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| Augmentative and Alternative Communication for Individuals With Complex Communication Needs: Systematic Reviews of Critical Factors |
| Saturday, May 23, 2020 |
| 10:00 AM–11:50 AM |
| Walter E. Washington Convention Center, Level 1, Salon G |
| Area: DDA; Domain: Applied Research |
| Chair: Sanikan Wattanawongwan (Texas A&M University) |
| Discussant: Joe Reichle (University of Minnesota) |
| CE Instructor: Joe Reichle, Ph.D. |
| Abstract: Individuals who are unable to use conventional speech are at risk for challenging behavior, social isolation, and poor long term outcomes. Approximately 30% of children with moderate-severe disabilities are at high risk for complex communication needs; most of these individuals would benefit from AAC. AAC has been supported as effective for a variety of implementers, procedures, and target outcomes. However, many questions remain regarding the quality of reporting this research, critical outcomes, and features of implementation. Without this information, it is difficult to determine when and how AAC-based interventions are most effective. Comprehensive systematic reviews examining the impacts of AAC for individuals with complex communication needs, including individuals with autism and intellectual disabilities, were conducted by the presenters and their research teams. The presenters will synthesize available evidence about AAC to address the methodological quality of the literature, effects of AAC intervention on speech production, the use of telehealth in AAC interventions, and factors related to parent-implementation of AAC-based interventions. Participants will gain an understanding of critical points related to implementing AAC and will be able to summarize the current state of the science. |
| Instruction Level: Intermediate |
| Keyword(s): AAC, Complex communication, Systematic review, Telehealth |
| Target Audience: Researchers, Graduate Students, Behavior Analysts |
| Learning Objectives: Audience members will be able to: 1. Identify elements of quality single case research in AAC. 2. Describe AAC interventions currently meeting evidence standard. 3. Identify features of telehealth and parent-implemented AAC that are most effective. |
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| Augmentative and Alternative Communication for Autism and Intellectual Disability: Systematic Review of Critical Reporting Factors |
| J.B. GANZ (Texas A&M University), Joe Reichle (University of Minnesota), Kimberly Vannest (University of Vermont), James Eric Pustejovsky (University of Texas at Austin), Lauren Pierson (Texas A&M University), Sanikan Wattanawongwan (Texas A&M University), April N. Haas (Texas A&M University), Sandy Smith (Texas A&M University) |
| Abstract: Individuals with autism and intellectual disabilities frequently have concomitant complex communication needs; such difficulties communicating frequently lead to social isolation, challenging behavior, and significant resource needs. Examination of the relevant literature base is critical; however, there are challenges in aggregating results across single-case studies, related to quality of methodology and reporting practices.
We have conducted the largest and most comprehensive, to date, systematic review examining the impacts augmentative and alternative communication-based interventions for the target population. The presenters will share data extracted from approximately 171 articles, following initial search procedures that produced a pool of 6690 documents, eligibility screening, and exclusion for failure to meet basic methodological quality standards.
Critical quality indicators are under-reported. We are particularly interested in factors related to naturalistic and effective intervention for autism spectrum disorder and intellectual disabilities, with complex communication needs. This presentation will report on methodological quality, with a focus on the reporting diagnostic, cognitive, and communication skill assessments; interventionist descriptions; procedural integrity; and setting in which the project was implemented and whether or not it was a natural context for the participants. Results indicate that these details are vastly underreported. The presenters will provide recommendations for relevant research. |
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| Effects of Augmentative and Alternative Communication Intervention on Speech Production in Developmental Disabilities: Systematic Review |
| RALF SCHLOSSER (Northeastern University), Oliver Wendt (University of Central Florida), Mariola Moeyaert (University at Albany) |
| Abstract: Individuals with Autism Spectrum Disorder (ASD) and other Developmental Disabilities (DD) often present with complex communication needs. Augmentative and alternative communication (AAC) interventions have been found effective in improving communicative competence and language skills. Yet, relevant stakeholders continue to fear that the adoption or the continued use of AAC modalities may hinder natural speech production. If left unanswered, this may lead families to postpone, or worse, reject AAC modalities altogether leaving their children less likely to reach their full potential. This systematic review, funded by the Health Resources Services Administration, will update previous reviews (Millar et al., 2006; Schlosser & Wendt, 2008) on the effects of AAC intervention on speech production in ASD/other DD. A multi-faceted search includes general-purpose databases, publisher databases, trial registers, reference lists, forward citation searches, and contacting authors. To be included a study has to meet criteria related to speech production, experimental design, diagnosis, and AAC use. Data extraction will focus on participant characteristics, AAC approach, effectiveness metrics, and risk of bias assessments. Meta-analyses will be performed as feasible. Previous reviews found AAC interventions to result in modest increases in speech production. This conclusion will be revised consistent with the updated data set and analyses. |
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| Telehealth use in Augmentative and Alternative Communication intervention: A systematic review |
| JESSICA J. SIMACEK (University of Minnesota), Marianne Elmquist (University of Minnesota), J.B. GANZ (Texas A&M University), Joe Reichle (University of Minnesota), Sanikan Wattanawongwan (Texas A&M University), Lauren Pierson (Texas A&M University), Ee Rea Hong (University of Tsukuba) |
| Abstract: Children with autism who experience complex communication needs (CCN) often benefit from augmentative and alternative communication (AAC) intervention.The umbrella of telehealth includes the provision of assessment or intervention via technology platforms to support the use of AAC for children with autism. Telehealth methodologies may help bridge barriers for children with CCN who may lack access to interventionists with expertise in AAC. The rapidly advancing fields of AAC and telehealth technology require evidence-based research to be translated to clinical recommendations. This presentation discusses a systematic review of the literature following PRISMA guidelines on the use of telehealth in AAC assessment or intervention for children and young adults with autism. The included studies were coded for 20 items, related to; first, the parameters of the participants, interventionists, and the interventions; and, second, reported measures and related findings on feasibility, efficacy, or cost-effectiveness. We anticipate the findings of this review will summarize the current state of the knowledge on telehealth to deliver AAC intervention for people with autism, including future directions specifically related to feasibility, efficacy, and cost-effectiveness. |
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| Parent-Implemented Augmentative and Alternative Communication Interventions for Children with Autism and Intellectual Disabilities: Systematic Review |
| MARIANNE ELMQUIST (University of Minnesota), Jessica J. Simacek (University of Minnesota), J.B. GANZ (Texas A&M University), Joe Reichle (University of Minnesota), Ee Rea Hong (University of Tsukuba), Sanikan Wattanawongwan (Texas A&M University), Lauren Pierson (Texas A&M University) |
| Abstract: Many individuals with autism and intellectual disabilities (ID) have complex communication needs (CCN) impacting their ability to verbally express their thoughts and needs, such that reductions in academic achievement, quality of life, and increases in challenging behavior are often reported. Augmentative and alternative communication (AAC) interventions are critical for improving language outcomes for individuals with CCN; therefore, it is important that individuals supporting those with CCN have access to the resources and training to implement AAC interventions effectively. The purpose of the current study is to review the parent-implemented AAC, literature for individuals with autism and ID to identify current training practices and explore how implementation fidelity is being measured and reported. A systematic review was conducted following the PRISMA guidelines. Included studies will be coded for; participant characteristics, training practices, intervention characteristics, AAC outcomes, and procedural fidelity. We anticipate that findings from the current review will provide an overview of the current practices used to train parents that can be used to inform practice but also provide future research directions in isolating effective training practices. |
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