Effects of Aided Language Input Intensity on AAC Use

Abstract

Aided forms of augmentative and alternative communication (AAC) enable individuals with significant disabilities to interact with people in their environment and be active participants in their lives. However, the provision of an AAC system is not enough and requires both general and focused systematic instruction to build language and communication skills in those who rely on aided forms of AAC. While interventions are often comprised of multiple strategies, aided language input is known to be of paramount importance. Prior research related to aided language input has varied considerably in how frequently it has been provided to participants. Three school-aged boys participated in the study (Mage = 8.5; age range = 6.8-10.8 years). One participant had a diagnosis of autism spectrum disorder, one had a diagnosis of Down syndrome, and one participant had diagnoses of autism spectrum disorder, Down syndrome, and an intellectual disability. Two of the three participants came from monolingual households, and one participant came from a bilingual household where English and Spanish were spoken. Information was collected during pre-intervention using parent questionnaires, Rowland’s Communication Matrix (Rowland & Fried, 2010), and modified standardized testing using the Test of Auditory Comprehension of Language 4th edition (Carrow-Woolfolk, 2014). Information was collected during intervention sessions through direct observation of AAC device use, number of different words used, as well as overall changes to communication. To determine effect sizes and statistical significance, Actual and Linear Interpolated values and a randomization test were calculated for (a) AAC use by participants, (b) number of different words used by participants, and (c) overall use of AAC/speech/sign. Post-intervention information was collected via parent questionnaire using Rowland’s Communication Matrix and re-administration of Test of Auditory Comprehension of Language 4th edition. Utilizing an alternating treatments design consisting of low-intensity and high-intensity conditions, this study investigated the effects that aided language input had on (a) the number of device activations produced by the participants, (b) the number of different words/pre-stored messages used by the participants, and (c) concurrent changes in communication and language. There were no statistically significant differences between the low and high intensity conditions on the number of device activations, the number of different words used, or on communication through all modalities. However, progress was made for each participant. This progress was different for each participant. One participant had improved scores on the receptive language test the Test of Auditory Comprehension of Language 4th edition. Another participant had an increasing trend in how much they used their device as well as an increasing trend in how many different words they utilized, while another participant demonstrated an increased number of words produced verbally, increased mean length of utterance in words, and by improved scores on parent report measures. These findings provide further evidence of the overall benefits that aided language input provides to children who use AAC and the different effects of aided language input on participants with different communication skills and profiles. Clinical implications and future research directions are provided.