Expressive Communication Skills Research Articles

Speech and language in DDX3X-neurodevelopmental disorder: A call for early augmentative and alternative communication intervention.

Pathogenic variants in DDX3X are associated with neurodevelopmental disorders. Communication impairments are commonly reported, yet specific speech and language diagnoses have not been delineated, preventing prognostic counseling and targeted therapies. Here, we characterized speech and language in 38 female individuals, aged 1.69-24.34 years, with pathogenic and likely pathogenic DDX3X variants (missense, n = 13; nonsense, n = 12; frameshift, n = 7; splice site, n = 3; synonymous, n = 2; deletion, n = 1). Standardized speech, language, motor, social, and adaptive behavior assessments were administered. All participants had gross motor deficits in infancy (34/34), and fine motor deficits were common throughout childhood (94%; 32/34). Intellectual disability was reported in 86% (24/28) of participants over 4 years of age. Expressive, receptive, and social communication skills were, on average, severely impaired. However, receptive language was significantly stronger than expressive language ability. Over half of the assessed participants were minimally verbal (66%; 22/33; range = 2 years 2 months-24 years 4 months; mean = 8 years; SD = 6 years) and augmented speech with sign language, gestures, or digital devices. A quarter of the cohort had childhood apraxia of speech (25%; 9/36). Despite speech and language impairments, social motivation was a relevant strength. Many participants used augmentative and alternative communication (AAC), underscoring the need for early, tailored, and comprehensive AAC intervention.

Evaluation of Deaf Employees' Work Ability on Cognitive, Affective and Psychomotor Aspects in a Cigarette Factory PT. Cakra Guna Cipta Malang Regency

Special Schools are formal institutions that are responsible for the quality of human resources for deaf people so that they can be accepted in the job market, especially labor-intensive industries. The learning process is expected to produce quality human resources in cognitive, affective and psychomotor aspects that influence work ability. This work ability will have an impact on the level of satisfaction of the company that employs them. This research aims to evaluate the work abilities of deaf people in cognitive, affective and psychomotor aspects. This research uses a qualitative exploratory case study methodology with an instrumental case study research design type. The research results prove that deaf employees who work at the Cakra Cigarette Factory must be able to communicate both orally and in writing. They generally have low literacy skills, poor receptive and expressive communication skills, resulting in a lack of understanding of the work contract text. In terms of discipline, they are much more disciplined than normal employees. Socially, they are able to establish good relationships with fellow colleagues. In terms of work skills, deaf employees have higher productivity than normal employees.

The Use of Image Rotation Media in Improving Oral Expressive Communication of Autistic Children in Special Schools

This study aims to improve the ability of oral language expressive communication in children with autism by using image rotation media in special schools precisely at Special School 01 Serang elementary school level grade 1 totaling one person. This research uses the experimental method with a Single-Subject Research (SSR) Experimental Study approach. Based on the results of the study showed an increase in oral language expressive communication skills. The baseline phase 1 (A1) which was conducted in 4 sessions showed a similar percentage value of 33%. The intervention phase (B) which was carried out in 8 sessions resulted in a percentage value of 79%, 79%, 79%, 85%, 85%, 85%, and 85%. The baseline 2 phase (A2) which was carried out 4 sessions showed a percentage value of 69%, 82%, 82%, and 82%. Effectiveness seen from the overlap percentage, from intervention (B) to baseline 1 (A1) and baseline 2 (A2) to intervention (B) does not show overlapping data. Overall, the use of image rotation media in improving oral language expressive communication skills in autistic children at Special School 01 Serang is effective.

Social interaction links active musical rhythm engagement and expressive communication in autistic toddlers.

Rhythm is implicated in both social and linguistic development. Rhythm perception and production skills are also key vulnerabilities in neurodevelopmental disorders such as autism which impact social communication. However, direct links between musical rhythm engagement and expressive communication in autism is not clearly evident. This absence of a direct connection between rhythm and expressive communication indicates that the mechanism of action between rhythm and expressive communication may recruit other cognitive or developmental factors. We hypothesized that social interactions, including general interpersonal relationships and interactive music-making involving children and caregivers, were a significant such factor, particularly in autism. To test this, we collected data from parents of autistic and nonautistic children 14-36 months of age, including parent reports of their children's rhythmic musical engagement, general social skills, parent-child musical interactions, and expressive communication skills. Path analysis revealed a system of independent, indirect pathways from rhythmic musical engagement to expressive communication via social skills and parent-child musical interactions in autistic toddlers. Such a system implies both that social and musical interactions represent crucial links between rhythm and language and that different kinds of social interactions play parallel, independent roles linking rhythmic musical engagement with expressive communication skills.

