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Brittlebank S, Light JC, Pope L. A scoping review of AAC interventions for children and young adults with simultaneous visual and motor impairments: Clinical and research Implications. Augment Altern Commun 2024; 40:219-237. [PMID: 38578299 DOI: 10.1080/07434618.2024.2327044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 01/23/2024] [Accepted: 02/29/2024] [Indexed: 04/06/2024] Open
Abstract
Individuals with multiple disabilities are among the most challenging to serve and AAC teams often lack direction in determining effective interventions. The purpose of this scoping review was to summarize the research evidence on AAC interventions for individuals with complex communication needs and simultaneous motor, and visual impairments as part of their multiple disabilities; to consider implications for practice; and to determine gaps and directions for future research. A total of 27 studies were identified and reviewed, involving 55 unique participants with multiple disabilities. Most studies focused on direct intervention to increase requesting or choice-making, with little focus on social communication. Only two studies focused on training communication partners. Results indicated that AAC interventions can be highly effective to increase communication for individuals with multiple disabilities. However, there is an urgent need for increased rigor and more detailed participant information in future AAC intervention research with this population. Future research should investigate AAC intervention to improve social communication and increase language development, not just expression of needs and wants. Future research should focus on the needs of individuals with multiple disabilities from culturally and linguistically diverse backgrounds and on implementation of AAC within natural environments.
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Affiliation(s)
- Savanna Brittlebank
- Communication Sciences and Disorders, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Janice C Light
- Communication Sciences and Disorders, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Lauramarie Pope
- Speech, Language and Hearing Sciences, Auburn University, Auburn, Alabama, USA
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Chezan LC, Bauer A, Drasgow E, Garcia H, Warman A. Generalization and Discrimination of Positively Reinforced Explicit Mands in Young Children with Autism Spectrum Disorder. Behav Modif 2024; 48:387-419. [PMID: 38288592 DOI: 10.1177/01454455241228768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Many children with autism spectrum disorder (ASD) exhibit generalization errors following mand training. In this study, we extended the literature on the generalization of positively reinforced explicit mands in three young children with ASD and complex communication needs. First, we used mand training to teach a new, socially appropriate, positively reinforced explicit mand to request preferred toys. Second, we assessed the discriminated generalization of the newly acquired mand by using untrained examples and nonexamples. Results suggest that our mand training resulted in acquisition of a discriminated positively reinforced explicit mand in all three children. Overgeneralization was documented for one of the three children included in the study. We discuss implications for researchers and practitioners related to the importance of assessing for generalization errors following mand training.
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Affiliation(s)
| | | | | | - Heidi Garcia
- Peninsula School at Faison Center, Newport News, USA
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O'Regan Kleinert J, Kearns JF, Page JL, Kleinert HL. Promising Strategies for Teaching Augmentative and Alternative Communication in Inclusive Educational Settings: A Systematic Review. Lang Speech Hear Serv Sch 2023; 54:1333-1357. [PMID: 37639539 DOI: 10.1044/2023_lshss-22-00178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
PURPOSE The purpose of this article was to conduct a systematic review of the literature on teaching or increasing the use of augmentative and alternative communication (AAC) by students with significant intellectual disabilities and complex communication needs (CCNs) within inclusive school settings. METHOD A systematic review of research literature from 1998 to 2022 was completed using multiple electronic databases, as well as citation chaining and cited author reference searches. Three hundred two articles were located with 17 meeting criteria for inclusion in this systematic review. Articles were initially screened by one author for potential inclusion; the remaining 83 were coded by one author and reviewed for consensus by three authors for inclusion in this review. Articles were analyzed and rated regarding both level of research design and quality of methodology. RESULTS All studies reported positive outcomes, with students with significant intellectual disabilities and CCN, of AAC intervention implemented in an inclusive setting. Fourteen over 17 studies were single-case designs with an average rating of 76% on the Single-Case Experimental Design measure of methodological quality. Less than half of the studies assessed generalization of subject learning. Review of interventions used in the studies, however, revealed the majority of studies utilized packages of interventions, making it difficult to determine the effectiveness of individual approaches. CONCLUSIONS This systematic review indicates there are promising interventions within inclusive settings for improved use of AAC by students with significant intellectual disabilities and CCN. Further research is needed, however, to obtain more data on generalization of student gains as well as to determine which specific interventions might be the most successful for this population of students in inclusive settings.
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Affiliation(s)
- Jane O'Regan Kleinert
- Department of Communication Sciences and Disorder, University of Kentucky, Lexington
| | | | - Judith L Page
- Department of Communication Sciences and Disorder, University of Kentucky, Lexington
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Danker J, Dreyfus S, Strnadová I, Pilkinton M. Scoping review on communication systems used by adults with severe/profound intellectual disability for functional communication. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:951-965. [PMID: 37341439 DOI: 10.1111/jar.13133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/13/2023] [Accepted: 06/07/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Adults with severe/profound intellectual disability typically face poor communication outcomes as they are often nonverbal and need their supporters to provide for their communication needs. This review aimed to identify studies focused on the communication resources people with severe/profound intellectual disability use for functional communication, and the enablers and barriers to functional communication. METHODS Nine databases were systematically reviewed with keywords pertaining to the functional communication of adults with severe/profound intellectual disability. Out of 3427 identified articles, 12 met the inclusion criteria. Hand searches and ancestral searches identified another 4 articles. Out of the 16 articles, two did not meet the quality assessment criteria and were excluded. Thus, 14 articles were included in this review. RESULTS The findings revealed that picture exchange communication systems is the most common communication system used to support the development of functional communication. The most common functions enabled by the communication systems were choice-making and making requests. Several barriers (e.g., individual factors related to adults with severe/profound intellectual disability, others' attitudes, behaviour and knowledge) to and enablers (e.g., accessibility and availability of the communication system, training for those supporting adults with severe/profound intellectual disability) of functional communication were identified. CONCLUSIONS Removing the barriers and enabling functional communication is essential to developing the functional communication of adults with severe/profound intellectual disability.
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Affiliation(s)
- Joanne Danker
- School of Education, University of New South Wales, Sydney, Australia
| | - Shoshana Dreyfus
- School of Humanities and Social Inquiry, University of Wollongong, Wollongong, Australia
| | - Iva Strnadová
- School of Education, University of New South Wales, Sydney, Australia
| | - Mary Pilkinton
- School of Education, University of New South Wales, Sydney, Australia
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Implementation of an Early Communication Intervention for Young Children with Cerebral Palsy Using Single-Subject Research Design. J Clin Med 2022; 12:jcm12010232. [PMID: 36615031 PMCID: PMC9821676 DOI: 10.3390/jcm12010232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
The implementation of an intervention protocol aimed at increasing vocal complexity in three pre-linguistic children with cerebral palsy (two males, starting age 15 months, and one female, starting age 16 months) was evaluated utilising a repeated ABA case series design. The study progressed until the children were 36 months of age. Weekly probes with trained and untrained items were administered across each of three intervention blocks. Successive blocks targeted more advanced protophone production and speech movement patterns, individualised for each participant. Positive treatment effects were seen for all participants in terms of a greater rate of achievement of target protophone categories and speech movement patterns. Tau coefficients for trained items demonstrated overall moderate to large AB phase contrast effect sizes, with limited evidence of generalisation to untrained items. Control items featuring protophones and speech movements not targeted for intervention showed no change across phases for any participant. Our data suggest that emerging speech-production skills in prelinguistic infants with CP can be positively influenced through a multimodal intervention focused on capitalising on early periods of plasticity when language learning is most sensitive.
