Reflections from Fellows of ISAAC

"It's like a guessing game all the time": parent insights on barriers, supports, and priorities for children with cortical visual impairment and complex communication needs

Parents of children with both cortical visual impairment (CVI) and complex communication needs offer unique perspectives on their children's journeys to receiving proper diagnoses, supports, and interventions, such as augmentative and alternative communication (AAC). This study explored the lived experiences, supports, and barriers identified by parents through a qualitative phenomenological approach. Nine parents of children with both CVI and complex communication needs were interviewed virtually. Results indicated five themes descriptive of the parents' experiences: Challenges Piecing Together a CVI Diagnosis; Dealing with Low Expectations of Others; Parents Empowered to Take Action; Guessing Game to Determine Appropriate AAC to Accommodate CVI; and Aligning Professional Practice with Parent Priorities. Whereas some of these themes echoed the experiences of parents of children with complex communication needs (such as those with cerebral palsy) who were not specifically diagnosed with CVI, other themes were unique to this set of parents including the uncertainty of AAC design and intervention given the challenges of CVI and the necessity of more than one way for children to communicate given their visual challenges. This study highlighted the dire need for continued investigation to determine effective AAC interventions for individuals with CVI.

Protecting people with communication disability from modern slavery: Supporting Sustainable Development Goals 8 and 16

PURPOSE

The 2030 Agenda for Sustainable Development identifies the need for inclusive societies and justice for people who experience, or are at risk of experiencing, modern slavery. The primary objective of this commentary paper is to consider current research and practice in relation to the protection of people with communication disability from modern slavery. The paper considers the role of SLPs in developing and disseminating accessible information to help achieve decent work and economic growth (SDG 8) and peace, justice, and strong institutions (SDG 16).

RESULT

This paper considers five areas for protecting people with communication disability from modern slavery: (1) accessible information, (2) advocacy, (3) rights-based approaches, (4) improved understanding about access to services, and (5) education. Practice examples are discussed across each of these areas, with a focus on accessible information.

CONCLUSION

This commentary asserts that information about modern slavery must be accessible so that people with communication disability experience inclusion, safety, and justice. SLPs are well placed to implement communication strategies, such as accessible information, to help protect people with communication disability from modern slavery. This commentary paper focuses on SDG 8 and SDG 16 and also addresses SDG 1, SDG 3, SDG 4 and SDG 10.

Personalized AAC Intervention to Increase Participation and Communication for a Young Adult with Down Syndrome

Many adults with Down syndrome (DS) experience difficulty with speech production, and intelligibility challenges and communication breakdowns are common. Augmentative and alternative communication (AAC) intervention can provide important supports for persons with these complex communication needs, but must be customized to address the goals, strengths, and needs of the individual. This article provides a description of a personalized AAC intervention for a young adult with DS whose speech was frequently unintelligible. The AAC intervention made use of a video visual scene display (VSD) approach, and was investigated in two separate studies in two key community settings: An inclusive post-secondary education program (a single-case reversal ABAB design), and a community shopping activity (a non-experimental AB case study design). The participant demonstrated sharp increases in successful communication and participation in both settings following the introduction of the video VSD, and both the participant and key stakeholders viewed the intervention positively. The results provide preliminary evidence that personalized AAC intervention, including the use of a video VSD approach, can provide important supports for communication and participation in community settings for adults with DS and complex communication needs.

Personalized Early AAC Intervention to Build Language and Literacy Skills: A Case Study of a 3-Year-Old with Complex Communication Needs

Personalized AAC intervention refers to an approach in which intervention is tailored to the individual's needs and skills, the needs and priorities of the individual's family and other social environments, the evidence base, and the individual's response to intervention. This approach is especially relevant to AAC intervention for young children with complex communication needs given their unique constellations of strengths and challenges, and the qualitative and quantitative changes that they experience over time as they develop, as well as the diversity of their families, schools, and communities. This paper provides detailed documentation of personalized AAC intervention over a six-month period for a 3-year-old girl with developmental delay and complex communication needs. The paper describes (1) personalization of multimodal AAC supports to provide this child with the tools to communicate; (2) personalized intervention to build semantic and morphosyntactic skills; and, (3) personalized instruction in literacy skills (i.e., letter-sound correspondences, sound blending, decoding, sight word recognition, reading simple stories, reading comprehension, and encoding skills). Specific goals, instructional materials, and procedures are described; data on speech, language, and literacy outcomes are presented.

The effects of literacy interventions on single-word reading for individuals who use aided AAC: a systematic review

The purpose of this systematic review was to investigate the effects of instruction on single-word reading of individuals who use aided augmentative and alternative communication (AAC). A systematic search identified nine single-case experimental design studies that involved 24 individuals who used aided AAC. Overall, the evidence indicated that instruction had positive effects on reading at the single-word level for individuals across ages and diagnostic categories (i.e., autism spectrum disorder (ASD), cerebral palsy (CP), Down syndrome, and intellectual disability). The studies revealed that these effects were consistent across a range of participant, intervention, and outcome measure characteristics. Phonological approaches, sight-word approaches, and a combination of these two approaches yielded very large effects. Despite the large effects, the findings must be viewed with caution due to limitations in the number of studies and participants and limitations in the reporting of detailed participant and intervention characteristics across the studies. In order to determine which interventions are most effective for which individuals, future research directions are discussed, including the need for greater specificity in describing participant and intervention characteristics, investigations into how to best measure intervention outcomes without requiring spoken responses, and investigations into longer-term interventions targeting a wider range of reading skills.