Alternative Communication Intervention Research Articles

Communication interventions for autism spectrum disorder in minimally verbal children.

Communication interventions for autism spectrum disorder in minimally verbal children.

Augmentative and alternative communication interventions are effective for adolescents and adults with autism spectrum disorder, but more work is needed

Q What AAC interventions are used, and what are their effects, for adolescents and adults with autism spectrum disorder (ASD)?Design: Systematic review.Data sources: Studies included in this review...

Responsiveness of a parent-reported outcome measure to evaluate AAC interventions for children and youth with complex communication needs

Evaluation of the effectiveness of augmentative and alternative communication (AAC) interventions requires reliable measures that are responsive to change. The aim of this study was to explore the potential of the Family Impact of Assistive Technology Scale for AAC (FIATS-AAC) to detect functional change in children and youth with AAC needs, aged 3–17 years, and their families, 6 and 12 weeks after receiving a graphic-based, speech-generating device (SGD). Parents whose children were awaiting a SGD as part of their regular AAC service participated in the study. In all, 45 parents completed the FIATS-AAC during each of three phone interviews: at the time of device delivery, and then 6 weeks and 12 weeks after receiving the device. Children and youth were aged 3–16 years (M = 7.8, SD = 3.3) and were mostly context-dependent communicators. Paired t-tests indicated statistically significant gains in functioning from baseline to both 6 and 12 weeks after receiving the AAC device. Effect sizes were 0.41 and 0.38, respectively. This study provides initial support for the ability of the FIATS-AAC to detect functional changes in children and youth and their families after receiving a graphic-based SGD.

A Case Study on the Augmentative and Alternative Communication Intervention of the T.A.C.L.E. Program in a Special Classroom of an Elementary School in the United States

A Case Study on the Augmentative and Alternative Communication Intervention of the T.A.C.L.E. Program in a Special Classroom of an Elementary School in the United States

Teachers’ Attitudes Towards Children Who Use AAC in Italian Primary Schools

ABSTRACTEarly Augmentative and Alternative Communication (AAC) interventions in school environments aim to support the development of the communication skills of children with complex communication needs. Goals of this study were to analyse the teachers’ attitudes towards children using AAC in primary schools in Italy and their perceptions of the barriers and the benefits of using AAC. Two groups of teachers, those with and without AAC experience, responded to an online survey. The five scales of the Teacher Attitude Scale (TAS) questionnaire and two open-ended questions were used to compare the attitudes and the perceptions between the groups of teachers. Results showed that there was a significant difference among the two groups for two of the five scales of the TAS questionnaire. Both groups reported similar barriers and benefits and indicated the use of AAC as being the main barrier. In conclusion, having experience with children who use AAC in class impacts the teachers’ perceptions of their own abilities and the teachers’ perceptions of the abilities of the children.

Effects of Interventions That Include Aided Augmentative and Alternative Communication Input on the Communication of Individuals With Complex Communication Needs: A Meta-Analysis.

The purpose of this meta-analysis was to investigate the effects of augmentative and alternative communication (AAC) interventions that included aided AAC input (e.g., aided AAC modeling, aided language modeling, aided language stimulation, augmented input) on communicative outcomes (both comprehension and expression) for individuals with developmental disabilities who use AAC. A systematic search resulted in the identification of 26 single-case experimental designs (88 participants) and 2 group experimental designs (103 participants). Studies were coded in terms of participants, intervention characteristics, dependent variables, outcomes, and quality of evidence. AAC interventions that included aided AAC input in isolation, or as part of a multicomponent intervention, were found to be highly effective across participants of various ages, disabilities, and language skills. The interventions typically included aided AAC input in conjunction with expectant delay, direct prompting (e.g., spoken, gestural), contingent responding, and open-ended questions. The interventions were found to be highly effective in supporting both comprehension and expression across the domains of pragmatics, semantics, and morphosyntax. Outcomes related to expression were reported more often than outcomes related to comprehension. Aided AAC input may reduce input-output asymmetry and enhance expression and comprehension for individuals who use AAC; the evidence suggests that partners should utilize this strategy. Future research is needed to investigate the effects of AAC input (aided and unaided) on long-term language development for individuals who require AAC. https://doi.org/10.23641/asha.6394364.

Alternative and Augmentative Communication in Support of Persons with Language Development Retardation

Frequently, a child with severe deficiencies is at an early stage of communication development, which symbolizes a disadvantage in comparison to his chronological age. Although the child may display a certain repertoire of incipient communication behavior due to his motor, sensory, cognitive, or another type of deficiency, it is possible that adults may not be able or may not know to respond to these types of behavior. Furthermore, when adults try to answer, it can happen that the child can not understand their signals. As a result, the child is not able to acquire the necessary understanding in order to make the cognitive progress from unintentional communication to an intended one. In the individual therapy sessions, where the parent will participate, the augmentative and alternative communication specialist will implement the individual intervention program in order to develop the child's language functions and the transition to the intentional, symbolic communication in order to achieve a recovery or a compensation of the language function. In Augmentative and Alternative Communication interventions, subjects will be encouraged to use various methods and means in different situations and with different comunication parteners. The Augmentative and Alternative Communication system represents the opportunity for people with a delay in language development to aquire a certain level of indepence, contributing to greater social participation by these people.

