And Alternative Communication Use Research Articles

Augmentative and alternative communication: the experience of Malaysian speech-language pathologists and caregivers of individuals with aphasia

ABSTRACT Background Augmentative and Alternative Communication (AAC) serves as a compensatory intervention approach for individuals with aphasia and is often introduced by speech-language pathologists (SLPs) after outcomes from restorative approaches plateau. Communication partners (i.e., caregivers) have a pivotal role in ensuring the successful use of AAC by adults with aphasia. Despite there being a large body of research on the use of AAC by adults with aphasia little is known about the experience of caregivers of individuals with aphasia who use AAC in supporting its use. Aims This study conducted in Malaysia was aimed to (a) explore the practices of Malaysian SLPs when introducing AAC to adults with acquired communication disorders (ACD) including aphasia and (b) describe the experience of caregivers regarding the use of AAC by adults with aphasia under their care. Method & Procedures This mixed-methods study had two phases. In Phase 1, a survey was distributed to 200 SLPs throughout Malaysia. Thirty-seven SLPs who met the inclusion criteria of having a caseload of more than 80% adults and at least 20% adults with aphasia responded to the survey and provided information about their use of AAC. For Phase 2, eight caregivers of adults with aphasia who had been introduced to AAC were interviewed to obtain information about their experience using AAC. Outcomes & Results Findings from Phase 1 indicated that Malaysian SLPs most often introduced unaided and low-tech AAC to adults with ACD (including aphasia). Most of them felt that they lacked knowledge and skills in the provision of AAC services to adults and hoped for more training. Three themes emerged from the qualitative content analysis conducted on interview transcripts from Phase 2: (a) the positive impact of the use of AAC, (b) challenges faced when using AAC, and (c) hopes for the future. The findings of this study suggest that both SLPs and caregivers recognize the importance of AAC for adults with ACD including aphasia and need to work together closely to promote inclusion of adults with aphasia who use AAC and acceptance of AAC as a form of aphasia rehabilitation.

Parents' Perceptions of Eye-Gaze Technology Use by Children With Complex Communication Needs.

Some preschool students with complex communication needs explore eye-gaze computer technology (EGCT) and adopt computer-based augmentative and alternative communication (AAC). The objective of this study was to follow preschool explorers of EGCT who are now school aged to describe the children's use of technology and parents' perceptions of its utility for communication, participation, or leisure. Ten parents completed survey questions by Internet and phone and reported their perceptions of nine children's effectiveness in the use and acceptance of AAC and the support they received in implementing technology. The results are reported as a descriptive study. All children in this research continue to use AAC technology in school and most at home. Many children who tried and obtained EGCT while in preschool continue to use that technology. Most parents agreed that the children understood how to use the devices, which enhanced the children's communication, and that the parents received sufficient support. Most children were limited in their use of the devices for leisure and control of their environments. Computer-based AAC for school-aged children who trialed it when they were in preschool appears to be a powerful means for them to communicate and participate. However, the technology appears not to be used to its full capabilities to support the children's agency to control environments and to pursue leisure. Teams may want to consider how to support children in using their AAC devices to meet multiple needs. The study was limited by its small sample size and its descriptive nature. Additional research on this subject is needed.

Indonesian Caregivers’ Perspectives on the Use of Augmentative and Alternative Communication for Children with Autism Spectrum Disorder

Abstract Children with Autism Spectrum Disorder (ASD) who have Complex Communication Needs (CCN) benefit from Augmentative and Alternative Communication (AAC) to support communication. Research on the use of AAC and how different stakeholders perceive the use of AAC has been heavily focused on Western culture. The purpose of this study was to understand Indonesian caregivers’ perspectives of their child’s use of AAC by conducting semi-structured interviews. Caregivers yearned for support and collaboration from professionals, showed perseverance and resilience by seeking other learning opportunities, supporting their children, and acting as advocates, and noted benefits from AAC when implemented in culturally responsive ways. Future directions and implications for practice and policy related to supports for Indonesian children with ASD and CCN are discussed.

