High-tech And Alternative Communication Research Articles

A proof-of-concept study for automatic speech recognition to transcribe AAC speakers’ speech from high-technology AAC systems

ABSTRACT Automatic speech recognition (ASR) is an emerging technology that has been used in recognizing non-typical speech of people with speech impairment and enhancing the language sample transcription process in communication sciences and disorders. However, the feasibility of using ASR for recognizing speech samples from high-tech Augmentative and Alternative Communication (AAC) systems has not been investigated. This proof-of-concept paper aims to investigate the feasibility of using AAC-ASR to transcribe language samples generated by high-tech AAC systems and compares the recognition accuracy of two published ASR models: CMU Sphinx and Google Speech-to-text. An AAC-ASR model was developed that transcribes simulated AAC speaker language samples. The AAC-ASR model’s word error rate (WER) was compared with those of CMU Sphinx and Google Speech-to-text. The WER of the AAC-ASR model outperformed (28.6%) compared with CMU Sphinx and Google when tested on the testing files (70.7% and 86.2% retrospectively). Our results demonstrate the feasibility of using the ASR model to automatically transcribe high-technology AAC-simulated language samples to support language sample analysis. Future steps will focus on developing the model with diverse AAC speech training datasets and understanding the speech patterns of individual AAC users to refine the AAC-ASR model.

Effects of Interaction Approaches and Added High-Tech Augmentative and Alternative Communication on Prelinguistic and Linguistic Communication from School-Age Beginning Communicators

Introduction: Augmentative and alternative communication (AAC) intervention research is rarely focused on school-age beginning communicators, despite the urgent need to ensure individuals in this population have access to the fundamental human right of communication. Methods: Four school-age children with multiple disabilities who were primarily prelinguistic communicators participated in the current study. The study used a single-subject research design to explore the effects of two interaction approaches – a social routine approach and a directive approach – on prelinguistic communication, compared to independent play and to one another. This study then evaluated the added effects of high-tech AAC within the most effective interaction approach for each participant. Results: All participants demonstrated prelinguistic communication indicating positive affect most frequently when interacting within a social routine. Furthermore, all participants increased linguistic communication while either maintaining or increasing prelinguistic communication when high-tech AAC was added to the social routine interaction. Conclusions: Clinicians should consider building accessible, predictable, engaging, and age-respectful social routines into leisure contexts to promote prelinguistic communication from school-age beginning communicators. Clinicians should also provide access to linguistic communication through high-tech AAC while continuing to honor and promote prelinguistic communication.

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.

A delayed intervention start randomized controlled trial of high- and low-tech communication training approaches for school-age autistic children with co-occurring intellectual disability.

The researchers designed a delayed intervention start randomized controlled trial to compare improvements in functional communication following augmentative and alternative communication (AAC) interventions. The study compared outcomes from function-based applied behavior analytic (ABA) and eclectic non-ABA forms of classroom-based communication strategies (waitlist control) as well as from high- and low-tech forms of AAC. High-tech AAC consisted of tablet-based communication, and low-tech AAC used an exchange of picture cards. The community-based sample consisted of 29 autistic children with a co-occurring intellectual disability. Participants were randomized to groups (AAC, waitlist control), and each group received approximately 3 months of communication intervention. Multilevel modeling of learner outcomes indicated that the function-based approach produced greater improvements than the eclectic alternative, but significant differences were not observed between outcomes of high- and low-tech forms of function-based AAC. These results are consistent with earlier investigations and provide supporting evidence that both high- and low-tech forms of function-based intervention are effective for use with autistic children with accompanying intellectual disability. Additional discussion is provided regarding further research into how technology is applied and incorporated into behavior analytic programming.

