Promoting Peer Interaction for Preschool Children With Complex Communication Needs and Autism Spectrum Disorder

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.

Increasing Reciprocal Social Interactions Between Children Who Use Augmentative and Alternative Communication and Peers Using a Collaborative Learning Framework

PURPOSE

Children with complex communication needs who rely on augmentative and alternative communication (AAC) strategies to express themselves face significant difficulties interaction with peers. This study sought to design, implement, and evaluate a collaborative photography intervention designed to increase reciprocal social interaction between children who use AAC and their same-age peers.

METHOD

A single-subject, withdrawal design (ABAB) was used to explore the functional relationship between engagement in a collaborative photography intervention and the frequency of reciprocal social interactions between children who use AAC and their same-age peers. Partial-interval time sampling was used to code the number of reciprocal social interactions across four dyads.

RESULTS

Increased frequencies of reciprocal social interactions were observed in intervention phases across all four dyads. Very large levels of effect and 100% nonoverlapping data were noted for Dyads 1 and 4. Moderate levels of effect and 70% of nonoverlapping data were noted for Dyads 2 and 3.

CONCLUSIONS

Collaborative learning frameworks may be used to increase reciprocal social interactions between children who use AAC and their peers. Speech-language pathologists should consider utilizing collaborative learning elements in activities with children who use AAC. Future research is needed to further explore collaborative learning frameworks for interventions for children who use AAC.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25464064.

Feasible Peer-Mediated Intervention for Autistic Children Using Minimal Speech: A Qualitative Intervention Development Process

PURPOSE

Qualitative engagement with stakeholders in the development of interventions can provide insight into strategies to maximize feasibility in real-life settings. We engaged stakeholders (autistic adults, early childhood educators, early childhood sector leaders and policy influencers, parents of autistic children, and speech-language pathologists) to inform the development of an educator-led peer-mediated intervention (PMI) for autistic preschoolers who use minimal speech that is feasible to implement in inclusive early childhood education and care (ECEC) settings.

METHOD

A qualitative iterative intervention design process was utilized. Stakeholders (N = 15) attended an online workshop and completed a document review exploring the acceptability and feasibility of the proposed embedded PMI. A two-step analysis procedure using the Theoretical Domains Framework and template analysis was conducted to identify the barriers, enablers, and supports to the implementation of embedded PMI in early childhood settings.

RESULTS

While embedded PMI was unanimously acceptable to stakeholders, several participants expressed concerns regarding feasibility. Barriers to the successful integration and implementation of PMI in inclusive preschool contexts included access to skills, knowledge, and resources. Participants identified strategies to overcome modifiable barriers and to enhance the existing enablers. These strategies are reflected in the following themes: build on the familiar, build capacity in augmentative and alternative communication, adopt a whole center approach, adapt to meet the needs of the ECEC setting, and engage in proactive implementation.

CONCLUSION

To address barriers to the implementation of embedded PMI, action is needed at various levels: macro (national/policy), meso (organization/setting), and micro (individual).

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25155770.

The use of augmentative and alternative communication by children with developmental disability in the classroom: a case study

PURPOSE

Augmentative and alternative communication (AAC) systems are often introduced to children with disabilities who demonstrate complex communication needs. As attending school is an essential part of these children's lives, it is important that they use their AAC system to communicate in the classroom. This study aimed to describe the nature of the use of AAC by students with developmental disabilities in the classroom.

MATERIALS AND METHOD

This study was conducted in Malaysia. Six students were observed twice each in their classroom and their classroom interactions were video recorded. The video recordings were transcribed and coded for the presence of a communication event, the student's mode of communication and communication function, the communication partner involved, and access to the AAC system.

RESULTS

Contrary to past studies, most students in this study spontaneously initiated interaction almost as many times as they responded. They primarily communicated with gestures and verbalizations/vocalizations despite having been introduced to an AAC system. When students communicated using their AAC system, they mainly interacted with the teachers, and for the function of either behavioral regulation or joint attention. It was found that for 39% of communicative events, the student's aided AAC system was not within arm's reach.

CONCLUSION

The findings highlight the need for efforts to encourage students with complex communication needs to use AAC more frequently in their classroom to be able to communicate more effectively and for a wider range of communicative functions. Speech-language pathologists can work closely with teachers to provide the necessary support to these students.

