David McNaughton

Many children who experience speech and communication disabilities use or could benefit from the use of augmentative and alternative communication (AAC). Despite the potential benefits of AAC use for these children, many experience challenges in using traditional AAC systems to communicate with others, including their peers. Without effective peer interactions, children can miss out on valuable opportunities for social interaction and the development of communication skills. Video visual scene displays (VSDs) offer a unique alternative to support children in engaging in social communication. Video VSDs embed videos, a preferred activity for many children, with relevant vocabulary that is programmed as hotspots to support communication. The purpose of this study was to examine the impacts of a video VSD approach on the symbolic communication of preschool children with neurodevelopmental disabilities and delays (including autism) during a shared high-interest video activity with neurotypical peers. All three children showed increased symbolic communication frequency, with two demonstrating very large effect sizes and one a moderate effect. Future research should evaluate the use of video VSDs in a shared video activity with decreased researcher involvement and should examine change in participants’ vocabulary as a result of the video VSD activity.

Traditionally, alternative and augmentative communication (AAC) research has been led by researchers without lived experience using AAC. However, it is important to include AAC users as equitable partners to ensure that research addresses their priorities. This scoping review aimed to identify the extent and nature of AAC user involvement in research focused on adults with cerebral palsy (CP) who use AAC. A systematic search identified 57 data-based studies from the last 22 years that focused on adults with CP who used AAC. Seven (12%) of those studies involved at least one AAC user in at least one research process (conceptualization of the problem, design of study materials and procedures, implementation of the study, data analysis, or dissemination of results). The studies provided examples of advisory, collaborative group, and people-led approaches to involve AAC users in these research processes. Most of the studies utilized qualitative methods (n = 5), although there were also examples of survey (n = 1) and intervention (n = 1) research. Strategies from these studies, along with supporting literature, offer practical guidance for involving AAC users in all stages of future research. Building on these insights, this review outlines future directions for advancing inclusive research.

Historically, priorities for research, technology development, and professional training in the field of augmentative and alternative communication (AAC) have been identified largely by nondisabled professionals with limited, if any, involvement of people who need or use AAC. In this paper, we argue that people who need or use AAC must be leaders and co-creators in all activities that are about them or impact them. AAC users are the ones who have the best insights into their unmet needs; they also are the best positioned to identify priorities, appropriate methods, and potential solutions to the needs of the AAC community. A paradigm shift toward inclusive research, technology development, and professional training will bring challenges, including: the current lack of knowledge and experience with these methods in the AAC field; the potential for tokenism; and systemic barriers driven by ableism, racism, and other oppression. Ultimately, the field will need to build meaningful collaborations guided by mutual respect, trust, and the consideration of new ideas through open communication, a shared vision, and a deep commitment to the guiding principle, Nothing about us without us.

Expanded opportunities for meaningful participation in society now exist for adults with developmental disabilities who need or use AAC, yet significant barriers to full community participation still remain. In this paper, we discuss both personal narratives by AAC users as well as current AAC research in four key domains of adult life: having a safe place to live, participating in meaningful activities, accessing needed services, and developing friendships and meaningful relationships. To support communication and participation in these key areas more effectively, AAC research and development must: (a) strengthen the expression of personal identity; (b) support integrated use of multimodal communication; and (c) reduce the demands of communicative interaction while supporting language and literacy development. Future AAC research and development must be guided by equitable partnerships between AAC users, researchers, and technology developers, and must be driven by the key priorities of people who need and use AAC.

Literacy supports participation in education, employment, healthcare, and community living, and enhances communication for individuals who need or use augmentative and alternative communication (AAC). Research has demonstrated that individuals with developmental disabilities who need or use AAC can successfully acquire a wide range of literacy skills when provided with effective tools and evidence-based, adapted instruction delivered by trained professionals. Unfortunately, individuals who need or use AAC typically face significant barriers to literacy learning: (1) They may be excluded from literacy instruction or only have access to instruction that requires spoken responses severely limiting their participation; (2) Their service providers may not be trained to provide effective instruction; and (3) They may not have access to AAC that supports the transition to literacy. Future research is urgently required to: develop and evaluate adapted assessment and instruction; improve professional training; and ensure uptake of evidence-based literacy instruction in schools. Future technology development is required to: support the transition from graphic symbols to literacy; build a text-rich environment to support literacy learning; and assist service providers in instructional decision making and material adaptation. Future research and development must prioritize inclusion of individuals who use AAC in meaningful roles to maximize relevancy and impact.

