Increasing Communicative Interactions of Young Children With Autism Using a Voice Output Communication Aid and Naturalistic Teaching

Abstract

We evaluated the effects of a voice output communication aid (VOCA) and naturalistic teaching procedures on the communicative interactions of young children with autism. A teacher and three assistants were taught to use naturalistic teaching strategies to provide opportunities for VOCA use in the context of regularly occurring classroom routines. Naturalistic teaching procedures and VOCA use were introduced in multiple probe fashion across 4 children and two classroom routines (snack and play). As the procedures were implemented, all children showed increases in communicative interactions using VOCAs. Also, there was no apparent reductive effect of VOCA use within the naturalistic teaching paradigm on other communicative behaviors. Teachers' ratings of children's VOCA communication, as well as ratings of a person unfamiliar with the children, supported the contextual appropriateness of the VOCA. Probes likewise indicated that the children used the VOCAs for a variety of different messages including requests, yes and no responses, statements, and social comments. Results are discussed in regard to the potential benefits of a VOCA when combined with naturalistic teaching procedures. Future research needs are also discussed, focusing on more precise identification of the attributes of VOCA use for children with autism, as well as for their support personnel.

Management of Children With Autism Spectrum Disorders

“…Some nonverbal people with ASDs may benefit from the use of voice-output communication aids, but published evidence for these aids is scant. 20,64 Introduction of augmentative and alternative communication systems to nonverbal children with ASDs does not keep them from learning to talk, and there is some evidence that they may be more stimulated to learn speech if they already understand something about symbolic communication. 61,62,65 Social Skills Instruction There is some objective evidence to support traditional and newer naturalistic behavioral strategies and other approaches to teaching social skills.…”

Effects of Peer-Mediated Instruction to Teach Use of Speech-Generating Devices to Students with Autism in Social Game Routines

“…Different activities (i.e., games) were used with the two students with ASD to accommodate their individual interests and abilities, as per previous SGD studies aimed at promoting social interaction in such students (e.g., Schepis et al, 1998;Trembath et al, 2009). The games were similar with regard to the length of time and the number of player turns required to produce a winner; and both games required visual identity matching, a skill that both students had in their repertoires.…”

“…All CAs produced by students with ASD were transcribed from videotapes of each session. CAs were coded according to the mode of communication, as follows: (a) SGD activations that were directed toward a confederate (via eye contact or body orientation); (b) hand or upper extremity gestures that were directed toward a confederate, the activity materials, or the SGD; (c) verbal utterances that were recognizable as English words and were directed toward a confederate (Schepis et al, 1998); and (d) vocalizations that were not recognizable as English words but were directed toward a confederate (Schepis et al, 1998). Vocal stereotypic behaviors were excluded.…”

“…Of the remaining 18 studies, 72.2% focused on requesting (i.e., gaining access to desired items, asking for a break, or asking for more) as the primary communicative function that was taught via the SGD, and 11.1% focused on spelling instruction. Only three of the 18 studies (16.7%) focused on one or more communicative functions in addition to requesting; these included responding to questions (McMillan, 2008;Schepis, Reid, Behrmann, & Sutton, 1998); social commenting (Schepis et al, 1998;Trembath, Balandin, Togher, & Stancliffe, 2009); and rejecting (Trembath et al, 2009). Although all three studies were conducted in preschool or school settings, only one (Trembath et al, 2009) was aimed at increasing social interactions with peers rather than adults.…”

Prescribing Assistive-Technology Systems: Focus on Children With Impaired Communication

“…As an example, for a young child who has an ASD but is limited in communication by using the PECS, a VOCA may be helpful, because at least 1 report has indicated that VOCAs can increase communication skills in preschool-aged children with autism spectrum disorders. 7 People who have normal speech are so accustomed to a high rate of speed that patience and appropriate training are necessary to communicate with an individual using AAC systems. This is especially true if the child is using a low-tech communication aid such as a symbol, letter, or word board.…”