Using Communication Assistants in Qualitative Health Research

Qualitative health research is hampered by narrow constructs of human communication that privilege participants with access to spoken and written (normative) language. With limited awareness of such things as augmentative and alternative communication (AAC) or the rights of people with complex communication access needs, qualitative research becomes a 'picker and chooser' of whose voices are included in studies and whose are not. In order for 'voices' to be heard, adaptations are required which include the acknowledgement and support of communication assistants (informal and formal) who can help provide a communication bridge between people with complex communication access needs and researcher(s). Yet little is known of who qualifies as a communication assistant nor the scope and limitations of this role in health research. Beginning with communication diversity arguments the article compares communication assistants with language interpreters before discussing practice and implications for health research.

A Social Turn-Taking, Parent Mediated Learning Intervention for a Young Child with Autism: Findings of a Pilot Telehealth Study

Social turn taking, a preverbal social communication competency often difficult for young children with autism, may be foundational to joint attention when included as a component of interventions for children with autism. In this study, social turn-taking was promoted through a parent mediated learning approach to intervention in a telehealth setting. Following a mixed-methods design, the present study explored the results of this new intervention model for a toddler with autism. The study also sought to understand any changes in the parent-child relationship because of the intervention. Findings indicate that the intervention supported the child's social communication competencies, including social turn-taking, joint attention, and facial focusing. Qualitative data revealed improvements in the parent-child relationship. These preliminary results lend support for promoting social turn-taking in interventions for children with autism, as well as for following developmental, parent-driven approaches to intervention. Studies with larger sample sizes are needed to understand these findings further. Implications for practice and research in early intervention are presented.

Supporting Children's Communication of Choices During Inpatient Rehabilitation: Effects of a Mobile Training for Health Care Providers

PURPOSE

Children with complex medical and communication needs often experience extensive or frequent hospital stays and rely on augmentative and alternative communication (AAC) strategies to communicate in this environment. Health care providers seldom receive training to effectively communicate with these children, which may lead to limited participation opportunities for the child during inpatient interactions.

METHOD

A pretest-posttest experimental group design was completed to evaluate the effects of a brief mobile training designed to teach providers a procedure to support children with complex communication needs to communicate choices. Each provider participated in two pretest and two posttest interactions with children with complex communication needs during naturally occurring inpatient activities. Providers in the treatment group completed the video training, whereas providers in the control group did not.

RESULTS

Following the training, (a) more providers offered choices to the children during hospital routines, (b) providers implemented the trained procedure with increased accuracy, and (c) the children with complex communication needs consistently communicated their choices when given the opportunity to do so. The providers rated the training as easy to use, effective, and suited to the needs of the inpatient setting.

CONCLUSIONS

This is the first AAC training designed to promote child-provider interactions in inpatient settings that demonstrates results that are efficient, socially valid, and effective in a real-world context. Future work is needed to develop additional brief and focused AAC partner trainings to teach providers to support the participation of children with complex communication needs in health care interactions.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22029008.

Effect of Video Augmentative and Alternative Communication Technology on Communication During Play With Peers for Children With Autism Spectrum Disorder

PURPOSE

Children with autism spectrum disorder (ASD) are at risk for exclusion from play with their peers due to difficulty with communication skills. Video augmentative and alternative communication (AAC) technology has the potential to support communication within the context of play using videos with integrated visual scene displays. This study investigated the effect of a video AAC intervention on the number of turns in which children with ASD demonstrated symbolic communication during interactions with a peer without disabilities. Maintenance of skills, generalization to untrained play scenarios, and stakeholder perceptions of the video AAC technology were also investigated.

METHOD

This study used a single-case, multiple-probe design across participant dyads. It included baseline, intervention, maintenance, and generalization phases. Six children with ASD and six peers participated in the study.

RESULTS AND CONCLUSIONS

All six participants with ASD demonstrated an increase in the number of turns in which they demonstrated at least one symbolic communication act following intervention, although one participant demonstrated variability in baseline performance, making it difficult to draw conclusions. Results provide preliminary evidence that instruction with video AAC technology can support communication for children with ASD during play interactions with peers.

