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Speech-Generating Devices Used at Home by Children With Autism Spectrum Disorders (summary)

VOCAs
 
used
 
at
Home
 
by
Children
 
with
 
ASD

Background

Difficulties with language and communication are a feature of autism spectrum disorder (ASD), and many people who have ASD might benefit from the use of augmentative and alternative communication (AAC) either permanently or in the short-term. The development of technology and a range of speech generating devices (SGDs) can be effective for some people with ASD who have limited or no functional speech.

Studies have also suggested that the use of SGDs by people in the environment of children with ASD to model language is important in developing successful SGD use, as is the child’s willingness to independently explore their device. Most of these research studies have considered children at a prelinguistic or very early stage of linguistic development in their schools or a clinical setting.

This study aimed to extend this to look at the use of SGDs at home and with children who had some functional speech.

It considered three elements:

  • How is communication in different activities at home affected by the introduction of an SGD, considering engagement in activity, role in turn-taking, communicative form and effectiveness?
  • How is the development of communication affected by the intervention?
  • Can children with ASD who have begun to develop functional speech benefit from SGD intervention?

 

What did they do?

Three boys aged between 5and 7 and their families took part in the study. The parents were interviewed before and after the intervention using a standardised assessment to measure outcomes for children with ASD.

All of the boys had diagnoses of some form of autism. One had previously used a small SGD, but not for spontaneous communication, he has learned to imitate words used on the device and used these functionally. The other boys had not used SGDs. All of the children had difficulty making themselves understood consistently.

The authors used a family-centred, collaborative model as a basis for the intervention. The choice of activities for intervention, (two for each child), communication goals and the vocabulary selected were decided in meetings between the parents, local service providers and the researchers. The activities were different for each child depending on their interests and motivations.

The SGDs used had dynamic screens on portable touch-screen computers. The number of vocabulary items programmed ranged from 115 to 279; mainly short phrases as sentence starters and single words.

The parents were given training in the use of the programs and if appropriate in story reading and the use of assistive technology for children with disabilities. They were also given guidance about using the SGDs in daily communication and encouraged to use them to augment their own speech and to model use of the device for their child. In addition to using the SGDs in specifically planned interventions they were encouraged to use them at other times too.

The families were supposed to video their chosen activities once a week on at least 4 occasions before the intervention began and 4 times following the introduction of the SGD; only one of the three families managed to do this according to the target schedule.

The video recordings were analysed and coded by the researchers considering a number of communicative behaviours: degree of engagement, role in turn taking, mode of communication and effectiveness of communication. 

 

What did they find?

The results varied between the three participants but all were found to have increased communicative effectiveness through the use of SGDs.

There was some increase in engagement in at least one activity for all three boys when they had SGDs and in 2/3rds of the activities the rate of communicative responses increased.

The mode of communication used did not show any consistent pattern across all participants though prelinguistic forms of communication reduced when an SGD was introduced.

The results of the parental interviews, pre- and post-intervention suggested positive changes including increased expressive communication effectiveness for all 3 and decreases in ‘maladaptive’ behaviour for 2 of the participants. Two also increased their speech production.

 

Conclusions:

This small study indicated that the use of SGDs can be beneficial for children with ASD who have some functional speech, supporting them to communicate more effectively at home. The authors also make it clear that further research into this area is needed.

 

Cautions:

This study involved only a small number of participants meaning that the results cannot be generalised more widely across the population of children who have ASD. The recording system used by the families was not entirely consistent and therefore the possible influence of the children maturating over time and this having an effect on the outcomes cannot be totally discounted.

The range of messages selected to be into the devices could also have had an influence on the outcomes.


Things you may want to look into:

Effects of synthetic speech output on requesting and natural speech production in children with autism: A preliminary study

Comparing Acquisition, Generalization, Maintenance, and Preference Across Three AAC Options in Four Children with Autism Spectrum Disorder

Enhancing the Alternative and Augmentative Communication Use of a Child with Autism through a Parent-implemented Naturalistic Intervention

Added to site June 2016


 


 

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