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Dhondt A, Van keer I, Ceulemans E, van der Putten A, Maes B. Describing the communicative profiles of young children with a significant cognitive and motor developmental delay. Augment Altern Commun 2022:1-12. [DOI: 10.1080/07434618.2022.2138780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ann Dhondt
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Ines Van keer
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Eva Ceulemans
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Annette van der Putten
- Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Bea Maes
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
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Sevcik RA, Barton-Hulsey A, Bruce S, Goldman A, Ogletree BT, Paul D, Romski M. It's Never Too Late: Debunking Myths About Communication and Adults With Severe Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:416-425. [PMID: 36162046 DOI: 10.1352/1934-9556-60.5.416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/27/2022] [Indexed: 06/16/2023]
Abstract
Communication infuses all dimensions and stages of life, influencing one's self-determination and quality of life. A number of empirical studies have demonstrated that people with severe disabilities continue to develop communication and language skills well into their adult years and make measurable gains when provided with appropriate communication services and supports. Several myths about age, ability, and experiences limit opportunities for persons with severe disabilities. In this paper, we confront and address these myths.
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Affiliation(s)
| | | | | | - Amy Goldman
- Amy Goldman, United States Society for Augmentative and Alternative Communication
| | | | - Diane Paul
- Diane Paul, American Speech Language Hearing Association
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Wofford MC, Ogletree BT, De Nardo T. Identity-Focused Practice in Augmentative and Alternative Communication Services: A Framework to Support the Intersecting Identities of Individuals With Severe Disabilities. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1933-1948. [PMID: 35973107 DOI: 10.1044/2022_ajslp-21-00397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this clinical focus article is to consider a framework of identity in provision of services to individuals with severe disabilities who use augmentative and alternative communication (AAC). METHOD Components of the framework for identity include personal, social, and cultural areas. These aspects are identified in extant literature on AAC services and discussed through the lens of the Communication Bill of Rights (National Joint Committee for the Communication Needs of Persons with Severe Disabilities in 1992). Identity-focused practice is discussed as being relevant to self-determination and quality of life among individuals with severe disabilities. RESULTS A case study illustrates identity-focused practice in delivery of services to an adolescent who uses AAC, considering personal, social, and cultural identities. CONCLUSIONS This clinical focus article proposes a theoretical framework and provides a practice example for addressing the intersecting identities of individuals with severe disabilities. Furthermore, this clinical focus article argues that identity is a basic human right and area in which additional efforts are needed in the application of AAC solutions.
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Affiliation(s)
- Mary Claire Wofford
- Department of Communication Sciences and Disorders, Western Carolina University, Cullowhee, NC
| | - Billy T Ogletree
- Department of Communication Sciences and Disorders, Western Carolina University, Cullowhee, NC
| | - Thales De Nardo
- Department of Communication Sciences and Disorders, Western Carolina University, Cullowhee, NC
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9
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Hughes DM, Vento-Wilson M, Boyd LE. Direct Speech-Language Intervention Effects on Augmentative and Alternative Communication System Use in Adults With Developmental Disabilities in a Naturalistic Environment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1621-1636. [PMID: 35442756 DOI: 10.1044/2022_ajslp-21-00242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Research involving the effects of augmentative and alternative communication (AAC) intervention in adults, especially in naturalistic settings, has been identified as a critical public health need. Despite rapid advances in high-tech AAC, many adults with developmental disabilities have experienced reduced access to assistive technology and AAC, which can function as a de facto environmental barrier to participation, for these individuals. As a means of decreasing barriers to participation, this study targeted skill increases in the operational, linguistic, social, and strategic use of AAC systems. METHOD This study used a preexperimental, single-case AB design to identify skill level changes in the operational, linguistic, social, and strategic use of their AAC system from baseline to the completion of intervention. The four adult participants with developmental disabilities and limited use of natural speech as a primary modality of communication were identified through a collaborative relationship between a communication sciences and disorder university program and a state-run adult day program for individuals who had aged out of the K-12 school system. Each participant received direct intervention in the four areas described across 7 weeks. RESULTS Visual analysis and percent of nonoverlap of all pairs were used to identify changes in performance occurring between baseline and the conclusion of the intervention period. Results revealed increases across the specific skills, with individuals' variation across participants and target area. Out of 22 total goals targeted, strong effect sizes were observed for 10 goals and moderate effect sizes were observed for seven. CONCLUSIONS Skill increases in the four areas of AAC system use can be achieved with direct intervention in adults with developmental disabilities and limited use of natural speech as a primary modality of communication. This approach also underscores the value of collaborations between university training programs, providers of adult services, and adult participants as a cost-effective strategy for service delivery.
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Affiliation(s)
- Deanna M Hughes
- Communication Sciences & Disorders, Crean College of Health & Behavioral Sciences, Chapman University, Irvine, CA
| | - Margaret Vento-Wilson
- Department of Speech-Language Pathology, College of Health and Human Services, California State University, Long Beach
| | - LouAnne E Boyd
- Computer Science, Fowler School of Engineering, Chapman University, Irvine, CA
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Bercaw LE, Levinson A, Fletcher D, Shuman SB, Hughes S, Peddada S, Walsh EG. Assessing Disparities in Medicaid Home- and Community-Based Services: A Systematic Review. J Aging Soc Policy 2022; 35:302-321. [PMID: 35648802 DOI: 10.1080/08959420.2022.2081424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In recent years, expansion of home and community-based services (HCBS) for older adults and persons with disabilities has become a national priority in the U.S. In addition, lawmakers and health-care providers are pursuing opportunities to minimize disparities in healthcare service delivery. Marrying these priorities will require policymakers to identify existing Medicaid HCBS disparities toward development of new, more equitable policies. This study provides a systematic literature review using an adapted theoretical framework to describe disparities in Medicaid HCBS. Key findings are organized into four domains: availability, accessibility, accommodation, and acceptability. We found a lack of concerted research effort targeting Medicaid HCBS disparities in the context of all four domains, with an especially notable dearth of content related to acceptability. We also identified very few articles that focused on specific marginalized groups, suggesting a need for more research into whether Medicaid HCBS are available, accessible, accommodating, and acceptable for a variety of diverse populations. Our findings underscore the need for researchers and policymakers to conceptualize and evaluate existing Medicaid HCBS policy toward development of a more equitable Medicaid HCBS program design in the future.
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Lord C, Charman T, Havdahl A, Carbone P, Anagnostou E, Boyd B, Carr T, de Vries PJ, Dissanayake C, Divan G, Freitag CM, Gotelli MM, Kasari C, Knapp M, Mundy P, Plank A, Scahill L, Servili C, Shattuck P, Simonoff E, Singer AT, Slonims V, Wang PP, Ysrraelit MC, Jellett R, Pickles A, Cusack J, Howlin P, Szatmari P, Holbrook A, Toolan C, McCauley JB. The Lancet Commission on the future of care and clinical research in autism. Lancet 2022; 399:271-334. [PMID: 34883054 DOI: 10.1016/s0140-6736(21)01541-5] [Citation(s) in RCA: 278] [Impact Index Per Article: 139.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022]
Affiliation(s)
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Paul Carbone
- Department of Pediatrics at University of Utah, Salt Lake City, UT, USA
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | | | - Themba Carr
- Rady Children's Hospital San Diego, Encinitas, CA, USA
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | | | | | | | | | | | - Peter Mundy
- University of California, Davis, Davis, CA, USA
| | | | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Emily Simonoff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Vicky Slonims
- Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul P Wang
- Simons Foundation Autism Research Initiative, Simons Foundation, New York, NY, USA; Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | | | - Rachel Jellett
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Patricia Howlin
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Szatmari
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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Walker VL, Chung YC. Augmentative and Alternative Communication in an Elementary School Setting: A Case Study. Lang Speech Hear Serv Sch 2022; 53:167-180. [PMID: 34902289 DOI: 10.1044/2021_lshss-21-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Although there is a strong evidence base supporting the use of augmentative and alternative communication (AAC) in school settings, the research-to-practice gap in this area remains a concern. Few studies have examined how AAC systems are implemented in school settings and whether these systems adequately promote communicative competence for students with complex communication needs. The aim of this case study was to better understand the ways in which elementary-age students with complex communication needs used AAC throughout daily routines. METHOD Observations of five students, four receiving services under the category of autism and one under intellectual disability, in school settings were conducted to document the communication function, type of AAC systems used, and the times and activities during which AAC systems were accessible. In addition, supplemental interviews were conducted to understand the rationale for AAC implementation from the perspective of the special education teacher and speech-language pathologist. RESULTS Overall, findings from the observations and interviews indicated that a variety of AAC modes were utilized. Interactions represented a range of communicative functions, with the exception of social closeness, and were primarily observed during academic activities. However, there were some discrepancies between observations and interview data. CONCLUSIONS Although these findings provide insight into how students with complex communication needs may use AAC in elementary school settings, more research is needed to explore AAC use across a range of students, classrooms, and schools. We present specific future research directions, along with implications and recommendations for AAC teams and researchers.