The effects of AAC video visual scene display technology on the communicative turns of preschoolers with autism spectrum disorder

Over 40% of children with autism spectrum disorder (ASD) experience difficulty in using speech to meet their daily communication needs. Although augmentative and alternative communication (AAC) can be of benefit, the AAC intervention must support beginning communicators in the early social interactions that provide the foundation for more sophisticated communication skills. An AAC video visual scene display approach uses an AAC app (provided on a tablet computer), including videos based on the interests of the child and infused with AAC supports, to provide opportunities for social interaction and communication between the child and the communication partner. The purpose of this study was to investigate the impact of video visual scene display technology on the communicative turns taken by three preschoolers with ASD and complex communication needs during a high-interest, shared activity (i.e., watching videos). All three participants demonstrated a large increase in the number of communicative turns taken with their partner (Tau-U of 1.00) following the introduction of the video VSD app. The results provide evidence that a video VSD approach may be a promising intervention to increase participation in communication opportunities for young children with ASD.

Evaluating Interactive Language for Children with Autism Spectrum Disorder (ASD) in Different Contexts

Autism spectrum disorder (ASD) is characterized by impairments in the use of appropriate interactive language (including structural language and pragmatic skills) in social contexts. However, the phenotype and causes of interactive language deficits in children with ASD, in different contexts, are still unclear. In this study, we examined the structural language and pragmatic skills of children with ASD in four contexts: playing, drawing, reading, and free talking. We found that while children with ASD did not exhibit deficits in structural language (e.g., vocabulary and utterance), they clearly exhibit deficits in pragmatic skills. We, also, found that contexts played a key role in the use of interactive language by children with ASD. For example, the reading context had a significant impact on the diversity of vocabulary, while the playing and drawing contexts made an important contribution to the formation of complex utterances. The free talking context, on the other hand, contributed to producing more turns. Furthermore, Spearman’s rank correlation analysis was used to examine the relationships between maternal input and children’s language output. We found that the correlations between structural language and maternal input in children with ASD were not as high as revealed in previous studies, while a, relatively, obvious relationship was found between pragmatic skills and maternal input. Specifically, the total number of turns (TNT) for a child with ASD is related to their mother’s TNT, as are the total number of words (TNW) and number of different words (NDW). These results suggest that (1) assessment of pragmatic skills should be included in the evaluation of children with suspected ASD (2) the influence of context on pragmatic skills needs to be taken into account, when assessing the pragmatic development of children with ASD; and (3) the impact of maternal language on children’s language use is of great importance, for children with ASD.

Supporting Peer Interactions for Students with Complex Communication Needs in Inclusive Settings: Paraeducator Roles

PURPOSE

This clinical focus article presents a review of literature supporting the importance of fostering positive peer interactions for students with complex communication needs. A resulting template is included to help guide educational teams, including speech-language pathologists (SLPs), in planning for paraeducator training specific to supporting peer interactions for children with CCN. This article summarizes the current literature available on inclusion and peer relationships for students with CCN in general education classrooms, and paraeducator roles and training. The World Health Organization (WHO) International Classification for Functioning, Disability and Health Children and Youth (ICF-CY) framework was consulted to help establish considerations relevant to paraeducator training. With many demands on the time of SLPs throughout the school day, paraeducators may offer an often untapped resource to help support positive peer relationships for students with CCN.

CONCLUSIONS

This article provides an overview of challenges that may impede positive peer relationships from developing in inclusive classroom settings, including ones related to: (1) the student with CCN, (2) the peers, (3) the AAC systems, or (4) the environment. The readers will be provided with a template to guide educational teams and SLPs in collaborating with paraeducators to foster positive peer interactions, including the following steps: (1) define goals for the student with CCN and determine supports required from paraeducators; (2) determine content of training for paraeducators; (3) choose an effective instructional approach; (4) establish a feasible training format; (5) implement the paraeducator training and evaluate outcomes to ensure benefits for students with CCN and their peers.

Breastfeeding Experiences of Autistic Women

PURPOSE

The purpose of this study was to explore the experiences of autistic women who breastfed.

STUDY DESIGN AND METHODS

We used a qualitative phenomenology design and a thematic analysis method. Semistructured interviews were conducted using a purposive sample from social media support groups for autistic adults. The interview involved one overarching question about their breastfeeding experience.

