How Are Stakeholders With Autism Spectrum Disorder Included in the Social Validation of Augmentative and Alternative Communication Research? A Scoping Review

2021 ◽  
Vol 30 (2) ◽  
pp. 817-832
Author(s):  
Kirsty Bastable ◽  
Sandra Klopper ◽  
Alecia Samuels ◽  
Shakila Dada
Keyword(s):  
Autism Spectrum Disorder ◽  
Scoping Review ◽  
Augmentative And Alternative Communication ◽  
Research Process ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Social Validation ◽  
Alternative Communication ◽  
The Social ◽  
Scoping Reviews

Introduction Social validation or the inclusion of stakeholders in the research process is beneficial, as it may decrease bias, increases efficacy, and prevents harm. For direct stakeholders such as individuals with autism spectrum disorder (ASD), social validation has mostly included participants who do not experience significant speech, language, and communication limitations while frequently omitting individuals with ASD who have complex communication needs (CCN). The presence of CCN indicates that augmentative and alternative communication (AAC) strategies are needed for individuals to express themselves. Social validation should not be limited to being participants in an intervention but should include involvement in the research process. This requires an understanding of the current trends, levels, and mechanisms of involvement in AAC research. Purpose This review aimed to identify and describe the inclusion of direct stakeholders with ASD in the social validation of AAC research. Method A scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews) methodology to identify AAC research that included stakeholders with ASD (direct and indirect) for social validation and to evaluate their level of involvement using the Typology of Youth Participation and Empowerment pyramid framework. Results Twenty-four studies were identified. Studies primarily included indirect stakeholders (e.g., caregivers) giving in-depth perspectives, while direct stakeholders were limited to being intervention participants. Conclusions Voices of direct stakeholders with ASD and CCN remain limited or excluded in research. Reasons for the exclusion of individuals with ASD and CCN from research and strategies for future inclusion are raised and discussed.

Instruction Using Augmentative and Alternative Communication Supports: Description of Current Practices by Speech-Language Pathologists Who Work With Children With Autism Spectrum Disorder

2020 ◽  
Vol 29 (2) ◽  
pp. 586-596 ◽  
Author(s):  
Kaitlyn A. Clarke ◽  
Diane L. Williams
Keyword(s):  
Autism Spectrum Disorder ◽  
Augmentative And Alternative Communication ◽  
Communication Systems ◽  
Diagnostic Category ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Alternative Communication ◽  
Speech Language Pathologists ◽  
Processing Differences

Purpose The aim of this research study was to examine common practices of speech-language pathologists (SLPs) who work with children with autism spectrum disorder (ASD) with respect to whether or not SLPs consider processing differences in ASD or the effects of input during their instruction. Method Following a qualitative research method, how SLPs instruct and present augmentative and alternative communication systems to individuals with ASD, their rationale for method selection, and their perception of the efficacy of selected interventions were probed. Semistructured interviews were conducted as part of an in-depth case report with content analysis. Results Based on completed interviews, 4 primary themes were identified: (a) instructional method , (b) input provided , (c) decision-making process , and (d) perceived efficacy of treatment . Additionally, one secondary theme, training and education received , was identified . Conclusions Clinicians reported making decisions based on the needs of the child; however, they also reported making decisions based on the diagnostic category that characterized the child (i.e., ASD). The use of modeling when teaching augmentative and alternative communication to individuals with ASD emerged as a theme, but variations in the method of modeling were noted. SLPs did not report regularly considering processing differences in ASD, nor did they consider the effects of input during instruction.

Comparative Effects of Picture Symbol With Paired Text and Text-Only Augmentative and Alternative Communication Representations on Communication From Children With Autism Spectrum Disorder

2021 ◽  
Vol 30 (2) ◽  
pp. 584-597
Author(s):  
Christine Holyfield
Keyword(s):  
Autism Spectrum Disorder ◽  
Augmentative And Alternative Communication ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
School Age Children ◽  
Book Reading ◽  
Single Subject ◽  
Alternative Communication ◽  
Children With Asd

Purpose Technology features that maximize communicative benefit while minimizing learning demands must be identified and prioritized to amplify the efficiency and effectiveness of augmentative and alternative communication (AAC) intervention. Picture symbols with paired text are a common representation feature in AAC systems for children with autism spectrum disorder (ASD) who are preliterate, yet little research about their comparative benefit exists. Method Four school-age children with ASD and limited speech who were preliterate participated in two single-subject studies. In one study, communication of high imageability words (e.g., nouns) on an AAC app during a book-reading activity was compared across two representation conditions: picture symbols with paired text and text only. In the second study, communication of low imageability words (e.g., verbs) was compared. Both studies had baseline, intervention, generalization, and maintenance phases. Results Prior to intervention, participants communicated across both representation conditions at low rates except two participants who were relatively successful using picture symbol with paired text representations of high imageability words. In response to intervention, all participants demonstrated increases in communication across representation conditions and maintained the increases. Participants demonstrated generalization in the text-only representation condition. Conclusions Children with ASD who were preliterate acquired communication at comparable rates regardless of whether an AAC app utilized picture symbol with paired text or text-only representation. Therefore, while larger scale research is needed, clinicians and technology developers could consider increasing the use of text in AAC representation given the inherent value associated with learning to recognize written words. Supplemental Material https://doi.org/10.23641/asha.13661357

