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

2018 ◽  
Vol 61 (7) ◽  
pp. 1743-1765 ◽  
Author(s):  
Tara O'Neill ◽  
Janice Light ◽  
Lauramarie Pope

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

2020 ◽  
Vol 26 (2) ◽  
pp. 153-178
Author(s):  
Patricia West ◽  
Marcia Van Riper ◽  
Gwen Wyatt ◽  
Rebecca Lehto ◽  
Sarah N. Douglas ◽  
...  

Families with children who have developmental disabilities and complex communication needs (CCNs) face challenging demands affecting family adaptation. Many children with CCNs use augmentative and alternative communication (AAC) devices to support communication, yet little is known about family adaptation to such technology. To fill this gap, an integrative review, guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation was conducted to assess conceptual foundations and the state of the science of family adaptation among children utilizing AAC. Web-based searches were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the Mixed Methods Appraisal Tool. Thirty-three studies met eligibility. Findings demonstrated that to enhance the science underpinning family adaptation to AAC use, future research should be grounded conceptually and address important components of the Resiliency Model. Work in this emerging area will identify and facilitate nursing efforts to assist families as they adapt to communication technology.


2018 ◽  
Vol 123 (5) ◽  
pp. 443-473 ◽  
Author(s):  
Elizabeth E. Biggs ◽  
Erik W. Carter ◽  
Carly B. Gilson

AbstractBuilding the communicative competence of individuals who use augmentative and alternative communication (AAC) requires intervention and support. This systematic review examined experimental studies involving aided AAC modeling to promote the expressive communication of children and youth (i.e., birth to age 21) with complex communication needs. A search yielded 48 studies involving 267 participants. Interventions were categorized according to three different approaches to aided AAC modeling—augmented input, models as prompts, and models within instructional demonstrations. Although the procedures varied, interventions were generally effective at improving diverse measures of expressive communication. This review provides insight for both researchers and practitioners by describing interventions involving three distinct approaches to aided AAC modeling, highlighting areas needing future research, and offering implications for practice.


2015 ◽  
Vol 24 (4) ◽  
pp. 680-695 ◽  
Author(s):  
Jessica Caron ◽  
Janice Light

PurposeThis study aimed to expand the current understanding of how persons with amyotrophic lateral sclerosis (pALS) use augmentative and alternative communication and social media to address their communication needs.MethodAn online focus group was used to investigate the experiences of 9 pALS who use augmentative and alternative communication and social media. Questions posed to the group related to (a) current use of social media, (b) advantages of social media, (c) barriers to independent use, (d) supports to independent use, and (e) recommendations for developers, policy makers, and other pALS.ResultsParticipants primarily reported that use of social media was a beneficial tool that provided increased communication opportunities, connections to communication partners, and networks of support. Specific results are discussed with reference to the research as well as implications for practice and recommendations for future research.ConclusionsAs individuals with ALS experience loss of function, some communication modes may no longer be viable. Providing access to different modes of communication, including social media, can allow independence, participation and better quality of life.


2020 ◽  
Vol 51 (3) ◽  
pp. 821-838
Author(s):  
Cindy Gevarter ◽  
Keri Horan ◽  
Jeff Sigafoos

Purpose Children with autism spectrum disorder (ASD) and complex communication needs are increasingly taught to use tablet-based speech-generating devices (SGDs). An important issue in designing such interventions is the selection of an appropriate format for displaying vocabulary. The purpose of this study was to determine (a) whether young children with ASD can be taught to use different SGD vocabulary display formats and (b) whether there are differences across the formats on a range of secondary measures (e.g., preference and generalization). Method Five preschoolers with ASD (and prior experience with simpler aided augmentative and alternative communication) were taught to use grid and visual scene display SGDs during a play-based intervention. Acquisition of functional responding was assessed using a single-case experimental design. Secondary variables included error types, antecedents for communication, preference, and generalization. Results All participants increased their use of functional target vocabulary using both the grid and the simple visual scene display. Of the five participants, three showed similar performance with both formats, whereas two had slightly higher rates of functional responding with the grid. Individualized differences across participants and formats were apparent across secondary variables (e.g., preference, error types, generalization). Conclusions Both simple grid and visual scene displays may be viable options when teaching functional use of SGDs to children with ASD who have prior aided augmentative and alternative communication experience. Analyzing secondary variables beyond device acquisition (e.g., generalization, preference) may have implications for individualizing intervention.


2017 ◽  
Vol 26 (2) ◽  
pp. 227-240 ◽  
Author(s):  
Andrea Barton-Hulsey ◽  
Jane Wegner ◽  
Nancy C. Brady ◽  
Betty H. Bunce ◽  
Rose A. Sevcik

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


2021 ◽  
Author(s):  
Jay Ganz ◽  
James E Pustejovsky ◽  
Joe Reichle ◽  
Kimberly Vannest ◽  
Margaret Foster ◽  
...  

