Критерии подбора систем альтернативной и дополнительной коммуникации для детей с расстройствами аутистического спектра

Access to Justice: An SLP’s Guide to Helping Persons with Complex Communication Needs Voice Their Case

Supporting Families of Children Who Use AAC

Augmentative and alternative communication (AAC) in pediatric cochlear implant recipients with complex needs: A scoping review.

A considerable number of studies have demonstrated that augmentative and alternative communication (AAC) is effective in increasing speech production in some children with autism spectrum disorder (ASD). Thus, this study aimed to (a) investigate the effects of a Picture Exchange Communication System (PECS) Phase IV protocol on the acquisition of spontaneous augmented requests, (b) evaluate the impact of progressive time delay and synthetic speech output on the development of vocal requests, and (c) determine the participants’ preferences for each modality after reaching mastery. A multiple-baseline design across four children with ASD was used to measure the acquisition of augmented and vocal requests during the transition from low-tech to high-tech AAC systems. During a natural condition (i.e., playtime), a modified PECS Phase IV protocol was applied to teach the participants to request by producing multisymbol messages (e.g., I WANT + names of a preferred item) using an iPad as well as vocalizations. After mastery, the participants’ preference for using the modified PECS Phase IV app or the communication book was assessed by comparing the response allocations. The preliminary results suggest that the modified PECS protocol can be used to transition from a low- to high-tech communication modality.

Few studies on augmentative and alternative communication (AAC) systems have addressed the potential for such systems to impact word utterances in children with autism spectrum disorders (ASD). The Picture Exchange Communication System (PECS) is an AAC system designed specifically to minimize difficulties with communication skills experienced by individuals with ASD. The current study examined the role of PECS in improving the number of words spoken, increasing the complexity and length of phrases, and decreasing the non-word vocalizations of three young children with ASD and developmental delays (DD) with related characteristics. Participants were taught Phases 1-4 of PECS (i.e., picture exchange, increased distance, picture discrimination, and sentence construction). The results indicated that PECS was mastered rapidly by the participants and word utterances increased in number of words and complexity of grammar.

Background: People with severe communication problems associated with aphasia and concomitant apraxia of speech are often unable to meet their daily communication needs through speech alone. For these people, augmentative and alternative communication (AAC) strategies may offer opportunities for improved communication effectiveness. However, it can be challenging to determine if individuals can learn to use alternative communication strategies independently or if they will require assistance from conversational partners to participate in meaningful communication interactions. Aims: The authors developed an assessment tool, the Multimodal Communication Screening Task for Persons with Aphasia (MCST‐A; Garrett & Lasker, 2005b), to help clinicians differentiate those individuals who would benefit most from partner‐dependent communication strategies (e.g., written choice conversation, partner‐presented symbol choices, tagged yes/no questions) and those who could learn to use AAC systems (e.g., digitised speech devices that store complete messages; multi‐level devices with stored messages and spelling capabilities) to communicate independently. This article describes the tool and its administration protocol. We also compare MCST‐A scores to profiles of actual communication strategy use for four individuals across a range of aphasia severity. Methods & Procedures: Four individuals with communication disabilities associated with aphasia were asked to locate pictorial, textual, or graphic symbols from an eight‐page stimulus manual to communicate simple needs and complex concepts, complete simple categories, tell and retell stories, or use partial spelling to convey novel information. Accuracy of responses and the amount and type of cueing required to complete each simulated communication task were tallied for each individual. MCST‐A test results are discussed in light of each individual's observed pattern of AAC strategy and system use both during and following functional communication treatment. Results: Descriptive analyses of the four cases revealed a correspondence between MCST‐A test scores, level of impairment as measured by the Western Aphasia Battery (Kertesz, 1982), and patterns of communication strategy use. The two individuals who received the lowest response accuracy scores and the highest cueing scores on the MCST‐A were primarily dependent on partner‐supported communication strategies in their daily lives. The two individuals with the lowest cueing scores and highest response accuracy scores had learned to use complex AAC communication devices to communicate independently and generatively in community settings. Conclusions: The hierarchy of scores seen on the MCST‐A corresponded with individuals' abilities to communicate using AAC strategies after participating in functional therapy. The MCST‐A may guide clinicians in identifying the most appropriate AAC strategies for individuals with aphasia. Further validation is warranted.

A descriptive case-study design was used to document the implementation of a four-phase intervention for a child with autism spectrum disorder (ASD) who uses augmentative and alternative communication (AAC) in an inclusive classroom. The focus of the intervention was on enhancing social communication through peer modelling of the child’s speech-generating app during news-sharing, and the intervention was developed and enacted in a collaborative partnership with the classroom teacher. Various sources of data, including interviews, observations, and data from the child’s AAC system, were collated and analysed. From this analysis, three key themes emerged: (a) Enhanced Participation, (b) Optimising AAC Acceptance and Use, and (c) Increased Teacher Agency. These themes suggest positive outcomes for a naturalistic, social-communication intervention, adding to the calls for further research in this area.

