Typical Toddlers' Participation in "Just-in-Time" Programming of Vocabulary for Visual Scene Display Augmentative and Alternative Communication Apps on Mobile Technology: A Descriptive Study

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.

Effects of an Augmentative and Alternative Communication Technology Decoding Feature on Single-Word Reading by Individuals With Down Syndrome and Limited Functional Speech

PURPOSE

Literacy skills are foundational to participation in adolescent and adult life, and decoding skills (i.e., sounding out to read words) are critical to literacy learning. Literacy also increases communication options for individuals with developmental disabilities who use augmentative and alternative communication (AAC). Yet, current AAC technologies are limited in their support of literacy development (especially decoding skills) for the individuals with developmental disabilities who require them. The purpose of this study was to conduct a preliminary evaluation of a new AAC feature designed to support decoding skills.

METHOD

Three individuals who had limited functional speech and limited literacy skills, specifically two adolescents and one young adult with Down syndrome, participated in the study. The study used a single-subject, multiple-probe, across-participants design.

RESULTS

All three participants demonstrated increases in reading performance, including decoding of novel words. High variability in performance was observed, however, and no participant reached reading mastery. Still, analysis reveals that for all participants, interacting using the new app feature increased reading.

CONCLUSIONS

These results offer preliminary evidence that an AAC technology feature that provides models of decoding (upon selection of AAC picture symbols) can support individuals with Down syndrome in building decoding skills. While not intended to replace instruction, this initial study offers initial evidence in its efficacy as a supplemental avenue for supporting literacy in individuals with developmental disabilities who use AAC.

Chinese-English speaking family perspectives of augmentative and alternative communication use with their children

INTRODUCTION

Culturally and linguistically diverse families who have children with complex communication needs (CCN) often have limited access to augmentative and alternative communication (AAC) devices and interventions due to the lack of services that acknowledge their families' cultural and linguistic needs. Despite the increasing need for culturally responsive services, little is known about Chinese-English speaking families' perspectives and experience related to AAC use and services. The objective of this study was to understand the perspectives and experiences of Chinese-English speaking family members of children who use AAC use.

METHODS

This study employs a qualitative descriptive methodology approach. The researchers conducted individual or group semi-structured interviews with 10 adult family members (mother, father, and grandparent) from four Chinese-English speaking families in the U.S. and Canada who have a child who uses AAC (ages 3-8).

RESULTS

Chinese-English speaking families have high acceptance and satisfaction with their child's AAC as long as they see the benefits of the AAC system. Mothers and siblings play unique roles in supporting home AAC practice given frequent engagement with and observed influence on the child who uses AAC. Family members indicated goals in building stronger family connections, but noted that the child's speech difficulties interfered with this goal. Chinese-English speaking families felt they can overcome limitations resulting from lower English language proficiency, but still find difficulties in obtaining resources because of the Western expectations of advocacy. Additionally, service providers' lack of responsiveness related to family goals could prevent families in obtaining AAC resources.

CONCLUSIONS

The findings suggest the need for family-centered services with cultural sensitivity and humility for those serving Chinese-English speaking families with children who use AAC. Additionally, involving family members beyond the mother within services may improve both family functioning and child communication.

Clinical and Research Perspectives on Visual Scene Displays

Purpose The purposes of this study were to measure the perceptions of speech-language pathologists (SLPs) and researchers regarding the design of visual scene displays (VSDs) and to investigate the perceived difficulties of SLPs in regard to the acquisition and programming of VSDs. Method We recruited 270 SLPs and nine researchers who focus on VSDs to complete an online survey. The SLP survey addressed both perception of VSD design and difficulties associated with implementing these images as communication supports in the clinical realm. The researcher group was surveyed solely regarding their opinions associated with VSD design. Results SLPs and researchers both ranked high-context VSDs as more effective at supporting communication than low-context VSDs. In addition, both groups ranked VSDs with task-engaged people as more effective at supporting communication than VSDs with camera-engaged people or no people. SLPs reported difficulties with acquiring high-quality VSDs from online sources as well as difficulties with maintenance and upkeep of VSDs. In addition, a large portion of SLPs reported challenges with representing complex concepts through VSDs. Conclusions Results from this study provide evidence of general agreement between SLPs and researchers regarding perception of VSD design. SLPs continue to report challenges with the acquisition and programming of VSDs. Further research is needed to develop evidence-based guidelines to support clinical endeavors in these areas.

A map of assistive technology educative instruments in neurodevelopmental disorders

PURPOSE

The use of assistive technology in mental health has gained an increased interest over the last decades. A growing number of studies have investigated diverse applications of technological interventions for rehabilitation of children with neurodevelopmental disorders. This article presents a map of the technological devises applied as therapeutic instruments.

METHODS

The research question of this review was which technological applications could be referred as an educational instrument for the management of children with autism spectrum disorders (ASDs), intellectual disability and attention deficit disorder. The articles included in this review were collected after a structured literature search in electronic databases using keywords such as "Assistive Technology", "technology devices", "robots", "Autism Disorder", "Intellectual Disabilities" and "Mental Retardation".

RESULTS

Assistive technology with the most up-to-date devices and applications helps children with intellectual disability and ASDs enhance cognitive skills and improve challenging behaviour, social communication and academic performance. Different technological tools are used to foster attention span and improve time management skills in children with attention deficit syndrome.

