Transitions from Augmentative or Alternative Communication (AAC) to Speech: A Pilot Investigation
University of Kansas
Nonverbal school-age children with autism have not received sufficient attention from the research world (NIH conference, April 2010). Despite considerable efforts to improve communication during preschool years, many children with autism remain nonverbal or have very minimal verbal repertoires. One of the goals identified in the strategic plan for Autism Speaks is to develop and test the efficacy of treatments for school age nonverbal children, specifically treatments aimed at improving a core autism symptom. The aim of this pilot study is to investigate a multi-modal comprehensive intervention focusing on word production that includes four components: speech sound practice based on principles of developmental phonology, joint book reading, computerized instruction, and AAC. The package will increase auditory and visual input (via picture symbols and text) for the targeted words as well as incorporating the words in actual communicative contexts. This multimodal approach will strengthen the representational connections between referents and symbols. The AAC component will teach participants to select target words on speech generating devices in communication routines. All components will focus on the same set of target vocabulary words, individualized for each participant based on principles of phonotactic probability. Target word selection uses an innovative procedure that identifies sounds in a child’s repertoire through speech sound recordings via a digitized recording device (LENA). Target vocabularies are then. One 5 year old boy with autism participated in a feasibility study and successfully completed all of the intervention activities. This pilot includes nine children between the ages of 5 and 9 years with autism and expressive vocabularies of less than 20 words will participate. Intervention will be provided 4 days per week for approximately an hour a day for up to six months per child. A multiple baseline across participants design will be used to determine if the intervention impacts spoken word and AAC word productions. In addition, the investigators will analyze correlations between participants’ intervention outcomes and their initial nonverbal cognition, language comprehension, imitation and play to identify potential predictors of outcomes. During the second year, the investigators will develop a detailed procedural manual that will enable future implementation of a large scale multi-site It is anticipated that the increased input through speech and visual images and additional practice with the sounds in targeted words will provide active ingredients that may have been missing from earlier intervention attempts. A manual describing the intervention procedures will be developed during this study in order to replicate the procedures in future research.