And Alternative Communication Apps Research Articles

Exploring the Augmented and Alternative Communication (AAC) for Promoting Independence in Daily Skills of Students with Learning Disabilities

Augmented and alternative communication (AAC) mobile apps are increasingly being used to support students with learning disabilities in developing their communication and daily skills. Mobile AAC apps offer portability, user-friendliness and customisation that enables students with learning disabilities to communicate by using symbols, pictures and words for clear expression. This study investigated the experiences of two teachers with AAC mobile apps in promoting daily skills among students with learning disabilities. Semi-structured interviews were conducted with the teachers, exploring their perspectives on the effectiveness of specific AAC mobile app features. The interview questions were adapted from the Mobile Application Rating Scale (MARs). The findings revealed that AAC mobile apps featuring these features were particularly effective in assisting students with learning disabilities in developing their daily skills. The teachers highlighted the benefits of AAC mobile apps in enhancing communication, promoting independence and facilitating the acquisition of essential daily skills. This study contributes valuable insights into the practical application of AAC mobile apps in educational settings and emphasise the significance of customisable features to cater for the individual needs of students with learning disabilities. Additionally, the study highlights the need for further research to explore the long-term impact of AAC mobile apps on the communication and daily skills development of students with learning disabilities. The findings of this study have the potential to inform the development and implementation of innovative AAC mobile app-based interventions for students with learning disabilities to help these students to achieve their full potential and become independent.

Design Specifications of Augmentative and Alternative Communication Apps for Individuals with Autism Spectrum Disorder

The literature has emphasized the positive impact of mobile technologies with augmentative and alternative communication (AAC) apps for enhancing the functional communication skills of individuals with autism spectrum disorders (ASD). Although various AAC apps are available, the system design of such apps presents assorted challenges, particularly for those with ASD in different cultures. Designing useful and engaging apps by considering the affordances of mobile technologies and the characteristics of individuals with ASD may contribute to the success of interventions. In this regard, the purpose of this study is to examine the design specifications of AAC apps based on the considerations of subject-matter experts from an instructional system design (ISD) perspective. The current research employed a design-based research framework, including different methods. An AAC app named as EBA was developed by following design specifications as suggested by the field experts to answer the research questions. The results of the study revealed several enhancements in usability, flexibility, and feasibility issues of AAC apps, and highlighted the importance of (a) personalized apps, (b) simple user-interface, (c) hierarchical representation of visuals, (d) responsive apps, (e) help and documentation, and (f) parent control service. Directions for future research are proposed.

The effects of AAC video visual scene display technology on the communicative turns of preschoolers with autism spectrum disorder

ABSTRACT Over 40% of children with autism spectrum disorder (ASD) experience difficulty in using speech to meet their daily communication needs. Although augmentative and alternative communication (AAC) can be of benefit, the AAC intervention must support beginning communicators in the early social interactions that provide the foundation for more sophisticated communication skills. An AAC video visual scene display approach uses an AAC app (provided on a tablet computer), including videos based on the interests of the child and infused with AAC supports, to provide opportunities for social interaction and communication between the child and the communication partner. The purpose of this study was to investigate the impact of video visual scene display technology on the communicative turns taken by three preschoolers with ASD and complex communication needs during a high-interest, shared activity (i.e., watching videos). All three participants demonstrated a large increase in the number of communicative turns taken with their partner (Tau-U of 1.00) following the introduction of the video VSD app. The results provide evidence that a video VSD approach may be a promising intervention to increase participation in communication opportunities for young children with ASD.

Comparative Effects of Picture Symbol With Paired Text and Text-Only Augmentative and Alternative Communication Representations on Communication From Children With Autism Spectrum Disorder.

Purpose Technology features that maximize communicative benefit while minimizing learning demands must be identified and prioritized to amplify the efficiency and effectiveness of augmentative and alternative communication (AAC) intervention. Picture symbols with paired text are a common representation feature in AAC systems for children with autism spectrum disorder (ASD) who are preliterate, yet little research about their comparative benefit exists. Method Four school-age children with ASD and limited speech who were preliterate participated in two single-subject studies. In one study, communication of high imageability words (e.g., nouns) on an AAC app during a book-reading activity was compared across two representation conditions: picture symbols with paired text and text only. In the second study, communication of low imageability words (e.g., verbs) was compared. Both studies had baseline, intervention, generalization, and maintenance phases. Results Prior to intervention, participants communicated across both representation conditions at low rates except two participants who were relatively successful using picture symbol with paired text representations of high imageability words. In response to intervention, all participants demonstrated increases in communication across representation conditions and maintained the increases. Participants demonstrated generalization in the text-only representation condition. Conclusions Children with ASD who were preliterate acquired communication at comparable rates regardless of whether an AAC app utilized picture symbol with paired text or text-only representation. Therefore, while larger scale research is needed, clinicians and technology developers could consider increasing the use of text in AAC representation given the inherent value associated with learning to recognize written words. Supplemental Material https://doi.org/10.23641/asha.13661357.

