***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE This r and omized group experiment compared the efficacy of 2 communication interventions ( Responsive Education and Prelinguistic Milieu Teaching [ RPMT ] and the Picture Exchange Communication System [ PECS ] ) on spoken communication in 36 preschoolers with autism spectrum disorders ( ASD ) . METHOD Each treatment was delivered to children for a maximum total of 24 hr over a 6-month period . Spoken communication was assessed in a rigorous test of generalization at pretreatment , posttreatment , and 6-month follow-up periods . RESULTS PECS was more successful than RPMT in increasing the number of nonimitative spoken communication acts and the number of different nonimitative words used at the posttreatment period . Considering growth over all 3 measurement periods , an exploratory analysis showed that growth rate of the number of different nonimitative words was faster in the PECS group than in the RPMT group for children who began treatment with relatively high object exploration . In contrast , analogous slopes were steeper in the RPMT group than in the PECS group for children who began treatment with relatively low object exploration The context for this work was an evaluation study [ Carr , D. , & Felce , J. A. ( in press ) ] of the early phases of the Picture Exchange Communication System ( PECS ) [ Frost , L. A. , & Bondy , A. S. ( 1994 ) . The picture exchange communication system training manual . Cherry Hill , NJ : Pyramid Educational Consultants , Inc. ; Frost , L. A. , & Bondy , A. S. ( 2004 ) . The picture exchange communication system training manual , 2nd edn . Newark , DE : Pyramid Educational Consultants , Inc. ] . This paper reports that five of 24 children who received 15 h of PECS teaching towards Phase III over a period of 4–5 weeks , showed concomitant increases in speech production , either in initiating communication with staff or in responding , or both . No children in the PECS group demonstrated a decrease in spoken words after receiving PECS teaching . In the control group , only one of 17 children demonstrated a minimal increase and four of 17 children demonstrated a decrease in use of spoken words after a similar period without PECS teaching The study investigated the impact of mastery of the Picture Exchange Communication System ( PECS ) to Phase III , on the communications of children with autism . Children aged between 3 and 7 years , formed a PECS intervention group and a non-intervention control group . The intervention group received 15 h of PECS teaching over 5 weeks . Three 2-h classroom observations recorded communications between the children and their teachers . These occurred : 6 weeks before teaching ; during the week immediately prior to teaching ; during the week immediately following teaching . For the control group , two 2-h observations were separated by a 5-week interval without PECS teaching .  Communicative initiations and dyadic interactions increased significantly between the children and teachers in the PECS group but not for the control group OBJECTIVE To assess the effectiveness of expert training and consultancy for teachers of children with autism spectrum disorder in the use of the Picture Exchange Communication System ( PECS ) . METHOD DESIGN Group r and omised , controlled trial ( 3 groups : immediate treatment , delayed treatment , no treatment ) . PARTICIPANTS 84 elementary school children , mean age 6.8 years . TREATMENT A 2-day PECS workshop for teachers plus 6 half-day , school-based training sessions with expert consultants over 5 months . OUTCOME MEASURES Rates of : communicative initiations , use of PECS , and speech in the classroom ; Autism Diagnostic Observation Schedule-Generic ( ADOS-G ) domain scores for Communication and Reciprocal Social Interaction ; scores on formal language tests . RESULTS Controlling for baseline age , developmental quotient ( DQ ) and language ; rates of initiations and PECS usage increased significantly immediately post-treatment ( Odds Ratio ( OR ) of being in a higher ordinal rate category 2.72 , 95 % confidence interval 1.22 - 6.09 , p < .05 and OR 3.90 ( 95%CI 1.75 - 8.68 ) , p < .001 , respectively ) . There were no increases in frequency of speech , or improvements in ADOS-G ratings or language test scores . CONCLUSIONS The results indicate modest effectiveness of PECS teacher training/consultancy . Rates of pupils ' initiations and use of symbols in the classroom increased , although there was no evidence of improvement in other areas of communication . TREATMENT effects were not maintained once active intervention ceased The purpose of this study was to determine ( 1 ) whether comprehension , production , and spontaneous use of language are greater following language training by sign-alone , speech-alone , simultaneous communication , or alternating between speech and sign ; ( 2 ) whether high- and low-verbal imitators benefit from the same mode of treatment ; and ( 3 ) whether retention of the language skills differs among the four training conditions . Subjects were 60 moderate to severe autistic children r and omly assigned to one of four treatment conditions . Subjects were divided into high- and low-verbal imitators based on verbal imitation performances . The results indicated that the high-verbal imitators did equally well in all four treatment conditions , while the low-verbal imitators did poorest in the speech-alone condition . The high-verbal imitators performed better than did the low-verbal imitators in all of the treatment conditions . Words or signs learned were retained for three months after treatment regardless of the treatment condition or level of imitative ability . The results were discussed in terms of the efficacy of using sign language with autistic children This study was carried out to test the main and interaction effects of training condition and pretreatment-elicited verbal imitation ability when predicting spoken language use during language training of 60 minimally verbal autistic children . Subjects were r and omly assigned to  Speech Alone , Sign Alone , Simultaneous Presentation of Sign and Speech , and Alternating Presentation of Sign and Speech training conditions . Speech Alone , Simultaneous Presentation , and Alternating Presentation condition facilitated more child-initiated speech during treatment than did the Sign Alone condition . Regardless of training condition , pretreatment verbal imitation ability positively predicted the size of child-initiated spoken vocabulary observed during training . Exploratory analyses indicated that , in addition to verbal imitation , pretreatment age and IQ may also predict spoken language developed during training 
    Output:
    
Results indicated that AAC interventions do not impede speech production .
In fact , most studies reported an increase in speech production .
However , in-depth analyses revealed that the gains were rather modest .