Advertisement

Journal of Autism and Developmental Disorders

, Volume 42, Issue 1, pp 60–74 | Cite as

A Meta-Analysis of Single Case Research Studies on Aided Augmentative and Alternative Communication Systems with Individuals with Autism Spectrum Disorders

  • Jennifer B. GanzEmail author
  • Theresa L. Earles-Vollrath
  • Amy K. Heath
  • Richard I. Parker
  • Mandy J. Rispoli
  • Jaime B. Duran
Original Paper

Abstract

Many individuals with autism cannot speak or cannot speak intelligibly. A variety of aided augmentative and alternative communication (AAC) approaches have been investigated. Most of the research on these approaches has been single-case research, with small numbers of participants. The purpose of this investigation was to meta-analyze the single case research on the use of aided AAC with individuals with autism spectrum disorders (ASD). Twenty-four single-case studies were analyzed via an effect size measure, the Improvement Rate Difference (IRD). Three research questions were investigated concerning the overall impact of AAC interventions on targeted behavioral outcomes, effects of AAC interventions on individual targeted behavioral outcomes, and effects of three types of AAC interventions. Results indicated that, overall, aided AAC interventions had large effects on targeted behavioral outcomes in individuals with ASD. AAC interventions had positive effects on all of the targeted behavioral outcome; however, effects were greater for communication skills than other categories of skills. Effects of the Picture Exchange Communication System and speech-generating devices were larger than those for other picture-based systems, though picture-based systems did have small effects.

Keywords

Autism spectrum disorders Augmentative and alternative communication Aided AAC Communication skills Social skills Interventions Meta-analysis Voice output communication aid Speech-generating device Picture Exchange Communication System 

References

References marked with an asterisk indicate studies included in the meta-analysis.