A systematic review of predictors, moderators, and mediators of augmentative and alternative communication (AAC) outcomes for children with autism spectrum disorder

Documented variability in augmentative and alternative communication (AAC) intervention outcomes makes it difficult for clinicians to select systems most likely to be effective for individual children with autism spectrum disorder (ASD). The aim of this study was to identify child-related factors associated with AAC intervention outcomes through a systematic review of the research literature. A search was conducted of peer-reviewed research articles in which AAC intervention outcomes and associated factors were reported for children with ASD. The search yielded 965 titles and abstracts, of which seven articles relating to six studies met criteria for inclusion. In total, 18 factors were examined, of which nine were assessed as predictors (e.g., cognition, ASD severity, language use), three as moderators (e.g., joint attention, object exploration), and six as mediators (e.g., frequency of therapy, communication partner knowledge). Child characteristics associated with communication outcomes were pre-intervention cognition, severity of ASD, verbal imitation, vocabulary comprehension, object use, joint attention, language use, and two multi-dimensional measures of communication competence. This study suggests emerging evidence for predictors, but less is known about what factors moderate and mediate response to AAC interventions.

Augmentative and Alternative Communication Intervention in Public Schools: Achieving Meaningful Outcomes Through Collaboration

Augmentative and alternative communication (AAC) interventions in public schools typically involve some level of collaboration between different professionals, including speech-language pathologist...

A Glossary of Behavior Analytic Terms for Speech-Language Pathologists' Considerations for Augmentative and Alternative Communication

At its core, productive collaboration between speech-language pathologists and behavior analysts requires effective communication between both parties. Successful communication can be gained in par...

Aided AAC for people with severe to profound and multiple disabilities: A systematic review of interventions and treatment intensity

Given the limited evidence, along with a rapidly evolving state of technology, research is needed to drive effective and efficient communication intervention for people with severe to profound and multiple disabilities. The purpose of the current review was to synthesize and evaluate the state of the aided, augmentative and alternative communication (AAC) intervention literature for this population from 1997 to 2016. Results synthesized findings from 25 studies (n = 59) on the extracted participant characteristics, intervention, and dosage parameters from the studies. Results included an under-reporting of sufficient dosage parameters in addition to implications for future directions in the areas of maintenance, generalization, and discriminated use of skills, and bridging aided low and high-tech AAC interventions.

Augmentative and Alternative Communication Intervention in Patients with Aphasia

Augmentative and Alternative Communication Intervention in Patients with Aphasia

Family Leisure as a Context to Support Augmentative and Alternative Communication Intervention for Young Children with Complex Communication Needs.

AbstractFamilies are often the most significant communication partners for children who require augmentative and alternative communication (AAC). Because family-centered approaches are recommended practice in speech-language pathology, a primary role for speech-language pathologists (SLPs) serving children who require AAC is to support families in integrating communication into highly valued, existing family activities. Family leisure activities can provide a naturally supportive context for AAC, because they provide multiple opportunities for children to interact and practice using AAC with natural communication partners. This article aims to guide SLPs in utilizing family leisure as a context for AAC intervention. We describe the benefits and constraints of engaging in leisure for families with children with disabilities. We define family leisure, which includes two distinct types of leisure activities: core and balance. Finally, we provide a case example of a family that highlights the integration of AAC into both types of leisure activities.

Local service provision of Augmentative and Alternative Communication and communication aids in England

BACKGROUND: Provision of Augmentative and Alternative Communication (AAC) interventions have been acknowledged to be highly variable in England and elsewhere. OBJECTIVE: The aim of the project described in this paper was to provide data to inform service planning and delivery of services delivering AAC including communication aids. METHODS: A survey was developed by an expert group and administered by telephone interview to service managers of primary and secondary services providing AAC interventions at a local level in England and data were included from two hundred and twenty respondents. RESULTS: Services included had mean caseload sizes of 0.09% of the catchment population for AAC provision, with a mean of 0.017% of the catchment population for high tech communication aids. Significantly higher levels of caseload and spend were reported for services working with children and young people as compared to those working with adults. Mean levels of unmet need for AAC equating to approximately one in every eight individuals on services' caseloads were reported. CONCLUSIONS: Although these data should be treated with caution, they suggest a significant level of variation of provision of AAC by local services.

Comparing the Effects of Speech-Generating Device Display Organization on Symbol Comprehension and Use by Three Children With Developmental Delays.

Three children ages 3;6 to 5;3 with developmental and language delays were provided experience with a traditional grid-based display and a contextually organized visual scene display on a speech-generating device to illustrate considerations for practice and future research in augmentative and alternative communication assessment and intervention. Twelve symbols were taught in a grid display and visual scene display using aided input during dramatic play routines. Teaching sessions were 30 minutes a day, 5 days a week for 3 weeks. Symbol comprehension and use was assessed pre and post 3 weeks of experience. Comprehension of symbol vocabulary on both displays increased after 3 weeks of experience. Participants 1 and 2 used both displays largely for initiation. Participant 3 had limited expressive use of either display. The methods used in this study demonstrate one way to inform individual differences in learning and preference for speech-generating device displays when making clinical decisions regarding augmentative and alternative communication supports for a child and their family. Future research should systematically examine the role of extant comprehension, symbol experience, functional communication needs, and the role of vocabulary type in the learning and use of grid displays versus visual scene displays.