The Communication Success Screener: A Preliminary Investigation of Perceived Communicative Success Across Modalities, Environments, and Demands.

Behavioral intervention targeting speech, language, and communication concerns is an established therapeutic approach for patients with communication concerns across a range of acquired neurogenic disorders. The multidimensional factors that contribute to a person's self-identified communication challenges and strengths in their daily communication needs must be considered to provide functional and person-centered care. While assessments grounded in clinician observation or client self-report exist, there is a direct need for a screening tool that comprehensively evaluates the roles of modality (verbal, text, gesture) and environment (in-person, virtual) on self-reported success across communicative demands. In this study, we describe a preliminary approach to monitoring the progression of receptive and expressive communication skills in people with chronic poststroke aphasia in the context of communication practices of the 21st century, culminating in the development and exploratory implementation of a novel clinical instrument: the Communication Success Screener (COMSS). Thirty-three participants with aphasia due to stroke were recruited to complete and evaluate the COMSS via an online survey. Quantitative responses and open-ended participant feedback were collected to validate and propose adaptations to the COMSS. Group-level analyses and case presentations were used to highlight COMSS features and outcomes. Participant responses to the COMSS questionnaire suggest that this screening tool creates differentiated communicative success profiles based on self-report. Participant feedback also indicated that the COMSS appropriately evaluates self-reported success across modalities of verbal, text, and gesture in the context of in-person and virtual environments. The communication concerns experienced by people with aphasia are often heterogeneous and vary as a function of their daily activities of living, preferred language modalities, and environmental supports. We present preliminary feasibility analyses of the COMSS as a potential tool to support the monitoring of functional change by evaluating self-reported communicative success across form, modality, environment, and task demand. https://doi.org/10.23641/asha.24521044.

Providing Virtual Support to Children With Mild Developmental Delays in Response to the Pandemic

The COVID-19 pandemic has had massive impacts across the globe. Children with developmental delays are an increasingly vulnerable population, highlighting the importance of ensuring they have access to high-quality virtual services during this time. The Early Discovery program currently provides therapeutic interventions for children with mild developmental delays. We sought to compare the outcomes of 2 cohorts within the Early Discovery program using different delivery approaches (n = 238 families): children who received services in person before the pandemic (n = 126) and children who received services via telehealth in the acute phase of the pandemic (n = 112). Both groups of children showed significant improvements in language skills posttreatment, and, with regard to auditory comprehension, both groups showed similar rates of improvement. However, children receiving in-person services before the pandemic showed greater improvements in expressive communication skills than children receiving telehealth services during the pandemic. Results indicate that the Early Discovery program was able to make adjustments during the pandemic that assisted families in maintaining progress in improving their child's language skills.

Developing Angelman syndrome-specific clinician-reported and caregiver-reported measures to support holistic, patient-centered drug development

BackgroundAngelman syndrome (AS) is a rare, heterogenous neurogenetic condition, which significantly impacts the lives of people with AS and their families. Valid and reliable measures reporting key symptoms and functional impairments of AS are required to support development of patient-centered therapies. We describe the development of clinician- and caregiver-reported, AS-specific Global Impression scales for incorporation into clinical trials. Best practice US Food and Drug Administration guidance for measure development was followed with input from expert clinicians, patient advocates, and caregivers during content generation and refinement.ResultsInitial measurement domains for the Symptoms of AS—Clinician Global Impression (SAS-CGI) and the Caregiver-reported AS Scale (CASS) were identified from a conceptual disease model of AS symptoms and impacts, derived from interviews with caregivers and clinicians. Two rounds of cognitive debriefing (CD) interviews were performed; clinicians debriefed the SAS-CGI, with patient advocates and caregivers debriefing the CASS to ensure relevance and comprehension. Feedback was used to refine items and ensure wording was age-appropriate and captured AS-specific symptoms, as well as associated impacts and functional impairments. The SAS-CGI and CASS capture global assessments of seizures, sleep, maladaptive behaviors, expressive communication, fine and gross motor skills, cognition, and self-care, which were determined by clinicians, patient advocates, and caregivers to be the most challenging aspects of AS. Additionally, the measures include items for assessing overall AS symptoms and the meaningfulness of any change. In addition to ratings for severity, impact, and change, a notes field was included in the SAS-CGI to provide the rationale for the chosen rating. CD interviews confirmed the measures covered key concepts of AS from the perspective of clinicians and caregivers, and demonstrated that the measures’ instructions, items, and response options were clear and appropriate. Interview feedback informed adjustments to the wording of the instructions and the items.ConclusionsThe SAS-CGI and CASS were designed to capture multiple AS symptoms, reflecting the heterogeneity and complexity of AS in children 1 to 12 years old. These clinical outcome assessments have been incorporated into AS clinical studies, which will allow for the evaluation of their psychometric properties and inform further refinements if needed.