Voices from the field: exploring service providers’ insights into service delivery and AAC use in Canada

Use of augmentative and alternative communication (AAC) often relies on the involvement of AAC service providers; however little is known about how AAC services are delivered across Canada. This study aimed to explore AAC service provision and factors influencing use of AAC from the perspectives of service providers across Canada who are involved in providing and/or supporting use of AAC systems. The 22 participants from nine (of the 10) provinces participated in online focus groups. Participants were speech-language pathologists, occupational therapists, communicative disorders assistants, and a teacher. Transcripts of the audio recordings were analyzed using reflexive thematic analysis. Four themes were generated that reflect service-related factors contributing to the use of AAC in Canada: Support of Organizational Structures, Concordant Relationships and Goals, Making the Right Decisions, and Influence of Knowledge and Attitudes. These themes highlight how government systems, key stakeholders, assessment practices, and knowledge of AAC influence service provision and use of AAC. Voices from across Canada highlighted shared experiences of services providers as well as revealed variability in service delivery processes. The findings bring to attention a need for further research and development of service provision guidelines to support consistency, quality in practice, and equity in AAC services.

"You Just Want to Be Able to Communicate With Your Child": Parents' Perspectives on Communication and AAC Use for Beginning Communicators on the Autism Spectrum.

For young children on the autism spectrum who are beginning communicators, augmentative and alternative communication (AAC) can support language development and participation in meaningful interactions. AAC is more likely to be effective when services align with the needs and priorities of the child's family. To better understand family perspectives, this study investigated the communication and AAC experiences of parents of young beginning communicators on the autism spectrum. The study used a phenomenological qualitative design. Eight caregivers of seven children on the autism spectrum participated in semistructured interviews, and thematic analysis was used to identify themes within the data. Five main themes and 15 subthemes emerged from the data. Parents situated communication and AAC experiences within the context of complex, busy lives. They discussed the value of communication and benefits of AAC, but described numerous challenges related to obtaining, learning, and implementing AAC that evolved over time as needs and skills changed. Parents discussed their children's individuality and the need for AAC systems and services to fit the unique needs of their child and their family. They also emphasized ways in which communication outcomes were affected by factors external to the child and the family, including factors related to professional services and the U.S. health care and educational systems. The results affirm the need to consider the family and the broader social system when providing AAC services to young children on the autism spectrum. Provision of family-centered services is critical to successful AAC. https://doi.org/10.23641/asha.24881562.

Parents' Perspectives of Augmentative and Alternative Communication: From Assessment to Implementation

Purpose: Parents are known to be effective communication partners in their children's augmentative and alternative communication (AAC) intervention. This study aimed to better understand the parent perspective in the AAC acquisition, implementation, and handing processes across various primary disability labels and ages. Method: Twenty-two parents of children who use AAC engaged in phone interviews to discuss their family's experiences with AAC obtainment and intervention. A thematic analysis of the interview data was conducted. Results: The following five themes emerged: assessment procedures, early recommendations for AAC, external variables that influence device access, supports and barriers parents face when navigating AAC use with their child, and what participants would do differently. Further subthemes were also established to categorize parent responses. Conclusions: Findings support the inclusion of family-centered care for children with complex communication needs who use AAC. Parent responses indicate a greater need for interprofessional communication between children's team members and their family to provide comprehensive support. Parents also emphasized a desire to introduce AAC earlier into their family.

Teacher perspectives on the use of augmentative and alternative communication systems for learners with complex communication needs

For learners with complex communication needs (CCN), teachers in special schools are encouraged to use a variety of communication techniques to help them participate in various classroom activities. Studies show limited data on the use of effective augmentative and alternative communication (AAC) strategies in special schools. The primary purpose of this study was to describe teacher perspectives on the use of AAC devices that they use in their classrooms in rural areas. We employed a qualitative methodology that included in-person interviews and focus groups. The focus group and face-to-face sessions each had 3 and 8 participants, respectively. Three main themes, namely modes of communication, training, and challenges and 12 subthemes were identified. We found that teachers employed pictures to improve communication of learners with CCN. We also discovered that since teachers didn’t use speech generating devices (SGD) frequently, they had trouble using them. The use of SGDs, one of the assistive technology tools that could be used to improve communication of learners with CCN, requires extensive teacher training, according to research. Further research is required to establish the efficacy on the use of AAC devices in special schools in rural areas.

Using longitudinal qualitative research to explore the experience of receiving and using augmentative and alternative communication.

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.

