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Department of Health Sciences

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Elizabeth Crais, PhD

Professor Emerita

Division of Speech and Hearing Sciences

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Education

  • PhD, University of Wisconsin 1987
  • MS, Vanderbilt University 1974
  • BS, University of Alabama 1972

Personal Statement

I joined the DSHS faculty in 1986 as a visiting assistant professor while finishing my dissertation. In 1987, I was fortunate enough to be selected to fill the position full-time. Currently, I am a professor, mother, wife, sister, faculty advisor for the student Autism Speaks U chapter at UNC-CH, and active in my neighborhood association. I am an avid reader, who loves the beach and the mountains and so am very happy to live in Chapel Hill, North Carolina which is mid-way between the mountains and the beaches. I encourage you to visit (or better yet live) here in this Tar Heel side of heaven. Life is very good here.

Teaching Philosophy

Years ago, I encountered and was intrigued by the following quotation: “In teaching, it is the method and not the content that is the message… the drawing out, not the pumping in,” (Montague, 1990). I agree with Montague in that I believe strongly that the method is a primary element in teaching any content and that it is the “drawing out” that should be one of our primary goals. Thus, my own teaching attempts include as many adult learning principles as I can accommodate in my classes throughout the class activities, readings, assignments, and evaluation methods. Fortunately, there is a growing body of literature regarding how best to promote self-directed learning and the transfer of information. Our challenge as educators is to utilize those principles and methods in our classes, workshops, and clinical supervision. Returning to Montague’s quotation regarding content, this is an area where we disagree. Although according to Montague, content may be secondary to method in teaching, I do not dismiss the importance of the content itself to the retention of what is learned and how it is applied. Within any academic area that also has a clinical or applied component (e.g., my own area focuses on the identification and assessment of and intervention with young children with communication disorders, particularly those with autism spectrum disorder, ASD), the need is great to provide content and skills that are both relevant and applicable to working with children and their families. Moreover, in valuing both content and method, a major part of our teaching mission becomes helping students and practitioners integrate new information with their existing knowledge base and challenging them to see the relevance and application of the material to life. In this way, as students and practitioners encounter new content, they will have strategies to explore and master that content. As Pearl S. Buck once wrote: “The secret of joy is contained in one word – excellence. To know how to do something well is to enjoy it.” I enjoy both my work and my life and I hope that there is some excellence in both.

Courses Currently Taught:

  • SPHS 864 Seminar in Language (MS level)
  • EDUC 862 (co-teach) Teaching and Personnel Development (PhD level)
  • SPHS 802 Doctoral Seminar in Prelinguisitic and Early Linguistic Communication Behavior (PhD level)
  • AHSC 913 Survey Design (PhD level)

Research Interests:

The kinds of research activities that I engage in are those that have direct application to providing services to young children with special needs and their families. Over the years, I have been part of a research team called the Program for Early Autism Research, Leadership, and Service (PEARLS) that has included Drs. Linda Watson, Grace Baranek, our late colleague Steve Reznick, and Lauren Turner-Brown. We collectively developed a parent-report tool, the First Year Inventory (FYI), focused on identifying 12-month-old children who are at risk for ASD and other communicative disorders. We piloted the tool with more than 1,100 families and followed those children at three years of age to identify the sensitivity and specificity of the tool (Turner-Brown et al., 2012). In addition, we are currently working on an expansion of the FYI (First Years Inventory) to screen children 10 to 16 months of age and have already collected normative data on thousands of children. Further, there are other researchers in and outside of the U.S. who are using the FYI with additional sets of children. Our ultimate goal is for physicians and other front-line providers who see children and families in the first two years of life to use it to screen all children for ASD. Recent studies focused on the FYI include Stephens et al. (2020) examining infant attentional behaviors are associated with ADHD symptomatology and executive function, and Stephens et al. (2018) identifying infant quantitative risk for autism spectrum disorder predicting executive function in early childhood.

We finished a pilot study (Baranek et al., 2015) and then completed a randomized control trial intervention study with 87 young children identified as at high risk on the FYI to examine the effects of early intervention begun at 14 months (Watson et al., 2017). The intervention is home-based and parent-mediated to improve the social communication and sensory skills of these young children. A few manuscripts detailing the study are Kinard et al. (2017) examining parents’ responsivity to their children, Nowell et al. (2020) looking at joint attention and sensory-regulatory features at 13 and 22, and Garrido et al. (2017) on early vocalizations. In addition, another project led by Drs. Brian Boyd and Linda Watson has examined the effectiveness of a preschool intervention developed by our team for young preschool children with ASD across four sites. The intervention is focused on facilitating joint attention and symbolic play skills in these young children within their preschool environments through working with their teachers and related service providers (Dykstra et al. 2012, 2015). The current extension of this study is to now develop a mobile application for parents and teachers to communicate around the intervention to extend school goals and progress to home settings.

