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Reichle J, Pustejovsky JE, Vannest KJ, Foster M, Pierson LM, Wattanawongwan S, Chen M, Fuller MC, Haas AN, Bhat BH, Sallese MR, Smith SD, Yllades V, Rodriguez D, Yoro A, Ganz JB. Systematic Review of Variables Related to Instruction in Augmentative and Alternative Communication Implementation: Group and Single-Case Design. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-24. [PMID: 37235744 DOI: 10.1044/2023_ajslp-22-00314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE This article provides a systematic review and analysis of group and single-case studies addressing augmentative and alternative communication (AAC) intervention with school-aged persons having autism spectrum disorder (ASD) and/or intellectual/developmental disabilities resulting in complex communication needs (CCNs). Specifically, we examined participant characteristics in group-design studies reporting AAC intervention outcomes and how these compared to those reported in single-case experimental designs (SCEDs). In addition, we compared the status of intervention features reported in group and SCED studies with respect to instructional strategies utilized. PARTICIPANTS Participants included school-aged individuals with CCNs who also experienced ASD or ASD with an intellectual delay who utilized aided or unaided AAC. METHOD A systematic review using descriptive statistics and effect sizes was implemented. RESULTS Findings revealed that participant features such as race, ethnicity, and home language continue to be underreported in both SCED and group-design studies. Participants in SCED investigations more frequently used multiple communication modes when compared to participants in group studies. The status of pivotal skills such as imitation was sparsely reported in both types of studies. With respect to instructional features, group-design studies were more apt to utilize clinical rather than educational or home settings when compared with SCED studies. In addition, SCED studies were more apt to utilize instructional methods that closely adhered to instructional features more typically characterized as being associated with behavioral approaches. CONCLUSION The authors discuss future research needs, practice implications, and a more detailed specification of treatment intensity parameters for future research.
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Affiliation(s)
- Joe Reichle
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis
| | | | | | - Margaret Foster
- Center for Systematic Reviews and Research Syntheses, School of Medicine, Texas A&M University, College Station
| | - Lauren M Pierson
- Department of Social Work and Communication Disorders, Tarleton State University, Fort Worth, TX
| | | | - Man Chen
- Department of Educational Psychology, University of Wisconsin-Madison
| | - Marcus C Fuller
- Department of Education, University of Maryland Eastern Shore, Princess Anne
| | | | - Bethany H Bhat
- Department of Educational Psychology, University of Texas at Austin
| | - Mary Rose Sallese
- Department of Curriculum and Instruction, University of Alabama-Birmingham
| | - S D Smith
- Department of Elementary, Early, & Special Education, Southeast Missouri State University, Cape Girardeau
| | | | - Daira Rodriguez
- Department of Educational Psychology, Texas A&M University, College Station
| | - Amara Yoro
- Department of Educational Psychology, Texas A&M University, College Station
| | - J B Ganz
- Department of Educational Psychology, Texas A&M University, College Station
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Chavers TN, Schlosser RW, Cheng C, Koul R. Effects of Interventions Involving Speech Output Technologies on Communication Outcomes for Individuals With Developmental Disabilities: A Scoping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2248-2267. [PMID: 35969850 DOI: 10.1044/2022_ajslp-22-00039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE This scoping review aimed to map the literature on the effects of interventions involving speech output technologies on communication outcomes for individuals with developmental disabilities other than autism spectrum disorder. METHOD A scoping review methodology was used to limit bias in searching, selecting, coding, and synthesizing relevant intervention studies. This involved a multifaceted search for studies conducted between 1991 and March 2021 using various electronic databases, ancestry searches, and forward citation searches from selected articles. Studies had to meet stringent inclusion criteria. Each study was summarized in terms of authors, purpose, participants, design, speech output, outcomes, effectiveness, and quality appraisal. RESULTS Twenty-five single-case experimental design studies (88 participants) and one group design studies (62 participants) qualified for inclusion. Most of the participants had multiple diagnoses followed by a diagnosis of cerebral palsy and Down syndrome. Most studies focused on requesting behaviors and to a much lesser extent on syntactic structure and word identification. A dearth of high-quality studies was identified. CONCLUSIONS Overall, there is a paucity of high-quality research investigating the effects of speech output technologies for children with developmental disabilities. Additionally, several directions for future research are posited. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20468928.