Aphasia and high-tech communication support: a survey of SLPs in USA and India

Purpose This survey was conducted to investigate American and Indian clinician’s preference and usage of high-tech communication supports (HTCS) for aphasia rehabilitation to identify factors in each country that support the use of HTCS for improving post-aphasia communicative outcomes. In this study, HTCS include speech-generating augmentative and alternative communication (AAC) devices with varying methods of access. Method The survey exploring clinically practicing speech-language pathologists’ (SLPs) training, assessment and aphasia rehabilitation practices using HTCS, was electronically distributed in both countries. The raw responses from the US SLPs (n = 56) and Indian SLPs (n = 43) were collected, segregated and then converted into percentages for all 41 survey questions. Results The responses from SLPs indicated higher (70%) and lower use (58%) of HTCS for aphasia in a developed country (USA) and developing country (India), respectively. In the US, identifiable factors for successful use of HTCS for aphasia rehabilitation were familiarity in procuring and programming the device, caregiver training and effectiveness in reducing the time of communicating through the device. In India, factors leading to successful inclusion of HTCS were AAC coursework and clinical training for clinicians and availability of HTCS at affordable prices for clients. Conclusion There is a considerable difference in the educational and clinical practice of AAC as SLPs in the US tend to have more clinical AAC experience with a stronger network for device dissemination in comparison to SLPs in India leading to higher usage of high-tech AAC for aphasia rehabilitation in a developed country. Implications for Rehabilitation For the SLPs, Improve exposure to programming AAC devices in developed countries and increase coursework, clinical training and exposure to programming AAC devices in developing countries. Enhance awareness about integrating high-tech AAC devices in intervention programs. Improve efficiency by minimizing the time in message creation on high-tech AAC device in developed countries. For the bioengineers, Develop AAC application interfaces in regional languages for easier usage in developing countries.

Multicultural considerations in augmentative and alternative communication

ABSTRACT Little is known about how well high-tech augmentative and alternative communication (AAC) systems accommodate language variation to meet the needs of people and families who are culturally and linguistically diverse. The purpose of this study was to investigate how high-tech AAC device manufacturers consider language variation and multilingualism in device design and language files, whether there is a difference in the modifications available on default language files on a dedicated AAC device as compared to communication applications on tablets, and the availability of these modifications. A coding schema was developed to assess features available that enabled user modification of default language files across four language domains: semantics, morphosyntax, phonology, and pragmatics. The results indicated that more changes were possible in semantics and phonology on default language files. There were not significant differences between language files offered on a dedicated AAC device or an application on a tablet. There were significant differences in the capabilities of the device to make modifications and in the ease of programming, but not in the resources provided to families. Based on these findings, it appears that device manufacturers have just begun to address the needs of families and users who are culturally and linguistically diverse.

Exploring high-technology augmentative and alternative communication interfaces: the effect of age and technology experience

Purpose Many people with aphasia have inadequate language skills for functional communication thereby necessitating well-designed augmentative and alternative communication (AAC) interfaces. Using both a grid and a VSD interface with single word hotspots by neurologically healthy adults, across ages and with different technology experiences, this study examines the utility of these interfaces prior to investigating their use with people with aphasia in future studies. Method Participants include 18 young adults, 24 older adults with technology experience, and 20 older adults with limited technology experience. The older adult groups were matched for mean age and for sex. Participants described pictures with each interface, and performance was measured based on four dependent variables: (a) the total number of correct information units (CIUs), (b) the percentage of CIUs, (c) CIUs per minute, and (d) preferred interface. Results There was a significant difference between older adults and the young adult group for the total number of CIUs (p < 0.001) and CIUs per minute (p < 0.001). Despite the changes in technology experience between the two older groups, there was no significant difference in performance. Additionally, there was no significant difference in performance across the two interfaces in any of the groups. Conclusion Findings suggest age does impact performance on AAC. However, the difference in technology experience in older adult groups did not affect performance. Furthermore, both interfaces used in the current study were equally beneficial when describing pictures by healthy adults. Implications for Rehabilitation Augmentative and alternative communication (AAC) systems involve various interface designs. Consequently, the comparative utility of these interfaces must be examined across populations and communicative functions. Advancement in technology has given rise to numerous high-tech AAC interface designs. However, older adults with acquired language difficulties whose technology experience is limited may become reluctant to use high-tech AAC. Hence, the influence of technology experience on high-tech AAC performance should be investigated. Prior to examining interfaces with individuals with acquired language difficulties, the current study examined the use of a) grid display and b) visual scene display (VSD) with single word hotspots, by healthy adults of different ages and technology experiences. The study revealed that older adults with limited technology experience were equally competent in using high-tech AAC interfaces, as those with technology experience. Hence, an individual’s technology experience should not be considered a deterrent to using high-tech AAC interfaces. Additionally, the study found no differences in performance between the two interfaces, making it essential to consider user's personal preference when adopting AAC interface designs.