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Affiliation(s)
- Virginia L Walker
- Department of Special Education and Child Development, University of North Carolina at Charlotte
| | - Yun-Ching Chung
- Department of Special Education, Illinois State University, Normal
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Andzik NR, Schaefer JM, Christensen VL. The effects of teacher-delivered behavior skills training on paraeducators' use of a communication intervention for a student with autism who uses AAC. Augment Altern Commun 2021; 37:1-13. [PMID: 33840318 DOI: 10.1080/07434618.2021.1881823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Special education teachers are often responsible for training their staff how to support children with autism spectrum disorder in their classrooms. In addition to academic and behavioral interventions, paraeducators also need to be prepared to support students with complex communication needs. This study was designed to investigate the effects of a paraeducator-implemented communication intervention in a public school. A multiple probe design across participants was used to evaluate a communication intervention that included providing opportunities to initiate with least-to-most prompting for a 10-year-old student with autism who used an augmentative and alternative communication (AAC) device. Prior to the intervention, the student was rarely observed initiating interactions with her AAC device, and paraeducators were rarely observed offering opportunities to initiate or providing supports to help the student initiate. Following training, data from each paraeducator indicated an increased rate when providing the communication intervention and as a result, the student displayed an increase in the targeted intervention, initiation. Findings from the intervention highlight the need for explicit teaching when promoting initiation among students with autism who use AAC.
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Affiliation(s)
- Natalie R Andzik
- Department of Special and Early Education, Northern Illinois University, DeKalb, IL, USA
| | - John M Schaefer
- Department of Teacher Education, Cleveland State University, Cleveland, OH, USA
| | - Victoria L Christensen
- Department of Special and Early Education, Northern Illinois University, DeKalb, IL, USA
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Wood S, Standen P. Is speech and language therapy effective at improving the communication of adults with intellectual disabilities?: A systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:435-450. [PMID: 33624400 DOI: 10.1111/1460-6984.12601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/30/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND A significant proportion of adults with intellectual disabilities (ID) experience speech, language and communication difficulties which are associated with poor physical and mental health outcomes. Speech and language therapy (SLT) interventions are an important way to address these communication difficulties, yet there is limited available evidence to provide information about the effectiveness of the different approaches used for this heterogeneous group. AIMS To review the evidence available for the effectiveness of SLT interventions aimed at improving communication for adults with ID. METHODS & PROCEDURES A systematic search across relevant databases was performed. Information on methodological details of each relevant study, along with descriptions of the SLT interventions employed, were extracted and the Crowe Critical Appraisal Tool (CCAT) was used to assess quality. Findings were discussed in a narrative synthesis grouped by target communication skill. OUTCOMES & RESULTS A total of 10 relevant studies met the inclusion criteria. These were predominantly interventions aimed directly at adults with ID to improve speech, increase augmentative and alternative communication (AAC) use and develop interaction skills, with one study addressing work with carers. The included studies were all rated as low quality. There is weak preliminary evidence that SLT input can improve the communication skills of adults with ID. CONCLUSIONS & IMPLICATIONS There is insufficient evidence to draw strong conclusions about the effectiveness of SLT in this population. Further high-level evidence across speech, language and communication domains is urgently needed. What this paper adds What is already known on the subject There is limited evidence for community health interventions used with adults with ID. Previous reviews of SLT interventions found a lack of evidence base for this population. Some areas of SLT practice such as AAC have demonstrated potential benefits and other areas including speech work, social communication skills and training for communication partners have some evidence base for children with ID but there is currently insufficient evidence for adults with ID. What this paper adds to existing knowledge The study systematically reviews the current evidence base available when considering the effectiveness of SLT intervention for adults with ID. It provides weak evidence to suggest SLT intervention can improve communication in this population and highlights the need for clinically relevant, robustly designed studies to be undertaken in this field. What are the potential or actual clinical implications of this work? The lack of high-quality studies with sufficient power to draw conclusions about effectiveness means SLTs are not able to base their intervention choices on firm evidence. There is an urgent need to conduct robust research into the effectiveness of SLT interventions for adults with ID.
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Affiliation(s)
- Siȃn Wood
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Penny Standen
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
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McCoy A, McNaughton D. Effects of Online Training on Educators' Knowledge and Use of System of Least Prompts to Support Augmentative and Alternative Communication. JOURNAL OF BEHAVIORAL EDUCATION 2021; 30:10.1007/s10864-020-09374-6. [PMID: 34421285 PMCID: PMC8375496 DOI: 10.1007/s10864-020-09374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The present study evaluated the effects of online training on educators' knowledge and use of system of least prompts (SLP) to support the communication of individuals with autism (ASD) who use augmentative and alternative communication (AAC). A pre/posttest group design with switching replications was utilized. Three dependent variables: (a) knowledge of SLP, (b) planning for SLP, and (c) performance of SLP implementation during teleconference role-plays, were analyzed using a two-way mixed analysis of variance (ANOVA). Results indicate that training was effective in increasing educators' knowledge as well as the ability to plan for SLP. Implementation of SLP also increased over time, however, data analysis did not support the conclusion that this result was directly related to the online training. Additional results suggest that the participants viewed online instruction, with teleconference role-play assessments and case study vignettes, as a socially valid activity. Participants reported learning a valuable skill and as a result of the training were more confident working with individuals who use AAC. Implications, limitations, and directions for future research are also discussed.
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Affiliation(s)
- Ashley McCoy
- School of Counseling & Special Education, Bowling Green State University, Bowling Green, Ohio
| | - David McNaughton
- Department of Educational Psychology, Counseling, and Special Education, Penn State University, University Park, PA
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Ho H, Perry A, Koudys J. A systematic review of behaviour analytic interventions for young children with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:11-31. [PMID: 32974933 DOI: 10.1111/jir.12780] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND According to several comprehensive systematic and narrative reviews, interventions based on applied behaviour analysis principles, or behaviour analytic interventions, are considered evidence based for children with autism spectrum disorder (ASD). However, no comprehensive review of the literature related to behaviour analytic interventions for children with intellectual disability (ID) currently exists. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (registration ID: CRD42018099317), the purpose of this study was to conduct a systematic review of the relevant published literature on the use of behaviour analytic interventions to develop skills in young children (0-8 years) with ID (and without ASD). A preliminary search of the literature identified 1209 potential studies published between January 2000 and April 2020. The review process resulted in 48 articles consisting of 49 studies (i.e. one paper contained two studies) that met the inclusion criteria. Most used single-case research designs. Studies were evaluated on five dimensions of methodological quality based on the Scientific Merit Rating Scale developed by the National Autism Center (NAC). The NAC definitions were also used for the quantity and quality of research evidence required for interventions to be considered established or emerging. RESULTS There were a number of limitations to the quality of the body of research. Nevertheless, various behaviour analytic interventions met criteria for being established interventions when used for targeting communication, adaptive and pre-academic skills in young children with ID. Behaviour analytic interventions targeting academic skills met criteria for emerging interventions. CONCLUSIONS Although the current literature is limited, results indicate that behaviour analytic interventions may be effectively used to support skill development in children with ID.