Bridging the gap from values to actions: a family systems framework for family-centered AAC services

Despite the growing recognition of the importance of family involvement in augmentative and alternative communication (AAC) intervention, little guidance exists on how professionals can establish successful collaborative relationships with families. In this paper, we discuss family systems theory and ecological systems theory as a framework to guide family-centered AAC practice, review family-focused research in AAC, consider how AAC may impact the family system, and provide examples of the clinical implications of using the proposed family systems framework to improve family-centered AAC practice.

Videos With Integrated AAC Visual Scene Displays to Enhance Participation in Community and Vocational Activities: Pilot Case Study With an Adolescent With Autism Spectrum Disorder

In order to maximize the positive outcomes of augmentative and alternative communication interventions, it is critical that interventions support the participation of individuals with complex communication needs within real-world interactions in their natural environments. A pilot case study was used to evaluate the effects of videos with integrated visual scene displays (VSDs), displayed on a tablet-based application (app), on the percent of task steps completed independently within three community and vocational activities by an adolescent with autism spectrum disorder (ASD). The results indicated noticeable gains in independent task completion and communication across contexts while using the video VSD app after only a few intervention sessions. These results provide preliminary evidence that videos with integrated VSDs may serve as an effective means to maximize independent participation and communication for individuals with complex communication needs and ASD in real-world contexts. Ultimately, this assistive technology could reduce dependence on aides (e.g., job coaches, paraprofessionals) and create increased opportunities for employment and independent participation in meaningful community activities for individuals with complex communication needs.

A Pilot Trial of Sodium Benzoate, a D-Amino Acid Oxidase Inhibitor, Added on Augmentative and Alternative Communication Intervention for Non-Communicative Children with Autism Spectrum Disorders

Background: This open-label clinical trial examined the efficacy and safety of a d-amino oxidase inhibitor, sodium benzoate, in the treatment of non-communicative children with autism spectrum disorder. We hypothesized that benzoate, through indirect glutamate stimulation, may enhance learning in communication. Method: Six children (five boys, one girl, 3-year-7-month to 9-year-6-month of age) completed the 12 weeks of study of receiving sodium benzoate in conjunction with communication training program. The outcome measures were Receptive and Expressive Vocabulary Test-Chinese, parent-reported Adaptive Behavior Assessment System-II, number of core vocabularies learned in the applied communication learning system, Chinese child developmental inventory and parenting stress index. Safety assessments included biweekly recorded vital signs, body weight, body height and adverse events. Results: We noted improvement of communication in half of the children on benzoate. An activation effect was reported by caregivers in three of the six children, and was corroborated by clinician’s observation. Conclusion: Though the data are too preliminary to draw any definite conclusions about efficacy, they do suggest this therapy to be safe, and worthy of a double-blind placebo-controlled study with more children participated for clarification of its efficacy.

A systematic review of research into aided AAC to increase social-communication functions in children with autism spectrum disorder

Augmentative and alternative communication (AAC) interventions have been shown to be effective in supporting children with autism spectrum disorder (ASD) to communicate, particularly to request preferred items and activities. The aim of this systematic review was to examine the effectiveness of AAC interventions in supporting children to produce a broader range of communicative functions and determine the extent to which these interventions have been evaluated beyond immediate effectiveness to address maintenance, generalization, and social validity. A systematic search and application of inclusion criteria yielded 30 interventions that focused on communication functions beyond object requests. In many of the studies, flaws detracted from the certainty of evidence, and maintenance, generalization, and/or social validity were not addressed. Further research is needed to evaluate the extent to which AAC interventions can support children with ASD to communicate using a variety of communication functions, as well as to demonstrate sustained, transferable, and meaningful change.

Research note: attitudes of teachers and undergraduate students regarding three augmentative and alternative communication modalities

The social validity of different communication modalities is a potentially important variable to consider when designing augmentative and alternative communication (AAC) interventions. To assess the social validity of three AAC modes (i.e., manual signing, picture exchange, and an iPad®-based speech-generating device), we asked 59 undergraduate students (pre-service teachers) and 43 teachers to watch a video explaining each mode. They were then asked to nominate the mode they perceived to be easiest to learn as well as the most intelligible, effective, and preferred. Participants were also asked to list the main reasons for their nominations and report on their experience with each modality. Most participants (68–86%) nominated the iPad-based speech-generating device (SGD) as easiest to learn, as well as the most intelligible, effective, and preferred. This device was perceived to be easy to understand and use and to have familiar and socially acceptable technology. Results suggest that iPad-based SGDs were perceived as more socially valid among this sample of teachers and undergraduate students. Information of this type may have some relevance to designing AAC supports for people who use AAC and their current and future potential communication partners.