We have also continued our work in looking retrospectively at the gesture development (Watson et al. 2012), and play development (Wilson et al., 2017) of young children (9 to 12 and 15 to 18 months of age) who have been diagnosed with ASD, have developmental disabilities, or who are typically developing. We have used videotapes collected of the children when they were in the first year of life and identified the type and function of the gestures used by the children in communication with their parents.

With a group of interdisciplinary professionals as part of the Autism State Implementation grant, we conducted eight focus groups with families of children birth to age eight diagnosed with ASD (four English speaking, two Spanish speaking, and two American Indian) and completed a survey with more than 400 North Carolina families of young children with ASD. These efforts have been aimed at identifying the facilitators and barriers to early identification, diagnosis and entry into early intervention for these children (Crais et al, 2020; Martinez, et al., 2018)..

Related to service activities and given the gap in early identification of underrepresented children, we developed a faith-based initiative. The project included Dr. Pretzel at the Carolina Institute for Developmental Disabilities and Maureen Morrell with the Autism Society of North Carolina. We utilized faith communities to reach underrepresented children at risk for ASD and their families. We worked with faith leaders and members to introduce them to early signs of ASD as well as help them gain strategies for including people with ASD in their faith communities. Following the project, a manual (Autism and Faith Communities: Welcoming and Supporting Families, 2018) was developed to guide others in setting up this type of initiative. We also worked with the Centers for Disease Control and Prevention’s “Learn the Signs. Act Early.” materials to raise awareness about development milestones and red flags for ASD to professionals and families in 14 rural counties in North Carolina.

Finally, Dr. Becky Pretzel from the Carolina Institute for Developmental Disabilities and I have received a grant (2019-2021) from the Health Services Resource Administration to work closely with pediatricians across the state and their staffs to enhance screening and referral practices in North Carolina. Part of this project also includes developing a family navigation guide and model for working with families of children with a disability including autism spectrum disorder. Once the guide is developed, we will be working with agencies and organizations across NC to train family navigators to use the family navigation guide and model. Our partners include Tamara Norris & Barbara Leach, Family Support Program; Kim Tizzard & Kerri Erb, Autism Society of North Carolina; Wanqing Zhang (methodologist, UNC-CH); Kori Flower, UNC Pediatrics; & Marian Earls, Community Care of North Carolina; and Doanne Ward-Williams (Project Coordinator).

Training Grants

I am also the Co-Director (along with Dr. Harriet Able in Applied Developmental Science and Special Education, and Dr. Nancy Bagatell in Occupational Science/Occupational Therapy) of three PhD level grants funded by the Office of Special Education from the U.S. Department of Education. All three grants focus on preparing PhD students in specialty areas such as ASD, translational and community engaged research, closing the research to practice gap, and developing meaningful outcomes for children with disabilities and their parents. All three grants support PhD level students from the three represented programs. The process to be eligible to participate in these grants is to first be accepted into one of the three participating PhD programs.

Referred Publications

(*current and former students):