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Affiliation(s)
- H Ho
- Department of Psychology, York University, Toronto, ON, Canada
| | - A Perry
- Department of Psychology, York University, Toronto, ON, Canada
| | - J Koudys
- Department of Applied Disability Studies, Brock University, St. Catharines, ON, Canada
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Schladant M, Dowling M. Parent Perspectives on Augmentative and Alternative Communication Integration for Children With Fragile X Syndrome: It Starts in the Home. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 58:409-421. [PMID: 33032315 DOI: 10.1352/1934-9556-58.5.409] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/29/2019] [Indexed: 06/11/2023]
Abstract
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.
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Affiliation(s)
| | - Monica Dowling
- Michelle Schladant and Monica Dowling, University of Miami, FL
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18
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Kristoffersson E, Dahlgren Sandberg A, Holck P. Communication ability and communication methods in children with cerebral palsy. Dev Med Child Neurol 2020; 62:933-938. [PMID: 32281100 DOI: 10.1111/dmcn.14546] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2020] [Indexed: 11/28/2022]
Abstract
AIM To investigate if communication ability and method were related to each other and to age, sex, gross motor function, or manual ability in children with cerebral palsy. METHOD This cross-sectional study used data registered in the Swedish Cerebral Palsy Surveillance Program registry, involving 3000 children aged 0 to 18 years. Pearson's χ2 test and Spearman's correlation were used to test associations between variables. RESULTS Communication ability and method were related to each other and to age, gross motor function, and manual ability. Aided communication methods were more frequently used among older children. The more functional the communication was, the less use of unaided communication occurred. Different communication methods were used across all Communication Function Classification System (CFCS) levels. Speech was most common in more functional levels, used by 72% of the children. Forty-five per cent were considered effective communicators in all environments. For classification of communication level and method, some recurring registration errors were made by the raters. INTERPRETATION Some raters may need clarification on interpretations of CFCS instructions. Results indicate that children should be presented to aided augmentative and alternative communication and manual signs earlier and to a greater extent.
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Affiliation(s)
| | - Annika Dahlgren Sandberg
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden.,Division of Logopedics, Phoniatrics and Audiology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Pernille Holck
- Department of Research and Development, Psychiatry and Habilitation, Pernille Holck, Region Scania, Sweden
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19
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A Selective Review of Milieu Interventions for Adults with Severe Intellectual Disabilities. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020. [DOI: 10.1007/s40474-020-00199-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Walker VL, Lyon KJ, Loman SL, Sennott S. A systematic review of Functional Communication Training (FCT) interventions involving augmentative and alternative communication in school settings. Augment Altern Commun 2019; 34:118-129. [PMID: 29783913 DOI: 10.1080/07434618.2018.1461240] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
The purpose of this meta-analysis was to summarize single-case intervention studies in which Functional Communication Training (FCT) involving augmentative and alternative communication (AAC) was implemented in school settings. Overall, the findings suggest that FCT involving AAC was effective in reducing challenging behaviour and promoting aided or unaided AAC use among participants with disability. FCT was more effective for the participants who engaged in less severe forms of challenging behaviour prior to intervention. Additionally, FCT was more effective when informed by a descriptive functional behaviour assessment and delivered within inclusive school settings. Implications for practice and directions for future research related to FCT for students who use AAC are addressed.
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Affiliation(s)
- Virginia L Walker
- a Department of Special Education , Illinois State University , Normal , IL , USA
| | | | - Sheldon L Loman
- c Department of Special Education , Portland State University , Portland , OR , USA
| | - Samuel Sennott
- c Department of Special Education , Portland State University , Portland , OR , USA
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21
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Muharib R, Alrasheed F, Ninci J, Walker VL, Voggt AP. Thinning Schedules of Reinforcement Following Functional Communication Training for Children with Intellectual and Developmental Disabilities: A Meta-analytic Review. J Autism Dev Disord 2019; 49:4788-4806. [PMID: 31456100 DOI: 10.1007/s10803-019-04191-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Functional communication training (FCT) is an evidence-based practice used to mitigate challenging behavior by increasing functional communication skills. To increase the practicality and feasibility of FCT in natural settings, thinning schedules of reinforcement are typically programmed following FCT. In this review, we meta-analyzed 28 studies that incorporated a thinning schedule procedure following FCT for 51 children with intellectual and developmental disabilities ages 8 and younger. Using Tau-U, the results demonstrated overall moderate effect sizes for both challenging behavior and functional communication responses. Additionally, moderator analyses pertaining to participant characteristics, interventions, and study quality were conducted. Thinning procedures were most effective for children who had stronger communication repertoire. Implications for future research and practice are discussed.
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Affiliation(s)
- Reem Muharib
- Department of Curriculum and Instruction, Texas State University, 601 University Dr., San Marcos, TX, 78666, USA.
| | | | | | | | - Ashley P Voggt
- University of North Carolina at Charlotte, Charlotte, NC, USA
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22
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Chung YC, Douglas KH, Walker VL, Wells RL. Interactions of High School Students With Intellectual and Developmental Disabilities in Inclusive Classrooms. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 57:307-322. [PMID: 31373547 DOI: 10.1352/1934-9556-57.4.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
As inclusive opportunities increase for students with disabilities, additional research is needed to examine high school students' classroom interactions. This descriptive study explores the nature of the social interactions of 10 high school students with intellectual and developmental disabilities (IDD) in the general education classroom. Findings from our observations indicated that students with IDD interacted with peers during approximately one out of every four minutes and interacted with the general educator during one out of every 10 minutes, less than their peer comparisons' interactions with peers and teachers. Students with IDD were present (M = 89.9%) and in proximity to peers (M = 71.7%) during the majority of the class period. We discuss additional results along with practical implications, limitations, and future research directions.
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Affiliation(s)
- Yun-Ching Chung
- Yun-Ching Chung, Department of Special Education, Illinois State University; Karen H. Douglas, School of Teacher Education and Leadership, Radford University; Virginia L. Walker, Department of Special Education and Child Development, University of North Carolina at Charlotte; Rachel L. Wells, Thomas Metcalf Laboratory School, Illinois State University
| | - Karen H Douglas
- Yun-Ching Chung, Department of Special Education, Illinois State University; Karen H. Douglas, School of Teacher Education and Leadership, Radford University; Virginia L. Walker, Department of Special Education and Child Development, University of North Carolina at Charlotte; Rachel L. Wells, Thomas Metcalf Laboratory School, Illinois State University
| | - Virginia L Walker
- Yun-Ching Chung, Department of Special Education, Illinois State University; Karen H. Douglas, School of Teacher Education and Leadership, Radford University; Virginia L. Walker, Department of Special Education and Child Development, University of North Carolina at Charlotte; Rachel L. Wells, Thomas Metcalf Laboratory School, Illinois State University
| | - Rachel L Wells
- Yun-Ching Chung, Department of Special Education, Illinois State University; Karen H. Douglas, School of Teacher Education and Leadership, Radford University; Virginia L. Walker, Department of Special Education and Child Development, University of North Carolina at Charlotte; Rachel L. Wells, Thomas Metcalf Laboratory School, Illinois State University
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23
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Biggs EE, Carter EW, Gilson CB. A Scoping Review of the Involvement of Children's Communication Partners in Aided Augmentative and Alternative Communication Modeling Interventions. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:743-758. [PMID: 31039322 DOI: 10.1044/2018_ajslp-18-0024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
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.
