Systematic Review of Verbal Operants in Speech Generating Device Research from Skinner's Analysis of Verbal Behavior

Effects of an Augmentative and Alternative Communication Intervention Package on Socio-Communicative Behaviors Between Minimally Speaking Autistic Children and Their Peers

PURPOSE

The purpose of this study is to investigate the effectiveness of an augmentative and alternative communication (AAC) intervention package consisting of systematic instruction and aided modeling with speech-output technologies on the acquisition, maintenance, and generalization of socio-communicative behaviors-initiating a request for a turn, answering questions, and commenting-in four, minimally speaking (MS) autistic children between the ages of 6 and 9 years.

METHOD

A multiple-probe design across behaviors replicated across participants was implemented to evaluate the effects of systematic instruction and aided modeling on initiating requests for a turn, answering questions, and commenting behaviors. Additionally, a pre- and posttreatment multiple-generalization-probes design was used to assess generalization across peers.

RESULTS

Visual analyses demonstrated experimental control for two participants (i.e., Derek, Ajay) showing a functional relationship between the intervention and outcomes across all social communicative behavior. For one participant (i.e., Matthew), experimental control could not be established because he did not reach the learning criterion for commenting. The fourth participant (i.e., John) transferred to a different school after making some progress on requesting. Effect size indicator analyses corroborated these findings, indicating medium-to-strong effects for initiating requests for a turn strong effects for answering questions, and medium-to-strong effects for commenting. Generalization of socio-communicative behaviors from researcher to a typically developing peer was variable across participants. Participants maintained socio-communicative behaviors 3 weeks after the last intervention session with varying degrees of success.

CONCLUSION

The outcomes of this study suggest that aided modeling and systematic instruction using speech-output technologies may lead to gains in socio-communicative behaviors in some MS autistic children.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25799935.

The Analysis of Whose Verbal Behavior?

Recent reviews of behavior analytic journals suggest that participant demographics are inadequately described. These reviews have been limited to brief periods across several journals, emphasized specific variables (e.g., socioeconomic status), or only included specific populations. The current scoping review included all published articles in The Analysis of Verbal Behavior from 1982-2020. Six demographic variables were coded for 1888 participants across 226 articles. Despite small sample sizes (i.e., fewer than six participants in 62.3% of studies), only age (85.4%) and gender identity (71.6%) were reported for the majority of participants. Socioeconomic status, race/ethnicity, and primary language were reported for fewer than 20% of participants. Over time, the number of demographic variables reported showed a slight increasing trend, although considerable variability was observed across years. These findings suggest that editors and reviewers must consider what constitutes acceptable participant characterization. Researchers might also be emboldened to extend their work to populations currently underrepresented in the journal.

Increasing linguistic and prelinguistic communication for social closeness during naturalistic AAC instruction with young children on the autism spectrum

This study examined the effects of an intervention package using high-tech augmentative and alternative communication (AAC) with Naturalistic Instruction (NI), time delay, and prompting during social routines for preschoolers on the autism spectrum. The AAC was a communication application on a tablet programmed with color photo representations of participants and communication partners engaged in social routines. The primary dependent measure was a linguistic communication turn on the AAC device completing the instructor's cloze phrase related to the routine. A secondary dependent measure was prelinguistic communication -nonspecific vocalizations and smiling - within each turn of the routine. Results indicated that all communication types increased and maintained for all three participants with two participants meeting mastery criteria within the minimal number of sessions. These results are significant in providing additional evidence for the effectiveness of AAC intervention beyond teaching simple object requests and in teaching more socially meaningful communication to children on the autism spectrum. Additionally, this study supports the use of color photo representations to promote social interaction. Future research should continue to evaluate such interventions on a larger scale and include naturally occurring communication partners, such as siblings and peers.

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.