Parental perceptions of social life before and after attending a parent training program for children with complex communication needs: the ComAlong example

Parent training programs aimed at improving language outcomes for children with complex communication needs have predominantly been evaluated on child-centered outcomes and less often on the impact on social life or parental well-being. This study examined parent perceptions of social life before and after ComAlong, a group intervention providing parents with knowledge and training in responsive communication, environmental-milieu teaching strategies and augmentative and alternative communication (AAC). Parents (N = 467) completed questionnaires during the first and last sessions of ComAlong groups held in Sweden 2012 to 2018. Main outcome measure was change in the Social Life Scale from the Family Impact Questionnaire. Associations between this measure and demographic factors of parents and children were analyzed, along with reported change in parents’ use of AAC. Pre-post comparisons revealed small significant positive changes in perceived impact of social life following intervention. The magnitude of the positive change was larger among parents of children with non-syndromic diagnoses and parents of children with autism spectrum disorder or attention deficit hyper activity disorder (ADHD). Differences in social life impact was not associated with parents’ gender, language proficiency, age, or educational background. In conclusion, communication-focused parent training programs can have a positive impact on social family life and may thereby influence children’s participation.

Turkish speech-language therapists' perceptions and experiences of augmentative and alternative communication

Objectives: In this study, it is aimed to reveal what extent speech and language therapists (SLT) working in Turkey used augmentative and alternative communication (AAC) systems in their working area. For this purpose, it was investigated how they perceive AAC in terms of its scope and role; ACC applications within the scope of interventions for communication, language and speech disorders; best practice insights on AAC; what factors are seen as facilitating or limiting the implementation of AAC within the scope of intervention and suggestions for providing the best practice for AAC. Methods: Phenomenology, one of the qualitative research methods, was used in the study. The subject of the study is the opinions of SLTs working in Turkey on their clinical practices and thoughts on the use of AAC. The study group consists of 15 SLTs from Turkey and determined by using maximum diversity sampling method. The semi-structured interview forms were used in which SLTs’ views, suggestions and expectations about AAC applications in the service delivery as a data collection tool. The obstacles and difficulties in these applications were discussed. Content analysis was used and also carried out using the qualitative data analysis program MAXQDA 2018. In order to ensure the consistency of the data analysis, the data were analyzed by another field expert and the 92% consensus was tried to be reached by using the consistency formula. Results: Participant opinions consist of benefiting status from AAC, opinions on the importance of AAC, preferred case groups and reasons for AAC implementation, opinions on current best practice understanding on communication and language intervention/use of AAC, opinions on current working conditions on AAC practices, opinions on the limitations of the use of AAC in communication and language intervention and recommendations for ensuring effective use of AAC themes. Conclusions: The results of the study show that supporting individuals who can benefit from AAC in the context of intervention services for communication disorders requires great effort. In addition, SLTs stated that they strongly believed in AAC and its potential value for individuals with communication disorders, but did not have sufficient self-confidence about their current or developing skills in this area. It is also seen that clinicians need training and support from employers, professional or government agencies that set policies and standards to achieve their AAC related goals.

Promising Strategies for Teaching Augmentative and Alternative Communication in Inclusive Educational Settings: A Systematic Review.

The purpose of this article was to conduct a systematic review of the literature on teaching or increasing the use of augmentative and alternative communication (AAC) by students with significant intellectual disabilities and complex communication needs (CCNs) within inclusive school settings. A systematic review of research literature from 1998 to 2022 was completed using multiple electronic databases, as well as citation chaining and cited author reference searches. Three hundred two articles were located with 17 meeting criteria for inclusion in this systematic review. Articles were initially screened by one author for potential inclusion; the remaining 83 were coded by one author and reviewed for consensus by three authors for inclusion in this review. Articles were analyzed and rated regarding both level of research design and quality of methodology. All studies reported positive outcomes, with students with significant intellectual disabilities and CCN, of AAC intervention implemented in an inclusive setting. Fourteen over 17 studies were single-case designs with an average rating of 76% on the Single-Case Experimental Design measure of methodological quality. Less than half of the studies assessed generalization of subject learning. Review of interventions used in the studies, however, revealed the majority of studies utilized packages of interventions, making it difficult to determine the effectiveness of individual approaches. This systematic review indicates there are promising interventions within inclusive settings for improved use of AAC by students with significant intellectual disabilities and CCN. Further research is needed, however, to obtain more data on generalization of student gains as well as to determine which specific interventions might be the most successful for this population of students in inclusive settings.

Reflections on Building a Multi-Country AAC Implementation Guide.