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Affiliation(s)
- Tiffany N Chavers
- Department of Speech, Hearing, and Language Sciences, The University of Texas at Austin
| | - Ralf W Schlosser
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, MA
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Cissy Cheng
- Department of Speech, Hearing, and Language Sciences, The University of Texas at Austin
| | - Rajinder Koul
- Department of Speech, Hearing, and Language Sciences, The University of Texas at Austin
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
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Crowe B, Machalicek W, Wei Q, Drew C, Ganz J. Augmentative and Alternative Communication for Children with Intellectual and Developmental Disability: A Mega-Review of the Literature. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2021; 34:1-42. [PMID: 33814873 PMCID: PMC8009928 DOI: 10.1007/s10882-021-09790-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 05/06/2023]
Abstract
Establishing evidence- and research-based practices relies upon research synthesis of individual studies in reviews and meta analyses. Further summarizing scientific evidence about a specific topic by synthesizing reviews is an area of need to determine practices that have a strong evidence base and to identify areas of methodological weakness and gaps in the literature. A mega-review of literature reviews, systematic reviews, and meta-analyses on interventions using aided augmentative and alternative communication (AAC) interventions for children with intellectual and developmental disabilities from 2000 to mid-2020 was conducted. Participant and interventionist demographics, interventions, settings, outcomes, and recommendations of each review were reported and summarized. A MeaSurement Tool to Assess systematic Reviews Revised (AMSTAR 2; Shea et al., 2017) was used to examine the methodological rigor of 84 included reviews. Over the past 20 years, published reviews have increased slightly in methodological rigor but demonstrate a number of methodological weaknesses that detract from the strength of evidence for AAC interventions with this population. Suggestions for improving the methodological rigor of literature reviews and areas for future research specific to AAC interventions are discussed.
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Affiliation(s)
- Becky Crowe
- Department of Special Education and Clinical Sciences, University of Oregon, 1589 E 15th Street, Eugene, OR 97403 USA
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, University of Oregon, 1589 E 15th Street, Eugene, OR 97403 USA
| | - Qi Wei
- Department of Special Education and Clinical Sciences, University of Oregon, 1589 E 15th Street, Eugene, OR 97403 USA
| | - Christine Drew
- Department of Special Education, Rehabilitation and Counseling, Auburn University, Auburn, AL USA
| | - Jay Ganz
- Department of Special Education and Educational Psychology, Texas A&M University, College Station, TX USA
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Ascari REOS, Pereira R, Silva L. Computer Vision-based Methodology to Improve Interaction for People with Motor and Speech Impairment. ACM TRANSACTIONS ON ACCESSIBLE COMPUTING 2020. [DOI: 10.1145/3408300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Augmentative and Alternative Communication (AAC) aims to complement or replace spoken language to compensate for expression difficulties faced by people with speech impairments. Computing systems have been developed to support AAC; however, partially due to technical problems, poor interface, and limited interaction functions, AAC systems are not widespread, adopted, and used, therefore reaching a limited audience. This article proposes a methodology to support AAC for people with motor impairments, using computer vision and machine learning techniques to allow for personalized gestural interaction. The methodology was applied in a pilot system used by both volunteers without disabilities, and by volunteers with motor and speech impairments, to create datasets with personalized gestures. The created datasets and a public dataset were used to evaluate the technologies employed for gesture recognition, namely the Support Vector Machine (SVM) and Convolutional Neural Network (using Transfer Learning), and for motion representation, namely the conventional Motion History Image and Optical Flow-Motion History Image (OF-MHI). Results obtained from the estimation of prediction error using K-fold cross-validation suggest SVM associated with OF-MHI presents slightly better results for gesture recognition. Results indicate the technical feasibility of the proposed methodology, which uses a low-cost approach, and reveals the challenges and specific needs observed during the experiment with the target audience.
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Iacono T, Trembath D, Erickson S. The role of augmentative and alternative communication for children with autism: current status and future trends. Neuropsychiatr Dis Treat 2016; 12:2349-2361. [PMID: 27703354 PMCID: PMC5036660 DOI: 10.2147/ndt.s95967] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Augmentative and alternative communication (AAC) interventions are used for children with autism, often as stand-alone communication interventions for those who are minimally verbal. Our aim was to synthesize the evidence for AAC interventions for children (up to 21 years), and then consider the role of AAC within established, comprehensive, evidence-based autism interventions targeting learning across multiple developmental domains. DESIGN We completed a systematic search of three databases (OVID Medline, PsycINFO, ERIC) as well as forward citation and hand searches to identify systematic reviews of AAC intervention efficacy research including children with autism, published between 2000 and March 2016 in peer-reviewed journals. Data pertaining to the quality indicators of included studies, effect sizes for intervention outcomes, and evidence for effectiveness were extracted for descriptive analysis. RESULTS The search yielded 17 systematic reviews. Most provided indicators of research quality for included studies, of which only relatively few provided conclusive results. Communication targets tended to be focused on teaching children to make requests. Still, effect size measures for included studies indicated that AAC was effective to highly effective. CONCLUSION There is growing evidence for the potential benefits of AAC for children with autism, but there is a need for more well-designed studies and broader, targeted outcomes. Furthermore, a lack of evidence for the role of AAC within comprehensive intervention programs may account for a tendency by autism researchers and practitioners to neglect this intervention. Attempts to compare evidence for AAC with other interventions for children with autism, including those in which the use of AAC is delayed or excluded in pursuit of speech-only communication, must take into account the needs of children with the most significant learning needs. These children pose the greatest challenges to achieving large and consistent intervention effects, yet stand to gain the most from AAC interventions.
