Communication access in action: evaluating AAC supports for young children in a community museum

Children with Autism Spectrum Disorders: Three Case Studies

Supporting Families of Children Who Use AAC

What is augmentative and alternative communication?: Augmentative and alternative communication (AAC) describes the ways people communicate without, or in addition to, speech.What do we know about AAC for autistic adults who can speak?: Research on AAC and autism has focused on nonspeaking children. However, autistic adults who use AAC sometimes tell each other about AAC. This community knowledge includes reasons AAC is important, useful AAC strategies, and barriers to AAC use. This article talks about autistic community knowledge about AAC and then makes suggestions.Why is AAC important for autistic adults who can speak?: Autistic adults, including those who talk, may not always be able to meet all their communication needs with speech alone. Autistic people who use speech may experience intermittent, unreliable, and/or insufficient speech.What AAC strategies do speaking autistic adults use?: The three main ways that autistic adults report on using AAC include: (1)Free or low-cost tools that are not specific to AAC (e.g., online chat rooms, text messaging applications, or handwriting).(2)Mobile applications designed for communication support.(3)Signed languages such as American Sign Language.What are some common barriers to AAC use for speaking autistic adults?: Several barriers may prevent AAC use. These include the following: Knowledge of AAC optionsAttitudes about who AAC is useful forBeliefs that the use of AAC should be decreased if a person can speakCost of AAC devices and applications.What are our recommendations to autistic adults who might use AAC and their supporters?: Support autistics in defining their own communication needs, regardless of speech.Evaluate communication goals and match them with system features when making decisions about AAC.Prioritize all communication, not just speech.Explore a variety of options to support communication.Explore low- and no-cost options to support communication. What are some research questions that still need to be answered?: What communication strategies do autistic adults see as effective?What AAC strategies are being used, in what environments, and by whom?What prevents effective AAC use?How can AAC specialists and autistic adults best collaborate to promote and evaluate AAC use?How can communication supports be designed to better meet the needs of autistic adults?

Evidence-Based Practice in AAC

Literacy in Ireland

Access to Justice: An SLP’s Guide to Helping Persons with Complex Communication Needs Voice Their Case