Direct Speech-Language Intervention Effects on Augmentative and Alternative Communication System Use in Adults With Developmental Disabilities in a Naturalistic Environment.

Research involving the effects of augmentative and alternative communication (AAC) intervention in adults, especially in naturalistic settings, has been identified as a critical public health need. Despite rapid advances in high-tech AAC, many adults with developmental disabilities have experienced reduced access to assistive technology and AAC, which can function as a de facto environmental barrier to participation, for these individuals. As a means of decreasing barriers to participation, this study targeted skill increases in the operational, linguistic, social, and strategic use of AAC systems. This study used a preexperimental, single-case AB design to identify skill level changes in the operational, linguistic, social, and strategic use of their AAC system from baseline to the completion of intervention. The four adult participants with developmental disabilities and limited use of natural speech as a primary modality of communication were identified through a collaborative relationship between a communication sciences and disorder university program and a state-run adult day program for individuals who had aged out of the K-12 school system. Each participant received direct intervention in the four areas described across 7 weeks. Visual analysis and percent of nonoverlap of all pairs were used to identify changes in performance occurring between baseline and the conclusion of the intervention period. Results revealed increases across the specific skills, with individuals' variation across participants and target area. Out of 22 total goals targeted, strong effect sizes were observed for 10 goals and moderate effect sizes were observed for seven. Skill increases in the four areas of AAC system use can be achieved with direct intervention in adults with developmental disabilities and limited use of natural speech as a primary modality of communication. This approach also underscores the value of collaborations between university training programs, providers of adult services, and adult participants as a cost-effective strategy for service delivery.

Systematic Physical Assistance During Intervention for People Who Use High-Tech Augmentative and Alternative Communication Systems: The Importance of Using a Common Vocabulary.

Speech-language pathologists (SLPs) use prompting hierarchies to facilitate learning and monitor treatment progress. When working with people who use augmentative and alternative communication (AAC), SLPs typically use physical assistance to prompt motor learning. However, there is currently no standardization regarding the number of physical prompting levels or an operational definition for each prompting level. Clinicians and researchers may be working from different definitions; making treatment progress monitoring and intervention effectiveness comparisons across research studies is problematic. The purpose of this article is to illustrate the advantage of using the language in the Functional Independence MeasureSM (FIM; Deutsch et al., 1996) to describe the level of physical assistance provided during AAC intervention and AAC intervention research for individuals who use high-tech AAC systems. Standardizing the level of physical assistance will provide important information regarding AAC learning that researchers may use as they continue to study the active ingredients of AAC intervention. Furthermore, standardizing the descriptions of physical assistance levels will enable clinicians to accurately describe a learner's performance. This article describes how the language used in the FIM may be used by SLPs to provide a consistent, continuous, and systematic approach to fading the physical assistance used during AAC intervention to ultimately support independent use of high-tech AAC systems.

Deep Neural Network-based Speaker-Aware Information Logging (SAIL) for Augmentative and Alternative Communication

People with complex communication needs can use a high-technology Augmentative and Alternative Communication (AAC) device to communicate with others. Currently, researchers and clinicians often use data logging from high-tech AAC devices to analyze AAC user performance. However, existing automated data logging systems cannot differentiate the authorship of the data log when more than one user accesses the device. This issue reduces the validity of the data logs and increases the difficulties of performance analysis. Therefore, this paper presents a solution using a deep neural network-based visual analysis approach to process videos to detect different AAC users in practice sessions. This approach has significant potential to improve the validity of data logs and ultimately to enhance AAC outcome measures.