Typical preschoolers’ perceptions of augmentative and alternative communication modes of a preschooler with autism spectrum disorder

Understanding typical preschoolers’ perceptions of communication modes could help guide augmentative and alternative communication (AAC) intervention for preschoolers with autism spectrum disorder (ASD). This study explored the perceptions of 16 typically developing preschoolers toward an (a) AAC application (app) on a tablet, (b) picture exchange using a binder with printed Picture Communication SymbolsTM, and (c) prelinguistic communication used by a preschooler with ASD in a series of videos the preschoolers watched. Using a multi-method design, the study implemented both quantitative (rank ordering and preference selection) and qualitative (interview) methodologies. Quantitative results revealed the typical preschoolers had a clear overall preference for the AAC app, but variation in preference existed when selecting a communication mode to use in specific social scenarios. Qualitative data show the children more easily understood the child with ASD when he used the AAC app and associated tablets with fun, which may have accounted for positive perceptions of this AAC mode. The study is exploratory in nature and limited by its size and scope. However, it provides insights useful for clinicians’ understanding not just how typical preschoolers perceive various modes of communication, but also why they may perceive some more favorably than others, in order to tailor intervention accordingly.

Effects of an AAC App with Transition to Literacy Features on Single-Word Reading of Individuals with Complex Communication Needs.

The purpose of this study was to investigate the effects of Transition to Literacy (T2L) software features (i.e., dynamic text and speech output upon selection of a graphic symbol) within a grid display in an augmentative and alternative communication (AAC) app on the sight word reading skills of five individuals with severe disabilities and complex communication needs. The study implemented a single case multiple probe research design across one set of three participants. The same design was utilized with an additional set of two participants. During intervention, the T2L feature was activated for targeted sight words during a book reading activity. The dependent variable was the number of 10 target words correctly identified. With only limited exposure to the T2L feature, the five participants all demonstrated increased accuracy in identification of 10 targeted sight words. Four of the five participants generalized learning to use of a text-only display for the 10 targeted sight words. This study provides preliminary evidence that redesigning AAC apps to include the provision of dynamic text combined with speech output can positively impact the sight-word reading of participants. This adaptation in AAC system design could be used to support improved outcomes in both language and literacy.

Incorporating discriminative stimuli into functional communication training with augmentative and alternative communication devices: a tutorial

Functional communication training (FCT) is a commonly used and effective treatment for problem behavior maintained by social reinforcement (e.g., an individual engages in self-injurious behavior to gain access to adult attention). FCT involves teaching an individual to emit an appropriate communication response to access the reinforcer maintaining problem behavior (e.g., pressing a “Play, please” symbol on a device to gain the communication partner’s attention) and withholding that reinforcer following problem behavior (e.g., the communication partner minimizes attention-following problem behavior and waits for a communication response). Techniques such as incorporating discriminative stimuli (e.g., differently colored cards) can make FCT more practical for caregivers by teaching individuals when reinforcement is and is not available for communication responses while simultaneously mitigating treatment relapse. Despite the effectiveness of FCT with discriminative stimuli, no studies have leveraged the capabilities of augmentative and alternative communication (AAC) devices by embedding discriminative stimuli within AAC software (e.g., by coloring communication symbols or grids). Our tutorial provides a comprehensive overview of how practitioners can incorporate FCT with discriminative stimuli into practice and includes video models of how to design these treatments on two common AAC apps.

Effect of AAC technology with dynamic text on the single-word recognition of adults with intellectual and developmental disabilities

Purpose: Single-word recognition can support participation in life, including engagement in leisure activities, navigation through the community, and vocational opportunities. Given the limited reading skills of many adults with intellectual and developmental disabilities (IDD) and limited speech, the current study evaluated the effects of using an augmentative and alternative communication (AAC) app, featuring dynamic text and speech output embedded in visual scene displays, on the single-word recognition performance of six adults with IDD who demonstrated limited speech.Method: A multiple baseline across participants single-subject design was used. Ten target sight words for each participant were selected on an individual basis, based on participant interest. Intervention consisted solely of interactions between investigators and individual participants using the app.Result: In the absence of any formal instruction and solely through the use of the AAC app interaction, three of the six participants demonstrated increased accuracy in single-word recognition.Conclusion: Results from the study were mixed, but suggest that AAC apps which provide the dynamic display of text in conjunction with voice output can assist some adults with IDD in achieving gains in single-word reading.

