Teaching Communicative Responses with a Speech-Generating Device Via Telehealth Coaching

Abstract

Caregivers need support with teaching augmentative and alternative communication (AAC). The purpose of this study was to coach caregivers via telehealth (i.e., live video conferencing with Google Hangout) to implement communication assessments, functional communication training (FCT), and/or navigation training to address either idiosyncratic or problem behavior exhibited by two young boys with developmental delay (age 5.5 years) and autism (age 7 years) who were non-verbal. An adapted multiple probe design and a multiple probe design across three contexts (play, break from demands, help) were used to evaluate acquisition of communicative requests using high tech aided AAC on a speech-generating device (SGD; a Tobii Dynavox T10 device). A forward chain was also introduced to teach symbol selection and navigation on the SGD. Both children acquired the communicative alternatives across each context. Caregiver implementation fidelity was measured with procedural checklists and was acceptable across baseline and intervention sessions for both children. Children with developmental disabilities face many barriers to accessing needed communication intervention and may not have access to interventionists with the expertise in AAC with a SGD. Our findings have potential research implications for the use of telehealth to improve access to expertise in high tech aided AAC communication assessment and intervention.

Agreement between structured descriptive assessments and functional analyses conducted over a telehealth system.

“…He lived with both parents. Leo's functional analysis results were previously reported in Dimian, Elmquist, Reichle, and Simacek (2018) for use in teaching functional communication responses on a speech-generating device. He used gestures in the form of pointing and reaching to communicate and had no recognizable vocal language.…”

Implementing Aided Augmentative Communication Systems With Persons Having Complex Communicative Needs

“…There is a growing evidence base supporting the use of telemedicine to (a) conduct parent training and coaching for the assessment and intervention of low-technology aided AAC, such as picture card exchange (e.g., Simacek, Dimian, & McComas, 2017), and high-technology, speech-generating aided AAC devices (e.g., Dimian, Elmquist, Reichle, & Simacek, 2018); (b) provide FCT through parent coaching intervention for children with autism or related disabilities at outpatient, satellite-site clinics and in children’s homes (Lindgren et al, 2016); and (c) provide parent training in intervention for social-communication skills of young children with autism (Meadan, Meyer, Snodgrass, & Halle, 2013; Vismara et al, 2013). Telemedicine, though not the only solution, does have the potential as one solution to increase the reach of AAC intervention and can be used to deliver both direct and indirect SLP services (Boisvert, Hall, Andrianopoulos, & Chaclas, 2012).…”

Using behavioural skills training via telehealth to increase teachers use of communication interventions and increase student use of speech‐generating devices in a high school functional skills classroom

“…For individuals with IDD and CCN, intensive systematic instruction may be required to fully support the acquisition of AAC systems (Dimian et al . 2018; Ganz et al ., 2017; Ludlow et al . 2005).…”

“…These results are similar to previous work in telehealth delivered interventions focused on reducing the occurrence of challenging behaviour (Dimian et al . 2018).…”