  1. Allison, D. B., & Gorman, B. S. (1993). Calculating effect sizes for meta-analysis: The case of the single case. Behaviour Research and Therapy, 31, 621–631.PubMedCrossRefGoogle Scholar
  2. Altman, D. G. (1999). Practical statistics for medical research. Bristol, UK: Chapman & Hall.Google Scholar
  3. American Psychiatric Association [APA]. (2000). Diagnostic and statistical manual of mental disorders (4th Ed., text rev.). Washington, DC: Author.Google Scholar
  4. American Speech-Language-Hearing Association [ASHA]. (1997). Augmentative and alternative communication (AAC). Retrieved from http://www.asha.org/public/speech/disorders/AAC.htm.
  5. *Angermeier, K., Schlosser, R. W., Luiselli, J. K., Harrington, C., & Carter, B. (2008). Effects of iconicity on requesting with the picture exchange communication system in children with autism spectrum disorder. Research in Autism Spectrum Disorders, 2, 430–446.Google Scholar
  6. Armitage, P., Berry, G., & Matthews, J. N. S. (2002). Statistical methods in medical research (4th ed.). Malden, Massachusetts: Blackwell Science.CrossRefGoogle Scholar
  7. Banda, D. R., & Therrien, W. J. (2008). A teacher’s guide to meta-analysis. Teaching Exceptional Children, 41, 66–71.Google Scholar
  8. Beck, A. R., Stoner, J. B., Bock, S., & Parton, T. (2008). Comparison of PECS and the use of a VOCA: A replication. Education and Training in Developmental Disabilities, 43, 198–216.Google Scholar
  9. Beretvas, S. N., & Chung, H. (2008). A review of single-subject design meta-analyses: Methodological issues and practice. Evidence-Based Communication Assessment and Intervention, 2, 129–141.CrossRefGoogle Scholar
  10. Bondy, A., & Frost, L. A. (2002). A pictures worth: PECS and other visual communication strategies in autism. Bethesda, MD: Woodbine House.Google Scholar
  11. Browne, R. H. (1979). On visual assessment of the significance of a mean difference. Biometrics, 35, 657–665.CrossRefGoogle Scholar
  12. *Buckley, S. D., & Newchok, D. K. (2005). Differential impact of response effort within a response chain on use of mands in a student with autism. Research in Developmental Disabilities, 26, 77–85.Google Scholar
  13. Carr, D., & Felce, J. (2007). Brief report: The effects of PECS teaching to phase III on the communicative interactions between children with autism and their teachers. Journal of Autism and Developmental Disorders, 37, 724–737.PubMedCrossRefGoogle Scholar
  14. Centers for Disease Control and Prevention (CDC). (2007). Prevalence of —autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2002. MMWR SS 2007; 56(No.SS-1). Retrieved August 28, 2009, from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5601a2.htm.
  15. *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-communication behavior, and problem behavior. Journal of Applied Behavior Analysis, 35, 213–231.Google Scholar
  16. Cochrane Collaboration (2006). Retrieved May 18, 2006, from http://www.cochrane.org/.
  17. *Drager, K. D. R., Postal, V. J., Carrolus, L., Castellano, M., Gagliano, C., & Glynn, J. (2006). The effect of aided language modeling on symbol comprehension and production in two preschoolers with autism. American Journal of Speech-Language Pathology, 15, 112–125.Google Scholar
  18. Fidler, F., & Thompson, B. (2001). Computing correct confidence intervals for ANOVA fixed- and random-effects effect sizes. Educational and Psychological Measurement, 61, 575–604.Google Scholar
  19. Fowler, R. J. (1985). Point estimates and confidence intervals in measures of association. Psychological Bulletin, 98, 160–165.CrossRefGoogle Scholar
  20. *Frea, W. D., Arnold, C. L., & Vittimberga, G. L. (2001). A demonstration of the effects of augmentative communication on the extreme aggressive behavior of a child with autism within an integrated preschool setting. Journal of Positive Behavior Interventions, 3, 194–198.Google Scholar
  21. Frost, L., & Bondy, A. (1994). The picture exchange communication system training manual. Cherry Hill, NJ: Pyramid Educational Consultants, Inc.Google Scholar
  22. Frost, L., & Bondy, A. (2002). The picture exchange communication system training manual (2nd ed.). Cherry Hill, NJ: Pyramid Educational Consultants.Google Scholar
  23. Ganz, J. B., Parker, R., & Benson, J. (2009). The impact of the picture exchange communication system: Effects on communication and collateral effects on maladaptive behaviors. Augmentative and Alternative Communication, 25, 250–261.PubMedCrossRefGoogle Scholar
  24. Ganz, J. B., Sigafoos, J., Simpson, R. L., & Cook, K. E. (2008a). Generalization of a pictorial alternative communication system across instructors and distance. Augmentative and Alternative Communication, 24, 89–99.PubMedCrossRefGoogle Scholar