PICTURE EXCHANGE COMMUNICATION SYSTEM AND ITS EFFECTIVITY TO THE COMMUNICATION OF LEARNERS WITH AUTISM SPECTRUM

Special education involves the preparation of teaching procedures and materials, and other interventions designed to address the needs of a child with learning differences, disabilities, and giftedness. Autism is a neurological complex condition that affects behavior, socialization and communication of the child. As such, PECS is a form of augmentative and alternative communication that uses pictures, images and symbols which was designed to provide aid and support to children with autism in enhancing their communication skills. In particular, this research assessed the extent of effectivity of Pictures Exchange Communication System to the communication skills of learners with Autism Spectrum Disorder at Bright Gem Learning Center, Consolacion Central - SPED Center, and Talamban Elementary School - SPED Center as basis for development plan. The study utilized a mixed type of research method: Quantitative - Qualitative research and Thematic Synthesis approach. This research study has 30 learner respondents, 30 parent/ guardian respondents, and three SPED teachers involved. The questionnaire for learners with ASD was adapted from the National Professional Development Center on Autism Spectrum Disorder, Picture Exchange Communication System: Steps for Implementation. For the parent/ guardian respondents and SpEd teachers, research-made questionnaires are provided to assess the effectivity of PECS in the communication of learners with ASD at home and at school settings. The study found out that the Physically Assisted Exchange was considered to be highly effective. On the contrary, Responding to What They Want, resulted to be moderately effective. Generally, the study concluded that PECS can enhance the communication skills of learners with ASD. It is strongly recommended, especially to non-verbal learners, to use PECS as one of the techniques to improve their receptive and expressive communication skills.

Self-Perception of Cognitive-Communication Functions After Mild Traumatic Brain Injury.

A mixed-method approach was used to investigate the lived experiences of adults with mild traumatic brain injury (mTBI). The study aimed to understand the perceived relationship between cognitive-communication problems, thinking and communication concerns, and neurobehavioral symptoms. We hypothesized that individuals with cognitive-communication problems would attribute their problems with communication to their mTBI history and their self-perceived problems would be correlated with symptomatology. The Neurobehavioral Symptom Inventory (NSI) and an online cognitive-communication survey was used to conduct a study of 30 adults with mTBI history. Quantitative survey and NSI scores were analyzed with content analysis and correlational statistics. The average NSI Total score was 17 with the following subscale scores: somatic (5), affective (8), and cognitive (3.9). Participants reported problems with expressive communication (56%), comprehension (80%), thinking (63%), and social skills (60%). Content analysis revealed problems in the following areas: expression (e.g., verbal, and written language), comprehension (reading and verbal comprehension), cognition (e.g., attention, memory and speed of processing, error regulation), and functional consequences (e.g., academic work, social problems, and anxiety and stress). A Pearson correlation indicated a statistically significant relationship (p < .01) between the Communication Survey Total and the Total, Somatic, Affective, and Cognitive subscales. This study highlights a multifactorial basis of cognitive-communication impairment in adults with mTBI. We show that those with mTBI history perceive difficulties with cognitive-communication skills: conversations, writing, and short-term memory/attention. Furthermore, those with mTBI perceive their cognitive-communication problems after injury have impacted their vocational, social, and academic success.

Improving Children's Expressive Language and Auditory Comprehension Through Responsive Caregiving: Evidence from a Randomized Controlled Trial of a Strength-Based Video-Coaching Intervention.