Augmentative and Alternative Communication (AAC) emerged as a combination of methods or strategies that constitute any device, such as Speech Generating Device (SGD), Program (mobile applications), Procedure (PECS, Picture Exchange Communication System), which enhances individual’s communication ability. Autism Spectrum Disorder (ASD) is a spectrum of comprehensive neurodevelopment disorder that leads to speech impairments, repetitive behavior, and social communication difficulties; therefore, it is imperative to underscore that at the core of all impediments are communication impairment. This article represents a systematic review of research initiatives that investigate multi-modal AAC strategies and functionality, features of mobile applications to reinforce communication and communal skills in verbally challenged ASD children because other researches are focused only on low or high-tech AAC or interventions to provide insights on ASD children respond to a particular approach. Following the PRISMA method, a total of 60 (January 2015 to October 2020) research articles were reviewed, indexed by Springer, Science Direct, Scopus, ACM, IEEE databases, and published in the AAC journal. The selected research articles are categorized into different themes where most of them focused on interactive mobile applications to improve emotional, social, learning, and overall communication skills in verbally challenged ASD children. This systematic review provides an outline of the paradigm shift in AAC modalities from PECS to Artificial Intelligence (AI), Machine Learning (ML), and Augmented Reality (AR) based applications. It opens up underline future opportunities to integrate intelligent analytics features in mobile applications to strengthen communication skills in verbally undermined ASD children.

ISSN: 1055-4181 (Print) / 1878-643X (Online) URL: The URL of the article is: http://iospress.metapress.com/content/fc7hawed1h21lrva/ Abstract: This study investigated the possibility of using Information Visualisation (IV) in the user interface of Augmentative and Alternative Communication (AAC) systems. AAC systems exist to assist people to overcome communication handicaps. Computer-based AAC systems can contain stored communication material for people with impaired communication to retrieve and use during interaction. As the size of the stored information corpus in an AAC system increases, the task of searching and retrieving items from that corpus will become more demanding, which will make it less easy for someone to successfully access and use such material. IV has therefore been investigated here as a way of accessing AAC content. A prototype visualisation interface was developed as a means of retrieving stored biographical text in an AAC context. Trial of this prototype showed that it was possible for people to successfully retrieve the stored information with the IV-based user interface, indicating that an IV-based interface could have potential within AAC. Further work could be pursued to investigate performance with larger corpora and alternative visualisation metaphors; alternative metaphors (using timelines, for example) may be preferred by different people who use AAC.

The study examined the perspectives of augmentative and alternative communication (AAC) users and their 'formal' and 'informal' communication partners in relation to two areas of relevance to AAC: firstly, communication strategies, and secondly, advantages and disadvantages of AAC systems. With respect to communication strategies, it was found that formal communication partners thought that more vocabulary for communicating social purposes was actually available to AAC users and they were less aware of daily routines within day and residential environments. With respect to advantages and disadvantages, three main areas of concern emerged: the effect of the AAC system on the users' communication; features of AAC systems; and the effect of AAC on the users' quality of life. Both high- and low-technology AAC systems were seen as having advantages and disadvantages. This study demonstrates the important contribution to be made by AAC users in the provision of a new set of priorities based on their user experiences.

Augmentative and alternative communication (AAC) technologies provide individuals who have complex communication needs with an effective means to communicate. Yet the effect of these technologies on long-term memory is unclear. In addition, little is known regarding the impact of learning modality on memory performance of individuals who rely on AAC. The aim of this study was to explore the effect of AAC technologies on the visual and auditory verbal long-term memory abilities of 12 young persons who relied on AAC and had intact cognitive abilities. Participants performed 2 verbal memory tasks, in which familiar words were visually or aurally (i.e., auditorily) presented. The words were either actively produced using the AAC system or not produced (merely read or heard; a production effect paradigm). Memory tests followed. A production benefit (higher recognition rates for produced than no-produced words) was documented in both the visual and the auditory tasks. These findings support the active production of words via the AAC system as a memory strategy. Such technique may be easily used in everyday situations as well as in educational contexts. The results showcase the cognitive benefits of AAC system usage and provide significant insights into rehabilitation.

