Expanding Communication Modalities and Functions for Preschoolers With Autism Spectrum Disorder: Secondary Analysis of a Peer Partner Speech-Generating Device Intervention

Abstract

Purpose This study reports a secondary analysis of the nature of communicative functions and modalities used in initiations and responses of minimally verbal preschoolers with severe autism spectrum disorder (ASD) from a previously published study ( Thiemann-Bourque, Feldmiller, Hoffman, & Johner, 2018 ). This analysis focused on the final cohort ( n = 6) from a group design study ( N = 45) that examined a peer mediation and speech-generating device (SGD) intervention compared to an SGD-only condition. Method After teaching peers to use an iPad as an SGD within a modified stay-play-talk approach, school staff implemented SGD instruction in child–peer dyads during typical preschool activities. To investigate individual differences among children who demonstrated increased communication acts in the peer + SGD condition, changes in reciprocity, modalities used, and communicative functions were examined using a multiple-baseline design across children. Fidelity of implementation and social validity data were also collected. Results Six children with ASD and their peers demonstrated more balanced reciprocity, with individual differences in how and why children communicated during exchanges. That is, all children with ASD increased in SGD use as their primary communication mode; 3 children used different modalities including more speech, and 3 children used primarily gestures and SGD. The most frequent function expressed was requests for objects. More modest increases were observed in comments and requests for actions, with negligible changes in gaining attention. Social validity reports by naïve judges reflected clear improvements in communication interactions. Conclusion Findings are promising for a preschool SGD intervention that can expand children's modalities and communicative functions to engage in balanced exchanges with peer partners. Supplemental Material https://doi.org/10.23641/asha.11374203

Peer-Mediated Augmentative and Alternative Communication Interventions for Young Children With Autism Spectrum Disorder and Limited to No Spoken Communication

“…By teaching peers to be responsive listeners and AAC partners, we are changing a child's social environment and number of learning opportunities-increasing the likelihood that both partners will become more competent in their social communicative interactions across familiar and novel social contexts. In addition, preliminary results demonstrate the promise of integrating peer mediation and AAC instruction to help children learn a larger repertoire of communicative functions and modalities (Bourque & Goldstein, 2020). One direction for future research is to determine how to best define and assess the construct of peer-related social communication competence and how children learning to use AAC may exhibit different profiles that require individualized treatment approaches.…”

“…To date, the primary targeted communication outcome of AAC intervention research is requesting skills (Iacono et al, 2016), and AAC studies documenting treatment effects on a range of communicative functions or modalities for children with ASD are minimal (Logan et al, 2017). Bourque and Goldstein (2020) addressed this gap in AAC intervention research by recoding communication data for one cohort (n = 6) of children with ASD who participated in the Thiemann- Bourque et al (2018) study. They measured changes in four communicative functions (i.e., requests for objects, requests for actions, comments, and requests for attention) and four modalities (i.e., gestures, speech, SGD, or speech + SGD), expressed as initiations or responses by children with ASD to trained peer partners.…”

Augmentative and Alternative Communication Supports for Language and Literacy in Preschool: Considerations for Down Syndrome and Autism Spectrum Disorder

“…For example, recent research targeting development of social communication skills in young children with DS and ASD using AAC found a stayplay-talk method, mediated by peers with typical development, improved reciprocal staying, and playing behaviors for all participants. [34][35][36] The stay-play-talk method of intervention is designed to increase the social interactions of peers with and without disabilities in inclusive classroom settings, by teaching peers with typical development specific strategies to play nearby and engage in talking to peers with disabilities. Peers with typical development are taught to simply play nearby and with toys of mutual interest to the peer with a disability, and to engage in conversation with them about the activity at hand.…”

“…Targeted outcomes of these interventions were communication turns taken, [37][38][39] functions of AAC use such as requests, 40 or initiations and responses with peers. 35,36 These interventions generally take place in naturalistic settings with motivating activities-aspects that are considered key to successful outcomes. Children with ASD have benefitted from AAC interventions targeting communication development in each of these areas.…”

Using an Antecedent Prompting Method to Teach an Extended Communication Sequence to Children with Autism Using a Speech Generating Device

“…A lack of social reciprocity is a core deficit of ASD; therefore, it is important to create interventions based on encouraging back-and-forth exchanges/turn-taking interactions that are a hallmark of communication and social interaction (American Psychological Association, 2013; Bourque & Goldstein, 2020;Snyder-McLean & McLean, 1978). Studies have been conducted in which participants successfully learned to engage in multiple types of communicative functions using an SGD set with a static display.…”