Enhancing the Use of Augmentative Communication Systems of Children with Autism Through Caregiver-Implemented Naturalistic Teaching Strategies

The effectiveness of using augmentative and alternative communication (AAC) for children who do not acquire functional speech or who have difficulty processing and comprehending spoken language is well documented in the literature. Considering that one of the core defining features of Autism Spectrum Disorder (ASD) is the inability to develop effective communication skills, children with ASD represent good candidates for AAC interventions. The research literature on autism has reported positive outcomes in communication intervention programs that start early, are held in the child's natural environment, use naturalistic teaching strategies and include parents as intervention agents. The purpose of this research project was to evaluate the effects of a caregiver-implemented AAC intervention on the communication performance of young children with ASD. A single-subject multiple-baseline design across routines with replications across participants was used to evaluate the effectiveness of the treatment. Four children (ages 4-8) diagnosed with ASD and their mothers participated in this study. Caregivers were taught to implement 4 naturalistic teaching strategies using AAC systems to enhance the communication skills of their children during home routines. The mothers effectively learned to apply the teaching procedures and generalize them to untrained routines. The four child participants increased their frequencies of communication turns (initiations and responses) using the AAC system across trained and untrained routines. These participants additionally increased their frequencies of verbalizations/vocalizations in at least one routine, while two children increased the use of gestures/manual signs. Two participants additionally increased the use of gestures. No significant changes were observed in the rate of imitative responses following intervention. Social validation data indicated that the three caregivers that completed the study were satisfied with the intervention program and perceived positive changes in their children's communication using the AAC system.