Augmentative and Alternative Communication (AAC) implementation at any level is a multifaceted process that requires selection of relevant and appropriate systems to suit individual users who may have complex communication needs and other co-occurring difficulties. Careful and systematic action may be required to develop skills and abilities in the use of chosen technologies with suitable ongoing support within a wide range of settings. The wider milieu in which services are provided must also be considered in order to provide a firm foundation for capacity building alongside considerations for multilingual and multicultural factors. UNICEF with the Global Symbols team supported by local professionals working with AAC users, their families and carers set out to collaboratively provide an implementation guide based on their experiences in several Eastern European countries. The aim of the guide was to illustrate work already being undertaken in the area and to ensure the sharing of knowledge and resources where gaps were discovered. The result became a series of linked webpages in an online framework that covered practical aspects for the development of policies and procedures to support early intervention for those with severe speech, language and communication needs across countries of differing cultures and languages. The actual AAC implementation required ingenuity on all sides with translations for pictographic symbol and software adaptations with Cyrillic and Latin alphabets, new synthetic voices alongside deployment and capacity development. Considerable local support was forthcoming and captured with interviews by those working with AAC users as technology was introduced and outcomes measured. As the guide was completed several videos were shared publicly by carers with examples of AAC and assistive technology use. Policies and procedures were also shared in the form of tables, charts, symbol sets, communication boards and software that illustrated not only the occurrence of knowledge transfer and the use of open licenses, but also differences in strategies and the way they were adapted to suit the range of settings in the various countries.

A Systematic and Quality Review of Augmentative and Alternative Communication Interventions that use Core Vocabulary

AbstractCore vocabulary is defined as “lexical items that are accepted as being central and indispensable to language use” (Bell, 2012, p. 1). Use of core vocabulary is common amongst professionals who teach augmentative and alternative communication (AAC) to individuals with disabilities. Although the use of AAC is often classified as an evidence-based practice (EBP) (Steinbrenner et al., 2020; Wong et al., Journal of Autism and Developmental Disorders, 45(7), 1951–1966, 2015) an analysis of the relevant intervention procedures as well as the vocabulary used is often missing from syntheses of the literature. Therefore, a systematic review was conducted to determine the quality and strength of the evidence for AAC interventions that use core vocabulary. A systematic database search and a subsequent screening process resulted in a total of 10 peer-reviewed studies that involved an AAC intervention that used core vocabulary. Each study’s outcomes were then categorized as positive, mixed, or negative and a quality review was performed using the Council for Exceptional Children’s (CEC) standards for evidence-based practices (Cook et al., Teaching Exceptional Children, 46(6), 206-212, 2015a; Remedial and Special Education, 36, 220-234, 2015b). Overall, the results suggest a lack of strong evidence in favor of AAC interventions that use core vocabulary. The results are discussed in the context of general suggestions for vocabulary selection and teaching practices for AAC systems.

Augmentative and alternative communication (AAC) in pediatric cochlear implant recipients with complex needs: A scoping review.

Augmentative and alternative communication (AAC) encompasses all forms of unaided and aided modes of communication, but typically excludes codified language such as spoken words or American Sign Language (ASL). In pediatric patients with a documented additional disability (population of interest), deficits in communication may pose a barrier to language development. While forms of AAC are frequently mentioned in the literature, recent innovations have permitted the use of high-tech AAC in the rehabilitation process. Our objective was to review the implementation of AAC in pediatric cochlear implant recipients with a documented additional disability. A scoping review of existing literature examining the use of AAC in pediatric CI recipients was conducted in the PubMed/MEDLINE and Embase databases. Studies with pediatric cochlear implant recipients with a concomitant diagnosis requiring additional therapeutic intervention outside the scope of standard post-CI follow-up care and rehabilitation from 1985 to 2021 met inclusion criteria (population of interest). Studies limited to spoken or formal sign language (e.g., American Sign Language, ASL) as communication modalities were excluded. Four hundred twenty studies were screened of which 29 were included. 13 were prospective, 10 were retrospective, 1 was cross-sectional, and 5 were case reports. Of these 29 studies, 378 patients met the inclusion criteria (age <18, CI user, additional disability, utilized AAC). Fewer studies (n=7) utilized AAC as the primary intervention for investigation. Autism spectrum disorder, learning disorder, and cognitive delay were frequently mentioned as additional disabilities in conjunction with AAC. Unaided forms of AAC included gesture/behavior, informal sign, and signed exact English, while aided AAC included a Picture Exchange Communication System (PECS), Voice Output Communication Aids (VOCA), and touchscreen programs such as TouchChat® HD. Various audiometric and language development outcome measures were mentioned, most commonly the Peabody Picture Vocabulary Test (PPVT) (n=4) and the Preschool Language Scale, Fourth Edition (PLS-4) (n=4). There is a gap in the literature regarding the use of aided and high-tech AAC in pediatric CI users with a documented additional disability. Given the use of multiple different outcome measures, additional exploration of the intervention of AAC is warranted.