You have accessThe ASHA LeaderGet Social1 Jul 2015Where Social Media Meets AACThe tech-heavy world of augmentative and alternative communication is well-suited for social media sharing. Vicki ClarkeMS, CCC-SLP Vicki Clarke Google Scholar More articles by this author , MS, CCC-SLP https://doi.org/10.1044/leader.GS.20072015.np SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In The families in our clinic pushed me into the world of social media several years ago. After a little investigation, we jumped wholeheartedly into online socializing with a Facebook page, Twitter and Tumblr accounts, Pinterest boards, an updated blog, secondary blog and, more recently, Instagram. Although social media has its share of selfies, dessert pictures and complaints about traffic, it’s also a wonderful source of information, resource sharing and connections for speech-language pathologists interested in augmentative and alternative communication (AAC). As professionals and families enjoy better access to AAC through mobile technology, the need for support, advice and resource-sharing also increases. AAC specialists are in short supply and demand is growing. Social media allow specialists to quickly share information with parents, SLPs and teachers. Clients and pros can find information on AAC in a variety of social media formats. There are blogs, video/photo-sharing, link shares and chats. Each has its advantages, so let’s take a look! Blogs By far, blogs give the most detailed information about techniques, equipment, apps and concepts. Some of my favorite bloggers are parents of children using AAC. These writers bring us distinctive views into the realities of raising AAC users. We celebrate, empathize and learn with these parents as they discuss daily experiences. My favorites: Kreed’s World Uncommon Sense There are wonderful professional blogs as well—my top three: PrAACtical AAC Teaching Learners With Multiple Needs Speak For Yourself Twitter Twitter users typically share links, photos and brief tips. Look for resources from our sister specialties of assistive technology and special education, which often also are relevant to AAC. I follow people from a variety of these related specialties. People highlight posts through hashtags, so search #augcomm or #aac to find pertinent tweets. #WeSpeechies posts frequently about AAC as well. Here are some “peeps” I follow: Kate Munro @speechiekate. ISAAC @ISAAC_AAC. US Society for AAC @USSAAC. Bronwyn Hemsley @BronwynHemsley. Gail Bennell @gailbennell. Jeremy Legaspi @azspeechguy. Facebook Facebook users post prolifically about AAC. Families, companies, individuals and AAC users themselves post pictures, videos, links, articles and personal stories. There are also Facebook groups that support AAC users, families and professionals. Here are a few to look up: Augmentative Communication Resources & Help AAC Language Lab AAC for the SLP There are also specific groups for AAC users, including: AAC Users! AAC- Alternative Awesome Communicators Instagram and YouTube Instagram is a photo- and video-sharing site where AAC families and professionals post materials, ideas, successes and equipment. I just started dabbling on Instagram and find it a great place to share quick videos of techniques and materials or brag on my patients and their families. AAC doesn’t yet have a significant presence on Instagram, but I see value in expanding topical knowledge to a broader audience through Instagram, which also uses hashtags. Search for #augcomm, #aac and #ashaigers. YouTube offers a wide variety of videos about AAC. AAC users and their families share stories, professionals give technique tips, and manufacturers and application developers offer training on products. Type a topic of interest into the search field to find videos. Pinterest Pinterest allows users to organize images with captions and links according to customizable “boards” or topics. You can follow “pinners” or specific boards. It’s also easy to search for AAC pins, enthusiasts or topics. Some pinners I follow include: Lauren Enders PrAACtical AAC ASHA Community The ASHA community provides the opportunity for SLPs to ask and answer specialized questions about AAC-related subjects. In the platform’s discussion area for ASHA Special Interest Group 12, Augmentative and Alternative Communication, SLPs can collaborate, troubleshoot and share regarding AAC. Social media offer easy access to a lot of AAC knowledge from and for professionals and consumers. Various sites better serve different learning styles, so check them all out. Most professionals and families sharing on social media use several different sites. You can expand your resources by finding favorites on one site and seeking them out on other social media, exploring their followers and the people they follow, too! Author Notes Vicki Clarke, MS, CCC-SLP, owns Dynamic Therapy Associates, a private practice specializing in AAC in Kennesaw, Georgia. With more than 25 years in the AAC world, she also evaluates, treats, trains and consults at schools, conferences and hospitals. [email protected] Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 20Issue 7July 2015 Get Permissions Add to your Mendeley library History Published in print: Jul 1, 2015 Metrics Current downloads: 530 Topicsasha-topicsleader_do_tagasha-article-typesleader-topicsCopyright & Permissions© 2015 American Speech-Language-Hearing AssociationLoading ...

Children with autism spectrum disorder (ASD) show differences in their communication development when compared to children who are typically developing and other clinical populations. In addition, children with ASD show divergence and delays in their expressive language when compared to each other, and a reported 30% do not develop spoken language even with access to early intervention. In order to support children with ASD in their communication development, there is a critical need for (a) detailed accounts of the emergence of expressive language for children receiving early intervention, (b) investigation of factors that might explain differences in expressive language abilities, and (c) investigation of sensitive predictors of expressive language change for children receiving early intervention. Children with ASD are often recommended augmentative and alternative communication (AAC) as part of early intervention to augment existing communication abilities, thus providing a complementary communication system while supporting early language development. Augmentative and alternative communication can be introduced as a focused intervention to target communication specifically, or it can be introduced as part of a comprehensive intervention program targeting multiple domains of learning. When used as part of a comprehensive intervention program, AAC is believed to support communication development broadly, including children’s use of spoken language. Despite emerging evidence for its effectiveness as a focused intervention and potential to support spoken language development within the context of comprehensive interventions, little research exists examining the mechanisms underpinning outcomes of AAC interventions. The current project aimed to address this gap by investigating both the emergence of expressive language in children with ASD, and factors underpinning concurrent and longitudinal expressive language abilities for children receiving an AAC-infused comprehensive intervention program. This research was conducted as a series of three studies: Study 1 investigated the communication profiles of 246 children with ASD upon entry and exit to a comprehensive early intervention program; Study 2 investigated mechanisms underpinning concurrent expressive language abilities, and Study 3 investigated predictors of longitudinal expressive language abilities, in 48 children with ASD receiving an AAC-infused comprehensive intervention program. The findings from Study 1 documented that 58.7% of children who started early intervention as minimally verbal remained minimally verbal after approximately 12 months of intervention, while 41.3% went on to develop phrase speech (using two-word phrases), highlighting an as yet unmet clinical need, as well as research need to understand these differences. The findings from Study 2 challenged previously held beliefs regarding word learning abilities in children with ASD, and extended on previous research by investigating the relationship between symbolic word learning and expressive language level. By focusing on processes that might be relevant to children’s development within interventions incorporating AAC, the findings from Study 3 provided preliminary data on the characteristics of children who might experience the largest gains in spoken language within AAC-infused comprehensive interventions. This research demonstrated a novel approach to investigating variability in expressive language development in children with ASD. The findings from this research demonstrate potential to explain some of the variability through analysis of social-cognitive learning processes that might help predict change within intervention. Finally, the findings of this research have potential to inform how researchers and clinicians approach individual differences in all children who present with complex developmental profiles.