Children with autism spectrum disorder (ASD) show differences in their communication development when compared to children who are typically developing and other clinical populations. In addition, children with ASD show divergence and delays in their expressive language when compared to each other, and a reported 30% do not develop spoken language even with access to early intervention. In order to support children with ASD in their communication development, there is a critical need for (a) detailed accounts of the emergence of expressive language for children receiving early intervention, (b) investigation of factors that might explain differences in expressive language abilities, and (c) investigation of sensitive predictors of expressive language change for children receiving early intervention. Children with ASD are often recommended augmentative and alternative communication (AAC) as part of early intervention to augment existing communication abilities, thus providing a complementary communication system while supporting early language development. Augmentative and alternative communication can be introduced as a focused intervention to target communication specifically, or it can be introduced as part of a comprehensive intervention program targeting multiple domains of learning. When used as part of a comprehensive intervention program, AAC is believed to support communication development broadly, including children’s use of spoken language. Despite emerging evidence for its effectiveness as a focused intervention and potential to support spoken language development within the context of comprehensive interventions, little research exists examining the mechanisms underpinning outcomes of AAC interventions. The current project aimed to address this gap by investigating both the emergence of expressive language in children with ASD, and factors underpinning concurrent and longitudinal expressive language abilities for children receiving an AAC-infused comprehensive intervention program. This research was conducted as a series of three studies: Study 1 investigated the communication profiles of 246 children with ASD upon entry and exit to a comprehensive early intervention program; Study 2 investigated mechanisms underpinning concurrent expressive language abilities, and Study 3 investigated predictors of longitudinal expressive language abilities, in 48 children with ASD receiving an AAC-infused comprehensive intervention program. The findings from Study 1 documented that 58.7% of children who started early intervention as minimally verbal remained minimally verbal after approximately 12 months of intervention, while 41.3% went on to develop phrase speech (using two-word phrases), highlighting an as yet unmet clinical need, as well as research need to understand these differences. The findings from Study 2 challenged previously held beliefs regarding word learning abilities in children with ASD, and extended on previous research by investigating the relationship between symbolic word learning and expressive language level. By focusing on processes that might be relevant to children’s development within interventions incorporating AAC, the findings from Study 3 provided preliminary data on the characteristics of children who might experience the largest gains in spoken language within AAC-infused comprehensive interventions. This research demonstrated a novel approach to investigating variability in expressive language development in children with ASD. The findings from this research demonstrate potential to explain some of the variability through analysis of social-cognitive learning processes that might help predict change within intervention. Finally, the findings of this research have potential to inform how researchers and clinicians approach individual differences in all children who present with complex developmental profiles.

Augmentative and alternative communication (AAC) is the study of the compensatory strategies for augmenting, supporting, or replacing communication via speech, e.g. speech generating devices (SGDs) and communication books. Because provision of AAC services (such as evaluation, treatment, and AAC system or device determination) is part of the scope of practice for speech and language pathologists (SLPs), it is important that students entering this field feel competent in their AAC knowledge. The purpose of this study was to examine the impact of additional components of AAC education (i.e., workshops and clinical practica) on SLP students’ preservice confidence levels in providing these services. An online survey was distributed via email to 49 SLP graduate students attending a large metropolitan university. The survey included questions in which students were asked to identify their education experiences, and then rate their levels of confidence in providing AAC services for individuals with complex communication needs (CCN). The results show trends indicating that additional clinical practica in AAC impacted student’s confidence levels in treating individuals with CCN and in determining appropriate AAC systems for the student. In conclusion, it is likely that required pre-service education in AAC needs to be more robust, especially in the area of device/system determination.

Despite the benefits of augmentative and alternative communication (AAC) systems for children with complex communication needs, these systems are not consistently accepted by parents. This study aimed to explore factors that contribute to the acceptance, rejection, or abandonment of AAC systems. Semi-structured interviews were conducted with 16 speech-language pathologists (SLPs) who had introduced at least one AAC system that was rejected or abandoned by the parent of a young child, as well as one that had been accepted. Thematic analysis revealed six themes that describe influences on parent acceptance of AAC systems: (a) The Way Parents View their Child, (b) Parents’ Views on AAC Intervention, (c) Support Networks Around Parents, (d) The Capacity of and Demands on Parents, (e) Services Provided by SLPs, and (f) Specific Features of AAC Systems. Themes were largely consistent with the existing literature; however, SLPs raised the novel concept of parent grief and loss as a potential contributor to AAC abandonment. To increase AAC acceptance, SLPs should consider not only the child with complex communication needs, but also the child’s parents, the AAC systems available, and their own clinical limitations.

PurposeThe purpose of this paper is to document augmentative and alternative communication (AAC) training provision by clinical services in England.Design/methodology/approachA questionnaire was used to obtain the following information concerning AAC training provision; frequency, length, type, content and cost, trainee occupations and numbers, and future training priorities, and information concerning training providers – service type, geographical area.FindingsIn total, 98 clinical service training providers in England responded. Services commonly reported providing AAC training to speech and language therapists, teaching assistants and teachers. Training around “use of specific AAC products, systems and technology” and “introducing/awareness raising of AAC products” were rated as high priority for future training and were two of the three subject areas where services reported the highest percentage of training. Training was predominantly provided at a foundation (basic) level.Originality/valueThere is no consensus on the amount or content of AAC training which professionals in England must receive. Evidence suggests that AAC training for pre-qualification professionals is limited and this paper has identified variation in the amount and type of post-qualification AAC training. While knowledge concerning specific AAC systems is necessary, focussing training primarily on this area may not address critical gaps in knowledge. There is a need for specific recommendations regarding AAC training for professionals in this field, to ensure professionals can fully support people who use AAC.