the autistic children were taken in
three locations: a large play room
(e.g., "What do you want?").
(not associated with therapy or
394 al.
394KAREN E. LASKI et
Child vocalizations included answers, which were responses that
imitations, which were verbal were contextually related to an
responses corresponding to the im immediately preceding verbal
mediately preceding parents' model; discriminative stim ulus such as
"What is this?"; and spontaneous tion free-play sessions to reduce
speech, defined as vocalizations demand charac
that did not have an immediate teristics.
verbal discriminative stimulus but Home free-play probes were also
were related to the context of the obtained dur
play session. ing 10-min videotaped sessions at
The frequency of echolalia was sites selected by parents. Parents
observed as an ancillary behavior. were asked to assemble a variety of
Immediate echoes were defined as toys and play with their child.
inappropriate repetitions of words Video equipment was placed as far
or phrases just emitted by the away as possible, and the camera
parent (e.g., in response to "What operator remained in another room
do you want?" the child responds, during taping. Home probes were
"What do you want?"). In contrast, randomly interspersed and scheduled
imitations were appropriate at parents' convenience.
repetitions, such as when the parent Break room data were collected
models "The ball is red" and the during 5-min segments of the
child responds "The ball is red." children's break from therapy at 1-
Similarly, delayed echoes were to 2-week intervals, and were
defined as non recorded on video equipment placed
functional repetitions that were out at one end of the room. Once again,
of context with the play activities parents were accustomed to
(e.g., while playing ball the child recording devices in this room.
recites lines from a TV commercial).
Design and procedures. A Reliability
multiple baseline design across Observers were graduate and
subjects was used with verbal inter undergraduate stu dents working at
action probes for the autistic the behavior therapy clinic. Using
children obtained in the three previously recorded sample probes,
generalization settings described
observers were trained (i.e., trial
above. Four probes were obtained scoring, feedback, rescoring) to
with the nonhandi capped score video recordings of
comparison children at monthly parent-child interactions. Actual
intervals. A multiple baseline was coding began when interobserver
used for probes of parents with reliability reached 85% on the
their autistic children's siblings.
sample tapes.
Baseline probes in the clinic play
Parent-training sessions.
room were obtained during weekly
Interobserver reliabil ity of
10-min sessions videotaped through
parents' proficiency in using NLP
a one-way mirror and were later
scored using a 10-s continuous procedures was obtained on 65% of
partial interval scoring procedure. the NLP parent-training sessions
Posttreatment probes began 1 week with percentage agreements
after parents met NLP criterion. calculated by dividing agreements
Before each observation, parents by the total number of agree ments
were instructed to engage in plus disagreements for each
free-play ac behavior and multiplying by 100.
tivities with their child including Mean point-by-point agree ment
toy play, cuddling, and percentages for occurrences and
conversation. Parents were nonoccur rences, respectively, were:
accustomed to this instruction and reinforcing attempts, 88% (range,
to the videotaped free-play
77% to 98%) and 89% (range, 79%
sessions, because similar procedures
were a routine part of the dinic's to 98%); turn-taking, 84% (range,
ongoing program evaluation. 79% to 88%) and 86% (range, 80%
Further, probes were intermixed to 88%); task variation, 89%
with the program evalua (range, 80% to 95%) and 90%
(range, 81% to 96%); and shared dinic and home free-play settings,
control, 94% (range, 85% to 97%) agreement for occurrence and
nonoccurrence of par ent
and 97% (range, 88% to 97%).
verbalizations was 90% (range, 66%
Parent-child generalization
probes. Interob server reliability to 100%) and 89% (66% to 100%),
was obtained on 49% of all gen respectively. For the combined
eralization probes and was category, child vocalizations
calculated as described above. In the (imitations,
TRAINING PARENTS TO INCREASE SPEECH 395
Baseline Post-teaunent Baselie Post-teatment

sco soo

1'00 100
..s
.~~Cil
5
~~~~ ~~~~~Cd1 0Child

t
100 100

50O.O' C*-hild2 0 Child 6 '100

50 2 10
so so
0
free-play0settings.) ____C(ihdd7

100 *100

50 50

Child 3

0~~~O~OOO-O ~~(withMor) 0 1Child 8 L...... ~~~0 2 4 6 8 10 12 14


16 18 20
cmie
Fiur 1. Paetvraiain n hl oaiain mttosnwradsotnossech)id7h
100

Free-play Sessions

0Y Child 4
0 2 4 6 8 1O 12 14 16 18 20
Free-play Sessions
Parent verbalizations and child vocalizations (combined imitations, answers, and
Figure 1.
spontaneous speech) in the
free-play settings.

396 al.