Purpose: The purpose of this article is to illustrate the potential of applying augmentative and alternative communication (AAC) intervention through a short-term (2 week), intensive protocol in order to increase the communication behaviors in Chinese-speaking children with autism. In addition, possible cultural factors that may affect the outcomes of AAC intervention were identified. Method: Our project investigated the feasibility of a 2-week AAC intervention using a 32-location touch screen AAC system designed to support Mandarin Chinese (MC) with nine children with autism spectrum disorder. Mixed model trajectory analyses (MMTA) was used to evaluate changes of the targeted communication behaviors over the course of intervention. A quality assurance survey was completed by eight parents and three speech language pathologists (SLPs) implementing the program at the collaborating hospital clinic in Shanghai, China as a social validation measure. Results: The results of this collaborative project suggest a significant increase in intentional AAC usage of the pre-stored MC vocabulary during typical child-centered activities. An increase in intentional speech was observed also along with a decrease in vocalizations and gestures over the two weeks of intervention. Both primary caregivers and SLPs of the nine children reported positive attitudes and favorable agreement of the AAC intervention with the MC AAC system. Conclusion: Use of MMTA showed that a short-term, intensive AAC intervention protocol incorporating the use of a high performance MC AAC system resulted in gains in communication competence. The protocol also showed the potential of improving natural speech using an AAC system with children with autism. The results across primary caregivers and the SLPs support the importance and resource feasibility of this Chinese AAC protocol. Family values and preferences influencing clinical decisions regarding intervention and methodological considerations are discussed.

Training and Intervention in South Africa

Research indicates that as many as 50% of children with autism spectrum disorders (ASD) will not develop adequate speech to meet their communication needs (Noens & van Berckelaer-Onnes, 2004). Thus, alternate means of communication such as Augmentative and Alternative Communication (AAC) are necessary. Though many music therapists work with clients with ASD, there is a lack of research regarding music therapists' use of aided AAC. This study sought to obtain information from music therapists who work with persons with ASD via a survey to answer the following questions: (a) how many music therapists are using aided AAC in their sessions, (b) how they are using aided AAC, and (c) what type of training they have had regarding AAC systems. To assess the research questions, the author created an electronic survey. Upon distribution, the survey response rate was 49.6%. Results indicated that only 14.6% of respondents utilize aided AAC with all of their clients who use aided AAC outside of music therapy. The most common form of aided input used by music therapists in their sessions with clients with ASD is a picture schedule. Only 40% of respondents have additional training in aided AAC. Chi square tests revealed significant relationships among many of the variables: use of aided AAC and additional training, use and treatment setting, literacy promotion and additional training, modeling and additional training, referral for AAC systems and length of work with clients with ASD, referral and additional training. Results are discussed in relation to current communication literature.

