The complexities of AAC intervention research: emerging trends to consider

Measuring communicative style in parents of infants with suspected neurodevelopmental disorders: Reliability test and adaptation of the RAACS instrument

INTRODUCTION

The Responsive Augmentative and Alternative Communication Style Scale, version 3 (RAACS 3) has been used when assessing communicative style in parents of children with communicative disabilities between 12 and 60 months of age and it has demonstrated validity and reliability. The aim of this study was to investigate the reliability of RAACS when applied to video-recorded communication between parents and their infants (aged four to 12 months) with suspected neurodevelopmental disorders, and, if needed, adapt, and retest the instrument.

METHOD

Four speech language pathologists performed a three-phase reliability procedure using twenty-six audio-video recordings of interactions between parents and infants. Inter- and intrarater agreement was calculated. In phase I the original instrument RAACS 3 was used, on twenty recordings. In phase II the instrument was adapted to better suit the target group (parents of infants aged four to 12 months) and was called RAACS 4. In phase III RAACS 4 was pilot tested on six new audio-video recordings. This phase also included two joint ratings and a consensus discussion between the raters preceding the rating procedure.

RESULTS

The testing during phase I showed low reliability rates of RAACS 3 independent of statistical test method. The pilot testing that was done during phase III showed that the adapted version, RAACS 4, had higher reliability rates.

CONCLUSIONS

RAACS 3 was not reliable for assessment of communicative style in parents of infants. RAACS 4 showed promising results when assessing communicative style of parents of infants with neurodevelopmental delays. Further reliability and validity investigation is needed.

10. Three Embodied Dimensions of Communication

In the last chapter, Janna van Grunsven, Caroline Bollen and Bouke van Balen show how the phenomenology of communication can inform the field of augmented or alternative communication technology (AAC-tech). AAC-tech is a set of technologies developed for people who are unable to use some of their bodily expressive resources due to congenital or acquired disability. This inability often makes it very difficult for those people to communicate. Developers of AAC-tech often take a cognitivist starting-point, thereby missing out on the subtle ways in which embodiment shapes communication. The phenomenological description of the lived experiences of these people offers a fruitful starting-point for recognizing the often forgotten embodied dimension of communication, and enables to formulate desiderata for how AAC-tech should be developed: AAC-tech should take into account (1) embodied address, (2) embodied enrichment, and (3) embodied diversity. Focusing on the lived experience of potential users of AAC-tech has, according to van Grunsven, Bollen, and van Balen, not only direct practical applications for technology development but also can inform phenomenology methodologically: focusing on a limit case as the one discussed in this chapter makes visible that communication takes place in a wide variety of ways and that it is not the task of the phenomenologist to lay bare a general or essential structure of communication that can be taken as a standard.

Teaching Parents via Online Asynchronous Training to Use Speech-Generating Devices with Their Autistic Children: A Pilot Study

Background/Objectives: Telepractice interventions have been found to alleviate barriers families face when seeking communication interventions. This study is a multiple-baseline single-subject design that measures parent communication opportunities and parent responsiveness to determine if parent training through online modules created for parents of children with communication support needs can be effective for training parents of autistic children with communication support needs. Methods: This study replicates work by utilizing online training used as well as the same variables and definitions. This study expands the original study by providing the children with speech-generating devices (SGDs). SGDs are an assistive technology tool to increase language production and give access to language to minimally verbal autistic people. A central difference between this study and study is that the only training parents received was the online modules and written instructions to set up the SGD. Results: Overall, the POWR modules appear to positively impact the communication opportunities provided by the parent during play and activities, increase child communication, and improve parent proficiency in implementing the POWR strategy. Conclusions: There is a need for a larger single-case study or a randomized control trial to replicate these findings. Additional instruction may be needed for parents of children with autism around responsive interactions. This study adds to innovative ways of providing family-centered training and access to AAC for those with barriers to service.

A scoping review of AAC interventions for children and young adults with simultaneous visual and motor impairments: Clinical and research Implications

Individuals with multiple disabilities are among the most challenging to serve and AAC teams often lack direction in determining effective interventions. The purpose of this scoping review was to summarize the research evidence on AAC interventions for individuals with complex communication needs and simultaneous motor, and visual impairments as part of their multiple disabilities; to consider implications for practice; and to determine gaps and directions for future research. A total of 27 studies were identified and reviewed, involving 55 unique participants with multiple disabilities. Most studies focused on direct intervention to increase requesting or choice-making, with little focus on social communication. Only two studies focused on training communication partners. Results indicated that AAC interventions can be highly effective to increase communication for individuals with multiple disabilities. However, there is an urgent need for increased rigor and more detailed participant information in future AAC intervention research with this population. Future research should investigate AAC intervention to improve social communication and increase language development, not just expression of needs and wants. Future research should focus on the needs of individuals with multiple disabilities from culturally and linguistically diverse backgrounds and on implementation of AAC within natural environments.