An elementary student with severe expressive communication impairment in a general education classroom: Sequential analysis of interactions

A scoping review of AAC research conducted in segregated school settings

BACKGROUND

School education for children with severe disabilities tends to occur in restricted or segregated settings, especially for students who require augmentative and alternative communication (AAC).

AIM

We sought to understand the role played by AAC, especially in supporting students' academic learning and social participation in studies conducted in segregated school settings.

METHODS

We conducted a scoping review, searching five databases, supplemented by hand, ancestral and forward citation searches of studies published from 2000 to 2020 involving compulsory school-aged students and featuring AAC. Data were extracted and summarized regarding study and participant characteristics, and key findings.

RESULT

Our search yielded 141 studies conducted in a segregated setting (n = 129) or mixed settings (n = 12). Most studies focused on communication skills (n = 69); academic skills (n = 27) and social participation (n = 17) were addressed to a far lesser extent.

CONCLUSIONS

Research into students requiring or using AAC has focused on teaching communication skills and far less on academic learning and social activities of classrooms and schools. There is a need for research that extends beyond functional communication into how AAC can promote access to these key aspects of school education.

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.

Social interactions of students with disabilities who use augmentative and alternative communication in inclusive classrooms

The purpose of this study was to explore the naturally occurring social interactions for students with disabilities who use augmentative and alternative communication (AAC) in general education classrooms. We observed 16 students who used AAC and received services under the categories of autism or intellectual disability. Participants primarily interacted with their support personnel and infrequently conversed with peers despite often being in close proximity. Few interaction episodes were initiated by students who used AAC, and initiations to peers and adults appeared to serve somewhat different functions. Students with disabilities relied more heavily on facial expressions and gestures than on the use of their AAC devices. Recommendations for promoting interaction opportunities among students are offered, and future research directions are suggested.

Communication Sampling and Analysis

Research has shown that communication sampling is important when analyzing communication behavior for individuals who have complex communication needs. Communication sampling and analysis (CSA) is an assessment tool designed for infants, toddlers, and children with multiple physical, sensory, speech, and/or cognitive, linguistic challenges. The purpose of the CSA is to capture and qualify the nature and extent of communication behavior of the communicatively challenged child with partners during interactive settings and contexts. This is important for establishing baseline levels of communicative functioning, setting goals for intervention, and evaluating the effectiveness of treatment. More reliability testing is needed to determine whether the direct sampling of communication behavior is a viable method for evaluation.

An AAC application using speaking partner speech recognition to automatically produce contextually relevant utterances: objective results

The purpose of this study was to evaluate the efficacy of a computer program, Converser, which uses the speech recognition of the speaking partner to predict contextually appropriate utterances and to store relevant noun phrases. The dyads (which consisted of a program user and a speaking partner) tested Converser in two communication tasks: a conversation and an interview. Two conditions were applied: A simple communication aid with an alphabet layout without Converser (alpha-only condition), and an identical aid with Converser (alpha-converser condition). Objective measurements were made concerning the program user's rate and Converser usage. The results showed that the alpha-converser condition generated a faster communication rate than the alpha-only condition. Also, the program users utilized the stored noun phrases in their productions more than the full utterances. Converser allowed for periodic instances of a fast rate of speech, which appeared to have a positive impact on communication.

Enhancing literacy development through AAC technologies

There is a critical need to understand teaching and technology supports that enable students who use augmentative and alternative communication (AAC) systems to engage in meaningful literacy experiences and foster conventional literacy skills. To thrive in classroom environments, they must have access to tools that can support them in active and independent literacy learning. These students need technology that allows them to move seamlessly between reading, writing, and communicating. They require technology that takes into account access needs, individual learning needs, the learning demands of technology, and literacy development across grades. Families and school teams need information that will assist them in providing the best tools and the most appropriate content within these tools throughout the school day. Teachers need information that supports them in providing exemplary literacy instruction to students who use AAC systems. This article explores and summarizes factors impacting literacy learning, including literacy capabilities of school-age students who use AAC, communication in literacy learning and use, reading and writing instruction in general education classrooms, and technology to support literacy learning. It is important that future technology tools provide a platform for levels of literacy learning: The power of technology will be reflected in its ability to provide access to and display the right content at the right time for students who use AAC. This article summarizes current factors thought to influence literacy learning and discusses priorities for future research and technology development.