Understanding Communication and Students with Autism Spectrum Disorder

2020 ◽  
pp. 39-66
Author(s):  
Alice M. Hammel ◽  
Ryan M. Hourigan
Keyword(s):  
Autism Spectrum Disorder ◽  
Joint Attention ◽  
Augmentative And Alternative Communication ◽  
Expressive Language ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Alternative Communication ◽  
Music Classroom ◽  
Students With Autism

Communication is one of the considerable challenges faced by children with autism. Before a child with autism can learn, their must be able to communicate. This chapter includes information on communication traits and characteristics of persons with autism as well as steps to obtain effective communication with students with autism in the music classroom. Other topics include joint attention, reciprocation, echolalia, receptive and expressive language, and augmentative and alternative communication for students with autism in the music classroom.

scholarly journals Peer-Mediated Augmentative and Alternative Communication Interventions for Young Children With Autism Spectrum Disorder and Limited to No Spoken Communication

2020 ◽  
Vol 5 (3) ◽  
pp. 602-610
Author(s):  
Kathy S. Bourque
Keyword(s):  
Autism Spectrum Disorder ◽  
Augmentative And Alternative Communication ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Research Note ◽  
Spectrum Disorder ◽  
Alternative Communication ◽  
Treatment Implementation ◽  
Children With Asd ◽  
Communicative Interactions

Purpose Increasingly, research has identified effective approaches to improve communication and social engagement of preschool-age children with autism spectrum disorder (ASD) with limited spoken communication during interactions with peer partners. These include teaching peers to use the same augmentative and alternative communication (AAC) system, along with direct instruction (Thiemann-Bourque et al., 2018 ). The purpose of this research note is to summarize the author's contributions to this literature and provide clinicians with evidence-based strategies to support communicative interactions between children with ASD and peers without disabilities. Method This research note describes a series of studies conducted by the author and her colleagues with a focus on peer-mediated and direct AAC instructional approaches, defining target skills and how to measure effects on children's social communication competence, and the potential benefits of integrating approaches for preschool children with ASD who have significant social and communication needs. Results Outcomes summarized include fidelity of treatment implementation, improved rates of augmented and spoken communication, increased functional communication using different modalities, and enhanced reciprocal communication between children with ASD and peers during routine activities. Study limitations and directions for future intervention research are also discussed. Conclusions Together, the research reviewed shows that peers can be taught to be responsive AAC communication partners at a young age, with high fidelity of strategy implementation by peers and by speech-language pathologists or other early intervention staff. Providing children with increased social learning opportunities within the context of shared AAC activities allows both partners to become more competent in their social communicative interactions.

scholarly journals The Assessment of Phase of Preschool Language: Applying the language benchmarks framework to characterize language profiles and change in four- to five-year-olds with autism spectrum disorder

2019 ◽  
Vol 4 ◽  
pp. 239694151986408
Author(s):  
Helen E Flanagan ◽  
Isabel M Smith ◽  
Fiona Davidson
Keyword(s):  
Autism Spectrum Disorder ◽  
Augmentative And Alternative Communication ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Alternative Communication ◽  
Community Based ◽  
Preschool Language ◽  
Common Area ◽  
Language Profiles ◽  
First Words

Background and aims We introduce the Assessment of Phase of Preschool Language (APPL), a rating form that characterizes children’s language according to a well-established framework recommended by Tager-Flusberg et al. (2009). The language benchmarks framework defines children’s language as falling at one of the Pre-verbal, First Words, Word Combinations, Sentences, or Complex Language phases for phonology, vocabulary, grammar, pragmatics, and overall language. The APPL is a flexible assessment tool that allows assessors to determine language phase using a range of assessment sources: natural language samples, standardized measures, and/or parent rating forms. Using the APPL, we examined language profiles in four- and five-year-olds with autism spectrum disorder and explored language development during a community-based Naturalistic Developmental Behavioral Intervention program. Methods Community speech-language pathologists completed the APPL with 95 four- and five-year-olds at the beginning of the treatment. The APPL was re-administered after a mean of 10 months of intervention (SD = 2 months) for 46 of these children. Children received treatment for up to 15 h per week in their homes and/or community childcare centers. Pivotal Response Treatment was the main form of intervention. The Picture Exchange Communication System or other augmentative and alternative communication systems were also used with many pre-verbal children. Results At the beginning of intervention, the most common language phase was Word Combinations (44%), followed by Pre-verbal (26%), Sentences (20%), and then First Words (10%). Only 24% of children had even profiles (i.e. phonology, vocabulary, grammar, and pragmatics skills at the same level). Phonology was a common area of relative strength, and pragmatics was a common area of relative weakness. Ten months of intervention was associated with gains in overall language phase for 37% of children. Approximately half gained at least one phase in Grammar (57%), Vocabulary (51%), and Phonology (46%), while Pragmatics improved for 33%. Gains varied based on initial language phase. Inclusion of skills using augmentative and alternative communication enhanced interpretation of change during intervention. Conclusions Four- and five-year-olds with autism spectrum disorder in this sample tended to have uneven skills across expressive language domains. Community-based Naturalistic Developmental Behavioral Intervention was associated with gains in language phase in older preschoolers with autism spectrum disorder. Gains varied across language domains and were influenced by initial language phase. Implications The Assessment of Phase of Preschool Language is a useful tool to support consistent application of the language benchmarks framework. It is important to consider all language domains when characterizing language skills and treatment impact in children with autism spectrum disorder.

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