Supporting Communication and Language Development in Preschool Children using AAC

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

With the use of augmentative and alternative communication (AAC), people with complex communication needs could participate in social situations even if they had severe speech impairments. Even though speech-language therapists in Thailand are aware of AAC, they still mainly teach young children with complex communication needs to mainly use speech as a means to communicate. This could lead to fewer opportunities for people with complex communication needs to use AAC systems. Therefore, this article aimed to analyze and classify the items related to communication success, as a guideline to generate a screening checklist for determining whether individuals with a communication impairment would benefit from using AAC. Three previously available screening checklists pertaining to communication success were analyzed to identify the 3 domains: 1) verbal communication intelligibility, 2) verbal functional communication, and 3) verbal communication comprehension. These 3 domains were divided into 2 aspects: 1) familiar/unfamiliar communication partners, and 2) familiar/unfamiliar settings. To create a standard screening checklist that speech-language pathologists in Thailand could utilize, more research would need to be done in the future.

Purpose Nearly 50% of school-based speech-language pathologists (SLPs) provide services to school-age children who use augmentative and alternative communication (AAC). However, many SLPs report having insufficient knowledge in the area of AAC implementation. The objective of this tutorial is to provide clinicians with a framework for supporting 1 area of AAC implementation: vocabulary selection for preliterate children who use AAC. Method This tutorial focuses on 4 variables that clinicians should consider when selecting vocabulary: (a) contexts/environments where the vocabulary can be used, (b) time span during which the vocabulary will be relevant, (c) whether the vocabulary can elicit and maintain interactions with other people, and (d) whether the vocabulary will facilitate developmentally appropriate grammatical structures. This tutorial focuses on the role that these variables play in language development in verbal children with typical development, verbal children with language impairment, and nonverbal children who use AAC. Results Use of the 4 variables highlighted above may help practicing SLPs select vocabulary that will best facilitate language acquisition in preliterate children who use AAC.

<p style="text-align: justify;"><strong>Context and relevance. </strong>A substantial proportion of children with autism spectrum disorder (ASD) have limited functional speech, which increases the relevance of augmentative and alternative communication (AAC). This article is the first part of a broader work analysing AAC tools used with children with ASD. <strong>Objective</strong>. To identify the AAC systems most commonly used with children with ASD, define key developmental domains relevant to AAC system selection, and describe selection criteria and indicators for specific AAC systems. <strong>Methods</strong>. A systematic literature review was conducted in PubMed, MEDLINE, and eLibrary.ru. Search terms included autism spectrum disorder/ASD, augmentative and alternative communication/AAC, and speech impairment. Thirty-four domestic and international publications meeting the topic relevance criteria were included. <strong>Results</strong>. The AAC systems most relevant for children with ASD were identified: the Picture Exchange Communication System (PECS), communication boards, natural gestures, single- and multi-message speech-generating devices, and AAC mobile applications. Evidence-based selection requires consideration of five developmental domains: expressive communication, visual perception, cognition, motor skills, and self-regulation. For each AAC system, selection criteria are described to accommodate the heterogeneity of children with ASD and different functional profiles. <strong>Conclusions</strong>. AAC systems address diverse needs of children with ASD. AAC selection should be individualized and based on the child’s asynchronous developmental profile and skill level, which may facilitate more effective AAC acquisition and potentially reduce social-communication difficulties.</p>

Purpose Children with severe speech and language impairments growing up in dual language environments may communicate in more than one language using augmentative and alternative communication (AAC). This study investigated predictors of bilingual children's ability to differentiate between Spanish and English using an AAC iPad app during a cued language-switching task and examined whether switching between languages using AAC incurred a cognitive cost. Method Participants were 58 Spanish-English bilingual children ages 4;0-6;11 (years;months; 23 with language impairments). Children received standardized language and cognitive assessments and completed an experimental language-switching task in which they were asked to differentiate between languages using an AAC iPad app containing English and Spanish vocabulary layouts paired with voice output. Results Results of a binary logistic regression indicated that, when controlling for age, processing speed significantly predicted whether children were classified as high or low performers on the experimental task. Nonparametric tests indicated that switching between languages did not incur a cognitive cost as evidenced by similar response times on trials where participants were required to switch between languages compared to trials where they did not switch. Conclusion This study contributes to the understanding of how young bilingual children with and without language impairments conceptualize and discriminate between languages represented in a visual-graphic modality paired with speech output. Supplemental Material https://doi.org/10.23641/asha.13289330.

This study examined the effects of using sensory, augmentative, and alternative communication (AAC), and supportive communication strategies on the rate and type of communication used by three students with severe speech and motor impairments (SSMI). Using a multiple baseline across behaviour design with sensory and AAC intervention phases, students were paired with a family member during shared reading activities using familiar and unfamiliar storybooks in their homes. All reading activities were video-recorded for analysis. Examination of recorded readings revealed that students demonstrated increases in their overall rates of communication. Further, these students successfully integrated communication devices into the reading process. The results suggest that students with severe disabilities can benefit from these forms of literacy strategies to increase their participation in reading tasks. Implications for research and practice are discussed.

