Cathy Binger

The effect of aided AAC modeling on the expression of multi-symbol messages by preschoolers who use AAC

A single subject, multiple probe design across participants was used to evaluate the impact of using aided AAC modeling to support multi-symbol message production. Five preschoolers (three who used voice output communication systems, two who used non-electronic communication boards) participated in the study. Aided AAC models were provided by pointing to two symbols on the childs aided AAC system and then providing a grammatically complete spoken model while engaging in play activities. Four of the five preschoolers learned to consistently produce multi-symbol messages; the fifth did not demonstrate consistent gains. The four preschoolers who met criterion all evidenced long-term use of symbol combinations and generalized use of symbol combinations to novel play routines. Results, clinical implications, and future research directions are discussed.

Story Reading interactions between preschoolers who use AAC and their mothers

The study investigated the early literacy experiences of five preschool-aged children with severe physical and speech impairments. The children were videotaped during two 10-minute story reading sessions with their mothers; the interactions were transcribed and coded. Results indicated that the participation patterns were asymmetrical. The mothers dominated the exchanges, and the children forfeited many of their communicative opportunities. The interactions were synchronous; the dyads shared a focus in the interactions. There was some variation across the dyads with respect to the specific communicative interaction patterns observed. The children in Dyads 3 and 4 participated infrequently during the story reading sessions; the children in Dyads 1, 2, and 5 were more active in the story reading interactions and demonstrated a greater range of communicative behaviors. Directions for intervention and for future research are discussed in light of the results.

Teaching Latino Parents to Support the Multi-Symbol Message Productions of their Children who Require AAC

Many children who require augmentative and alternative communication (AAC) have difficulties shifting from the single- to multi-symbol stage of language development. Ensuring that children who use AAC receive evidence-based interventions to address this problem is critical. Furthermore, there has been little AAC treatment efficacy research to date that addresses the needs of multicultural populations, particularly those of Latino children who use AAC and their families. To address these issues, the current investigation used a mixed methodology, which included a focus group to determine if any changes needed to be made to an existing instructional program; and a single subject, multiple probe, across participants design to evaluate the effects of a caregiver instructional program on the multi-symbol utterance productions of Latino children who used AAC. Specifically, a cognitive strategy instructional approach that has been used to teach turn-taking skills to both Caucasian and African American children who use AAC was modified and used to teach caregivers how to support the production of their childrens multi-symbol messages. In order to foster emergent literacy skills, caregivers implemented the strategy during book reading activities. Focus group results revealed that changes to the instructional program may be required for some Latino families. With regard to the instructional program, all caregivers successfully learned to use the instructional strategy, and all children increased their use of multi-symbol messages. Research and clinical implications of the findings are discussed.

Demographics of Preschoolers Who Require AAC.

PURPOSE The purpose of the investigation was to gather demographic information pertaining to preschoolers who require augmentative and alternative communication (AAC). METHOD To obtain this information, a survey was developed and then distributed to preschool speech-language pathologists (SLPs) in Pennsylvania. RESULTS Results indicated that approximately 12% of preschoolers receiving special education services required AAC. These children came from diverse ethnic and racial backgrounds, had a wide variety of disabilities, used a range of AAC systems, and required services from a wide range of educational professionals. IMPLICATIONS The findings indicate the pressing need for all preschool SLPs to be prepared to provide services for children who require AAC.

The Morphology and Syntax of Individuals who use AAC: Research Review and Implications for Effective Practice

A research review of 31 studies pertaining to the morphology and syntax of individuals who use augmentative and alternative communication (AAC) and who had severe speech and physical impairments (SSPI) was completed. Results suggest that, although many individuals who use AAC exhibit comprehension and expression of a wide range of grammatical structures, these individuals are at risk for experiencing grammar deficits. A wide range of individual differences was noted, both within and across many of the investigations. One of the more robust findings was that individuals tended to produce shorter utterances when they used graphic symbol-based AAC systems than would be expected, based on participant profiles; however, there appeared to be a developmental trend toward using longer utterances. There has been a dearth of research pertaining to the development and evaluation of appropriate assessment tools and intervention techniques to enhance grammar acquisition for individuals who use AAC. Considerations for developing such tools and techniques are discussed.