Young children from low-SES backgrounds are at higher risk for delayed language development, likely due to differences in their home language environment and decreased opportunities for back and forth communicative exchange. Intervention strategies that encourage reciprocal caregiver-child interactions may effectively promote young children's language development and enhance optimal language outcomes. The Filming Interactions to Nurture Development (FIND) program is a brief strength-based video-coaching intervention designed to promote increased back and forth ("serve and return") interactions between caregivers and their children. The current study used data from a randomized controlled trial (RCT) to examine the effectiveness of the FIND program in improving auditory comprehension and expressive communication skills among children from low-SES backgrounds. The current study used a pretest-posttest design to evaluate intervention effects from an RCT with 91 low-SES families. Families with children aged 4 to 36months old (41.8% female) were randomly assigned to an active control or FIND intervention group. Children's auditory comprehension and expressive communication were assessed using the Preschool Language Scales, Fifth Edition (PLS-5) during both pre- and post-intervention sessions. Children in the FIND intervention group showed significantly increased expressive communication skills and a non-significant increase in auditory comprehension skills across the intervention period. In contrast, children in the active control group showed non-significant changes in expressive communication and a statistically significant decline in auditory comprehension abilities between pre- and post-intervention assessments. All analyses controlled for sex, age, and home language. This study provides preliminary evidence that the FIND intervention promotes the development of expressive and receptive language skills among young children in high-stress, low-SES environments.

An Overview of the Adaptive Behaviour Profile in Young Children with Angelman Syndrome: Insights from the Global Angelman Syndrome Registry

ObjectivesAngelman syndrome (AS) is a rare genetic disorder that affects the expression of the UBE3A gene within the central nervous system that profoundly impacts neurodevelopment. Individuals with AS experience significant challenges across multiple adaptive behaviour domains including communication, motor skills, and the ability to independently perform daily functions such as feeding, and toileting. Furthermore, persons with AS can demonstrate specific behaviours that limit their ability to participate within their social environment that vary with age. The aim of this paper is to explore the adaptive behaviour profile through parent report from the Global Angelman Syndrome Registry.MethodsSpecific parent report data from the Global Angelman Syndrome Registry were analysed to explore the adaptive profile of 204 young children, under the age of 6 years old, with formal diagnoses of AS. Analysis of data focused on communication skills, gross and fine motor skills, daily self-care skills (feeding, toileting, and dressing), and behavioural characteristics. Several relationships were explored: (a) the age at which certain skills were first performed based on genotype; (b) abilities in motor and adaptive behaviours, according to age and genotype, and (c) the frequency at which children performed specific communication skills and the presence and frequency of challenging behaviours, across age and genotype.ResultsWe visually present the ages at which frequent speech, walking, and independent dressing and toileting were first mastered by children. Additionally, we provide in-depth descriptives of expressive and receptive communication skills (including the use of alternative communication forms), fine and gross motor skills, eating, dressing, toileting, anxiety, aggression, and other behavioural characteristics.ConclusionsThis cross-sectional profile of adaptive skills in 204 young children with AS showcases that although many communication, motor and adaptive skills were determined by age, children with a non-deletion aetiology exhibited advantages in communication skills, which may have impacted upon subsequent adaptive skills. The use of parent report in the present study provides valuable insight into the adaptive behaviour profile of young children with AS.

"Hello, Selamat Datang!" A preliminary proposed model of Tourism interpersonal communication from an Islamic perspective amongst frontliners

These articles explore interpersonal communication in the tourism industry. As the industry faced changes post-pandemic, there is a great reason for the industry to refine people inside the industry, especially the frontliners. Since the frontliners are the first people met and greeted by the tourist, the responsibilities of these groups of industrial players are indeed higher than others. Pieces of the literature suggest that tourism service providers must have expressive communication skills to give a superior product and create a pleasant experience for tourists. Hence, tourism frontliners are expected to be able to express effective interpersonal communication skills both internal and external communication. Interpersonal communication skills in dealing with people are one of the major demands in the industry nowadays. This has created a skills gap in the hospitality industry, which must be addressed if businesses are to remain competitive. It is suggested that the staff in tourism and hospitality should be carefully recruited and should undergo continual training because their communication skills are a significant indicator of their ability to foster favorable interactions with clients. Therefore, this conceptual paper aims to suggest an Islamic approach to improve current tourism frontliners interpersonal communications through Islamic-based communications. The need for interpersonal communication skills in the tourism industry is also highlighted in this article. An integrated model of tourism interpersonal communication with Islamic-based communication was proposed at the end of the article. It is hoped that this conceptual paper will be a stepping stone for research in tourism communication from an Islamic view.