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Affiliation(s)
- Elizabeth E Biggs
- Department of Special Education, University of Illinois at Urbana-Champaign
| | - Erik W Carter
- Department of Special Education, Vanderbilt University, Nashville, TN
| | - Carly B Gilson
- Department of Educational Psychology, Texas A & M University, College Station
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24
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Icht M. Introducing the Beatalk technique: using beatbox sounds and rhythms to improve speech characteristics of adults with intellectual disability. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:401-416. [PMID: 30478972 DOI: 10.1111/1460-6984.12445] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/19/2018] [Accepted: 10/29/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Individuals with intellectual disability (ID) often demonstrate speech impairments and reduced intelligibility. However, traditional treatment methods, which involve using repetitive verbal and non-verbal exercises, may not be fully suitable for this population. As adults with ID tend to lose interest and motivation facing the demands of a typical speech therapy session, other intervention methods are needed. The current study tested a novel intervention technique, Beatalk, based on practising vocally produced sounds and rhythms, imitating the sounds produced by rhythm machines in an a cappella musical context (i.e., human beatboxing). Human beatboxing may be a particularly effective tool since it involves intense production of speech sounds (phonemes) that can be misarticulated in the presence of speech disorders; it is relatively easy to learn and practice, and is also considered 'fun'. AIMS As many of the features of beatboxing make it a promising method for speech therapy, this pioneering study aimed to examine its effectiveness in comparison with a traditional speech therapy. METHODS & PROCEDURES Twelve adults with moderate ID and low speech intelligibility (age 24-48 years) participated in a speech therapy group for 6 weeks. Six participants were assigned to the Beatalk (study) group and six to a traditional (control) therapy group. Pre- to post-treatment changes in speech intelligibility and voice measures were assessed. OUTCOMES & RESULTS The preliminary data demonstrate that both types of therapy groups resulted in improved performance in articulation accuracy and voice measures, yet the Beatalk technique yielded larger gains. CONCLUSIONS & IMPLICATIONS The results present initial evidence for the beneficial effect of the Beatalk technique as an intervention tool for adults with ID. It is an easy-to-use technique in the context of speech therapy, and may enhance verbal communication skills in this population.
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Affiliation(s)
- Michal Icht
- Department of Communication Disorders, Ariel University, Ariel, Israel
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25
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Quinn ED, Cook A, Rowland C. An online community of practice to improve intervention for individuals with complex communication needs. Augment Altern Commun 2019; 35:142-147. [PMID: 30900476 DOI: 10.1080/07434618.2019.1566400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Collaboration and information sharing are essential in the fast moving world of augmentative and alternative communication (AAC). This paper describes communities of practice, justifies their need in AAC, and introduces the Communication Matrix Community of Practice (CMCoP)-an online community of practice for professionals and family members supporting individuals at the earliest stages of communication development. Stakeholders share the goal of advancing language and communication intervention for individuals with complex communication needs. Features of the CMCoP include a community forum for discussing and sharing information; collections of posts by professionals and nonprofessionals on various topics; an events calendar of AAC-related activities relevant to stakeholders; and a shared science section offering portraits of the communication skills of various populations with severe communication disorders. The utility of these and other CMCoP features in supporting the implementation of AAC assessment and intervention strategies is discussed.
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Affiliation(s)
- Emily D Quinn
- a Department of Special Education , Vanderbilt University , Nashville , TN , USA
| | - Alexandria Cook
- b Department of Pediatrics , Oregon Health and Science University , Portland , OR , USA
| | - Charity Rowland
- b Department of Pediatrics , Oregon Health and Science University , Portland , OR , USA
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26
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McNaughton D, Light J, Beukelman DR, Klein C, Nieder D, Nazareth G. Building capacity in AAC: A person-centred approach to supporting participation by people with complex communication needs. Augment Altern Commun 2019; 35:56-68. [DOI: 10.1080/07434618.2018.1556731] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- David McNaughton
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, University Park, PA, USA
| | - Janice Light
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, University Park, PA, USA
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Light J, McNaughton D, Beukelman D, Fager SK, Fried-Oken M, Jakobs T, Jakobs E. Challenges and opportunities in augmentative and alternative communication: Research and technology development to enhance communication and participation for individuals with complex communication needs. Augment Altern Commun 2019; 35:1-12. [DOI: 10.1080/07434618.2018.1556732] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Janice Light
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA, USA
| | - David McNaughton
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA, USA
| | - David Beukelman
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Susan Koch Fager
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Melanie Fried-Oken
- Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA
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28
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Light J, McNaughton D, Caron J. New and emerging AAC technology supports for children with complex communication needs and their communication partners: State of the science and future research directions. Augment Altern Commun 2019; 35:26-41. [DOI: 10.1080/07434618.2018.1557251] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Janice Light
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA, USA
| | - David McNaughton
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, University Park, PA, USA
| | - Jessica Caron
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA, USA
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29
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Trief E, Cascella PW, Bruce SM. A Field Study of a Standardized Tangible Symbol System for Learners who are Visually Impaired and have Multiple Disabilities. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x1310700303] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction The study reported in this article tracked the learning rate of 43 children with multiple disabilities and visual impairments who had limited to no verbal language across seven months of classroom-based intervention using a standardized set of tangible symbols. Methods The participants were introduced to tangible symbols on a daily basis during a seven-month field study. The tangible symbols were embedded into the curriculum during daily classroom routines and were used in addition to any other forms of expressive or receptive communication that were already in place in the classroom. The data were collected daily from teachers and therapists. Throughout the seven-month period, data were recorded for 30,220 opportunities to use tangible symbols. The participants had 2 to 9 recorded opportunities to use tangible symbols per day throughout the study. Results Over a four-month period, the participants identified 46% of the tangible symbols to which they were exposed, and cognitive, language, play, and symbolism skills were not factors related to the successful acquisition of tangible symbols. The strongest predictor of outcome was independent ambulation, and seven symbols were the most often identified. In addition, decontextualized pre- and posttesting proved less effective as a measurement tool than did daily classroom probes immediately following activities. Discussion The results suggest that even children with the most severe impairments were able to identify the use of many of the tangible symbols. Implications for practitioners One implication of this research is that data collection allows teachers or therapists to measure progress in the acquisition of tangible symbols objectively and that it fosters the development of goals for the students’ Individualized Education Programs.
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Affiliation(s)
- Ellen Trief
- Department of Special Education, Blind and Visually Impaired and Severe and Multiple Disabilities Including Deaf-blindness, Hunter College, 695 Park Avenue, Room 911W, New York, NY 10019
| | - Paul W. Cascella
- Communication Sciences, Hunter College, 425 East 25th Street, Room 900, New York, NY, 10010
| | - Susan M. Bruce
- Department of Teacher Education, Special Education, Curriculum and Instruction, Boston College, Campion Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
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Kline AD, Moss JF, Selicorni A, Bisgaard AM, Deardorff MA, Gillett PM, Ishman SL, Kerr LM, Levin AV, Mulder PA, Ramos FJ, Wierzba J, Ajmone PF, Axtell D, Blagowidow N, Cereda A, Costantino A, Cormier-Daire V, FitzPatrick D, Grados M, Groves L, Guthrie W, Huisman S, Kaiser FJ, Koekkoek G, Levis M, Mariani M, McCleery JP, Menke LA, Metrena A, O'Connor J, Oliver C, Pie J, Piening S, Potter CJ, Quaglio AL, Redeker E, Richman D, Rigamonti C, Shi A, Tümer Z, Van Balkom IDC, Hennekam RC. Diagnosis and management of Cornelia de Lange syndrome: first international consensus statement. Nat Rev Genet 2018; 19:649-666. [PMID: 29995837 PMCID: PMC7136165 DOI: 10.1038/s41576-018-0031-0] [Citation(s) in RCA: 193] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cornelia de Lange syndrome (CdLS) is an archetypical genetic syndrome that is characterized by intellectual disability, well-defined facial features, upper limb anomalies and atypical growth, among numerous other signs and symptoms. It is caused by variants in any one of seven genes, all of which have a structural or regulatory function in the cohesin complex. Although recent advances in next-generation sequencing have improved molecular diagnostics, marked heterogeneity exists in clinical and molecular diagnostic approaches and care practices worldwide. Here, we outline a series of recommendations that document the consensus of a group of international experts on clinical diagnostic criteria, both for classic CdLS and non-classic CdLS phenotypes, molecular investigations, long-term management and care planning.