Telling tales: unlocking the potential of AAC technologies

Augmentative and alternative communication (AAC) has been transformed by the social media revolution made possible by the emergence of mobile technology. The cumbersome dedicated devices of the 1970s have evolved into a burgeoning AAC app industry. However, the limited use and abandonment of AAC technologies remains high. Unlocking the untapped potential of technology requires a paradigm shift in the design of AAC technologies by building systems that minimize the cognitive load placed on users, adapting to their individual physical and language needs. Telling Tales shares insights and stories of how the combination of user‐centred design, interdisciplinary research and the application of intelligent computing is providing a vision of future generations of AAC technologies.

AAC services for multilingual populations: South African service provider perspectives

BackgroundIn South Africa, many persons in need of augmentative and alternative communication (AAC) come from multilingual backgrounds. There is as yet a limited evidence base (locally and internationally) for the provision of AAC services to multilingual populations. The perspectives of service providers can assist in gaining an understanding of current practices and the factors that influence these. AimsThe study aimed to obtain the perspectives of AAC service providers about practices in providing AAC systems and AAC intervention to clients from multilingual backgrounds. Methods & proceduresFifteen AAC service providers were purposefully chosen to participate in one of three focus groups – two face-to-face and one online focus group. Data from the face-to-face focus groups was transcribed verbatim. Thematic analysis was used to identify themes and subthemes in the data. Outcomes & resultsFour overarching themes were identified, namely (a) current practices, (b) factors influencing current practices, (c) service provides’ orientation towards different language options in AAC intervention, and (d) needs and desired developments regarding AAC technology. This paper reports on the first three themes. Service providers reported their practices to range from a focus on L1 exclusively, L2 exclusively, to a multilingual (sequential or simultaneous) approach. The South African language context, family language preferences and choices, service provider skill and knowledge, as well as AAC technology were identified as factors influencing their practices. Although many viewed access to multiple languages through AAC as positive, they also expressed concerns and reservations about providing multilingual AAC services. Conclusions & implicationsAlthough service providers in general saw the need to give clients from multilingual backgrounds access to multiple languages using AAC, this did not always translate into multilingual AAC practices. Both extrinsic factors (e.g. the lack of appropriate AAC devices, software and apps giving access to non-English languages) and intrinsic factors (service providers’ language competency and their beliefs about the cognitive demands of multilingual AAC systems) influenced their practices and choices. Appropriate AAC service delivery to multilingual populations in South Africa would require not only appropriate AAC technology developments, but also research evidence to establish the efficacy of multilingual AAC interventions for clients with a variety of characteristics.

Effects of dynamic text in an AAC app on sight word reading for individuals with autism spectrum disorder

The purpose of this study was to investigate the effects of Transition to Literacy (T2L) software features (i.e., dynamic text and speech output upon selection of a graphic symbol) within a grid display in an augmentative and alternative communication (AAC) app, on the sight word reading skills of individuals with autism spectrum disorders (ASD) and complex communication needs. The study implemented a single-subject multiple probe research design across one set of three participants. The same design was utilized with an additional set of two participants. As part of the intervention, the participants were exposed to an AAC app with the T2L features during a highly structured matching task. With only limited exposure to the features, the five participants all demonstrated increased accuracy of identification of 12 targeted sight words. This study provides preliminary evidence that redesigning AAC apps to include the provision of dynamic text combined with speech output, can positively impact the sight-word reading of participants during a structured task. This adaptation in AAC system design could be used to complement literacy instruction and to potentially infuse components of literacy learning into daily communication.