Measuring the importance of communication skills in tourism

Tourism service providers need to have expressive communication skills to be able to offer a better tourism product and create a pleasant tourist experience. To better understand, conceptualize, and achieve the multidimensional concept of communication skills, this paper aims to investigate the literature and propose a measurement scale adapted to the modern tourism workplace. Results, based on a literature review and questionnaire survey, show that five communication skill dimensions emerge: written, oral, listening, digital, and non-verbal communication skills. The paper's theoretical contribution is the systematization of the literature and the conceptualization of communication skills up to date, while its empirical contribution is based on the examination of collected data related to the validated scale measurement. The scale presented in this paper will assist future empirical research on communication skills required in the field of tourism. The paper will help generate novel research questions for identifying and analyzing acquired communication skills.

Augmentative and Alternative Communication in the Context of Dramatic Storytelling: A Single-Case Study of a Pre-schooler With a Cochlear Implant

This single-case study of a pre-schooler with a cochlear implant aimed to integrate an Augmentative and alternative communication (AAC) intervention with dramatic storytelling activities to improve Jenny’s receptive and expressive language ability and communication skills as a means to address her communication needs. The researcher developed a functional communication image-text vocabulary list of 50 items with five categories: people, social interactions, animals, colors, and frequently used verbs. The intervention was conducted during the regular school day in the corner of a regular classroom 3 days a week for 6 weeks. This study demonstrated that AAC developed during dramatic storytelling activities helped Jenny to improve the effectiveness of functional communication vocabulary learning and increase the frequency of oral language communication. Group dramatic storytelling provides opportunities for learning through peer imitation during naturally occurring activities as well as ones for intentional and systematic AAC instruction during activities.

Uso de sistema robusto de comunicação alternativa no transtorno do espectro do autismo: relato de caso

ABSTRACT This study aimed at investigating the impact of using a robust augmentative and alternative communication (AAC) system on the communication of a child with autism spectrum disorder. This longitudinal intervention research is a single case study. Skills were assessed with data obtained with the protocol Communication Assessment in Autism Spectrum Disorder at the beginning and end of the intervention. Receptive and expressive communication and behavioral skills increased respectively by 62.5%, 36.84%, and 55.53%. Hence, positive results were found in communication development using the robust AAC system in the intervention, as verified in the progress in receptive and expressive communication and behavioral skills.

Career Maturity for Deaf Children: Obstacles And Solutions

This research was conducted at SMK Garut Regency on Deaf children who have difficulties in making decisions about careers at school and post-school careers. The decision to choose student majors is currently based on the strong will of parents, besides that teacher are less able to provide alternatives to the choice of majors they are interested in and are not based on the results of the assessment of talents and interests. Therefore, the purpose of this study is to see the obstacles of students in achieving career maturity based on the results of the needs analysis. This study uses a qualitative approach with descriptive methods. The participants of this study were Deaf children that had an impact on language skills and cognitive abilities in interpreting information, other subjects were classroom teachers, subject teachers, and special education teachers closest to the student's environment. Data collection techniques used observation, interviews, and documentation studies, and data analysis techniques used data triangulation. The results of this study indicate that the obstacles for students in making career decisions are caused by the impact of their deafness so that they are hampered by expressive and receptive communication skills that do not support them to ask questions so that they only get information from outside and find it difficult to interpret the information they get. The encouragement and prestige of parents and friends are other obstacles in determining student decisions that are not following their interests and talents. Another obstacle is that teachers have not specifically assessed the interest in talent for student careers before entering school to date. Based on these findings, a solution to determine the level of career maturity of students at this time requires an assessment of interests and talents which can then be used by teachers or parents in making transition programs in which focus is on developing soft skills for children in terms of making appropriate career decisions.

An Initial Investigation Into the Feasibility of the Communication Matrix Professional Development Program for Educational Professionals Working With Students With Complex Communication Needs.