RESULTS

Twenty-three autistic women who breastfed their infant(s) participated in our study. Three main themes were identified including intense sensory perception, focused determination, and one size doesn't fit all. Three subthemes helped to describe intense sensory perception: overstimulated, overtouched, and overwhelmed.

CLINICAL IMPLICATIONS

Autistic adults can have social interaction and expressive communication differences. Nurses can promote positive communication and provide appropriate care through supportive action. These findings offer a guide for nurses to better understand the experiences of autistic breastfeeding women.

Effectiveness of Responsivity Intervention Strategies on Prelinguistic and Language Outcomes for Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis of Group and Single Case Studies

We conducted a systematic review to identify randomized controlled trials (RCTs) and single case research design (SCRD) studies of children with autism spectrum disorder that evaluate the effectiveness of responsivity intervention techniques for improving prelinguistic and/or language outcomes. Mean effect sizes were moderate and large for RCTs (33 studies; g = 0.36, 95% CI [0.21, 0.51]) and SCRD (34 studies; between-case standardized mean difference = 1.20, 95% CI [0.87, 1.54]) studies, respectively. Visual analysis (37 studies) revealed strong evidence of a functional relation for 45% of the opportunities and no evidence for 53%. Analyses of moderator effects and study quality are presented. Findings provide support for responsivity intervention strategies with more robust support for context-bound outcomes than more generalized outcomes.

Association of turn-taking functions with joint attention in toddlers with autism

LAY ABSTRACT

Back-and-forth interaction, or turn taking, may support later joint attention, a more complex form of interaction, when promoted in interventions for young children with autism, especially depending on the child's intent when interacting. In the present study, we observed videos of 20 toddlers with autism engaging in turn taking with their caregivers during an intervention designed to support children's joint attention. We sought to identify when the children displayed turn taking socially and when they were using it for nonsocial purposes in the intervention videos. We also observed videos after the intervention was complete to identify when children used joint attention when interacting with their caregivers. After these observations, we used these video data to explore the relationship of social turn taking to joint attention, and the relationship of nonsocial turn taking to joint attention. We found a significant relationship between social turn taking and joint attention, but not between nonsocial turn taking and joint attention. These findings support the importance of considering social turn taking in interactions between young children with autism and their caregivers.

Augmentative and Alternative Communication Supports for Language and Literacy in Preschool: Considerations for Down Syndrome and Autism Spectrum Disorder

Children with Down syndrome and children with autism spectrum disorder have a range of speech abilities during preschool that impacts access to both language and literacy instruction. It is the responsibility of the speech-language pathologist to advocate for and provide intervention using augmentative and alternative communication (AAC) through individualized assessment. This article provides a review of the literature supporting the use of AAC during preschool for both language and literacy development in children with Down syndrome and children with autism spectrum disorder who have limited speech. A small scale exploratory report is discussed to highlight differences in early literacy skills found in children in each group. Implications for AAC intervention during preschool to support both language and literacy are discussed.

Measuring Stakeholder Perceptions: A Review of Social Validity Reporting in ASHA Journals

Purpose Intervention research in speech-language pathology is growing; however, there remains a gap between research and clinical practice. To promote evidence-based practice, stakeholder input may be solicited during the development and evaluation of treatments. One method of evaluating stakeholder input is by subjectively measuring social validity. Social validity probes end users' satisfaction and acceptability of a treatment. Method This review article explores the type and frequency of subjective social validity measures reported in speech-language pathology treatment literature published in American Journal of Speech-Language Pathology; Journal of Speech, Language, and Hearing Research; and Language, Speech, and Hearing Services in Schools from January 2017 through April 2019. In total, 93 treatment studies were included and coded descriptively. Results Of the 93 treatment studies included in this review, 20 reported subjective measures of social validity. The most common method of measurement was questionnaires (n = 19), followed by interviews (n = 5), and direct observation (n = 1). Conclusions Only 21.5% of reviewed speech-language pathology treatment articles from American Speech-Language-Hearing Association journals reported measures of social validity, although it is a crucial component of implementation of evidence-based practice. We urge researchers and journal editors to include social validity measures in treatment literature as we promote the uptake of evidence-based practices and the involvement of stakeholders during the development of evidence-based practices. We also encourage the development of social validity measures that can be validated on individuals with communication disorders.