Exploring Classroom Factors and Augmentative and Alternative Communication Use in Qualitative Interviews.

This qualitative study explores classroom contextual factors influencing augmentative and alternative communication (AAC) use in early childhood classrooms. Semistructured interviews were conducted with six special education teachers, 13 speech-language pathologists (SLPs), and one SLP assistant. Interviews were analyzed inductively in a systematic, multistep coding process using the constant comparative method with member checking. Seven themes were identified that affected AAC use in the classroom. Each theme was organized into three categories: individual-, classroom-, or school-level factors. Three themes were categorized as individual-level factors: Students' AAC systems are unavailable, professionals face challenges obtaining AAC knowledge and skills, and students' disruptive behaviors reduce access to AAC. One theme was a classroom-level factor: Classroom demands prevent AAC use. Finally, three themes were considered school-level factors: The culture of AAC influences AAC acceptance, team collaboration is essential for successful implementation, and teams need administrative support to deliver AAC interventions effectively. Conclusions: Teachers and SLPs felt that collaborative teams with AAC expertise, a school culture that endorsed AAC, and solid administrative support accelerated AAC adoption by normalizing AAC use in the classroom. Due to classroom demands, they struggled to use strategies such as aided AAC modeling and responsiveness during group instruction. Finally, participants emphasized that while it was necessary to customize AAC systems for each student, this individualization makes it harder for staff to learn each system and integrate them into classroom activities. https://doi.org/10.23641/asha.23681718.

Identifying Implementation Strategies to Increase Augmentative and Alternative Communication Adoption in Early Childhood Classrooms: A Qualitative Study.

The goal of this study was to identify promising implementation strategies that may increase teachers' and speech-language pathologists' (SLPs) adoption of augmentative and alternative communication (AAC) during routine classroom activities. A grounded theory approach was used to collect and code online, semistructured interviews with six special education teachers and 14 SLPs who taught children aged 3-8 years who used AAC in inclusive and self-contained special education classrooms. Interviews were transcribed and coded verbatim using the constant comparative method. During a member checking process, six participants (n = 30%) confirmed their transcripts and commented on emerging themes. Participants shared a range of implementation strategies to increase AAC use during typical classroom activities, which were organized into seven themes: distribute modern AAC equipment, provide foundational training, share video examples, develop a systematic plan for adoption, deliver practice-based coaching, alter personnel obligations to provide protected time, and connect with professionals. A preliminary thematic map was created to link implementation barriers, strategies, and potential outcomes. AAC interventions effective in clinical research can be difficult to translate into routine practice unless investigators directly explore the needs of and demands on educational professionals. Future research should define implementation strategies clearly, solicit feedback from school-personnel, and match implementation strategies to the needs of local schools to support the uptake of AAC interventions in routine classroom settings. https://doi.org/10.23641/asha.23699757.

Speech pathologists' perspectives on the use of augmentative and alternative communication devices with people with acquired brain injury and reflections from lived experience.

Communication changes following acquired brain injury (ABI) may necessitate use of augmentative and alternative communication (AAC). Speech pathologists regularly assist people with ABI and their families with AAC assessment and recommendations, as well as education and training on AAC use. To date, there has been no Australian research investigating the perspectives of speech pathologists working in the field of ABI and AAC. This research aimed to 1) Explore speech pathologists' insights regarding enablers and barriers to considerations and uptake, and ongoing use, of AAC by people with ABI and 2) Understand their perspectives on AAC acceptance, abandonment and rejection. A qualitative research design, with semi-structured interviews, was used with seven speech pathologists working across three Australian states. Interviews were transcribed verbatim, and thematically analysed. To triangulate results, the lived experience reflections of one co-author, who has an ABI and uses AAC, were drawn on. Seven themes were identified, relating to four of the five domains of the World Health Organization's assistive technology model. These included that AAC should be person-centred, with consideration of both products and personnel required, and with effective policy aiding AAC trial, uptake and use. This research has highlighted considerations for AAC use by people with ABI, from the perspective of speech pathologists and aided by lived experience reflections. Speech pathologists need to understand the breadth of products, and good practice service steps, to ensure successful AAC use and skill development. Listening to the perspectives of people with ABI is central to that understanding.