  25. *Ganz, J. B., & Simpson, R. L. (2004). Effects on communicative requesting and speech development of the picture exchange communication system in children with characteristics of autism. Journal of Autism and Developmental Disorders, 34, 395–409.Google Scholar
  26. *Ganz, J. B., Simpson, R. L., & Corbin-Newsome, J. (2008b). The impact of the picture exchange communication system on requesting and speech development in preschoolers with autism spectrum disorders and similar characteristics. Research in Autism Spectrum Disorders, 2, 157–169.Google Scholar
  27. Glass, G. V. (1976). Primary, secondary, and meta-analysis of research. Educational Researcher, 5, 3–8.Google Scholar
  28. Goldstein, H., & Healy, M. J. R. (1995). The graphical presentation of a collection of means. Journal of the Royal Statistical Society, 158, 175–177.CrossRefGoogle Scholar
  29. Hintze, J. (2010). NCSS (Number Cruncher Statistical System), NCSS, "Meta-analysis Module” LLC. Kaysville, Utah. www.ncss.com.
  30. Horner, R. H., Carr, E. G., Halle, J., McGee, G., Odom, S., & Wolery, M. (2005). The use of single-subject research to identify evidence-based practice in special education. Exceptional Children, 71, 165–179.Google Scholar
  31. Individuals with Disabilities Education Improvement Act Regulations, 34 C.F.R. § 300.35 et seq. (2004). Google Scholar
  32. *Johnston, S., Nelson, C., Evans, J., & Palazolo, K. (2003). The use of visual supports in teaching young children with autism spectrum disorder to intiate interactions. Augmentative and Alternative Communication, 19, 86–103.Google Scholar
  33. Jones, V., & Prior, M. (1985). Motor imitation abilities and neurological signs in autistic children. Journal of Autism and Developmental Disorders, 15, 37–46.PubMedCrossRefGoogle Scholar
  34. Kavale, K. A. (1984). Potential advantages of the meta-analysis technique for research in special education. Journal of Special Education, 18, 61–72.CrossRefGoogle Scholar
  35. Kavale, K. A. (1998). Some methods are more effective than others. Intervention in School and Clinic, 33, 195–200.CrossRefGoogle Scholar
  36. Kavale, K. A. (2001). Meta-analysis: A primer. Exceptionality, 9, 177–183.CrossRefGoogle Scholar
  37. *Kravits, T. R., Kamps, D. M., Kemmerer, K., & Potucek, J. (2002). Brief report: Increasing communication skills for an elementary-aged student with autism using the picture exchange communication system. Journal of Autism and Developmental Disorders, 32, 225–230.Google Scholar
  38. *Lund, S. K., & Troha, J. M. (2008). Teaching young people who are blind and have autism to make requests using a variation on the picture exchange communication system with tactile symbols: A preliminary investigation. Journal of Autism and Developmental Disorders, 38, 719–730.Google Scholar
  39. *Marckel, J. M., Need, N. A., & Ferreri, S. J. (2006). A preliminary analysis of teaching improvisation with the picture exchange communication system to children with autism. Journal of Applied Behavior Analysis, 39, 109–115.Google Scholar
  40. Marquis, J. G., Horner, R. H., Carr, E. G., Turnbull, A. P., Thompson, M., Behrens, G. A., et al. (2000). A meta-analysis of positive behavior support. In R. Gersten, E. Schiller, S. Vaughn, & J. Schumm (Eds.), Contemporary special education research: Syntheses of knowledge base on critical instructional issues (pp. 137–178). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  41. Mirenda, P. (2001). Autism, augmentative communication and assistive technology: What do we really know? Focus on Autism and Other Developmental Disabilities, 16(3), 141–151.CrossRefGoogle Scholar
  42. Mirenda, P. (2003). Towards functional augmentative and alternative communication for students with autism: Manual signs, graphic symbols, and voice output communication aids. Language, Speech, and Hearing Services in Schools, 34, 203–216.CrossRefGoogle Scholar
  43. No Child Left Behind Act of 2001, 20 U.S.C. 70 §6301 et seq. (2002)Google Scholar
  44. *Nunes, D., & Hanline, M. F. (2007). Enhancing the alternative and augmentative communication use of a child with autism through a parent implemented naturalistic intervention. International Journal of Disability, Development and Education, 54, 177–197.Google Scholar
  45. Ogletree, B. T., & Oren, T. (2006). How to use augmentative and alternative communication. Austin, TX: Pro-Ed.Google Scholar
  46. *Olive, M. L., Cruz, B. d. l., Davis, T. N., Chan, J. M., Lang, R. B., & O’Reilly, M. F., et al. (2007). The effects of enhanced milieu teaching and a voice output communication aid on the requesting of three children with autism. Journal of Autism and Developmental Disorders, 37, 1505–1513.Google Scholar