Technological Evolvement in AAC Modalities to Foster Communications of Verbally Challenged ASD Children: A Systematic Review

Augmentative and Alternative Communication (AAC) emerged as a combination of methods or strategies that constitute any device, such as Speech Generating Device (SGD), Program (mobile applications), Procedure (PECS, Picture Exchange Communication System), which enhances individual’s communication ability. Autism Spectrum Disorder (ASD) is a spectrum of comprehensive neurodevelopment disorder that leads to speech impairments, repetitive behavior, and social communication difficulties; therefore, it is imperative to underscore that at the core of all impediments are communication impairment. This article represents a systematic review of research initiatives that investigate multi-modal AAC strategies and functionality, features of mobile applications to reinforce communication and communal skills in verbally challenged ASD children because other researches are focused only on low or high-tech AAC or interventions to provide insights on ASD children respond to a particular approach. Following the PRISMA method, a total of 60 (January 2015 to October 2020) research articles were reviewed, indexed by Springer, Science Direct, Scopus, ACM, IEEE databases, and published in the AAC journal. The selected research articles are categorized into different themes where most of them focused on interactive mobile applications to improve emotional, social, learning, and overall communication skills in verbally challenged ASD children. This systematic review provides an outline of the paradigm shift in AAC modalities from PECS to Artificial Intelligence (AI), Machine Learning (ML), and Augmented Reality (AR) based applications. It opens up underline future opportunities to integrate intelligent analytics features in mobile applications to strengthen communication skills in verbally undermined ASD children.

Transitioning from a low- to high-tech Augmentative and Alternative Communication (AAC) system: effects on augmented and vocal requesting

A considerable number of studies have demonstrated that augmentative and alternative communication (AAC) is effective in increasing speech production in some children with autism spectrum disorder (ASD). Thus, this study aimed to (a) investigate the effects of a Picture Exchange Communication System (PECS) Phase IV protocol on the acquisition of spontaneous augmented requests, (b) evaluate the impact of progressive time delay and synthetic speech output on the development of vocal requests, and (c) determine the participants’ preferences for each modality after reaching mastery. A multiple-baseline design across four children with ASD was used to measure the acquisition of augmented and vocal requests during the transition from low-tech to high-tech AAC systems. During a natural condition (i.e., playtime), a modified PECS Phase IV protocol was applied to teach the participants to request by producing multisymbol messages (e.g., I WANT + names of a preferred item) using an iPad as well as vocalizations. After mastery, the participants’ preference for using the modified PECS Phase IV app or the communication book was assessed by comparing the response allocations. The preliminary results suggest that the modified PECS protocol can be used to transition from a low- to high-tech communication modality.

Growing Up With Technology

The increasing integration of technology into the daily events and social interactions of our society present incredible opportunities for children with complex communication needs (CCN) who rely on augmentative and alternative communication (AAC) strategies. Children with CCN who utilize high-tech AAC options at an early age are essentially growing up with a technology that is inserted into interactions across multiple contexts for communication. An aided system can potentially create additional demands, serve a complementary role, or even be a platform to create a collaborative space for social interaction. This article discusses the impact of technology on contexts for communication and presents a progression from unaided AAC strategies to the use of aided systems for fostering expressive language skills and supporting participation. Augmentative and alternative communication strategies offer many possibilities in terms of access to communication; however, where a device is placed both physically and figuratively can make an important difference.