Objective: This meta-analysis reviews the literature on communication modes, communicative functions, and types of augmentative and alternative communication (AAC) interventions for school-age participants with autism spectrum disorders and/or intellectual disabilities who experience complex communication needs. Considering potential differences related to outcomes that were targeted for intervention could help identify the most effective means of individualizing AAC interventions. Methods: We performed a systematic literature search using Academic Search Ultimate, ERIC, PsycINFO, Web of Science, and Proquest Dissertations & Theses Global to retrieve research conducted between 1978 and the beginning of 2020. Studies included in the synthesis are (a) in English; (b) has one or more participants with an intellectual delay, developmental disability(ies); (c) reported the results of an augmentative and alternative communication (AAC) intervention to supplement or replace conventional speech for people with complex communication needs; (d) was a SCED; (e) measured social-communicative outcomes. We synthesized results across studies using multi-level meta-analyses of two case-level effect size metrics, Tau and log response ratio. We conducted moderator analyses using meta-regression with robust variance estimation.Results: Across 114 included studies with 330 participants and 767 effect size, overall Tau effects were moderate, Tau = 0.72, 95% CI [0.67, 0.77], and heterogeneous. For the subset of data series where log response ratio could be estimated, the overall average effect was LRR = 1.86, 95% CI [1.58, 2.13], and effects were highly heterogeneous. There were few statistically significant differences found between moderator categories, which included communication mode, communicative function, and type of AAC implemented.Conclusions: This meta-analysis highlights the potential differences related to outcomes that were targeted for AAC interventions for individuals with ASD and IDD. AAC intervention has been shown to improve communication outcomes in this population. However, there was a lack of sufficient data to analyze for some potential moderators such as insufficient descriptive information on participant characteristics. This is likely due to the heterogeneity of the participants and implementation factors; however, these factors were frequently underreported by original study authors which disallowed systematic analysis. That said, there is a need for more detailed participant characteristic descriptions in original research reports to support future aggregation across the literature. Sponsorship: We received funding for the review from the Institute of Education Sciences.Protocol: The review protocol was registered in the PROSPERO system (CRD42018112428).


2020 ◽  
Vol 5 (1) ◽  
pp. 219-230 ◽  
Author(s):  
Sarah N. Douglas ◽  
Patricia West ◽  
Rebecca Kammes

Purpose Services for children with complex communication needs require well-trained practitioners. Yet, research shows that augmentative and alternative communication (AAC) practitioners often receive insufficient preservice training for direct services to these children. Therefore, we explored the preservice and in-service training experiences of AAC practitioners to inform improvements in practitioner training and ultimately improve services for individuals with complex communication needs. Method A focus group study was conducted with AAC practitioners (three focus groups with 13 AAC practitioners in total) in one midwestern U.S. state to explore preservice and in-service training experiences and gain knowledge to inform future training efforts. Constant comparative analysis was used to analyze data gathered from the focus groups. Results This study highlighted important gaps in preservice and in-service training for AAC practitioners, barriers related to AAC training, and suggestions for improving AAC training. Conclusions This study provides important insights into ways AAC practitioner training might improve. We provide clinical implications and future research directions to continue improving AAC practitioner preparation and subsequent services for individuals with complex communication needs.


2021 ◽  
pp. 152574012199147
Author(s):  
Natalie R. Andzik ◽  
Yun-Ching Chung

The authors conducted a systematic review of the literature including studies that used a single-case design (SCD) and taught augmentative and alternative communication (AAC) use to adults with complex communication needs. The purpose of this review was to describe (a) adults receiving AAC intervention, (b) components of the interventions used, and (c) how the literature met quality standards set by the What Works Clearinghouse (WWC). Across the 12 SCD studies included, a total of 28 adults with complex communication needs received intervention. As part of the intervention, the majority of the participants ( n = 24; 86%) were introduced to new AAC systems (e.g., picture, communication application). Ten of 12 studies showed at least moderate evidence of effectiveness. Only three of 12 studies met the WWC standards without reservation. Findings from this review call for action to ensure quality AAC access and services are available to adults with complex communication needs.


Author(s):  
Janis Doneski-Nicol ◽  
Jody Marie Bartz

Augmentative and Alternative Communication (AAC) systems are a common assistive technology (AT) intervention for learners with complex communication needs (CCN) – those learners who are unable to use speech and language as a primary mode of communication. AAC systems can be a powerful intervention; however, these systems must be integrated with strong, early and conventional literacy instructional opportunities. In this chapter, we provide parents, educators, researchers, academics, and other professionals with the most up to date and innovative information as well as practical resources regarding early literacy and AAC for learners with CCN. Emphasis will be on young children with CCN in preschool and early elementary school settings. Features of AAC systems and evidence-based literacy assessment and intervention, as well as the benefits and challenges, are presented to provide the reader with information on the current state of the field. The chapter concludes with directions for future research and provides a comprehensive list of resources and organizations.


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