Teaching Augmentative and Alternative Communication to Students with Severe Disabilities: A Review of Intervention Research 1997–2003

Abstract

This paper provides results of a descriptive analysis of peer-reviewed, single subject design, intervention research on augmentative and alternative communication (AAC) for individuals with severe disabilities, from birth to 21 years, published in English between 1997 and 2003. A database of 40 studies was found that met seven specified criteria. The descriptive analysis showed that a variety of antecedent, both adult and child directed, and consequent intervention components, typically used in combination, were effective in improving communication. Most research contexts were rated as less natural. Parents, teachers, and siblings or peers were infrequently involved in intervention. When problem behavior and communication were targeted, functional communication training (FCT) was the method of choice. Treatment integrity was infrequently measured. When measured, generalization and maintenance of treatment effects were good but were reported less than half of the time. Implications for interventionists and researchers are discussed.

AAC Interventions for Children in a Family Environment: Implementing Evidence in Practice

“…However, the level of evidence supporting the effectiveness of these AAC specific aspects of intervention remains largely anecdotal; to date, few studies have investigated the effectiveness of AAC-specific aspects of intervention in a family context. In their review of 40 studies of AAC interventions for children with severe disabilities, Snell et al (2006) reported that only 15% (6 of the 40 studies) had parents implementing AAC intervention methods, and only 20% (8 of the 40 studies) focused on conducting interventions in home environments. Given the lack of formal research, it is difficult to draw any empirically based conclusions about the effectiveness of AAC-specific aspects of interventions in family environments.…”

“…Although primary effects (e.g., the child's behavior and skills for interacting with the environment) are important, secondary effects (e.g., social interaction within the family environment) can be of equal importance. Results of the systematic review of AAC interventions for children with severe disabilities conducted by Snell et al (2006) suggested that few studies set goals and then measured outcomes related to social interaction within the family (i.e., secondary effects). The categorization of interventions in the Snell et al review only covered the primary effects of intervention on a child's interaction with other family members.…”

“…AAC interventions, by definition, involve using alternative modes and/or symbols of communication (e.g., graphic symbols, manual signs, synthetic speech). Most of the outcomes or goals targeted in AAC research to date have been defined in terms of understanding or using these alternative modes and/or symbols for communication (Snell, Chen, & Hoover, 2006). Usually, outcomes have been measured under experimental conditions in either experimental settings and/ or settings outside the home (Snell et al, 2006).…”

“…Albin, Lucyshyn, Horner, and Flannery (1996) found that, when treatment recommendations from professionals took into account the routines and patterns of family life, the families carried out the recommendations to a greater extent. Snell et al (2006) synthesized the AAC intervention research from 1997-2003 and analyzed family involvement in intervention decisions. They reported that few studies described how treatment decisions were made, and drew the conclusion that probably little collaboration took place between parents and researchers/interventionists in the decision making process.…”

The effect of pause time upon the communicative interactions of young people who use augmentative and alternative communication

“…However, most studies have included some or all of these strategies as part of a group of strategies taught in an intervention program. Specific information on the effects of strategies such as pause time is limited (Liboiron & Soto, 2006;Light et al, 1992;Myers, 2007;Newcombe, 2000;Snell et al, 2006). The children were taught in a class setting and received both individual instruction and participated in workshop style activities.…”