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.

While the augmentative and alternative communication (AAC) field has advanced in terms of theoretical underpinnings, research-supported strategies, technological improvements, and accessibility of appropriate clinical services, most people with AAC needs continue to experience considerable difficulty in the journey to become linguistically proficient. This paper explores some of the changes that have specifically impacted our understanding of language, language acquisition, and language intervention in individuals with significant communication challenges. Implications for AAC interventionists are reviewed, along with guidelines for moving toward better language outcomes.

Assistive technology (AT) is defined as any device or technology ranging from low to high that helps to improve functional skills of individuals with cognitive, physical, or neurological disorders. These technologies are devised to improve the functional activities of persons. ATs focussing on cognitive disorders like dementia, autism spectrum disorders, etc. can be categorized as ATs for cognition (ATC) and augmentative and alternative communication (AAC). AAC interventions consist of tools that aid the challenges faced by individuals with speech impairment during communication. AACs used often are speech-generating devices (SGD), software programs, and communication apps for efficient production of speech. ATCs include social stories and video modeling strategies. The use of assistive technology in autism spectrum disorder (ASD) has great importance due to increased requirement for interventions in helping students. There are several lines of evidence showing the effectiveness of technology-assisted training in ASD patients.

Approximately 60 millon people in India fall under the category of physically or mentally disabled out of which 2.1 millon people are affected with severe speech and motor impairments (SSMI). Unfortunately only a minute fraction of them have any access whatsoever to Advanced Assistive Devices (AAD) which are still very expensive and beyond the affordability of a majority of people in India. Moreover, such devices generate text messages or speech mostly in English which makes them unusable by a majority of the Indian population. It should be our endeavour to make these assistive devices accessible to the common multitude. This paper briefly describes a portable version of Sanyog, an Augmentative and Alternative Communication (AAC) tool developed in India which caters to Indian multilingual needs. The communication tool is based on an iconic query-response interface. The system is currently available in English, Bengali and Hindi versions, and is used in a range of Indian institutions serving children with speech and motor impairments.

Purpose As is the case with children who rely on spoken language, speech-language pathologists must support and track the expressive language development of children with complex communication needs who use graphic symbols to communicate. This research note presents a framework of the progression of expressive English sentence development using graphic symbols and introduces possible approaches for measuring and analyzing graphic symbol use. Method Current issues in measuring graphic symbol utterances are explored, and a range of measures designed to analyze individual graphic symbol utterances as well as larger samples of utterances are presented. Results Both the Graphic Symbol Utterance and Sentence Development Framework and suggested measures are based on years of graphic symbol intervention research, including two large ongoing research studies of preschoolers with severe speech impairments. Our framework adapts the work of Hadley (2014) to depict expressive language progression from early symbol combinations to childlike and adultlike sentences and highlights developmental patterns unique to graphic symbol productions. Adaptations of existing measures (such as mean length of utterance) as well as measures unique to graphic symbol analyses are presented and discussed. Conclusion To accurately track changes in early graphic symbol utterance growth and complexity, a multidimensional approach, which includes analyses such as symbol relevance, word class diversity, and lexical diversity, is recommended.

Augmentative and Alternative Communication (AAC) is an expressive and receptive method of communication that helps in developing language and communication skills for people with speech and/or language impairment. Autism spectrum disorders (ASD) children who lack communication can improve functional communication by personalizing AAC intervention. This paper is based on literature to promote AAC interventions to enhance English language acquisition in autism spectrum disorder (ASD) children. This paper also explores how multimodal and naturalistic AAC benefit ASD children's communicative and language skills. Recommended herewith is to personalize AAC intervention based on children's mental and physical condition and their needs, skills, and social environment's priority.

Enhancing language in children who are deaf/hard-of-hearing using augmentative and alternative communication technology strategies

Chapter 8 - Computer Vision for Augmentative and Alternative Communication

Sistemas gráficos inseridos nos recursos de Comunicação Suplementar Alternativa (CSA) são ferramentas prioritárias para ampliar as possibilidades de comunicação. Objetivo: Descrever o histórico de uso da CSA de uma usuária, identificando a sua percepção e de seus interlocutores sobre os meios de comunicação utilizados. Procedimentos Metodológicos: Estudo de caso único, realizado por meio da análise dos dados obtidos do histórico da usuária de CSA nas intervenções de terapia ocupacional; duas entrevistas com a usuária e nove entrevistas com seus interlocutores. Resultados: Foram identificadas a importância da CSA para a facilitação da comunicação da usuária; a necessidade de reorganização constante dos símbolos em função da habilidade motora da usuária, bem como a relação entre a comunicação estabelecida e a demanda de suas atividades, sugerindo que a comunicação restrita com os interlocutores relacionar-se-ia com a pouca vivência de atividades sociais. Conclusões: Necessidade de uma reorganização das pranchas, envolvendo maior conteúdo de vocabulário, tornando a comunicação mais rápida; intervenções em sua rotina a fim de ampliar suas relações com seus interlocutores.