CONCLUSION

It is important that therapists choose the instrument that will offer the best approach towards the goal that is set. Future research could provide evidence based data, evaluating each specific methodology and tailoring each therapeutic approach specifically to a case.IMPLICATIONS FOR REHABILITATIONTechnology creates environments in which children could practice and learn in a safer, more predictable and pleasant manner.Assistive Technologies provide the opportunity for better acquisition of selfhelp skills and the power of social interaction for individuals with disabilities.By mapping out the wide array of Assistive Technology that is available today, future applications for rehabilitation of children with neurodevelopmental disorders could help extend therapeutic strategies out of the clinical and school settings and into the home, thereby incorporating the family and emphasizing personalization.Future studies could develop a model for the choice and use of each tool, tailoring each therapeutic approach specifically to each case.

Parent Perspectives on Augmentative and Alternative Communication Integration for Children With Fragile X Syndrome: It Starts in the Home

Many children with fragile X syndrome (FXS) have complex communication needs and may benefit from augmentative and alternative communication (AAC). This qualitative study explored how four mother-child dyads used AAC in the home. Data were collected using participant observations, open-ended interviews, and record reviews, and analyzed using grounded theory methods. Findings revealed that mothers found AAC to be a useful tool for addressing their children's complex communication needs, but practical and personal factors impacted its use in the home. This study sheds light on how mothers of children with FXS view and utilize AAC as a way to promote communication at home. Understanding parental perspectives can help to guide professionals in planning appropriate AAC interventions specific to FXS.

Core vocabulary lists for young children and considerations for early language development: a narrative review

For early symbolic communicators, acquisition of an initial vocabulary is a critically important achievement that sets the stage for future language development. Children who require augmentative and alternative communication (AAC) rely on others to select and provide these important first words for them. One resource to help guide this process includes published lists of words that may contribute to a core vocabulary for individuals who require AAC. Although some clinicians report that they consider or prioritize core words during the vocabulary selection process, it is not known whether an emphasis on core words will best meet the expressive vocabulary needs of early symbolic communicators. The purposes of this narrative review were to (a) review studies that have developed word lists to inform selection of a core vocabulary for young children who require AAC, (b) compare the words on these lists to the early words used by children with typical development, and (c) consider the implications for vocabulary selection and language development for early symbolic communicators who require AAC. Results suggest that core word lists may under-emphasize many of the types of words that predominate in early expressive vocabulary; these lists may not be the most appropriate resources to guide AAC system design and instruction for early symbolic communicators.

Comparative Effects of High-Tech Visual Scene Displays and Low-Tech Isolated Picture Symbols on Engagement From Students With Multiple Disabilities

Purpose

Augmentative and alternative communication (AAC) is an intervention approach that can promote communication and language in children with multiple disabilities who are beginning communicators. While a wide range of AAC technologies are available, little is known about the comparative effects of specific technology options. Given that engagement can be low for beginning communicators with multiple disabilities, the current study provides initial information about the comparative effects of 2 AAC technology options—high-tech visual scene displays (VSDs) and low-tech isolated picture symbols—on engagement.

Method

Three elementary-age beginning communicators with multiple disabilities participated. The study used a single-subject, alternating treatment design with each technology serving as a condition. Participants interacted with their school speech-language pathologists using each of the 2 technologies across 5 sessions in a block randomized order.

Results

According to visual analysis and nonoverlap of all pairs calculations, all 3 participants demonstrated more engagement with the high-tech VSDs than the low-tech isolated picture symbols as measured by their seconds of gaze toward each technology option. Despite the difference in engagement observed, there was no clear difference across the 2 conditions in engagement toward the communication partner or use of the AAC.

Conclusions

Clinicians can consider measuring engagement when evaluating AAC technology options for children with multiple disabilities and should consider evaluating high-tech VSDs as 1 technology option for them. Future research must explore the extent to which differences in engagement to particular AAC technologies result in differences in communication and language learning over time as might be expected.

Effect of mobile technology featuring visual scene displays and just-in-time programming on communication turns by preadolescent and adolescent beginning communicators

PURPOSE

Visual scene displays (VSDs) and just-in-time programming supports are augmentative and alternative communication (AAC) technology features with theoretical benefits for beginning communicators of all ages. The goal of the current study was to evaluate the effects of a communication application (app) on mobile technology that supported the just-in-time programming of VSDs on the communication of preadolescents and adolescents who were beginning communicators.

METHOD

A single-subject multiple-baseline across participant design was employed to evaluate the effect of the AAC app with VSDs programmed just-in-time by the researcher on the communication turns expressed by five preadolescents and adolescents (9-18 years old) who were beginning communicators.

RESULT

All five participants demonstrated marked increases in the frequency of their communication turns after the onset intervention.

CONCLUSION

Just-in-time programming support and VSDs are two features that may positively impact communication for beginning communicators in preadolescence and adolescence. Apps with these features allow partners to quickly and easily capture photos of meaningful and motivating events and provide them immediately as VSDs with relevant vocabulary to support communication in response to beginning communicators' interests.

Effect of AAC partner training using video on peers' interpretation of the behaviors of presymbolic middle-schoolers with multiple disabilities

Children require consistent responses from partners to their presymbolic behaviors in order to increase the frequency and variety of these behaviors and eventually build symbolic language. This study served as an initial attempt to evaluate the effect of AAC training on typically-developing peers' interpretation of the behavior of three students with multiple disabilities whose communication was presymbolic and idiosyncratic in nature. The study used a pretest-posttest control group design with 12 peers in each condition (i.e., experimental and control). During the pretest, peers in both groups were inaccurate in their interpretations of the behaviors of the students with multiple disabilities. During the posttest, peers who completed the training interpreted the behaviors of the students with multiple disabilities with statistically significantly higher accuracy than participants who did not complete the training. The training may be an effective intervention approach to increase the accuracy and consistency with which communication partners interpret the idiosyncratic behaviors of children with multiple disabilities. Future research should evaluate the efficacy of using such training to increase communication partners' identification of and responsivity to idiosyncratic behaviors within the context of real-world interactions.