Enhancing language in children who are deaf/hard-of-hearing using augmentative and alternative communication technology strategies

BackgroundDespite early identification and intervention, many children who are deaf/hard of hearing (D/HH) demonstrate significant gaps in language development which can directly impact social interactions. AimsThe objective of this pilot study was to determine whether integrating augmentative and alternative communication (AAC) core word language strategies into a speech-language therapy program for young children who are D/HH improves spoken language outcomes. MethodsEleven young children, median age 5 years 7 months (range 3y;11 m to 10y;8 m) with bilateral hearing loss were enrolled in a single-case experimental design and completed a 24-week intervention that incorporated high-tech AAC strategies into a traditional speech-language therapy model (technology-assisted language intervention or TALI). The goal of the TALI was to improve spoken language development in children who were D/HH. Language samples were collected throughout the study and pragmatic language was assessed pre and post intervention. ResultsAt the end of 24 weeks, children demonstrated a significant increase in their mean length of utterance, number of words spoken, and mean turn length according to language samples. Children also made gains in their pragmatic skills pre to post intervention. ConclusionsResults of this study suggest that using AAC core word language strategies delivered via iPad technology may support continued and rapid spoken language skill growth among young school-age children who are D/HH. By leveraging AAC technology, we are pioneering a structured and dynamic approach to language learning, building an effective foundation for concepts and grammar for children who are D/HH.

Augmentative and Alternative Communication (AAC) Advances: A Review of Configurations for Individuals with a Speech Disability.

High-tech augmentative and alternative communication (AAC) methods are on a constant rise; however, the interaction between the user and the assistive technology is still challenged for an optimal user experience centered around the desired activity. This review presents a range of signal sensing and acquisition methods utilized in conjunction with the existing high-tech AAC platforms for individuals with a speech disability, including imaging methods, touch-enabled systems, mechanical and electro-mechanical access, breath-activated methods, and brain–computer interfaces (BCI). The listed AAC sensing modalities are compared in terms of ease of access, affordability, complexity, portability, and typical conversational speeds. A revelation of the associated AAC signal processing, encoding, and retrieval highlights the roles of machine learning (ML) and deep learning (DL) in the development of intelligent AAC solutions. The demands and the affordability of most systems hinder the scale of usage of high-tech AAC. Further research is indeed needed for the development of intelligent AAC applications reducing the associated costs and enhancing the portability of the solutions for a real user’s environment. The consolidation of natural language processing with current solutions also needs to be further explored for the amelioration of the conversational speeds. The recommendations for prospective advances in coming high-tech AAC are addressed in terms of developments to support mobile health communicative applications.

Augmentative and alternative communication in the Philippines: a survey of speech-language pathologist competence, training, and practice

A cross-sectional survey study was undertaken to describe the perceived competence, pre- and post-professional training, and practice of Filipino speech-language pathologists (SLPs) in augmentative and alternative communication (AAC). Printed and electronic questionnaires were distributed to all SLPs in the Philippines with at least 1 year of practice experience. A total of 152 (47%) questionnaires were returned. Based on these data, 108 respondents (71%) practiced AAC, but most (range = 59–89%) did not perceive themselves to be competent in working with various client populations with complex communication needs. A majority (range = 70–93%) of the respondents reported limited pre-professional training in all AAC content areas, and at least 82% strongly desired continuing education in almost all areas of AAC. Almost 90% of respondents only occasionally (53%) or rarely (36%) recommended AAC, and 82% considered it as a last resort. Major practice challenges reported were families’ negative attitudes toward AAC and lack of AAC-specific interdisciplinary collaboration. Infrequent use of high-tech AAC was also reported. The findings suggest various ways through which AAC education and services in the Philippines may be enhanced. They also imply the need for further research on alternative service delivery models, as well as additional members of the AAC team.

A pilot community-based randomized comparison of speech generating devices and the picture exchange communication system for children diagnosed with autism spectrum disorder.