Child-Parent-Provider Interactions of a Child With Complex Communication Needs in an Inpatient Rehabilitation Facility: A Pilot Study

Purpose Children with complex medical needs often require extensive hospitalizations in the first years of life. Many of these children also experience complex communication needs and use augmentative and alternative communication (AAC) strategies to interact with health care staff. Unfortunately, suboptimal communication experiences have been reported among these children, their families, and hospital staff; however, no studies have described the patterns of interactions beyond measures of self-report. The purpose of this study was to describe child-parent-provider interaction patterns that occurred in an inpatient unit. Method Observational techniques were used to systematically describe the interactions of a 28-month-old child with complex communication needs, her parents, and 26 health care providers on an inpatient rehabilitation unit over 10 days. Results Results indicated that substantial variability in the child's routine occurred across days and providers. Interactions were generally short and occurred for only a small proportion of the child's waking hours. The child and her mother actively communicated to varying degrees across sessions, yet health care providers often dominated interactions. The child used multiple modes of communication in each interaction; however, no aided AAC systems were used despite availability. Conclusions Training is urgently required to equip health care providers to (a) incorporate the use of aided AAC strategies during inpatient interactions and (b) increase the active participation of both children with complex communication needs and their parents during these interactions. Supplemental Material https://doi.org/10.23641/asha.13345187.

The Effects of Shared e-Book Reading With Dynamic Text and Speech Output on the Single-Word Reading Skills of Young Children With Developmental Disabilities

Purpose This study investigated the use of a new software feature, namely, dynamic text with speech output, on the acquisition of single-word reading skills by six children with developmental disabilities during shared e-book reading experiences with six typically developing peers. Method A single-subject, multiple-probe design across participants was used to evaluate the effects of the software intervention. Six children with developmental delays were the primary focus for intervention, while six children with typical development participated as peer partners in intervention activities. e-Books were created with the new software feature, in which a child selects a picture from the e-book and the written word is presented dynamically and then spoken out. These e-books were then used in shared reading activities with dyads including a child with a disability and a peer with typical development. Participants engaged in the shared reading activity for an average of 13 sessions over a 6-week time period, an average of 65 min of intervention for each dyad. Results Participants with disabilities acquired an average of 73% of the words to which they were exposed, a gain of 4.3 words above the baseline average of 1.7 correct responses. The average effect size (Tau-U) was .94, evidence of a very large effect. Conclusion The results provide evidence that the use of e-books with the dynamic text and speech output feature during inclusive shared reading activities can be an effective and socially valid method to develop the single-word reading skills of young children with developmental disabilities.

Augmentative and Alternative Communication (AAC) Use Among Patients Followed by a Multidisciplinary Cleft and Craniofacial Team

OBJECTIVE

To establish preliminary data describing the number of patients who visit a multidisciplinary cleft and craniofacial team who use augmentative and alternative communication (AAC) supports.

DESIGN

This retrospective study consisted of chart reviews for all patients who visited a single site's multidisciplinary cleft and craniofacial team for 1 calendar year.

SETTING

A single multidisciplinary craniofacial team at a tertiary teaching hospital.

PARTICIPANTS

Four hundred sixty-four patients met the inclusion criteria for this study. Of these, 59.9% (n = 278) were male and 40.1% (n = 186) were female.

RESULTS

Of the sample population, 6.9% (n = 32) were AAC users as they received AAC intervention in a therapeutic context, while 93.1% (n = 432) were not. The AAC group had a mean age of 5.1 years (standard deviation [SD]: 4.2) and was 68.8% (n = 22) male. The non-AAC group had a mean age of 6.3 (SD: 4.9) and was 59.3% (n = 256) male. Within the AAC group, 40.6% (n = 13) were found to have an identified syndromic diagnosis in comparison to 17.6% (n = 76) of the non-AAC group (P = .003).

CONCLUSIONS

This is the first study to report the prevalence of AAC use among patients in the care of multidisciplinary cleft and craniofacial teams. Our findings suggest that a subset of craniofacial team patients may have complex communication disorders that require AAC supports. Craniofacial teams should be aware of resources available for these patients so that the patients' communication needs are met in the hospital, in school, and in the community.