Effects of Communication Partner Instruction on the Communication of Individuals using AAC: A Meta-Analysis

The purpose of this study was to conduct a systematic review and meta-analysis of the augmentative and alternative communication (AAC) partner instruction intervention literature to determine (a) the overall effects of partner interventions on the communication of individuals using AAC, and (b) any possible moderating variables relating to participant, intervention, or outcome characteristics. Seventeen single-case experimental design studies (53 participants) met the inclusion criteria and were advanced to the full coding and analysis phase of the investigation. Descriptive analyses and effect size estimations using the Improvement Rate Difference (IRD) metric were conducted. Overall, communication partner interventions were found to be highly effective across a range of participants using AAC, intervention approaches, and outcome measure characteristics, with more evidence available for participants less than 12 years of age, most of whom had a diagnosis of autism spectrum disorder or intellectual/developmental disability. Aided AAC modeling, expectant delay, and open-ended question asking were the most frequently targeted communication partner interaction skills. Providing a descriptive overview, instructor modeling, guided practice, and role plays were the most frequently incorporated communication partner intervention activities within the included studies.

Personnel Roles in the AAC Assessment Process

Completing an augmentative and alternative communication (AAC) assessment is a complex process that involves many stakeholders and professionals. To help clarify professional roles and provide assessment guidelines, an AAC Assessment Personnel Framework was developed. This framework was adapted from the work of Beukelman, Ball, and Fager in 2008, which focused on general AAC needs (not just assessment) and concentrated specifically on adults. In contrast, the present model examines the assessment process for all individuals who require AAC. The following AAC assessment personnel are discussed: AAC finders, general practice SLPs, AAC clinical specialists, facilitators and communication partners, collaborating professionals, AAC research and policy specialists, manufacturers and vendors, funding agencies and personnel, and AAC/assistive technology agencies and personnel. Current barriers for successful assessment outcomes are discussed, and suggestions for addressing personnel-related barriers are explored.

Tales from school trenches: AAC service-delivery and professional expertise.

School-based speech-language pathologists work with a broad spectrum of students with varying needs. Recent reports indicate that ~50% of speech-language pathologists working in school settings have students who use augmentative and alternative communication (AAC) on their caseloads. Therefore, AAC service-delivery continues to emerge as an area of great interest and concern in the school setting. As researchers and clinicians strive to validate and provide high-quality AAC services, it is important to examine current AAC service-delivery issues in the schools. Several recent investigations include data that describe current trends and issues in AAC service provision. This article will use findings from several recent reports and investigations as a basis for (a) presenting contemporary issues relating to AAC service-delivery and professional expertise in the schools and (b) exploring practical future directions for AAC clinicians and researchers.

The effects of aided AAC interventions on AAC use, speech, and symbolic gestures.

Augmentative and alternative communication (AAC) service provision can be time-consuming, and it is important to ensure that the time invested in aided AAC interventions is worth the costs. As children who use AAC are multimodal communicators, it is important to understand the effects that aided AAC interventions may have not only on AAC use but also on other communication modes, including speech and symbolic gestures. Toward these ends, this article contains a review of commonly used AAC intervention techniques, a discussion of how use of these techniques affects aided AAC use, and an examination of the effect that AAC interventions have on other communication modes, including speech and various types of gestures. Overall, current research findings indicate that aided AAC interventions can be highly effective for teaching students who use AAC to become more effective communicators and that such interventions do not have a negative effect on speech-and may, in some cases, have a positive effect on speech.

Using Dynamic Assessment to Evaluate the Expressive Syntax of Children who use Augmentative and Alternative Communication

Abstract The developmental readiness of four 5-year-old children to produce basic sentences using graphic symbols on an augmentative and alternative communication (AAC) device during a dynamic assessment (DA) task was examined. Additionally, the ability of the DA task to predict performance on a subsequent experimental task was evaluated. A graduated prompting framework was used during DA. Measures included amount of support required to produce the targets, modifiability (change in participant performance) within a DA session, and predictive validity of DA. Participants accurately produced target structures with varying amounts of support. Modifiability within DA sessions was evident for some participants, and partial support was provided for the measures of predictive validity. These initial results indicate that DA may be a viable way to measure young childrens developmental readiness to learn how to sequence simple, rule-based messages via aided AAC.