A pilot community-based randomized controlled trial was conducted to compare the effects of the Picture Exchange Communication System (PECS) to a teaching sequence using a high-tech Speech Generating Device (SGD) to teach social communication behaviors. The two approaches were compared to evaluate the effectiveness of the newer, more high-tech intervention using technology to improve social and communicative behavior of children diagnosed with Autism Spectrum Disorder. A total of 35 school-age children were randomized to either a high-tech (SGD device) or low-tech (PECS cards) form of Augmentative and Alternative Communication (AAC). Study participants received 4 months of communication training delivered in their classrooms, and the primary outcome measures of the trial were several functional communication skills emphasized in the PECS teaching sequence. Results indicated that both high-tech and low-tech AAC approaches resulted in significant improvements in communication, and that these improvements did not differ significantly between the two approaches. These findings support the use of high-tech AAC, and highlight the need for evidence-based guidelines for its use as well as evaluation with individuals with a range impairments and disabilities. Autism Research 2018, 11: 1701-1711. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study compared the effectiveness of a free and open-source app for teaching social and communicative behavior to children with autism spectrum disorder (ASD) to traditional picture card approaches. Thirty-five children with ASD were randomized to a picture card or app-based intervention and both treatment approaches resulted in significant improvements in social and communicative behavior. These data indicated that both "high-tech" and "low-tech" interventions were effective for improving behavior and that there was not a significant difference between the two approaches.

A systematic quality review of high-tech AAC interventions as an evidence-based practice

Although high-tech augmentative and alternative communication (AAC) is commonly used to teach social-communication skills to people with autism spectrum disorder or intellectual disabilities who have complex communication needs, there is a critical need to evaluate the efficacy of this approach. The aim of this systematic review was to evaluate the quality of single-case experimental design research on the use of high-tech AAC to teach social-communication skills to individuals with autism spectrum disorder or intellectual disabilities who have complex communication needs, to determine if this intervention approach meets the criteria for evidence-based practices as outlined by the What Works Clearinghouse. Additionally, information on the following extended methodological standards is reported on all included studies: participant description, description of setting and materials, interventionist description, baseline and intervention description, maintenance, generalization, procedural integrity, and social validity. The results from 18 multiple-baseline or multiple-probe experiments across 17 studies indicate that using high-tech AAC to teach social-communication skills to individuals with autism spectrum disorder or intellectual disabilities and complex communication needs can be considered an evidence-based practice, although the review of comparison (i.e., alternating treatment) design studies did not indicate that high-tech AAC is significantly better than low-tech AAC.

The feasibility of improving discourse in people with aphasia through AAC: clinical and functional MRI correlates

ABSTRACTBackground:The theory of intersystemic reorganization, along with the ability of people with chronic aphasia to recover language function, suggests that a high-tech augmentative and alternative communication (AAC) device could be employed as a dual-purpose tool that simultaneously facilitates language recovery and compensates for deficits. To date, treatments based on intersystemic reorganization have focused on writing, drawing, and gesturing. Further, despite a movement to identify neural mechanisms that support intervention-related recovery, the neurobiological markers of AAC-induced changes have not been established.Aims: The purpose of this study is twofold: (1) to examine the feasibility of providing a high-tech AAC treatment to people with chronic aphasia, with the goal of evoking changes in spoken language; and (2) to identify evidence of AAC-induced changes in brain activation.Method and Procedures: We employed a pre- and post-treatment design with a control (usual care) group to observe the impact of an AAC treatment on aphasia severity and spoken discourse. Further, we used functional magnetic resonance imaging (fMRI) to examine associated neural reorganization.Outcomes and Results: Compared to the usual care group, the AAC intervention trended toward larger treatment effects and resulted in a higher number of responders on behavioral outcomes. Both groups demonstrated a trend toward greater leftward lateralization of language functions via fMRI. Secondary analyses of responders to treatment revealed increased activation in visual processing regions, primarily for the AAC group.Conclusions: This study provides preliminary guidance regarding how to implement AAC treatment in a manner that simultaneously facilitates language recovery across a variety of aphasia types and severity levels while compensating for residual deficits in people with chronic aphasia. Further, this work motivates continued efforts to unveil the role of AAC-based interventions in the aphasia recovery process and provides insight regarding the neurobiological mechanisms supporting AAC-induced language changes.

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

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