Transcript Augmentative/Alternative Communication Evaluation

The Increase in Verbal
Operants Following the
Implementation of
Augmentative and Alternative
Communication (AAC) Devices
with Children on the Autism
Spectrum
Gili Rechany M.A., BCBA
Megan Petrizio M.A., SLP-CCC
Literature
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Charlop-Christy, M. H., Carpenter, M., Le, L., LeBlanc, L. A., &
Kellet, K. (2002). Using the picture exchange communication
system (PECS) with children with autism: Assessment of pecs
acquisition, speech, social-communicative behavior, and
problem behavior. Journal of Applied Behavior Analysis, 35,
213-231.
Schepis, M. M., Reid, D. H., Behrmann, M. M., & Sutton, K. A.
(1998). Increasing communicative interactions of young
children with autism using a voice output communication aid
and naturalistic teaching. Journal of Applied Behavior
Analysis, 31, 561-578.
Mirenda, P., (2003) Toward Functional Augmentative and
Alternative Communication for Students with Autism: Manual
Signs, Graphic Symbols, and Voice Output Communication.
Aids Journal of Language, Speech, and Hearing Services in the
Schools, 34, 203-216.
Johnston, S., Reichle, J. (2004) Supporting Augmentative and
Alternative Communication Use by Beginning Communicators
with Severe Disabilities. American Journal of Speech
Language Pathology, 13, 20-30.
Abstract
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The current investigation focuses on the evaluation and
implementation of AAC devices with children presenting with
Autism Spectrum Disorder (ASD).
This study explores prerequisite skills needed for successful
implementation of an AAC device by examining the children’s
performance on the ABLLS assessment, as well as direct
observation of functional communication in the classroom.
A multiple baseline across participants design was
implemented.
This study measures the increase of verbal operants following
the implementation of augmentative and alternative
Communication (AAC) Devices.
Three Verbal Behavior operants were measured; generalized
mands, generalized tacts, and generalized intraverbals.
Method: Participants
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Participants
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Two school age boys and one preschool boy
diagnosed with an Autism Spectrum Disorder
(ASD) participated in this study.
Student A- 8 years old. He is a listener/speaker.
He is an emerging reader/writer.
Student B- 4 years old. He is a listener/ emerging
speaker. He is an emerging reader/writer.
Student C- 7 years old. He is an emerging
listener/speaker. He is a beginner reader/writer.
Method: Setting
Shema Kolainu- Hear Our Voices
 All sessions were conducted in the
participants’ classrooms. The students are
in a self-contained class for students with
an Autism Spectrum Disorder.
 Behavioral Analytic Program
 6:1:3 classroom ratio
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Experimental Design
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Data Collection
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Interobserver Agreement
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Independent variable: High-Tech Augmentative and
Alternative Communication Devices (AAC)
Dependent variables: Verbal Operants- generalized mands,
generalized tacts, and generalized intraverbals.
Interobserver agreement was calculated by the number of
agreements divided by the number of disagreements times
100. IOA was done daily for 10 minutes.
Participant A- 89%
Participant B-92%
Participant C- 97%
Design
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A multiple baseline design across participants was used to
show the relationship between the independent and the
dependent variables.
Study Sequence
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Baseline
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Evaluation
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Complete assessment of both direct and indirect
observations was completed
Training
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Generalized, mands, tacts and intraverbals were recorded
throughout the day (8:30-2:00). The students used their
PECS books for communication.
Navigating and Transporting the device
Implementation
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Generalized, mands, tacts and intraverbals were recorded
throughout the day (8:30-2:00). The students used a high
tech devices for communication.
AAC Evaluation Procedures
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Two Part Assessment
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Cognitive Evaluation
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ABLLS Scores
Kaufman Praxis Test
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Preschool Language Scale
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Assessed Speech Production and Intelligibility
Informal
Expressive Language Skills
Receptive Language Skills
Observations
In classroom, playground, 1:1 therapy
Interviews with parents/teachers/allied professionals
Technical Evaluation
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Low Technology Evaluation
High Technology Evaluation
Low Technology Evaluation
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Initial Assessment of Symbolic
Language Abilities for Aided AAC
Systems
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Pointing as Communication
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Discrimination
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Sequencing Symbols
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Categorizing and Associations
Low Technology Evaluation
cont…
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Switches for activation of motorized
toys
 Range
of Motion
 Following Directions
 Cause and Effect
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TechTalk 8
 Can
they handle a static display?
 Array of 2-4, 4-6, 6-8 pictures/symbols/icons
 Were they able to take part in activities
(Discriminate, Sequence, Categorize)
 Can they carry it, open it, and start the device
High Technology Evaluation
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IIIDV4
 Large
dynamic display device
 Keyboard capabilities
 Word prediction
 Synthesized speech
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IIIMT4
 Same
as above, but smaller for portability
Training Hierarchy
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Device Activation
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Touch-Screen Navigation
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using the “on” button after transitioning between
activities independently
navigating through the main screen
independently
navigating through two or more screens
independently
Device Mobility
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carrying the device using the carrying case in all
settings independently
Implementation
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Generalized mands, tacts, and
intraverbals were recorded
throughout the day.
Mands
 Tacts
 Intraverbals
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Student A
195
Low - Tech Augmantive Communication
Device
High - Tech Augmantive Communication Device
175
155
Generalized Verbal Operants
135
115
Mands
Tacts
95
Intraverbals
75
55
35
15
-5
1
2
3
4
5
6
7
8
9
10
11
12
Days
13
14
15
16
17
18
19
20
21
22
23
Student B
345
Low -Tech Augmantive Communication
Device
High -Tech Augmantive Communication Device
295
Generalized Verbal Operants
245
195
Mands
Tacts
Intraverbals
145
95
45
-5
1
2
3
4
5
6
Days
7
8
9
10
11
Student C
95
Low -Tech Augmantive Communication Device
High -Tech Augmantive
Communication Device
85
75
Generalized Verbal Oparents
65
55
Mands
45
Tacts
Intraverbals
35
25
15
5
-5
1
2
3
4
5
6
7
8
9
10
11
Days
12
13
14
15
16
17
18
19
20
Discussion
Different trend for each learner based
on their verbal behavior
 All students communication increased
following the implementation of a high
tech AAC device
 Student C requires additional
interventions to strengthen his listener
and listener/speaker domains.
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Questions
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1.) To what extent does the vocalization increase
paired with the use of an AAC device for students
who are stimuable for the production of speech
sounds? Considering the demonstration of student
B’s high levels of generalized tacts with vocalizations,
it appears that this behavior requires further
exploration.
2.) Which learners present higher in certain areas
and lower in others? Taking into account the three
types of learners included in this study are there
may be trends specific to the implementation of an
AAC device and that specific type of learner.
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3.) Does measured generalization of the AAC
device continue to take place with all three
types of learners over an extended period of
time?
4.) Can we expect the merging listenerspeaker to demonstrate similar behaviors as
other learners in the study?
5.) Are similar results possible with low
technology voice output devices or is there a
discrepancy between the implementation of a
high technology device versus a low
technology device, specifically with the ASD
population?