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Affiliation(s)
- Teresa Iacono
- Living with Disability Research Centre, La Trobe University, Bendigo, VIC, Australia
| | - David Trembath
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Shane Erickson
- Living with Disability Research Centre, La Trobe University, Melbourne, VIC, Australia
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Gevarter C, O'Reilly MF, Kuhn M, Mills K, Ferguson R, Watkins L, Sigafoos J, Lang R, Rojeski L, Lancioni GE. Increasing the vocalizations of individuals with autism during intervention with a speech-generating device. J Appl Behav Anal 2015; 49:17-33. [DOI: 10.1002/jaba.270] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 09/22/2015] [Indexed: 11/08/2022]
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Romski M, Sevcik RA, Barton-Hulsey A, Whitmore AS. Early Intervention and AAC: What a Difference 30 Years Makes. Augment Altern Commun 2015; 31:181-202. [DOI: 10.3109/07434618.2015.1064163] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Heath AK, Ganz JB, Parker R, Burke M, Ninci J. A Meta-analytic Review of Functional Communication Training Across Mode of Communication, Age, and Disability. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2015. [DOI: 10.1007/s40489-014-0044-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wandin H, Lindberg P, Sonnander K. Communication intervention in Rett syndrome: a survey of speech language pathologists in Swedish health services. Disabil Rehabil 2014; 37:1324-33. [PMID: 25250808 DOI: 10.3109/09638288.2014.962109] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate communication intervention that speech language pathologists (SLPs) provide to people with Rett syndrome. METHODS A web-based survey targeting all Swedish SLPs working with people currently receiving support from habilitation services. RESULTS The SLPs reportedly followed recommended practice in the following aspects: (1) Information on communicative function was collected from several sources, including observation in well-known settings and reports from the client s social network, (2) Multimodal communication was promoted and, (3) Responsive partner strategies were largely targeted in the intervention. However, few instruments or standard procedures were used and partner instruction was given informally. Most SLPs used communication aids in the intervention and their general impression of using communication aids was positive. Further, augmentative and alternative communication (AAC) was estimated to increase and clarify communicative contributions from the person. CONCLUSIONS Communication aids were reported to have a positive influence on communicative functions. Swedish SLP services followed best practice in several aspects, but there are areas with potential for development. Tools and best practice guidelines are needed to support SLPs in the AAC process for clients with Rett syndrome. [Box: see text].
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Affiliation(s)
- Helena Wandin
- Department of Public Health and Caring Sciences, Research in Disability and Habilitation, Uppsala University , Uppsala , Sweden
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Hua L, Wang S, Gong Y. Text prediction on structured data entry in healthcare: a two-group randomized usability study measuring the prediction impact on user performance. Appl Clin Inform 2014; 5:249-63. [PMID: 24734137 DOI: 10.4338/aci-2013-11-ra-0095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/18/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Structured data entry pervades computerized patient safety event reporting systems and serves as a key component in collecting patient-related information in electronic health records. Clinicians would spend more time being with patients and arrive at a high probability of proper diagnosis and treatment, if data entry can be completed efficiently and effectively. Historically it has been proven text prediction holds potential for human performance regarding data entry in a variety of research areas. OBJECTIVE This study aimed at examining a function of text prediction proposed for increasing efficiency and data quality in structured data entry. METHODS We employed a two-group randomized design with fifty-two nurses in this usability study. Each participant was assigned the task of reporting patient falls by answering multiple choice questions either with or without the text prediction function. t-test statistics and linear regression model were applied to analyzing the results of the two groups. RESULTS While both groups of participants exhibited a good capacity of accomplishing the assigned task, the results were an overall 13.0% time reduction and 3.9% increase of response accuracy for the group utilizing the prediction function. CONCLUSION As a primary attempt investigating the effectiveness of text prediction in healthcare, study findings validated the necessity of text prediction to structured date entry, and laid the ground for further research improving the effectiveness of text prediction in clinical settings.
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Affiliation(s)
| | - S Wang
- Department of Nursing, Tianjin First Central Hospital , Tianjin, China
| | - Y Gong
- School of Biomedical Informatics, University of Texas Health Science Center , Houston, TX, USA
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