Augmentative and alternative communication for children with autism spectrum disorder: An evidence-based evaluation of the Language Acquisition through Motor Planning (LAMP) programme (summary)



 It is estimated that up to 50% of people with autism spectrum disorder (ASD) do not use functional speech and there is evidence to suggest that augmentative and alternative communication (AAC) can improve the quality of life for non-verbal children with ASD by supporting them to increase their communication. There are many different forms of AAC available including high-tech systems that can be used to generate speech and allow for spontaneous expression.

Motivation and independence are essential factors in developing a child’s communication ability. Structured teaching is an educational theory that includes environmental considerations being included into education making the learning setting understandable and suitable for individual student’s needs. Structured teaching is central to the curriculum and teaching approach used at Autism Spectrum Australia (Aspect), the centre at which this study was carried out. It incorporates approaches used in the Treatment and Education of Autistic and related Communication-handicapped Children (TEACCH) and in the naturalistic behaviour-based pivotal response training intervention which aims to increase a student’s motivation to respond to educational activities that are central to the development of complex language, play and social interaction skills.

The Language Acquisition through Motor Planning (LAMP) approach provides strategies for teaching communication using a voice output communication aid (VOCA) in which words are stored in a consistent position within the device and is based on five teaching elements necessary to teach effective communication. The LAMP approach provides opportunities to learn word meanings through natural consequences, in the same way as speaking children learn. The programme also focusses on ‘core’ words that are used frequently, with a variety of meanings, in everyday situations; words such as stop, go, more, eat, drink etc.


What did they do?

The aim of the study was to test whether AAC can improve the functional communication of children with ASD in their daily lives. The researchers used the LAMP approach in addressing the 4 aims:

  • To evaluate the level of improvement of functional use of words in children with ASD in their natural environments.
  • To identify whether this functional communication could be used consistently, spontaneously and independently.
  • To look into the confidence of parents and teachers in using the LAMP programme.
  • To consider long term use and generalisation of the LAMP programme two years after the initial study.

The authors evaluated the developmental progression of communication in the participants.

Eight families with children aged between 4 and 12 who had ASD completed participation in the study and 7 of these completed the 2 year follow up.

All of the children were receiving speech and language therapy prior to the study and were using some level of picture exchange to communicate, but not consistently, spontaneously and independently.

Teachers and therapists involved with the children were given LAMP training. Children were given both structured and non-structured sessions using the LAMP approach. Both core and fringe words were taught using different levels of prompting.

Data was collected, pre and post intervention, using Aspect’s expressive and receptive communication checklists. These considered functions and methods of communication, whether this was pre-intentional, intentional or symbolic, and understanding and level of support needed to enable the child to respond. Data was also gathered through the built in LAMP data logging option and a parent and teacher questionnaire.

The two year follow up was carried out in a telephone interview.

The research was carried out in the children’s homes and school over a fourteen week period, with 5 weeks of direct intervention. Child assessments were carried out immediately before and after the intervention period and 2 weeks after it ended. Parents and teachers were surveyed pre and post intervention.


What did they find?

The biggest improvements were in the children’s expressive outcomes. All of the children had reached the level of using symbolic communication at the end of intervention. Those who were at a symbolic level prior to intervention improved and established a consistent method of communicating after 5 weeks. The participants also increased the range of communicative functions they used and the amount of spontaneous communication. All of the children demonstrated increases in the number of vocabulary items used and the length of utterance.

All but one of the parents and teachers showed an increase in their confidence to teach other people how to use the LAMP approach.

At the two year follow up five of the families were still using the device in a variety of settings, two of the families had found they could not use it in everyday life. The main concerns were about lack of technical support and lack of confidence in problem solving. Those who had continued with LAMP use reported that their children actively requested their device.

The ongoing support of a LAMP trained speech pathologist was found to have positive outcomes. All families reported some difficulties, mainly technical, in using the device.



The use of the LAMP programme on a VOCA was found to improve communication in young children with ASD when a family-centred, individualised plan is used. It was also found that, with ongoing support, the system will continue to be used long-term.

The study found that all eight participating children improved their use of functional core words and, at the post-programme assessment all were communicating independently and were not restricted only to words that had been taught.

In addition to improvements in expressive communication other positive outcomes were reported. These included increases in joint attention, interest, motivation and engagement with other people, plus an overall willingness to communicate. Increases in play and social communication were also reported as were improvements in behaviour and reductions in frustration.



This study was carried out in a single school setting and with a small number of families. The findings might not be transferable to the wider population of children with ASD.


Things you may want to look into:

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

Facilitating requesting skills using high-tech augmentative and alternative communication devices with individuals with autism spectrum disorders: A systematic review

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

AAC Interventions for Individuals with Autism Spectrum Disorders: State of the Science and Future Research Directions


Added to site July 2016