The Relationship Between Augmentative and Alternative Communication Use by Pediatric Psychiatric Inpatients With Autism Spectrum Disorder and Interfering Behaviors.

Previous research conducted by Williams et al. (2018) using data from the Autism Inpatient Collection (AIC) found a weak and inconsistent association between verbal ability and the severity of interfering behaviors; however, adapting/coping scores were significantly associated with self-injury, stereotypy, and irritability (including aggression and tantrums). The previous study did not account for access to or use of alternative forms of communication in their sample population. This study uses retrospective data to investigate the association between verbal ability and augmentative and alternative communication (AAC) use and the presence of interfering behaviors in individuals with autism who have complex behavioral profiles. The sample included 260 autistic inpatients, ages 4-20 years, from six psychiatric facilities, enrolled during the second phase of the AIC when detailed information about AAC use was collected. Measures included AAC use, method, and function; comprehension and production of language; receptive vocabulary; nonverbal IQ; severity of interfering behaviors; and the presence and severity of repetitive behaviors. Lower language/communication abilities were related to increased repetitive behaviors and stereotypies. More specifically, these interfering behaviors appeared to be related to communication in those individuals who were candidates for AAC but who were not reported to have access to it. Although the use of AAC did not predict a decrease in interfering behaviors, receptive vocabulary scores-as measured by the Peabody Picture Vocabulary Test-Fourth Edition-were positively correlated with the presence of interfering behaviors in participants with the most complex communication needs. The communication needs of some individuals with autism may be unmet, prompting the use of interfering behaviors as a form of communication. Further investigation of the functions of interfering behaviors and the related functions of communication skills may provide greater support for an increased focus on the provision of AAC to prevent and ameliorate interfering behaviors in individuals with autism.

The use of augmentative and alternative communication by children with developmental disability in the classroom: a case study

Purpose Augmentative and alternative communication (AAC) systems are often introduced to children with disabilities who demonstrate complex communication needs. As attending school is an essential part of these children’s lives, it is important that they use their AAC system to communicate in the classroom. This study aimed to describe the nature of the use of AAC by students with developmental disabilities in the classroom. Materials and Method This study was conducted in Malaysia. Six students were observed twice each in their classroom and their classroom interactions were video recorded. The video recordings were transcribed and coded for the presence of a communication event, the student’s mode of communication and communication function, the communication partner involved, and access to the AAC system. Results Contrary to past studies, most students in this study spontaneously initiated interaction almost as many times as they responded. They primarily communicated with gestures and verbalizations/vocalizations despite having been introduced to an AAC system. When students communicated using their AAC system, they mainly interacted with the teachers, and for the function of either behavioral regulation or joint attention. It was found that for 39% of communicative events, the student’s aided AAC system was not within arm’s reach. Conclusion The findings highlight the need for efforts to encourage students with complex communication needs to use AAC more frequently in their classroom to be able to communicate more effectively and for a wider range of communicative functions. Speech-language pathologists can work closely with teachers to provide the necessary support to these students.

Chinese-English speaking family perspectives of augmentative and alternative communication use with their children.

Culturally and linguistically diverse families who have children with complex communication needs (CCN) often have limited access to augmentative and alternative communication (AAC) devices and interventions due to the lack of services that acknowledge their families' cultural and linguistic needs. Despite the increasing need for culturally responsive services, little is known about Chinese-English speaking families' perspectives and experience related to AAC use and services. The objective of this study was to understand the perspectives and experiences of Chinese-English speaking family members of children who use AAC use. This study employs a qualitative descriptive methodology approach. The researchers conducted individual or group semi-structured interviews with 10 adult family members (mother, father, and grandparent) from four Chinese-English speaking families in the U.S. and Canada who have a child who uses AAC (ages 3-8). Chinese-English speaking families have high acceptance and satisfaction with their child's AAC as long as they see the benefits of the AAC system. Mothers and siblings play unique roles in supporting home AAC practice given frequent engagement with and observed influence on the child who uses AAC. Family members indicated goals in building stronger family connections, but noted that the child's speech difficulties interfered with this goal. Chinese-English speaking families felt they can overcome limitations resulting from lower English language proficiency, but still find difficulties in obtaining resources because of the Western expectations of advocacy. Additionally, service providers' lack of responsiveness related to family goals could prevent families in obtaining AAC resources. The findings suggest the need for family-centered services with cultural sensitivity and humility for those serving Chinese-English speaking families with children who use AAC. Additionally, involving family members beyond the mother within services may improve both family functioning and child communication.