Purpose The goal of this study was to investigate the initial feasibility of the Communication Matrix Professional Development Program (CMPDP), an online program created to help educational professionals teaching students with complex communication needs. Method A one-group pretest-posttest design was employed with 102 educational professionals and their students with complex communication needs. Students (M age = 12.5 years, SD = 4.8 years) had severe expressive communication impairments characterized by an expressive vocabulary of < 10 words. The online CMPDP included webinars, coursework, and engagement with an online community of practice. We examined the students' expressive communication skills measured by the Communication Matrix Assessment and Individualized Education Program (IEP) goal quality measured by the Design to Learn IEP Goal Development Guide before and after their teachers and speech-language pathologists participated in the intervention. Results Students showed small but significant increases on the Communication Matrix Assessment. The average increase in scores was 10.6, z = 5.37, 95% confidence interval (CI; [6.65, 14.54]), Glass's delta = 0.37. The mean gain in scores for IEP quality was not significant (0.82, z = 2.43, 95% CI [0.14, 1.49], Glass's delta = 0.28). Conclusions Results demonstrate the initial feasibility of the CMPDP for educational professionals and their students with complex communication needs. Findings must be interpreted cautiously as the study design has methodological limitations including lack of a control condition and a potential for correlated measurement error and demand characteristics. Supplemental Material https://doi.org/10.23641/asha.16734553.

IMPROVING LISTENER RESPONDING SKILL USING BEE-BOT® IN AUTISM SPECTRUM DISORDER: CASE STUDY

Children with autism spectrum disorder may have a variety of communication deficits. Their communication difficulties include language delay, limited vocabulary, inability to speak words, echolalia or repetitive use of phonemes, words, or phrases, absence of eye-contact during communication, and poor non-verbal communication skills. Moreover, some of them are nonverbal so they have to learn how to communicate by using alternative and augmentative communication techniques. Some children on the spectrum in order to improve their receptive and expressive communication skills need to work on a highly structured therapeutic environment and others need to work on a natural environment. Educational robotics can be a successful tool for children on the spectrum in order to improve communicational skills. The main goal of this study is to implement Bee-Bot® robotic toy as a supportive tool for a child with autism in order to improve his listener responding skill across actions. The results showed that during speech and Applied Behavior Analysis intervention, the child improved his receptive skill in a more funny and educational way. Researchers identified that by using Bee-Bot®, the participant communicated intensively and participated to the activity more enthusiastically than using the traditional method of teaching at the table. Nevertheless, researchers should implement generalization and maintenance procedures to ensure that the participant will be able to apply the learned behavior and skill outside of the learning environment and continue to practice the acquired skill over time.&#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0781/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

User Experiences of Eye Gaze Classroom Technology for Children With Complex Communication Needs

This study examines interactions between students with atypical motor and speech abilities, their teachers, and eye tracking devices under varying conditions typical of educational settings (e.g., interactional style, teacher familiarity). Twelve children (aged 4–12 years) participated in teacher-guided sessions with eye tracking software that are designed to develop augmentative and alternative communication (AAC) skills. Assessments of expressive communication skills before and after the testing period demonstrated significant improvements. 164 sessions conducted over a 3-month period were analyzed for positive engagement (e.g., gaze direction, session time) and system effectiveness (e.g., lag time, gaze registration) between integrated and non-integrated systems. Findings showed that integrated systems were associated with significantly longer sessions, more time spent looking at the screen, greater proportion of gaze targets registered by the system, and higher response rate to prompts from teachers. We discuss the implications for the facilitated use of eye tracking devices in special education classrooms.

The Impact of Eye-gaze Controlled Computer on Communication and Functional Independence in Children and Young People with Complex Needs – A Multicenter Intervention Study

ABSTRACT Introduction: Children and young people with complex needs (severe motor impairments and without speech) have few opportunities to use alternative devices for communication. Eye-gaze controlled computers (EGCCs) might provide individuals with complex needs increased opportunities for communication and participation in society. Objective: To investigate the impact of EGCCs on communication, functional independence and participation in activities in children and young people with complex needs. Methods: A multicenter intervention study during seven months, measuring outcomes with or without EGCC at four time points, was conducted in Sweden, Dubai, and in USA. Seventeen participants (aged 3–26 years, diagnosis e.g. cerebral palsy, Rett syndrome) were provided with EGCC and services from an Assistive Technology center to implement EGCC in school and/or at home. Results: Participants significantly increased their expressive communication skills and functional independence with EGCC compared to baseline. All but one (16 of 17) increased their activity repertoire and computer use with EGCC. With EGCC, participation in computer activities averaged 4.1 performed activities (e.g. communication, play), with a duration of 70 minutes/day and a frequency of 76% of days. Discussion: The study strengthened the research evidence that EGCC can be an effective intervention in daily life for children and young people with complex needs. Communication and independence, common goals of intervention, were shown to be relevant EGCC outcomes.