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Affiliation(s)
- Antonie D Kline
- Harvey Institute of Human Genetics, Greater Baltimore Medical Centre, Baltimore, MD, USA
| | - Joanna F Moss
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - Angelo Selicorni
- Department of Paediatrics, Presidio S. Femro, ASST Lariana, Como, Italy
| | - Anne-Marie Bisgaard
- Kennedy Centre, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Glostrup, Denmark
| | - Matthew A Deardorff
- Division of Human Genetics, Children's Hospital of Philadelphia, and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Peter M Gillett
- GI Department, Royal Hospital for Sick Children, Edinburgh, Scotland, UK
| | - Stacey L Ishman
- Departments of Otolaryngology and Pulmonary Medicine, Cincinnati Children's Hospital Medical Centre, University of Cincinnati, Cincinnati, OH, USA
| | - Lynne M Kerr
- Division of Pediatric Neurology, Department of Paediatrics, University of Utah Medical Centre, Salt Lake City, UT, USA
| | - Alex V Levin
- Paediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Paul A Mulder
- Jonx Department of Youth Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Feliciano J Ramos
- Unit of Clinical Genetics, Paediatrics, University Clinic Hospital 'Lozano Blesa' CIBERER-GCV02 and ISS-Aragón, Department of Pharmacology-Physiology and Paediatrics, School of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Jolanta Wierzba
- Department of Paediatrics, Haematology and Oncology, Department of General Nursery, Medical University of Gdansk, Gdansk, Poland
| | - Paola Francesca Ajmone
- Child and Adolescent Neuropsychiatric Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - David Axtell
- CdLS Foundation UK and Ireland, The Tower, North Stifford, Grays, Essex, UK
| | - Natalie Blagowidow
- Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore, MD, USA
| | - Anna Cereda
- Department of Paediatrics, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Antonella Costantino
- Child and Adolescent Neuropsychiatric Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valerie Cormier-Daire
- Department of Genetics, INSERM UMR1163, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Paris, France
| | - David FitzPatrick
- Human Genetics Unit, Medical and Developmental Genetics, University of Edinburgh Western General Hospital, Edinburgh, Scotland, UK
| | - Marco Grados
- Division of Child and Adolescent Psychiatry, John Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laura Groves
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - Whitney Guthrie
- Centre for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Sylvia Huisman
- Department of Paediatrics, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Frank J Kaiser
- Section for Functional Genetics, Institute for Human Genetics, University of Lübeck, Lübeck, Germany
| | | | - Mary Levis
- Wicomico County Board of Education, Salisbury, MD, USA
| | - Milena Mariani
- Clinical Paediatric Genetics Unit, Paediatrics Clinics, MBBM Foundation, S. Gerardo Hospital, Monza, Italy
| | - Joseph P McCleery
- Centre for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Leonie A Menke
- Department of Paediatrics, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | | | - Julia O'Connor
- Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Chris Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - Juan Pie
- Unit of Clinical Genetics, Paediatrics, University Clinic Hospital 'Lozano Blesa' CIBERER-GCV02 and ISS-Aragón, Department of Pharmacology-Physiology and Paediatrics, School of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Sigrid Piening
- Jonx Department of Youth Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Carol J Potter
- Department of Gastroenterology, Nationwide Children's, Columbus, OH, USA
| | - Ana L Quaglio
- Genética Médica, Hospital del Este, Eva Perón, Tucumán, Argentina
| | - Egbert Redeker
- Department of Clinical Genetics, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - David Richman
- Department of Educational Psychology and Leadership, Texas Tech University, Lubbock, TX, USA
| | - Claudia Rigamonti
- Child and Adolescent Neuropsychiatric Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angell Shi
- The Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - Zeynep Tümer
- Kennedy Centre, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Glostrup, Denmark
| | - Ingrid D C Van Balkom
- Jonx Department of Youth Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
- Rob Giel Research Centre, Department of Psychiatry, University Medical Centre Groningen, Groningen, Netherlands
| | - Raoul C Hennekam
- Department of Paediatrics, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands.
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Biggs EE, Carter EW, Gilson CB. Systematic Review of Interventions Involving Aided AAC Modeling for Children With Complex Communication Needs. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 123:443-473. [PMID: 30198767 DOI: 10.1352/1944-7558-123.5.443] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Building the communicative competence of individuals who use augmentative and alternative communication (AAC) requires intervention and support. This systematic review examined experimental studies involving aided AAC modeling to promote the expressive communication of children and youth (i.e., birth to age 21) with complex communication needs. A search yielded 48 studies involving 267 participants. Interventions were categorized according to three different approaches to aided AAC modeling-augmented input, models as prompts, and models within instructional demonstrations. Although the procedures varied, interventions were generally effective at improving diverse measures of expressive communication. This review provides insight for both researchers and practitioners by describing interventions involving three distinct approaches to aided AAC modeling, highlighting areas needing future research, and offering implications for practice.
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Snodgrass MR, Meadan H. A boy and his AAC team: building instructional competence across team members. Augment Altern Commun 2018; 34:167-179. [DOI: 10.1080/07434618.2018.1491059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Melinda R. Snodgrass
- Department of Special Education, Hunter College, City University of New York, New York, NY, USA
| | - Hedda Meadan
- Department of Special Education, University of Illinois, Champaign, IL, USA
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Fleury A, Wu G, Chau T. A wearable fabric-based speech-generating device: system design and case demonstration. Disabil Rehabil Assist Technol 2018; 14:434-444. [DOI: 10.1080/17483107.2018.1462860] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Amanda Fleury
- Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Gloria Wu
- Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Tom Chau
- Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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Liang J, Wilkinson K. Gaze Toward Naturalistic Social Scenes by Individuals With Intellectual and Developmental Disabilities: Implications for Augmentative and Alternative Communication Designs. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1157-1170. [PMID: 29710313 DOI: 10.1044/2018_jslhr-l-17-0331] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 12/20/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE A striking characteristic of the social communication deficits in individuals with autism is atypical patterns of eye contact during social interactions. We used eye-tracking technology to evaluate how the number of human figures depicted and the presence of sharing activity between the human figures in still photographs influenced visual attention by individuals with autism, typical development, or Down syndrome. We sought to examine visual attention to the contents of visual scene displays, a growing form of augmentative and alternative communication support. METHOD Eye-tracking technology recorded point-of-gaze while participants viewed 32 photographs in which either 2 or 3 human figures were depicted. Sharing activities between these human figures are either present or absent. The sampling rate was 60 Hz; that is, the technology gathered 60 samples of gaze behavior per second, per participant. Gaze behaviors, including latency to fixate and time spent fixating, were quantified. RESULTS The overall gaze behaviors were quite similar across groups, regardless of the social content depicted. However, individuals with autism were significantly slower than the other groups in latency to first view the human figures, especially when there were 3 people depicted in the photographs (as compared with 2 people). When participants' own viewing pace was considered, individuals with autism resembled those with Down syndrome. CONCLUSION The current study supports the inclusion of social content with various numbers of human figures and sharing activities between human figures into visual scene displays, regardless of the population served. Study design and reporting practices in eye-tracking literature as it relates to autism and Down syndrome are discussed. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.6066545.
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Affiliation(s)
- Jiali Liang
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
| | - Krista Wilkinson
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
- E. K. Shriver Center of the University of Massachusetts Medical School, Worcester
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Simacek J, Reichle J, Byiers BJ, Parker-McGowan Q, Dimian AF, Elmquist M. Promoting Conditional Use of Communication Skills for Learners With Complex Communication Needs: A Tutorial. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:519-535. [PMID: 29582087 DOI: 10.1044/2017_ajslp-17-0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 11/14/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE Conditional use of communication skills refers to the ability of a learner to appropriately generalize and discriminate when, where, and how to communicate based on constant variation and shifts in environmental cues. METHOD We describe discrimination and generalization challenges encountered by learners with complex communication needs and ways in which these challenges are fostered through traditional communication intervention programming. We address arrangements in instruction that maximize the probability of learners acquiring the conditional use of new vocabulary and the modest instructional technology implemented when planning for generalization. RESULTS We propose establishing well-discriminated and generalized use of new vocabulary items through the application of a general case instruction framework to communication intervention programming. CONCLUSION We provide intervention methodology, including intervention steps for general case instruction, a plethora of functional examples, and graphic displays to assess and intervene to promote conditional use of communication skills for learners with complex communication needs.