  47. *Olive, M. L., Lang, R. B., & Davis, T. N. (2008). An analysis of the effects of functional communication and a voice output communication aid for a child with autism spectrum disorder. Research in Autism Spectrum Disorders, 2, 223–236.Google Scholar
  48. Parker, R. I., Hagan-Burke, S., & Vannest, K. (2007). Percentage of all non-overlapping data (PAND): An alternative to PND. The Journal of Special Education, 40, 194–204.CrossRefGoogle Scholar
  49. Parker, R. I., Vannest, K. J., & Brown, L. (2009). The improvement rate difference for single case research. Exceptional Children, 75, 135–150.Google Scholar
  50. Payton, M. E., Greenstone, M. H., & Schenker, N. (2003). Overlapping confidence intervals or standard error intervals: What do they mean in terms of statistical significance? Journal of Insect Science, 3(34), 1–6.Google Scholar
  51. Payton, M. E., Miller, A. E., & Raun, W. R. (2000). Testing statistical hypotheses using standard error bars and confidence intervals. Communications in Soil Science and Plant Analysis, 31, 547–552.CrossRefGoogle Scholar
  52. *Reichle, J., McComas, J., Dahl, N., Solberg, G., Pierce, S., & Smith, D. (2005). Teaching an individual with severe intellectual delay to request assistance conditionally. Educational Psychology, 25, 275–286.Google Scholar
  53. Reichow, B., Volkmar, F. R., & Cicchetti, D. V. (2008). Development of the evaluative methods for evaluating and determining evidence-based practices in autism. Journal of Autism and Developmental Disorders, 38, 1311–1319. doi: 10.1007/s10803-007-0517-7.PubMedCrossRefGoogle Scholar
  54. Rosenberg, M. S., Adams, D. C., & Gurevitch, J. (2000). MetaWin 2.0. [Computer software]. Sunderland, MA: Sinauer Associates.Google Scholar
  55. Rosenthal, R. (1991). Meta-analysis procedures for social science research. Beverly Hills, CA: Sage.Google Scholar
  56. Rotholz, D. A., et al. (1989). Functionality of two modes of communication in the community by students with developmental disabilities: A comparison of signing and communication books. Journal of the Association for Persons with Severe Handicaps, 14, 227–233.Google Scholar
  57. Sackett, D. L., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (Eds.). (1997). Evidence-based medicine: How to practice and teach EBM. London: Churchill Livingstone.Google Scholar
  58. Schenker, N., & Gentleman, J. F. (2001). On judging the significance of differences by examining overlap between confidence intervals. The American Statistician, 55, 182–186.CrossRefGoogle Scholar
  59. *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.Google Scholar
  60. *Schlosser, R. W., & Blischak, D. M. (2004). Effects of speech and print feedback on spelling by children with autism. Journal of Speech, Language and Hearing Research, 47, 848–862.Google Scholar
  61. *Schlosser, R. W., Blischak, D. M., Belfiore, P. J., Bartley, C., & Barnett, N. (1998). Effects of synthetic speech output and orthographic feedback on spelling in a student with autism: A preliminary study. Journal of Autism and Developmental Disorders, 28, 309–319.Google Scholar
  62. Schlosser, R. W., & Sigafoos, J. (2009). Navigating evidence-based information sources in augmentative and alternative communication. Augmentative and Alternative Communication, 25, 225–235.PubMedCrossRefGoogle Scholar
  63. *Schlosser, R. W., Sigafoos, J., Luiselli, J. K., Angermeier, K., Harasymowyz, U., & Schooley, K., et al. (2007). Effects of synthetic speech output on requesting and natural speech production in children with autism: A preliminary study. Research in Autism Spectrum Disorders, 1, 139–163.Google Scholar
  64. Schneider, N., Goldstein, H., & Parker, R. (2008). Social skills interventions for children with autism: A meta-analytic application of percentage of all non-overlapping data (PAND). Evidence-Based Communication Assessment and Intervention, 2, 152–162.CrossRefGoogle Scholar
  65. Schuler, A. L., & Baldwin, M. (1981). Nonspeech communication and childhood autism. Language, Speech, and Hearing Services in the Schools, 12, 246–257.Google Scholar
  66. Scruggs, T. E. (1992). Single subject methodology in the study of learning and behavioral disorders: Design, analysis and synthesis. In T. E. Scruggs & M. A. Mastropieri (Eds.), Advances in learning and behavioral disabilities (Vol. 7, pp. 223–248). Greenwich, CT: JAI Press.Google Scholar
  67. Scruggs, T. E., & Mastropieri, M. A. (1998). Summarizing single-subject research: Issues and applications. Behavior Modification, 22, 221–242.PubMedCrossRefGoogle Scholar