Expanding Communication Modalities and Functions for Preschoolers With Autism Spectrum Disorder: Secondary Analysis of a Peer Partner Speech-Generating Device Intervention

Purpose This study reports a secondary analysis of the nature of communicative functions and modalities used in initiations and responses of minimally verbal preschoolers with severe autism spectrum disorder (ASD) from a previously published study (Thiemann-Bourque, Feldmiller, Hoffman, & Johner, 2018). This analysis focused on the final cohort (n = 6) from a group design study (N = 45) that examined a peer mediation and speech-generating device (SGD) intervention compared to an SGD-only condition. Method After teaching peers to use an iPad as an SGD within a modified stay-play-talk approach, school staff implemented SGD instruction in child-peer dyads during typical preschool activities. To investigate individual differences among children who demonstrated increased communication acts in the peer + SGD condition, changes in reciprocity, modalities used, and communicative functions were examined using a multiple-baseline design across children. Fidelity of implementation and social validity data were also collected. Results Six children with ASD and their peers demonstrated more balanced reciprocity, with individual differences in how and why children communicated during exchanges. That is, all children with ASD increased in SGD use as their primary communication mode; 3 children used different modalities including more speech, and 3 children used primarily gestures and SGD. The most frequent function expressed was requests for objects. More modest increases were observed in comments and requests for actions, with negligible changes in gaining attention. Social validity reports by naïve judges reflected clear improvements in communication interactions. Conclusion Findings are promising for a preschool SGD intervention that can expand children's modalities and communicative functions to engage in balanced exchanges with peer partners. Supplemental Material https://doi.org/10.23641/asha.11374203.

Providing Services to Individuals With Complex Communication Needs in the Inpatient Rehabilitation Setting: The Experiences and Perspectives of Speech-Language Pathologists

Purpose To guide the development of future trainings in the inpatient rehabilitation setting, this study aimed to expand the current understanding of (a) the experiences of speech-language pathologists (SLPs) who work in inpatient rehabilitation settings when providing augmentative and alternative communication (AAC) services to individuals with complex communication needs and (b) the challenges and facilitating factors related to AAC services within this context. Method An online focus group was used to explore experiences of 11 SLPs who work within the inpatient rehabilitation setting. Information was gathered about (a) the role of the inpatient SLP in AAC service delivery, (b) rehabilitation team service delivery, (c) successes and challenges to supporting individuals with complex communication needs within this setting, and (d) communication training opportunities. Results Themes that emerged related to (a) the complicated logistics of rehabilitation; (b) the centrality of the rehabilitation team; (c) the limited AAC tools, knowledge, and trainings for rehabilitation providers; and (d) SLPs' attitudes. Participants reported navigating complicated logistics unique to the inpatient rehabilitation related to time constraints, limited AAC funding, the continuum of rehabilitation care, and limited AAC policies in attempting to meet patient needs. Generally, participants suggested successful team collaboration, yet limited time, expertise, tools, and training opportunities challenged attempts to support individuals with complex communication needs. Conclusions Increased access to AAC tools and the development of AAC trainings are recommended to equip rehabilitation professionals with skills to build interprofessional and AAC skills so patients with complex communication needs can maximally participate in the rehabilitation experience. Supplemental Material https://doi.org/10.23641/asha.7728710.

A Scoping Review of the Involvement of Children's Communication Partners in Aided Augmentative and Alternative Communication Modeling Interventions

Purpose The purpose of this study was to inform practice and research by identifying and synthesizing research on interventions in which natural communication partners implemented aided augmentative and alternative communication (AAC) modeling strategies. Method A scoping review yielded 29 studies. Data were charted related to participant characteristics, intervention characteristics, partner instruction and assessment, and partner perspectives of social validity. Results More than 157 peer and 100 adult communication partners (e.g., parents, special educators, paraprofessionals) implemented aided AAC modeling strategies within included studies. To teach communication partners intervention strategies, researchers frequently reported using (a) oral instruction, (b) modeling, and (c) practice or application opportunities with performance feedback. Partner instruction frequently involved both training and concurrent support (e.g., coaching, facilitation, consultation, follow-up support). Conclusion Findings from this review inform the design and delivery of aided AAC modeling interventions by children's natural communication partners. Findings also highlight important avenues for enhancing the rigor of future research on interventions involving aided AAC modeling, including the quality of reporting and application of principles from implementation science. Supplemental Material https://doi.org/10.23641/asha.8038505.