Is Research on Augmentative and Alternative Communication Intervention With Children With Autism Spectrum Disorder Reflected in the Clinical Practice of Speech-Language Pathologists?

Abstract

Purpose: Individuals with autism spectrum disorder (ASD) who have little to no functional speech require augmentative and alternative communication (AAC). Research on AAC intervention with individuals with ASD consistently indicates that teaching requesting skills has been the primary focus, with limited guidance on teaching social communication skills, despite the critical impact of these skills on language development. Furthermore, receptive language is typically not considered when measuring responsiveness to intervention. Thus, it is unclear how individuals with severely affected receptive language respond to current intervention techniques and whether these techniques support generalization of skills. The purpose of this qualitative study was to determine if clinical practice follows the patterns observed in the research literature and to learn more about how intervention techniques are impacting individuals in this population. Method: Thirteen practicing speech-language pathologists (SLPs) were interviewed to describe AAC intervention with this population. An interpretive phenomenological approach was used to analyze qualitative data and identify unique themes. Results: Seven primary themes emerged related to intervention targets, requesting, social communication, motivation, receptive language, perceived efficacy and challenges, and communication partners. Subthemes for each primary theme are described. Conclusions: Clinical practice resembles the research literature, as SLPs emphasize requesting and report the use of evidence-based strategies. However, SLPs reported a lack of guidance for teaching social communication, limited generalization of skills, and lack of AAC uptake by communication partners. Finally, SLPs may not consider individual receptive language abilities when making clinical decisions related to AAC. This article indicates a robust need to identify more effective AAC intervention methods that promote social communication, meet the needs of children with severely affected receptive language, and include families to improve outcomes.