  68. Scruggs, T. E., & Mastropieri, M. A. (2001). How to summarize single-participant research: Ideas and applications. Exceptionality, 9, 227–244.CrossRefGoogle Scholar
  69. Scruggs, T. E., Mastropieri, M. A., & Casto, G. (1987). The quantitative synthesis of single-subject research: Methodology and validation. Remedial and Special Education, 8(2), 24–33.CrossRefGoogle Scholar
  70. Seal, B. C., & Bonvillian, J. D. (1997). Sign language and motor functioning in students with autistic disorder. Journal of Autism and Developmental Disorders, 27, 437–466.PubMedCrossRefGoogle Scholar
  71. *Sigafoos, J., Drasgow, E., Halle, J. W., O’Reilly, M., Seely-York, S., & Edrisinha, C., et al. (2004). Teaching VOCA use as a communicative repair strategy. Journal of Autism and Developmental Disorders, 34, 411–422.Google Scholar
  72. *Sigafoos, J., O’Reilly, M., Seely-York, S., & Edrisinha, C. (2004). Teaching students with developmental disabilities to locate their AAC device. Research in Developmental Disabilities, 25, 371–383.Google Scholar
  73. Simpson, R. L. (2005). Evidence-based practices and students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 20, 140–149.CrossRefGoogle Scholar
  74. Simpson, R. L. (2008). Children and youth with autism spectrum disorders: The search for effective methods. Focus on Exceptional Children, 40, 1–14.Google Scholar
  75. Simpson, R. L., McKee, M., Teeter, D., & Beytien, A. (2007). Evidence-based methods for children and youth with autism spectrum disorders: Stakeholder issues and perspectives. Exceptionality, 15, 203–217.CrossRefGoogle Scholar
  76. Tankersley, M., Cook, B. G., & Cook, L. (2008). A preliminary examination to identify the presence of quality indicators in single-subject research. Education and Treatment of Children, 31, 523–548.CrossRefGoogle Scholar
  77. Thompson, B. (2002). What future quantitative social science research could look like: Confidence intervals for effect sizes. Educational Researcher, 31, 24–31.CrossRefGoogle Scholar
  78. Thompson, B. (2007). Effect sizes, confidence intervals, and confidence intervals for effect sizes. Psychology in the Schools, 44, 423–432.CrossRefGoogle Scholar
  79. *Thompson, R. H., Fisher, W. W., Piazza, C. C., & Kuhn, D. E. (1998). The evaluation and treatment of aggression maintained by attention and automatic reinforcement. Journal of Applied Behavior Analysis, 31, 103–116.Google Scholar
  80. *Tincani, M. (2004). Comparing the picture exchange communication system and sign language training for children with autism. Focus on Autism and Other Developmental Disabilities, 19, 152–163.Google Scholar
  81. *Tincani, M., Crozier, S., & Alazetta, L. (2006). The Picture Exchange Communication System: Effects on manding and speech development for school-aged children with autism. Education and Training in Developmental Disabilities, 41, 177–184.Google Scholar
  82. Vannest, K. J., Harrison, J., Parker, R., Harvey, K. T., & Ramsey, L. (2010). Improvement rate differences of academic interventions for students with emotional and behavioral disorders. Remedial and Special Education. doi: 10.1177/0741932510362509.
  83. Wendt, O. (2009). Research on the use of manual signs and graphic symbols in autism spectrum disorders: A systematic review. In P. Mirenda & T. Iacono (Eds.), Autism spectrum disorders and AAC. Baltimore, MD: Paul H. Brookes Publishing Co.Google Scholar
  84. White, D. M., Rusch, F. R., Kazdin, A. E., & Hartman, D. P. (1989). Applications of meta-analysis in individual subject research. Behavioral Assessment, 11, 281–296.Google Scholar
  85. Wolf, F. M. (1986). Meta-analysis: Quantitative methods for research synthesis. Beverly Hills, CA: Sage.Google Scholar
  86. Yoder, P., & Stone, W. L. (2006a). A randomized comparison of the effect of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers with ASD. Journal of Speech. Language and Hearing Research, 49(4), 698–711.CrossRefGoogle Scholar
  87. Yoder, P., & Stone, W. L. (2006b). Randomized comparison of two communication interventions for preschoolers with autism spectrum disorders. Journal of Counseling and Clinical Psychology, 74(3), 426–435.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Jennifer B. Ganz
    • 1
    • 3
    Email author
  • Theresa L. Earles-Vollrath
    • 2
  • Amy K. Heath
    • 1
  • Richard I. Parker
    • 1
  • Mandy J. Rispoli
    • 1
  • Jaime B. Duran
    • 1
  1. 1.Texas A&M UniversityCollege StationUSA
  2. 2.University of Central MissouriWarrensburgUSA
  3. 3.Department of Educational Psychology4225 TAMUCollege StationUSA

Personalised recommendations