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Yoo A, Kim M, Ross MM, Vaughn-Lee A, Butler B, dosReis S. Engaging Caregivers in the Treatment of Youth with Complex Developmental and Mental Health Needs. J Behav Health Serv Res 2018. [DOI: 10.1007/s11414-018-9604-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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van der Meer L, Matthews T, Ogilvie E, Berry A, Waddington H, Balandin S, O'Reilly MF, Lancioni G, Sigafoos J. Training Direct-Care Staff to Provide Communication Intervention to Adults With Intellectual Disability: A Systematic Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:1279-1295. [PMID: 29084306 DOI: 10.1044/2017_ajslp-16-0125] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 06/16/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE The aim of this review was to summarize and evaluate studies on training direct-care staff to provide communication intervention to adults with intellectual disability. METHOD Systematic searches identified 22 studies. These were summarized and evaluated in terms of (a) participants; (b) settings; (c) training aims and procedures; (d) research designs; (e) reliability, integrity, and social validity; (f) outcomes; (g) generalization and follow-up; and (h) certainty of evidence. RESULTS A total of 437 staff and 254+ adults with intellectual disability participated. Staff training most frequently involved combinations of verbal instruction, role play, modeling, practice, and feedback. Reliability was assessed in 18 studies with acceptable standards for most of these studies. Treatment integrity and social validity were assessed in 1 and 3 studies, respectively, with positive outcomes. Generalization and maintenance were assessed in 5 and 8 studies, respectively, with predominantly positive outcomes. Most studies reported positive outcomes for staff and positive or mixed outcomes for the adults with intellectual disability. Certainty of evidence was rated as conclusive in 1 study, suggestive in 14 studies, and inconclusive in 7 studies. CONCLUSIONS There is sufficient evidence to conclude that direct-care staff can be taught to provide effective communication intervention to adults with intellectual disability. Professionals involved in providing training and support to direct-care staff could expect positive outcomes from multicomponent training programs that include opportunities for practice and feedback.
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Affiliation(s)
| | - Tamyra Matthews
- School of Education, Victoria University of Wellington, New Zealand
| | - Emily Ogilvie
- School of Education, Victoria University of Wellington, New Zealand
| | - Alice Berry
- School of Education, Victoria University of Wellington, New Zealand
| | | | - Susan Balandin
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Mark F O'Reilly
- Department of Special Education, The University of Texas at Austin
| | - Giulio Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Italy
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, New Zealand
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Drager KDR, Light J, Currall J, Muttiah N, Smith V, Kreis D, Nilam-Hall A, Parratt D, Schuessler K, Shermetta K, Wiscount J. AAC Technologies with Visual Scene Displays and "Just in Time" Programming and Symbolic Communication Turns Expressed by Students with Severe Disability. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2017; 44:321-336. [PMID: 31263379 PMCID: PMC6601622 DOI: 10.3109/13668250.2017.1326585] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND The current study investigated the impact of an intervention that included aided augmentative and alternative communication (AAC) technologies on the frequency of symbolic communication turns of school-age children, adolescents, and young adults with severe disability. METHOD Nine students ages 8-20 were engaged in interactive activities using an aided AAC system with visual scene displays (VSDs; concepts embedded within a photograph of a naturally occurring event), and "just-in-time" (JIT) programming (the capability to add new contexts "on the fly"). Effectiveness was evaluated using a single subject multiple probe across participants design. RESULTS All participants demonstrated increases in symbolic communication turns upon introduction of the AAC technologies with VSDs using JIT technology. CONCLUSIONS AAC with VSDs and JIT programming may be effective in increasing symbolic communication for students with severe developmental disability. The fast and easy creation of VSDs and hotspots to provide communication may be a valuable tool for interventionists.
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Affiliation(s)
- Kathryn D R Drager
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
| | - Janice Light
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
| | - Jessica Currall
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
| | - Nimisha Muttiah
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
| | - Vanessa Smith
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
| | - Danielle Kreis
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
| | - Alyssa Nilam-Hall
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
| | - Daniel Parratt
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
| | - Kaitlin Schuessler
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
| | - Kaitlin Shermetta
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
| | - Jill Wiscount
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA
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Quinn ED, Rowland C. Exploring Expressive Communication Skills in a Cross-Sectional Sample of Children and Young Adults With Angelman Syndrome. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:369-382. [PMID: 28384804 DOI: 10.1044/2016_ajslp-15-0075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 10/19/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE This study explores data on expressive communication skills of 300 individuals aged 0.0-21.11 years with Angelman syndrome (AS). These data provide a composite portrait of communication skills in a large sample of children and young adults with this rare disorder, specifying new detailed information about expressive communication. METHOD The database associated with the Communication Matrix assessment (Rowland, 2004, 2011; Rowland & Fried-Oken, 2010) was mined for data regarding individuals with AS. We extracted data on the reasons for communicating, level of communication achieved, and use of various expressive communication modes to convey 24 specific messages. The performance of children and young adults in 5 age groups in the cross-sectional sample were contrasted. RESULTS Results confirmed earlier studies showing that few individuals with AS use natural speech. However, in addition to using presymbolic modes, many children used alternative symbolic modes such as picture symbols, object symbols, and manual signs. Assessment scores increased slightly with age, F(4, 295) = 2.416, p = .049. CONCLUSIONS Aggregating data on a large sample of individuals with AS provides a reference point for practitioners and family members and a basis for future investigations.
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Bruce SM, Bashinski SM. The Trifocus Framework and Interprofessional Collaborative Practice in Severe Disabilities. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:162-180. [PMID: 28514472 DOI: 10.1044/2016_ajslp-15-0063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 09/09/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE Individuals with severe disabilities are a diverse group of learners with complex communication needs. This article presents a synthesis of the literature addressing the five strategies of the trifocus framework, with its triadic structure of learner with disability, communication partner, and environment. The application of interprofessional collaborative practice (IPCP) to the implementation of trifocus framework communication strategies is emphasized. METHOD A literature search was conducted using Google Scholar and EBSCO to identify literature and research studies on IPCP and communication intervention for learners with severe disabilities, published 1994-2015, and then organized within the trifocus framework. The trifocus strategies are enhancing sensitivity, utilizing routines, increasing communication opportunities, modifying the communication environment, and augmenting input. Studies that included at least one participant with severe disabilities and their communication partners were considered. A secondary search was then conducted by reviewing the articles referenced in the original articles. CONCLUSION Effective IPCP in communication intervention considers the learner's characteristics, the knowledge and skills required of communication partners, and effective environmental arrangements to support communication. Future research should include clear participant descriptions, documentation of fidelity measures, and evidence of generalization to support professionals to know when findings are relevant to the individuals they serve.
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41
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Erickson K, Quick N. The Profiles of Students With Significant Cognitive Disabilities and Known Hearing Loss. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2017; 22:35-48. [PMID: 27599868 PMCID: PMC6279204 DOI: 10.1093/deafed/enw052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 07/23/2016] [Accepted: 07/25/2016] [Indexed: 06/06/2023]
Abstract
The present study describes the characteristics of students in Grades 3-12 with significant cognitive disabilities (SCD) and known hearing loss. The study analyzed results of a survey of teachers of students with SCD (n = 38,367) who were slated to participate in an alternate assessment based on alternate achievement standards in 14 states in the United States. Analysis revealed similar profiles in academic achievement and symbolic language use combined with an increased incidence of additional sensory impairments among students with SCD and known hearing loss compared to their peers without known hearing loss. Results suggest that hearing loss may be underidentified and underserved among students with SCD and point to the need for improved hearing screenings and evaluations combined with services delivered by teams that follow a model of interprofessional practice.
