Purpose Augmented input is the act of concurrently modeling language verbally and on a communication device, and is one strategy for teaching individuals to effectively use aided modes of communication. The purpose of this literature review is to assess the efficacy of augmented input for increasing communication and to identify intervention components, participant characteristics, and instructional contexts related to therapeutic outcomes. Method We double screened all potential sources and double coded all included sources. Database, forward, and backward searches yielded 99 single case designs in 26 sources. We coded characteristics of participants, instructional contexts, independent variables, and dependent variables. We also coded quality/rigor and primary outcomes for each design or comparison. Results Across high-quality studies, two thirds of designs indicated that augmented input was effective compared to baseline conditions and alternative interventions, and exploratory analyses indicated that receptive language skills, age, and diagnoses may moderate intervention efficacy. Most augmented input interventions included additional components that may serve as “active ingredients” (e.g., systematic prompting, contextual reinforcement). Most studies also did not report participant characteristics hypothesized to moderate intervention efficacy (e.g., joint attention skills, imitation repertoire). Results also indicated high risk of publication bias, with peer-reviewed sources twice as likely to include positive effects than dissertations and theses. Conclusions Across high-quality studies, augmented input was inconsistently effective as a stand-alone intervention. Packaged interventions that included augmented input were typically more effective than augmented input in isolation, particularly for individuals who were young, had strong receptive language skills, or had no comorbid diagnoses.
Purpose: Early language and communication interventions for children with language impairments have been shown to be effective in assessments administered immediately after treatment. The purpose of the current systematic review and meta-analysis was to assess the overall durability of those effects over time and whether durability was related to outcome type, etiology of child language impairments, implementer of intervention, magnitude of posttest effects, time between intervention and follow-up, and study risk of bias. Method: We conducted a systematic search of online databases and reference lists to identify experimental and quasi-experimental group design studies. All studies tested the effects of early communication interventions at least 3 months post-intervention. Participants were children 0–5 years old with language impairments. Coders identified study features and rated methodological quality indicators for all studies. Effect sizes at long-term timepoints and associations with potential moderators were estimated using multilevel meta-analysis with robust variance estimation. Results: Twenty studies with 129 long-term outcome effect sizes met inclusion criteria. Studies included children with developmental language disorders or language impairment associated with autism. The overall average effect size was small and significant ( g = .22, p = .002). Effect size estimates were larger for prelinguistic outcomes ( g = .36, p < .001) than for linguistic outcomes ( g = .14, p = .101). Significant factors were the posttest effect sizes, the risk of bias for randomized trials, and etiology of language impairment for linguistic outcomes. Time post-intervention did not significantly predict long-term effect sizes. Conclusions: Outcomes of early language and communication interventions appear to persist for at least several months post-intervention. More research is needed with collection and evaluation of long-term outcomes, a focus on measurement, and consistency of primary study reporting. Supplemental Material: https://doi.org/10.23641/asha.23589648
Purpose: Optimal augmentative and alternative communication (AAC) systems for children with complex communication needs depend in part on child characteristics, child preferences, and features of the systems themselves. The purpose of this meta-analysis was to describe and synthesize single case design studies comparing young children’s acquisition of communication skills with speech-generating devices (SGDs) and other AAC modes. Method: A systematic search of published and gray literature was conducted. Data related to study details, rigor, participant characteristics, design information, and outcomes were coded for each study. A random effects multilevel meta-analysis was performed using log response ratios as effect sizes. Results: Nineteen single case experimental design studies with 66 participants ( M age = 4.9 years) met inclusion criteria. All but one study featured requesting as the primary dependent variable. Visual analysis and meta-analysis indicated no differences between use of SGDs and picture exchange for children learning to request. Children demonstrated preferences for and learned to request more successfully with SGDs than with manual sign. Children who preferred picture exchange also learned to request more easily with picture exchange than with SGDs. Conclusions: Young children with disabilities may be able to request equally well with SGDs and picture exchange systems in structured contexts. More research is needed comparing AAC modes with diverse participants, communication functions, linguistic complexity, and learning contexts. Supplemental Material: https://doi.org/10.23641/asha.22111181
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