AAC and social interaction (summary)


Background Many children with developmental disabilities who use AAC have deficits in social skills, or the ability to comfortably interact with others. While previous research in the field of paediatric AAC has shown that children often prefer one type of AAC over another, little research has been done on the potential effect of AAC interventions on social interactions of children with developmental disabilities.

What was the aim of the study? This study investigated the effects of AAC interventions of the social interactions of one child.

What did the authors do? The authors worked with Trevor, a fifteen-year-old boy with diagnoses of autism and Down syndrome who was in a class of six children with developmental disabilities.

The study took place in three parts. First, Trevor was taught to use both a picture exchange system and a speech-generating device in order to request his favourite snacks. Second, the researchers determined whether Trevor preferred using one method over the other. Third, the researchers investigated whether social interaction could be increased by varying the distance between Trevor and his communication partner.

What did they find? Trevor successfully learned to use both the picture exchange system and the speech-generating device in order to request a snack in the classroom. However, for most of the time he was acquiring these skills, Trevor was socially withdrawn. He turned away from his communication partner and remained with his head between his knees and his arms wrapped around his shins. This may have been because Trevor did not find social interaction satisfying, and the scenario used to teach Trevor to use AAC did not require much social interaction.

Trevor showed only a slight preference for one AAC system over the other. This contrasts with other research that reported children with developmental disabilities clearly preferred certain types of AAC given a choice of two or more options. Rather, Trevor selected the AAC device that was nearest to him and that required the least overall movement from his withdrawn position. Trevor showed only a slightly more frequent use of picture exchange, so this system was used in the final part of the study. It also was easier to implement in the classroom setting, and Trevor's teacher was more familiar with it than speech-generating devices.

The final part of the study was successful in increasing Trevor's social interaction. Trevor's communication partner stood 60, 90 and 120 centimetres away from the table at which Trevor sat with the picture exchange system, and Trevor usually left his seat and approached his partner with the picture symbol in order to request a snack. This method left little time for Trevor to be socially withdrawn, and after he returned to the table with his snack, Trevor usually remained oriented toward his partner.

Cautions: The picture exchange system used in this study was not the one extensively developed by Frost and Bondy and often reported elsewhere in the literature. The authors of this study used a more general form of picture exchange that was suitable for the aims of the study, which was to compare two types of AAC systems rather than to teach only one form.

Importantly, Trevor did not make his requests in this study spontaneously. When he requested a snack, it was always in response to a prompt from his communication partner asking him to 'let me know if you want a snack'. Thus, though Trevor was successful in learning how to make requests, it is likely this skill was limited to the specific setting of responding to prompts.

Additionally, the authors point out that Trevor spent less time socially withdrawn in the last part of the study, but this is most likely a by-product of the requesting requirements. Trevor learned how to behave in order to obtain a snack, but it was not clear that he showed any more interest in social interaction than in other parts of the study.

Conclusions: Picture exchange systems and speech-generating devices can both be used successfully to aid the communication of children with developmental disabilities. However, the use of such AAC systems alone is not sufficient to produce an increase in social interaction. This will be important to parents and therapists designing interventions for and working with children like Trevor.

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Added to site January 2014