KAREN E. LASKI et
answers, and spontaneous speech in (range,69% to 100%) and 96%
the clinic and home free-play (range,88% to 100%), respec tively,
settings), mean occurrence and non and 96% (range, 88% to 100%) and
occurrence agreement was 87% 97% (range, 89% to 100%) for
echolalia. In the break room, mean observed for Child 8 (baseline M =
occurrence and nonoccurrence reli
ability was 78% (range, 50% to =
100%) and 91% (range, 67% to 11%; posttreatment M 62%) and
100%) for parent verbalizations, 87% Child 6 (baseline M =
13%;
(range, 67% to 100%) and 90%
(range, 77% to 100%) for child posttreatment M = 65%).
vocalizations, and 96% (range, 88% Comparative Data
to 100%) and 97% (range, 89% to Parent verbalizations.
100%) for echolalia. Posttreatment increases of lower
magnitude were also observed in
RESULTS parent verbalizations with the
siblings. Baseline and post treatment
Changes in Parent and Child means and ranges were: Sibling 1,
Verbal Behavior Free-play settings.
base line M = 50% (48% to 51%)
Changes in the parents' and their
autistic child's verbal behavior are and posttreatment M = 65% (57% to
presented in Figure 1. All parents 75%); Sibling 2, baseline M = 48%
increased the percentage of intervals
(42% to 58%) and posttreatment M
in which they presented a
= 67% (57% to 77%); Sibling 3,
discriminative stimulus to which
their child could respond vocally. baseline M = 33% (30% to 35%) and
The greatest increase was seen in posttreatment M = 45% (33% to
the verbalizations 64%). This suggests that the parents
of Child 2's mother (baseline M = were also more verbal with their
other children after the NLP
34%; post treatment M = 84%) and
training.
the smallest, but still substantial,
Parent verbalizations for the
gain seen with Child 7's mother
comparison mothers of
(base line M = 48%; posttreatment nonhandicapped children were
M = 67%). generally lower and relatively stable
All children increased the across the four monthly probes, with
percentage of intervals in which means and ranges for each of 29%
they vocalized. Child 3, who was the (15% to 42%), 27% (20% to 33%),
least verbal during baseline, showed 24% (22% to 27%), 25% (13% to
the greatest gains (baseline M = 37%), 21% (18% to 27%), and 12%
(7% to 17%).
0%; posttreatment M = 27%). In
Child vocalizations. Table 1
contrast, Child 7, who was the most
presents the mean and range of each
verbal during baseline, showed only
child's vocalization by type (im
minimal gains (baseline M itation, answers, and spontaneous
= 68%; posttreatment M = 72%). speech) in the clinic free-play
Break room setting. Posttreatment setting. Data obtained in the home
increases in parent verbalizations free-play and break room settings
were observed for all but one of the are not presented; however,
caregivers (Child 4's aunt), with individual children's verbal
greatest gains seen for parents of behavior was similar across all
settings. Increases in imitations were
Child 2 (baseline M =
observed for all of the autistic
4%; posttreatment M = 47%) and children, with the greatest increases
parents of Child 6 (baseline M = observed with Children 2, 5, and 8.
4%; posttreatment M = 62%) (see Answers increased for 4 of the
autistic chil dren (Children 1, 2, 4,
Figure 2). Correspondingly,
posttreatment in creases in child and 5), remained relatively
vocalizations were observed for all unchanged for Children 6 and 7, and
children, with greatest gains decreased for Child 8. Slight
increases in spontaneous speech were relatively un
observed for Children 1, 3, 6, and 8, changed across the four probes.
whereas others remained relatively Although these data varied
stable. considerably from posttreatment
For the siblings, slight increases data in terms of frequency and
were observed in imitation for content of verbalizations, when
Sibling 2, in answers for Siblings 2 considered from a normative
and 3, and in spontaneous speech for perspective they must be considered
Sibling 3. As expected, the in the context of the purpose of our
frequency of vocalizations for the
nonhandicapped children remained
TRAINING PARENTS TO 397
INCREASE SPEECH

100-

50

100

50
Parent v
Baseline Post-utmaent SO .. -I

L .......

100-
< Child

Child I
0I
so0

AI__
So
100

s o

SO
100
100-
I
a
Baseline
Post-aunent "a
50
I

I'
I
' ~~Chid 2 . . . IsI; .
.__.J~~~~~~~~~
II

II

______________
Child 7

Child s

* *Cw
* -uix

Child 3

00-
Child 3
f'''
(with Momi

SO .C .
I

I"Al
W .I I "

- .'
o *_ _ * __ _ . . . 0

0V-a_ ChldS6
0 2 4 6 8 10
(with Dad) 0 tOO Break-room
100- o0-
Sessions

SO
Iis.~~~~~~~~~~~~

8
0 2 4 6 10
Break-room Sessions
and
Figure 2. Parent verbalizations and child vocalizations (combined imitations, answers,
in
spontaneous speech) the break room setting.
KAREN E. LASKI et al.
