Generalization of a Pictorial Alternative Communication System across Instructors and Distance

Advances in AAC intervention: some contributions related to applied behavior analysis

This article extends Dr. Bob Remington's call for collaborations between those supporting behavioral approaches and those supporting more natural developmental approaches to beginning communication intervention. This article expands areas previously discussed by Dr. Remington. Topics that are addressed include pivotal behaviors that may facilitate communication acquisition, matching law and response efficiency, generalization, maintenance, and the related topics of general case instruction (which involves an understanding of stimulus and response classes). These topics reflect contemporary areas of research that could be better integrated into translational research and have not been extensively integrated into augmentative and alternative communication (AAC) practice. Dr. Remington's article discussed the value of behavioral approaches and corresponding methodology to AAC researchers and practitioners. We agree and discuss the need for greater interaction among proponents of varying approaches to intervention.

A Communicative Intervention to Improve the Psychoemotional State of Critical Care Patients Transported by Ambulance

BACKGROUND

Communication is key to understanding the emotional state of critical care patients.

OBJECTIVE

To analyze the effectiveness of the communicative intervention known as CONECTEM, which incorporates basic communication skills and augmentative alternative communication, in improving pain, anxiety, and posttraumatic stress disorder symptoms in critical care patients transported by ambulance.

METHODS

This study had a quasi-experimental design with intervention and control groups. It was carried out at 4 emergency medical centers in northern Spain. One of the centers served as the intervention unit, with the other 3 serving as control units. The nurses at the intervention center underwent training in CONECTEM. Pretest and posttest measurements were obtained using a visual analog scale to measure pain, the short-version State-Trait Anxiety Inventory to measure anxiety, and the Impact of Event Scale to measure posttraumatic stress disorder symptoms.

RESULTS

In the comparative pretest-posttest analysis of the groups, significant differences were found in favor of the intervention group (Pillai multivariate, F2,110 = 57.973, P < .001). The intervention was associated with improvements in pain (mean visual analog scale score, 3.3 pretest vs 1.1 posttest; P < .001) and posttraumatic stress disorder symptoms (mean Impact of Event Scale score, 17.8 pretest vs 11.2 posttest; P < .001). Moreover, the percentage of patients whose anxiety improved was higher in the intervention group than in the control group (62% vs 4%, P < .001).

CONCLUSION

The communicative intervention CONECTEM was effective in improving psychoemotional state among critical care patients during medical transport.

Speech-Language pathologists' decisions when designing an aided AAC display for a compilation case study of a beginning communicator

PURPOSE

The current study sought to identify decisions speech-language pathologists (SLPs) make and their rationale for those decisions when designing an AAC display for a hypothetical school-aged child who was a beginning communicator. Augmentative and alternative communication (AAC) displays support communicative interactions for children who are unable to use spoken language to meet their communication needs. Children who are at the early stages of learning language, often termed beginning or emerging communicators, may rely heavily on the AAC display to support comprehension and expression. Thus, it is important for speech-language pathologists (SLPs) to design a display that facilitates beginning communicators' communication development.

METHODS

This paper reports on the answers related to a specific case study presented in an online survey completed by 77 SLPs with experience in AAC.

RESULTS

Data illustrated design decisions driven by child-specific characteristics and informed by research regarding type of layout, representation, and the importance of various design features.

CONCLUSIONS

Suggestions for future research are provided, including identifying goals and communicative functions best supported by different types of displays, clinicians' challenges/successes growing a system with the child, and determining the importance of symbol arrangement and organisation in communicative tasks by AAC users.Implications for RehabilitationIdentification of current practices reported by speech-language pathologists given a case study to develop and implement future research.A gap between research and practice suggests the need for better dissemination and application of research supporting the inclusion of people engaged in the event depicted in a visual scene display.Foundations for future research to provide guidance regarding best design of and communication goals supported by visual scene displays and grid-based displays.

