Effects of Varying Lengths of Synthetic Speech Output on Augmented Requesting and Natural Speech Production in an Adolescent with Klinefelter Syndrome

A Systematic Review of Research on Augmentative and Alternative Communication Interventions for Children Aged 6-10 in the Last Decade

Purpose The purpose of this systematic review was to identify, appraise, and critically synthesize the latest available evidence on the effects of augmentative and alternative communication (AAC)-based interventions on communication skills in children aged between 6 and 10 years with mixed diagnoses. Method MEDLINE (OVID), PsycINFO (EBSCO), ERIC (ProQuest), SCIELO (WOS), Teacher Reference Center (EBSCO), and Education Database (ProQuest) were searched. The studies were independently selected by two reviewers for the purposes of the review. The methodological quality of the included studies was assessed, and characteristics and results of the studies were extracted. Results This review included 14 studies from a total of 1,204 found through an electronic search. The AAC interventions studied were effective at improving various outcomes in children with mixed diagnoses. Interventions that focused on narrative skills were the most common type. When considering the quality of the studies, the independence of assessors, data analysis, replication, and generalization of interventions were the weaker areas. Conclusions Interventions analyzed in this review improve communication skills, including phonological awareness, vocabulary, requesting, and developing narrative skills in children aged between 6 and 10 years with mixed diagnoses. The results of one study also indicate that the acquisition of skills using an AAC method is superior when the child prefers the method. Supplemental Material https://doi.org/10.23641/asha.14462256.

Systematic Review of Verbal Operants in Speech Generating Device Research from Skinner's Analysis of Verbal Behavior

Skinner's (1957) book Verbal Behavior is a critical tool in designing effective communication programs for individuals with limited speech. The purpose of this systematic review was to analyze the speech generating device (SGD) research literature from Skinner's taxonomy of primary verbal operants. An extraction procedure yielded 56 studies published between 1995 and 2018, with a total of 221 participants, most of whom had autism spectrum disorder (ASD) or an intellectual and developmental disability (IDD). The large majority of SGD studies (42) targeted multiply controlled mands, whereas only a handful of studies targeted verbal operants that were not mands. Few studies employed procedures for fading contrived sources of stimulus control to promote spontaneous responding, and few studies targeted more sophisticated, topography-based responses (e.g., typing, speech). Results of the review highlight the need for better dissemination of Skinner's Verbal Behavior, the need for research to evaluate effects of SGD in teaching a greater variety of spontaneous verbal operants, and the need to focus on application of SGD with populations beyond individuals with ASD and IDD.

Speech-generating devices: effectiveness of interface design-a comparative study of autism spectrum disorders

Background

We analyzed the efficacy of the interface design of speech generating devices on three non-verbal adolescents with autism spectrum disorder (ASD), in hopes of improving their on-campus communication and cognitive disability. The intervention program was created based on their social and communication needs in school. Two operating interfaces were designed and compared: the Hierarchical Relating Menu and the Pie Abbreviation-Expansion Menu.

Methods

The experiment used the ABCACB multiple-treatment reversal design. The test items included: (1) accuracy of operating identification; (2) interface operation in response to questions; (3) degree of independent completion. Each of these three items improved with both intervention interfaces.

Results

The children were able to operate the interfaces skillfully and respond to questions accurately, which evidenced the effectiveness of the interfaces.

Conclusions

We conclude that both interfaces are efficacious enough to help nonverbal children with ASD at different levels.

Comparing Single Case Design Overlap-Based Effect Size Metrics From Studies Examining Speech Generating Device Interventions

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.

Comparisons of intervention components within augmentative and alternative communication systems for individuals with developmental disabilities: a review of the literature

Decisions regarding augmentative and alternative communication (AAC) for individuals with developmental disabilities (e.g. what AAC to use and how to teach a person to use a specific AAC modality) should involve consideration of different intervention component options. In an effort to elucidate such decisions and options, this review synthesized 14 studies, published between 2004 and 2012, comparing different AAC intervention components including different symbol sets, instructional strategies, or speech output within aided AAC systems, and different verbal operants within unaided AAC. Evidence supported the following: (a) different instructional strategies such as building motivation, using errorless learning, or adding video models to picture exchange interventions may improve the acquisition or rate of acquisition of picture exchange mands, (b) limited data supports training mimetic (imitated) or mand signs over tacts and (c) differences in symbol sets and speech output levels appeared to have little effect on AAC-based mand acquisition, but listener-based differences should be considered. These findings have implications for future research and clinical practice.