398

Table 1
Mean (and Range) Percentage of Intervals of Child Vocalizations in Clinic Free-Play
Setting

Imitations Answers Spontaneous

Post- Post- Post


Baseline treatment Baseline treatment Baseline treatment Autistic children

1 0 29 (20-37) (20-40) 7
With Mom 6
7 14 -10) (8-20) 13 23 (2-20) (2-10) 1 (0-20) 27
2 (10-37) 11 23
(2 (0-3) 0 (7-52) 26
21 66 (5. (3-19) (10-38) (0-65)
3 -23) (56-77) 0 (Not measured) 0
With Dad 3 21 (15-25) 29
(Not measured)
4 5 6 7 8 9 39 -15) (3. Siblings 1 2
(30-47) 4 (0-7) (0-5)
23
16 47 -38) (5. (0-12) 19 17 13
(10-37) 33
(37-63) 4 8 -15) (5-32) 46 (7-25) 14 (5-22) 29
(2-14) (13-53) 41
(0 (37-52) 41 (8-20) 29 (12-43) 35
6 54 -11) (0 (33-50) 43
(23-50) 40 (21-43) 12 (17-57) 27
(40-72) 13 51 -25) (33-52) 20
(25-55) (0-25) (15-33)
(2. (40-60) (15-28)
20 (26-32)
15
Comparison (30-59) 35
(18-22) 6 (7-22) 18 34 children 35 (30-40) 28
(3-7) (3-35) 4 (33-35) 38 (28-43) 29 (20-33) 45
2 3 3 (3-5) 22 (28-48) 48 (20-40) 29 (31-55)
(0-5) 29 (10-35) (43-52) 39 (22-35)
(0-3) 0 19 (11-27) 17 33 (7-60)
1 (0-3) 0 (13-22) 11 (8-18) 28 (23-35) 46
10 (5-18) 17 28 (15-42) 31 (30-57)
2 3 4 5 6
(15-22) 25 (22-28) (13-50) 30 (23-42)
14 (2-22) 1 (0-3) 1

intervention, which was to increase Children 2, 3, 4, or 7. In the


the autistic chil dren's vocalizations free-play settings, slight posttreatment
and the frequency with which parents de creases were observed in the echolalic
set the occasion for speech. =
behavior of Child 1 (baseline M 3%;
Ancillary Child Behavior: Echolalia posttreatment M = 1%), Child 6
There was no echolalic behavior =
(baseline M 30%; posttreatment
observed throughout the study for
= parent training program designed to
M = 19%), and Child 8 (baseline M
increase autistic chil dren's verbal
11%; posttreatment M = 3%). No behavior. Posttreatment increases in
differences in echolalia were observed parents' requests for vocalizations from
in the break room.
their autistic children were observed in
the generalization set

DISCUSSION
This study presented a promising new

TRAINING PARENTS TO INCREASE SPEECH 399


tings. Additionally, parents showed generalization effects are
evidence of generalizing these encouraging in that they may
behaviors with the siblings of their provide additional support for the
autistic children. These motivating qualities of natural lan
guage programs for both parent and not have been interacting similarly
child (Halle, 1984). when not under observation. Third,
The autistic children appeared to the logs maintained by parents were
be more ver bally responsive self

following NLP training. This is report measures and as such


contained no inde pendent validation
quite noteworthy given that the
of their accuracy. Future re search is
primary reinforce ment for parents in
needed to assess more adequately
promoting verbal skills is often
parents' long-range proficiency in
successful communication and
conducting the NLP and continued
changes in the child's communicative
competence (Rogers-Warren & use of the NLP in the home. Fourth,
Warren, 1984). In addition, increases parents and children in this
investigation were con currently
in children's appropriate speech were
participating in a behavioral clinic
not accompanied by in creases in
pro gram that may have influenced
echolalia. Perhaps the NLP took
acquisition of NLP training skills.
advan tage of the children's
Finally, some measures of social val
echolalia by converting it to
idation may determine the
appropriate imitative speech
naturalness and appro priateness of
(Charlop, 1983; Pri zant, 1984).
parents' interactions and the
It was also important to determine
children's
whether par ents maintained the
speech following NLP training.
training sessions in the home.
Efforts are currently underway to
According to their self-report logs,
address some of these issues.
parents of the nonverbal children
reported that they consistently
implemented the program, whereas REFERENCES
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their parents' inconsistent use of Behavior Analysis, 16, 111-126.
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Thibodeau, M. G. (1985). Increasing
NLP procedures may be quite spontaneous verbal responding in autistic
powerful in eliciting speech. children using a time delay procedure.
Additionally, the parents who did Journal of Applied Behavior Analysis,
18, 155-166.
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Culatta, B., & Horn, D. (1981). Systematic
did report that they were modification of parental input to train
incorporating principles of NLP into language symbols. Language, Speech, and
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Fay, W. H., & Schuler, A. L. (1980).
some questions that might also be
Emerging language in autistic children.
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Received March 3, 1987
Initial editorial decision April 30, 1987
Revisions received August 3, 1987;
January 19, 1988; May 13, 1988;
July 17, 1988
Final acceptance July 27, 1988
Action Editor, Nancy A. Neef

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