Effect of mobile technology featuring visual scene displays and just-in-time programming on communication turns by preadolescent and adolescent beginning communicators

PURPOSE

Visual scene displays (VSDs) and just-in-time programming supports are augmentative and alternative communication (AAC) technology features with theoretical benefits for beginning communicators of all ages. The goal of the current study was to evaluate the effects of a communication application (app) on mobile technology that supported the just-in-time programming of VSDs on the communication of preadolescents and adolescents who were beginning communicators.

METHOD

A single-subject multiple-baseline across participant design was employed to evaluate the effect of the AAC app with VSDs programmed just-in-time by the researcher on the communication turns expressed by five preadolescents and adolescents (9-18 years old) who were beginning communicators.

RESULT

All five participants demonstrated marked increases in the frequency of their communication turns after the onset intervention.

CONCLUSION

Just-in-time programming support and VSDs are two features that may positively impact communication for beginning communicators in preadolescence and adolescence. Apps with these features allow partners to quickly and easily capture photos of meaningful and motivating events and provide them immediately as VSDs with relevant vocabulary to support communication in response to beginning communicators' interests.

Training Education Professionals to Use the Picture Exchange Communication System: a Review of the Literature

The Picture Exchange Communication System (PECS) is a popular augmentative and alternative communication strategy. Like many communication interventions, the successful use of PECS is dependent on the skills of the communication partner. This article provides a systematic review of the published research on teaching education professionals (EPs) to use PECS. Training of EPs was usually conducted during individual or small group sessions and included a description of the PECS strategy, practice on implementation of PECS, and feedback on performance. Instructional activities typically resulted in an immediate increase in the quality and/or quantity of PECS opportunities provided by the EP; however, mixed findings are reported for maintenance and generalization. Implications for future research and practice are discussed.

A Review of Intervention Studies Conducted with Individuals with Autism and Sensory Impairments

Introduction

Recently, there has been heightened interest in individuals with autism and sensory impairments, and interventions that affect this population. To date, no reviews have analyzed intervention studies, and the present study adds to intervention research literature.

Methods

Based on an electronic search, eight studies were included in the review.

Results

The results indicated that four of the studies focused on communication skills, while the other four targeted problem behaviors. All participants made progress in communication and showed improvements in their behaviors.

Discussion

Although positive results were seen in all participants, the studies suffer from methodological limitations. Thus, future research is needed to replicate studies as well as provide maintenance and generalization data.

Implications for practitioners

Some suggestions are to include preference assessments prior to the development of intervention studies to create a modified picture exchange communication system with tangible objects or symbols.

Meta-analysis of PECS with individuals with ASD: investigation of targeted versus non-targeted outcomes, participant characteristics, and implementation phase

The Picture Exchange Communication System (PECS) is a widely used picture/icon aided augmentative communication system designed for learners with autism and other developmental disorders. This meta-analysis analyzes the extant empirical literature for PECS relative to targeted (functional communication) and non-targeted concomitant outcomes (behavior, social skills, and speech) for learners with autism, learners with autism and intellectual disabilities and those with autism and multiple disabilities. Effect size analyses were done using the Improvement Rate Difference method, an advanced metric. Effect sizes were independently analyzed for targeted and non-targeted outcomes, student age, learner disability, and number of phases in the PECS protocol acquired by learners. Results supported the judgment that PECS is a promising intervention method. Analysis also revealed that functional communication outcomes associated with the PECS protocol were most impacted, that preschool children and those with autism generally showed the strongest training effects, and that in general students who advanced through the most PECS protocol phases had the best outcomes.

Impact of the picture exchange communication system: effects on communication and collateral effects on maladaptive behaviors

Many children with autism require intensive instruction in the use of augmentative or alternative communication systems, such as the Picture Exchange Communication System (PECS). This study investigated the use of PECS with three young boys with autism to determine the impact of PECS training on use of pictures for requesting, use of intelligible words, and maladaptive behaviors. A multiple baseline-probe design with a staggered start was implemented. Results indicated that all of the participants quickly learned to make requests using pictures and that two used intelligible speech following PECS instruction; maladaptive behaviors were variable throughout baseline and intervention phases. Although all of the participants improved in at least one dependent variable, there remain questions regarding who is best suited for PECS and similar interventions.