Effect of mobile technology featuring visual scene displays and just-in-time programming on communication turns by preadolescent and adolescent beginning communicators

Purpose: Visual scene displays (VSDs) and just-in-time programming supports are augmentative and alternative communication (AAC) technology features with theoretical benefits for beginning communicators of all ages. The goal of the current study was to evaluate the effects of a communication application (app) on mobile technology that supported the just-in-time programming of VSDs on the communication of preadolescents and adolescents who were beginning communicators.Method: A single-subject multiple-baseline across participant design was employed to evaluate the effect of the AAC app with VSDs programmed just-in-time by the researcher on the communication turns expressed by five preadolescents and adolescents (9–18 years old) who were beginning communicators.Result: All five participants demonstrated marked increases in the frequency of their communication turns after the onset intervention.Conclusion: Just-in-time programming support and VSDs are two features that may positively impact communication for beginning communicators in preadolescence and adolescence. Apps with these features allow partners to quickly and easily capture photos of meaningful and motivating events and provide them immediately as VSDs with relevant vocabulary to support communication in response to beginning communicators’ interests.

Comparison of the effects of mobile technology AAC apps on programming visual scene displays

Parents and professionals who work with individuals who use augmentative and alternative communication (AAC) face tremendous time pressures, especially when programming vocabulary in AAC technologies. System design (from programming functions to layout options) necessitates a range of skills related to operational competence and can impose intensive training demands for communication partners. In fact, some AAC applications impose considerable learning demands, which can lead to increased time to complete the same programming tasks. A within-subject design was used to investigate the comparative effects of three visual scene display AAC apps (GoTalk Now, AutisMate, EasyVSD) on the programming times for three off-line programming activities, by adults who were novices to programming AAC apps. The results indicated all participants were able to create scenes and add hotspots during off-line programming tasks with minimal self-guided training. The AAC app that had the least number of programming steps, EasyVSD, resulted in the fastest completion times across the three programming tasks. These results suggest that by simplifying the operational requirements of AAC apps the programming time is reduced, which may allow partners to better support individuals who use AAC.

Development and evaluation of a mobile AAC: a virtual therapist and speech assistant for people with communication disabilities

Purpose: The currently existing Augmentative and Alternative Communication (AAC) technologies have limitations to produce the best communication rehabilitation outcomes and therefore a better solution is needed.Method: In this work, a mobile AAC app was developed based on results from research studies. Sophisticated AAC language programming, embedded training materials, and real-time communication performance reporting were integrated into the app. Two groups of study participants were recruited to participate a usability study and a preliminary feasibility study for the purpose of evaluating this mobile AAC app, respectively.Results: A tablet-based AAC app was developed to support communication rehabilitation. User studies of the app were conducted and included able-bodied individuals and people with verbal communication disabilities. All study participants agreed that the app establishes a usable alternative treatment protocol for communication rehabilitation.Conclusions: The app’s integrated features have great potential to maximize users’ communication effectiveness, enhance language skills, and ultimately improve users’ quality of life.Implications for rehabilitationWe have developed and evaluated an integrated mobile AAC language-based app.This tablet-based app integrated AAC with embedded trainings and real-time performance report.

Typical Toddlers' Participation in "Just-in-Time" Programming of Vocabulary for Visual Scene Display Augmentative and Alternative Communication Apps on Mobile Technology: A Descriptive Study.

Augmentative and alternative communication (AAC) promotes communicative participation and language development for young children with complex communication needs. However, the motor, linguistic, and cognitive demands of many AAC technologies restrict young children's operational use of and influence over these technologies. The purpose of the current study is to better understand young children's participation in programming vocabulary "just in time" on an AAC application with minimized demands. A descriptive study was implemented to highlight the participation of 10 typically developing toddlers (M age: 16 months, range: 10-22 months) in just-in-time vocabulary programming in an AAC app with visual scene displays. All 10 toddlers participated in some capacity in adding new visual scene displays and vocabulary to the app just in time. Differences in participation across steps were observed, suggesting variation in the developmental demands of controls involved in vocabulary programming. Results from the current study provide clinical insights toward involving young children in AAC programming just in time and steps that may allow for more independent participation or require more scaffolding. Technology designed to minimize motor, cognitive, and linguistic demands may allow children to participate in programming devices at a younger age.

Designing augmentative and alternative communication applications: the results of focus groups with speech-language pathologists and parents of children with autism spectrum disorder