The field of special education (SPED) has been suffering a shortage of professionals at every level for several years. This shortage is especially pronounced at higher education faculty level and for individuals who are considered culturally diverse (CD). To increase the number of CD SPED faculty, it is important to understand the positive and negative experiences of individuals who have succeeded in graduating with doctoral degrees in SPED. Utilizing the Social Capital Theory, the current study investigates the factors that influence successes and barriers in SPED doctoral programs for culturally diverse scholars. A multiple phase data collection process was used (i.e., survey, N = 16; focus groups, N = 9) respectively. Results indicated that most students identified a lack of social capital based on cultural differences within their programs. Additionally, social capital by way of financial support was identified as a strong positive in program persistence to graduation. Broader implications discussed.

We used the Council for Exceptional Children (CEC) Standards for evidence-based practices (EBP) in Special Education to evaluate the effectiveness research on the use of visual scene displays (VSDs) and video VSDs with young children with autism spectrum disorder and/or intellectual and developmental disability (ASD/IDD). VSDs and video VSDs are designed to support communication for individuals with speech or speech-related disabilities. In a high-tech VSD approach, images are programmed (on a tablet computer) with “hotspots” that produce speech when touched. Twelve of the 14 articles located for the review met all eight quality indicators as identified by the CEC Standards for evidence-based practices, and presented positive results for 37 of the 42 participants. We conclude that the use of VSDs and video VSDs can be considered an EBP in communication intervention for young children with ASD/IDD during social interaction activities commonly observed in early childhood settings.

Literacy skills can assist in the navigation and enjoyment of adult life. For individuals who have reached adulthood without strong literacy skills, opportunities for continued literacy learning are few. Redesigning AAC technologies to support literacy skill development could extend literacy learning opportunities for adults with developmental disabilities who have limited speech. The current preliminary study evaluated an AAC technology feature designed to support literacy development. The study used a multiple probe across participants design. Three adults with Down syndrome who had limited speech and only basic decoding skills participated. Results suggest the participants made modest gains in decoding accuracy after interacting using the AAC app with the literacy supportive feature, though performance was highly variable. Results also offer emerging evidence that, for two participants, some generalization to encoding performance may have also been achieved. Results showed that, for all the participants, interacting using the literacy supportive feature increased their reading confidence. Altogether, the study's results show preliminary evidence that the feature can support adults with Down syndrome in their ongoing literacy learning, though access to formal instruction is still critical. Future research is needed to continue to explore this and other AAC technology redesigns to increase learning opportunities for the people who use the technology every day to communicate.

Purpose: Literacy skills are foundational to participation in adolescent and adult life, and decoding skills (i.e., sounding out to read words) are critical to literacy learning. Literacy also increases communication options for individuals with developmental disabilities who use augmentative and alternative communication (AAC). Yet, current AAC technologies are limited in their support of literacy development (especially decoding skills) for the individuals with developmental disabilities who require them. The purpose of this study was to conduct a preliminary evaluation of a new AAC feature designed to support decoding skills. Method: Three individuals who had limited functional speech and limited literacy skills, specifically two adolescents and one young adult with Down syndrome, participated in the study. The study used a single-subject, multiple-probe, across-participants design. Results: All three participants demonstrated increases in reading performance, including decoding of novel words. High variability in performance was observed, however, and no participant reached reading mastery. Still, analysis reveals that for all participants, interacting using the new app feature increased reading. Conclusions: These results offer preliminary evidence that an AAC technology feature that provides models of decoding (upon selection of AAC picture symbols) can support individuals with Down syndrome in building decoding skills. While not intended to replace instruction, this initial study offers initial evidence in its efficacy as a supplemental avenue for supporting literacy in individuals with developmental disabilities who use AAC.

Purpose: Children with complex medical and communication needs often experience extensive or frequent hospital stays and rely on augmentative and alternative communication (AAC) strategies to communicate in this environment. Health care providers seldom receive training to effectively communicate with these children, which may lead to limited participation opportunities for the child during inpatient interactions. Method: A pretest–posttest experimental group design was completed to evaluate the effects of a brief mobile training designed to teach providers a procedure to support children with complex communication needs to communicate choices. Each provider participated in two pretest and two posttest interactions with children with complex communication needs during naturally occurring inpatient activities. Providers in the treatment group completed the video training, whereas providers in the control group did not. Results: Following the training, (a) more providers offered choices to the children during hospital routines, (b) providers implemented the trained procedure with increased accuracy, and (c) the children with complex communication needs consistently communicated their choices when given the opportunity to do so. The providers rated the training as easy to use, effective, and suited to the needs of the inpatient setting. Conclusions: This is the first AAC training designed to promote child–provider interactions in inpatient settings that demonstrates results that are efficient, socially valid, and effective in a real-world context. Future work is needed to develop additional brief and focused AAC partner trainings to teach providers to support the participation of children with complex communication needs in health care interactions. Supplemental Material: https://doi.org/10.23641/asha.22029008