<b>Purpose: </b>To ensure long-term adoption and use of augmentative and alternative communication (AAC) technologies, they must be designed to support children to participate within everyday activities and routines that are prioritized by families. The aim of this study was to gain parent perspectives on how AAC technologies were integrated into everyday life.<b>Method: </b>Nine parents of children with cerebral palsy who used AAC technologies participated in semistructured interviews to provide their perspectives on how AAC technologies were integrated into the functional contexts of everyday life.<b>Results: </b>Five major themes emerged from the discussions: (a) integrating AAC into life, (b) AAC technologies, (c) child needs and skills, (d) parent responsibilities and priorities, and (e) AAC process and decision making. Children were able to use AAC technologies within a variety of everyday contexts with various partners; however, challenges included access to technologies within care routines and outdoor activities as well as partners who lacked knowledge regarding operational competencies and effective interaction strategies. To integrate AAC technologies into life, parents prioritized technology features including ease of programming, improved physical design, features to enhance efficiency and ease of access, and availability of multiple functions and features (e.g., games and leisure activities, environmental controls).<b>Conclusion: </b>AAC manufacturers and mainstream technology developers should work to ensure that technologies are responsive to the supports, limitations, and ideal features identified by parents. Future research should seek input from a larger group of stakeholders and use longitudinal methods to examine perceptions of AAC technologies over time.<br><b>Supplemental Material S1. </b>Semi-structured interview guide. <br><b>Supplemental Material S2. </b>Codebook. <br><b>Supplemental Material S3. </b>Bracketing statement. <br>O'Neill, T., &amp; Wilkinson, K. M. (2020). Preliminary investigation of the perspectives of parents of children with cerebral palsy on the supports, challenges, and realities of integrating augmentative and alternative communication into everyday life. <i>American Journal of Speech-Language Pathology. </i>Advance online publication. https://doi.org/10.1044/2019_AJSLP-19-00103

People who have communication difficulties may benefit from using augmentative and alternative communication (AAC). Understanding and measuring outcomes from the use of AAC is an important part of evaluating the impact of devices and services. Outcome measurement needs to reflect the changing nature of the impact of using AAC on an individual's ability to participate in activities of daily life. There is a limited understanding of the concepts that should inform the evaluation of outcomes from AAC device provision, nor how people's expectations from AAC may change over time. To inform the development of a patient-reported outcome measure for AAC by understanding more about people's expectations from AAC and how these change over time. A longitudinal qualitative research study was designed and carried out with seven participants over a period of 2 years. Participants were recruited from a regional specialist assessment service for AAC in the south-west of the UK. Four semi-structured interviews were carried out: (1) before assessment for AAC, (2) after assessment, (3) directly after provision of an AAC device and (4) between 6 and 12 months after provision. An original analytic method was used in this study that built on the principles of longitudinal interpretative phenomenology analysis, applied with a dialogic theoretical lens. This approach enabled the inclusion of a range of multimodal and embodied data collected to this study and allowed the research team to draw out salient themes across the cohort group while attending to the influence of time and context on experience. The results confirm and extend the three core concepts that were used to guide analysis: changes; contexts; future possibilities. The contextual and temporal influences on outcomes attainable from AAC for this cohort were also identified and illustrated through cross-case comparison. Deeper, analytic, and conceptual engagement with theory, which was then applied to analysis of the data, provided methodological rigour in the study. The results enhance our understanding of people's hopes and expectations from AAC and how these change over time. This qualitative longitudinal research study provides new insights into the journeys of people who experience communication disability, and the shifting nature of their sense of identity as they engage with, and learn from using, AAC. The study is significant as it attends to the dynamic nature of experience and how contextual and experiential factors influence people's hopes and expectations from AAC. The paper presents an original application of longitudinal qualitative research methodology with people who use AAC which can be further applied and tested in the field of communication disability research. What is already known on this subject We did not know the impact that time has on the concepts that have been identified to represent important outcomes from AAC. The existing concepts used to define outcomes from AAC were not adequately conceptualized to develop a patient-reported outcome measure. This study sought to extend our knowledge about outcomes from AAC. What this paper adds to the existing knowledge This study adds to the methodological toolkit available for qualitative inquiry in the field of communication disability research by presenting a longitudinal qualitative research methodology. It adds depth to our understanding of the concepts that underpin outcomes from AAC and highlights the dynamic nature of contexts and how this influences desired outcomes. What are the potential or actual clinical implications of this work? This longitudinal qualitative research study provides a broader perspective on the experience of getting AAC. It will enable clinicians to better navigate the contextual and transitionary factors that influence people's experience of acquiring AAC devices. The enhanced concepts described will also support clinical conversations that consider the wider facets of communication and what AAC can add to existing communicative tool kits beyond getting a message across.

Understanding the rejection and abandonment of augmentative and alternative communication systems by parents of children with complex communication needs

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