Purpose: The purpose of this study was to gain insight from speech-language pathologists (SLPs) and parents of children with autism spectrum disorder (ASD) regarding appealing features of augmentative and alternative communication (AAC) applications.Method: Two separate 1-hour focus groups were conducted with 8 SLPs and 5 parents of children with ASD to identify appealing design features of AAC Apps, their benefits and potential concerns. Participants were shown novel interface designs for communication mode, play mode and incentive systems. Participants responded to poll questions and provided benefits and drawbacks of the features as part of structured discussion.Results: SLPs and parents identified a range of appealing features in communication mode (customization, animation and colour-coding) as well as in play mode (games and videos). SLPs preferred interfaces that supported motor planning and instruction while parents preferred those features such as character assistants that would appeal to their child. Overall SLPs and parents agreed on features for future AAC Apps.Conclusion: SLPs and parents have valuable input in regards to future AAC app design informed by their experiences with children with ASD. Both groups are key stakeholders in the design process and should be included in future design and research endeavors.Implications for RehabilitationAAC applications for the iPad are often designed based on previous devices without consideration of new features.Ensuring the design of new interfaces are appealing and beneficial for children with ASD can potentially further support their communication.This study demonstrates how key stakeholders in AAC including speech language pathologists and parents can provide information to support the development of future AAC interface designs.Key stakeholders may be an untapped resource in the development of future AAC interfaces for children with ASD.

Early Sentence Productions of 5-Year-Old Children Who Use Augmentative and Alternative Communication

Four 5-year-old children with receptive language within normal limits and who required augmentative and alternative communication (AAC) received instruction in producing six different semantic–syntactic structures (three treatment and three generalization targets). Participants accessed single-meaning graphic symbols using an AAC app on an iPad to create their messages. A single-case, multiple probe across targets design was used to assess the progress of each participant, and supplementary measures including self-corrections and error types were analyzed. Three participants mastered all six targets during baseline, with a fourth mastering four of six targets in baseline. In contrast to prior reports, findings from the current study indicate that some young children who require AAC can learn to produce rule-based messages using single-meaning graphic symbols rapidly and with minimal instruction. Careful attention to participant characteristics and task demands are required in future research to further refine approaches to teaching young participants to produce rule-based graphic symbol messages.

Social media experiences of adolescents and young adults with cerebral palsy who use augmentative and alternative communication

Purpose: This pilot study aimed to expand the current understanding of how adolescents and young adults with cerebral palsy (CP) and complex communication needs use social media.Method: An online focus group was used to investigate the social media experiences of seven individuals with CP who used Augmentative and Alternative Communication (AAC). Questions posed to the group related to social media: (a) advantages; (b) disadvantages; (c) barriers; (d) supports; and (e) recommendations.Result: Adolescents with CP who use AAC used a range of communication media to participate in daily interactions, including social media. An analysis of the focus group interaction revealed that the participants used social media to: bypass the constraints of face-to-face interactions; communicate for a number of reasons (e.g. maintain relationships, share experiences); and support independent leisure (e.g. playing games, looking at pictures/videos). Despite the advantages, the participants discussed barriers including limitations related to AAC technologies, social media sites and literacy skills.Conclusion: The results suggest that service providers should implement interventions to support social media use, including enhancement of linguistic, operational and strategic competence. Technology manufacturers should focus on improving the designs of AAC apps and social media sites to facilitate access by individuals who require AAC.

AAC Modeling With the iPad During Shared Storybook Reading Pilot Study

This pilot study describes an intervention package, MODELER for Read and Talk, designed to provide enriched language interaction for children with complex communication needs who require augmentative and alternative communication (AAC). MODELER (Model, Encourage, Respond) includes (a) modeling AAC as you speak, (b) encouraging communication (through time delay for this study), and (c) responding to child communication (by recasting using AAC as you speak for this study). This pilot A-B design study reports on a method for coaching educational assistants (EAs) to use MODELER for Read and Talk in the context of shared book reading with a pre-school-aged child using an Apple iPad and AAC app. The study provides positive results indicating EA instructional performance gains in MODELER steps and large gains in AAC models performed. The results indicated that the child participant subsequently engaged in higher levels of communication turns. Implications for practice, limitations, and future research directions are discussed.

User-Centered Design and Augmentative and Alternative Communication Apps for Children With Autism Spectrum Disorders

Communication difficulties are among the most frequent characteristics of children with autism spectrum disorders (ASD). Lack of communication can have a significant impact on the child’s life. Augmentative and alternative communication (AAC) apps are a common form of AAC interventions that involve a combination of affordable technology with software that can be utilized to assist with communication. While AAC apps have been found to have some impact on improving the communication skills of children with ASD, current research exploring this topic is still limited. Focusing on the design process of AAC apps may provide better insight into improving clinical outcomes and user success. The user-centered design process incorporates a continuous cycle of user feedback to help inform and improve the functions and the capabilities of the technology, and it is an essential component in AAC app development. This article outlines how the user-centered design process could be adopted for the development of AAC apps for children with ASD.