  1. Uzonyi, T., Page, J., DuBay, M., & Crais, E. (2022). Perceptions on Screening for Developmental Disabilities and Autism in Child Care Settings. Infants and Young Children. Infants & Young Children, 35 (2), April/May 2022.
  2. Baranek, G. T., Sideris, J., Chen, Y.-J., Crais, E. R., Turner-Brown, L., & Watson, L. R. (2022). Early measurement of autism risk constructs in the general population: A new factor structure of the First Years Inventory (FYIv3.1) for ages 6–16 months. Autism Research, 1–14. https://doi.org/10.1002/aur.2691
  3. Chen, Y., Sideris, J., Watson, L., Crais, E., & Baranek, G. (2022). Developmental trajectories of sensory patterns from infancy to school age in a community sample and associations with autistic traits. Child Development, DOI: 10.1111/cdev.13745.
  4. Stephens, R., Elsayed, H., Reznick, S. Crais, E., & Watson, L. (2021). Infant attentional behaviors are associated with ADHD symptomatology and executive function in early childhood. Journal of Attention Disorders, Vol. 25(13), 1908–1918.
  5. *Artis, J., Watson, L., & Crais, E. (2021). Parent Coaching Behaviors used within an Adaptive Responsive Teaching Intervention. Journal of Early Intervention, Research Report, 1-22.
  6. Davis, P., Elsayed, H., Crais, E., Watson, L., & Grzadzinski, R. (2021). Caregiver Responsiveness as a Mechanism to Improve Social Communication in Toddlers: Secondary Analysis of a Randomized Controlled Trial. Autism Research.1-13.
  1. Grzadzinski, R., Nowell, S.W., Crais, E.R., Baranek, G.T., Turner-Brown, L., & Watson, L.R. (2021). Parent Responsiveness Mediates the Relationship between Child Hypo-reactivity at 12 months and Child Communication at 24 months. Autism Research;14:2027–2037. https://doi.org/10.1002/aur.2557
  2. Uzonyi, T., Crais, E., Watson, L., Nowell, S., Baranek, G., & Turner-Brown, L. (2021). Measuring Transactional Engagement Among Young Children with Elevated Likelihood for Later Autism Spectrum Disorder Diagnosis. Journal of Autism and Developmental Disorders, ttps://doi.org/10.1007/s10803-021-05124-3.
  3. Crais, E. (2021). Early Identification of Young Children with ASD and Other Developmental Disabilities: Areas for Improvement. Medical Research Archives, vol 9 issue 5.
  4. Lee HY, Vigen C, Zwaigenbaum L, Smith IM, Brian J, Watson LR, Crais ER, Baranek GT. (2021). Construct validity of the First-Year Inventory (FYI Version 2.0) in 12-month-olds at high-risk for Autism Spectrum Disorder. Autism, 25(1):33-43.
  5. Crais, E., McComish, C., Kertcher, E., Hooper, S., Pretzel, R., Mendez, L., & Villalobos, M. (2020). Autism Spectrum Disorder Identification, Diagnosis, and Navigation to Services:  Learning from the Voices of Caregivers. Focus on Autism and Other Developmental Disabilities, 35(4) 246–256.
  6. Crais, E. & Harrison Savage, M. (2020). Communication Sciences and Disorders PhD Graduates’ Perceptions of Their PhD Program. Perspectives: Special Interest Group 10 – Issues in Higher Education, 1-18.
  7. Nowell, S., Watson, L., Crais, E., Baranek, G., Faldowski, R., & Turner-Brown, L. (2020). Joint Attention and Sensory-Regulatory Features at 13 and 22 Months as Predictors of Preschool Language and Social-Communication Outcomes. Journal of Speech, Language, and Hearing Research, 63(9), 3100-3116.
  8. Jackman, T., May, W., & Crais, E., (online). Understanding Mississippi’s Current Practices Concerning Autism Screening at 18 & 24 Months. Social Work in Public Health, https://www.tandfonline.com/loi/whsp20.
  9. Nowell, S., Regan, T., Amsbary, J., Crais, E. & Able, H. (2020). The impact of service-learning on undergraduate awareness and knowledge of Autism Spectrum Disorder. Journal of Higher Education Outreach and Engagement, Volume 24, Number 1, p. 55-72.
  10. Lee, H., Vigen, C., Zwaigenbaum, L., Bryson, S., Smith. I., Brian, J., Watson, L., Crais, E., Turner-Brown, L., Reznick, J.S., & Baranek, G.T. (2019). The Performance of the First Year Inventory (FYI) Screening on a Sample of High-Risk 12-month-olds Diagnosed with Autism Spectrum Disorder (ASD) at 36 months. Journal of Autism and Developmental Disorders, 49, pages4957–4973.
  11. Crais, E. (2019). Autism Spectrum Disorder. In M. Ball & J. Damico (Eds.), SAGE Encyclopedia of Human Communication Sciences and Disorders. Thousand Oaks, CA: Sage.
  12. Eshghi, M., Adatorwovor, R., Preisser, J., Crais, E. & Zajac, D. (2019). Vocabulary growth from 18 to 24 months of age in children with and without repaired cleft palate. Journal of Speech, Language, and Hearing Research, https://doi.org/10.1044/2019.
  13. Reinhartsen, D.B., Tapia, A.L., Watson, L., Crais, E., Bradley, C., Fairchild, J., Herring, A. H. & Daniels, J. (2019). Expressive dominant vs. receptive dominant language patterns in young children: Findings from the Study to Explore Early Development. Journal of Autism and Developmental Disabilities. https://doi.org/10.1007/s10803-019-03999-x.
  14. Stephens, R., Watson, L., Crais, E., & Reznick, S. (2018). Infant quantitative risk for autism spectrum disorder predicts executive function in early childhood. Autism Research, 11 (11), 1532-1541.