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Logan K, Iacono T, Trembath D. A systematic review of research into aided AAC to increase social-communication functions in children with autism spectrum disorder. Augment Altern Commun 2016; 33:51-64. [DOI: 10.1080/07434618.2016.1267795] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Kristy Logan
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Teresa Iacono
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - David Trembath
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
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Waddington H, van der Meer L, Carnett A, Sigafoos J. Teaching a Child With ASD to Approach Communication Partners and Use a Speech-Generating Device Across Settings: Clinic, School, and Home. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2016. [DOI: 10.1177/0829573516682812] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Individuals with autism spectrum disorder (ASD) often have difficulty generalizing newly acquired communication skills to different contexts. In this study, a multiple baseline across settings (clinic, school, and home) design was used to determine whether an 8-year-old boy with ASD could learn to approach communication partners to request preferred items using an iPad®-based speech-generating device (SGD). Results indicated that the participant learned to approach communication partners to request across all settings. Acquisition of this skill was fastest at school and slowest in the clinic. The participant’s learning generalized to a novel room within the same setting, and he was also able to retrieve the SGD prior to approaching the communication partner without additional teaching. Results suggest that individuals with ASD may benefit from being systematically taught to use an SGD across different settings and communication partners.
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Andzik NR, Chung YC, Kranak MP. Communication Opportunities for Elementary School Students who use Augmentative and Alternative Communication. Augment Altern Commun 2016; 32:272-281. [DOI: 10.1080/07434618.2016.1241299] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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45
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Chung YC, Stoner JB. A meta-synthesis of team members’ voices: what we need and what we do to support students who use AAC. Augment Altern Commun 2016; 32:175-86. [DOI: 10.1080/07434618.2016.1213766] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Yun-Ching Chung
- Department of Special Education, Illinois State University, Normal, IL, USA
| | - Julia B. Stoner
- Department of Special Education, Illinois State University, Normal, IL, USA
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Chen M, Hyppa-Martin JK, Reichle JE, Symons FJ. Comparing Single Case Design Overlap-Based Effect Size Metrics From Studies Examining Speech Generating Device Interventions. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 121:169-93. [PMID: 27119210 PMCID: PMC5313391 DOI: 10.1352/1944-7558-121.3.169] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Meaningfully synthesizing single case experimental data from intervention studies comprised of individuals with low incidence conditions and generating effect size estimates remains challenging. Seven effect size metrics were compared for single case design (SCD) data focused on teaching speech generating device use to individuals with intellectual and developmental disabilities (IDD) with moderate to profound levels of impairment. The effect size metrics included percent of data points exceeding the median (PEM), percent of nonoverlapping data (PND), improvement rate difference (IRD), percent of all nonoverlapping data (PAND), Phi, nonoverlap of all pairs (NAP), and Tau(novlap). Results showed that among the seven effect size metrics, PAND, Phi, IRD, and PND were more effective in quantifying intervention effects for the data sample (N = 285 phase or condition contrasts). Results are discussed with respect to issues concerning extracting and calculating effect sizes, visual analysis, and SCD intervention research in IDD.
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Affiliation(s)
- Mo Chen
- Mo Chen, University of Minnesota, Minneapolis, MN
| | - Jolene K Hyppa-Martin
- Jolene K. Hyppa-Martin, University of Minnesota, Minneapolis, MN and University of Minnesota Duluth, Duluth, MN
| | - Joe E Reichle
- Joe E. Reichle, University of Minnesota, Minneapolis, MN; and
| | - Frank J Symons
- Frank J. Symons, University of Minnesota, Minneapolis, MN
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Brady NC, Bruce S, Goldman A, Erickson K, Mineo B, Ogletree BT, Paul D, Romski MA, Sevcik R, Siegel E, Schoonover J, Snell M, Sylvester L, Wilkinson K. Communication Services and Supports for Individuals With Severe Disabilities: Guidance for Assessment and Intervention. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 121:121-38. [PMID: 26914467 PMCID: PMC4770561 DOI: 10.1352/1944-7558-121.2.121] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The National Joint Committee for the Communication Needs of People With Severe Disabilities (NJC) reviewed literature regarding practices for people with severe disabilities in order to update guidance provided in documents originally published in 1992. Changes in laws, definitions, and policies that affect communication attainments by persons with severe disabilities are presented, along with guidance regarding assessment and intervention practices. A revised version of the Communication Bill of Rights, a powerful document that describes the communication rights of all individuals, including those with severe disabilities is included in this article. The information contained within this article is intended to be used by professionals, family members, and individuals with severe disabilities to inform and advocate for effective communication services and opportunities.
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Affiliation(s)
- Nancy C Brady
- Nancy Brady, University of Kansas, Speech Language Hearing Sciences and Disorders, Lawrence, KS. The National Joint Committee on the Communication Needs of Persons with Severe Disabilities Members:
| | - Susan Bruce
- Susan Bruce, Boston College, Chestnut Hill, MA
| | - Amy Goldman
- Amy Goldman, College of Education, Temple University, Philadelphia, PA
| | - Karen Erickson
- Karen Erickson, The Center for Literacy & Disability Studies University of North Carolina, Chapel Hill, NC
| | - Beth Mineo
- Beth Mineo, Human Development & Family Studies, University of Delaware, Newark, DE
| | - Bill T Ogletree
- Bill T. Ogletree, College of Education & Allied Professions, Western Carolina University, Cullowhee, NC
| | - Diane Paul
- Diane Paul, American Speech-Language-Hearing Association, Rockville, MD
| | - Mary Ann Romski
- Mary Ann Romski, Department of Communication, Georgia State University Atlanta, GA
| | - Rose Sevcik
- Rose Sevcik, Department of Psychology, Georgia State University, Atlanta, GA
| | - Ellin Siegel
- Ellin Siegel, University of Nebraska-Lincoln, Special Education Department, Lincoln, NE
| | | | - Marti Snell
- Marti Snell, Curry School, University of Virginia, Charlottesville, VA
| | - Lorraine Sylvester
- Lorraine Sylvester, University of Oklahoma, Health Sciences Center, Department of Rehabilitation Sciences, College of Allied Health, Oklahoma City, OK; and
| | - Krista Wilkinson
- Krista Wilkinson, Department of Communication Sciences and Disorders, Penn State University, State College, PA
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48
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McNaughton D, Light J. What We Write about When We Write About AAC: The Past 30 Years of Research and Future Directions. Augment Altern Commun 2015; 31:261-70. [PMID: 26490318 DOI: 10.3109/07434618.2015.1099736] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
For the past 30 years, the Augmentative and Alternative Communication (AAC) journal has both documented and instigated change in the field of AAC. We reviewed the papers published in the AAC journal from 1985-2014 in order to identify trends in research and publication activities. Intervention research made up the largest proportion of the four types of research (i.e., intervention, descriptive, experimental, and instrument and measurement development) reported in the journal. Intervention research has most commonly focused on the individual with complex communication needs, and most frequently on younger individuals (aged 17 and younger) with developmental disabilities. While much has been learned in the past 30 years, there continues to be a need for high quality research in a large number of areas. There is a special need for reports of interventions with older individuals with complex communication needs as a result of acquired disabilities, and for information on effective interventions for the communication partners of persons with complex communication needs.
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Affiliation(s)
- David McNaughton
- a Departments of Educational and School Psychology and Special Education and
| | - Janice Light
- b Communication Sciences and Disorders , The Pennsylvania State University , University Park , PA , USA
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Light J, Mcnaughton D. Designing AAC Research and Intervention to Improve Outcomes for Individuals with Complex Communication Needs. Augment Altern Commun 2015; 31:85-96. [DOI: 10.3109/07434618.2015.1036458] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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50
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Thistle JJ, Wilkinson KM. Building Evidence-based Practice in AAC Display Design for Young Children: Current Practices and Future Directions. Augment Altern Commun 2015; 31:124-36. [DOI: 10.3109/07434618.2015.1035798] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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