AAC and Autism: Manual Signs and Pecs, a Comparison

Autism Spectrum Disorders (ASD) represent a heterogeneous group of disorders, with onset in developmental age, which present a clinical expressiveness that varies from subject to subject and in the same subject over time. The DSM 5 defines Autism Spectrum Disorders according to two main criteria: persistent deficits in social communication and social interaction in multiple contexts and limited and repetitive patterns of behavior, interests or activities. This disorder can manifest itself across a broad spectrum of severity levels. Indeed, ASD includes clinical conditions from low functioning (LF—Low Functioning) to high functioning (HF—High Functioning), taking cognitive and adaptive functioning as a reference. One of the main characteristics of individuals with ASD is a delay in receptive and expressive communication. These deficits have led to the identification of evidence-based practices, particularly for those with severe communication difficulties. Augmentative Alternative Communication (AAC) has been implemented to compensate for deficits in functional communication and language skills in individuals with complex communication deficits. The AAC comprises communication systems including the Manual Signs, speech and image output devices (Communicators), and Image Exchange Systems (PECS); these systems have been shown to actually improve various abilities in autism such as social skills, modify and improve dysfunctional behaviors and, above all, improve learning. Recent meta-analyses have shown how PECS and Manual Sign can have great effects on the communication skills of young people with autism. The aim of this study is to compare these two types of intervention to improve communication in terms of vocalization in subjects with ASD and try to understand which of the two lead to more significant and rapid improvements.

Effects of a Systematic Augmentative and Alternative Communication Intervention Using a Speech-Generating Device on Multistep Requesting and Generic Small Talk for Children With Severe Autism Spectrum Disorder

Purpose The purpose of this study was to determine the effects of augmentative and alternative communication (AAC) intervention using a speech-generating device (SGD) on acquisition, maintenance, and generalization of multistep requesting and generic small talk in three children with severe autism spectrum disorder (ASD) between the ages of 7 and 13 years. Method A multiple-baseline design across participants combined with a posttreatment multiple-generalization-probe design was used to assess acquisition, generalization, and maintenance of target communicative behaviors with the experimenter and the participants' familiar communication partners (FCPs). Intervention was composed of systematic instruction in the use of an SGD using least-to-most prompting, constant time delay, error correction, and reinforcement. Results Visual analysis established a strong functional relationship between the independent variable and the two dependent variables (i.e., requesting preferred activities, engaging in generic small talk) for all three participants. Effect size indicator analyses corroborated these findings, indicating strong effects for performing multistep requesting and medium effects for engaging in generic small talk. All participants were able to generalize the acquired communicative behaviors to request new and untrained snacks and activities and engage in generic small talk with FCPs who were not part of the training. Maintenance of acquired communicative behaviors was demonstrated 3 weeks post completion of intervention. Conclusion This study provides preliminary evidence that AAC intervention using an SGD and incorporating least-to-most prompting, constant time delay, error correction, and reinforcement is effective in terms of multistep requesting and generic small talk behaviors in children with severe ASD. Supplemental Material https://doi.org/10.23641/asha.16663630.

Matrix training to teach tacts using speech generating devices: Replication and extension

Research has shown that training diagonal targets in a matrix may result in correct responses to the nondiagonal targets within the same matrix and novel targets from a separate matrix. This study replicated prior research using matrix training to teach tact noun-verb combinations to 3 male participants with autism who use a speech generating device to communicate. Two matrices were constructed (Matrix 1 and Generalization Matrix), using mastered nouns and verbs. Following baseline, diagonal targets within Matrix 1 were trained. Posttests were conducted for the Generalization Matrix and Matrix 1. Two participants showed recombinative generalization within Matrix 1 and correct responding to all targets within the novel generalization matrix. For the 3rd participant, recombinative generalization was observed within Matrix 1. However, correct responding with the generalization matrix targets was only observed after training with 3 additional matrices. These results replicate and extend previous findings.

Tact instruction for children with autism spectrum disorder: A review

Tacts facilitate social interaction, and a strong tact repertoire can lead to the development of other verbal operants. For children with autism spectrum disorder (ASD), the development of a tact repertoire can reduce stereotypical and repetitive language and increase social communication, as functional language may reduce the amount of stereotypical vocal behavior that children engage in. However, teaching tact repertoires to children with ASD that maintain and generalize is difficult. The current study reviewed tact interventions for children with ASD from 2000 to 2019 to provide an overview of current tact interventions, their effectiveness, and the inclusion of intervention components that may promote maintenance and generalization of learned tacts in children with ASD. Fifty-one studies were included in the review. Of the studies that met criteria for effect size calculations 87.18% of the interventions showed excellent or high effect. Although many of the studies focused more on stimulus control to answer specific research questions, some studies implemented intervention components and procedures that could promote acquisition and generalization of learned tacts in children with ASD. We discuss implications and the need to increase research regarding tact intervention components that can increase generalization in children with ASD.