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A Systematic Review of Evidence-based Instruction for Individuals with Autism Using Mobile Augmentative and Alternative Communication Technology

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Abstract

For individuals with autism spectrum disorder (ASD) who have limited to no vocal speech abilities, mobile augmentative and alternative communication (AAC) technology provides opportunities for communication with those around them. Interventionists can incorporate evidence-based practices into AAC instruction to heighten the efficacy of its intervention. The purpose of this systematic review was to identify and evaluate the evidence-based practices that have been employed to date in AAC intervention research for individuals with ASD using mobile AAC technology. Thirty-eight studies with 106 total participants met inclusion criteria. Results indicated that many strategies including prompting, time delay, reinforcement, differential reinforcement, discrete trial training, naturalistic intervention, modeling, peer-mediated instruction, task analysis, and parent-implemented intervention have been used effectively within the context of AAC intervention. Quality indicators, communication behavior types targeted for intervention, participant characteristics, and type of mobile AAC technology were reviewed. Implications for clinicians and guidance for instructional planning are discussed including the use of multiple evidence-based practices and ample opportunities for skill demonstration. Suggestions for further research include an increased focus on adolescent or adult participants, community contexts, variation of communicative functions, and application of other evidence-based strategies.

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References

  • *Achmadi, D., Kagohara, D. M., van der Meer, L., O’Reilly, M. F., Lancioni, G. E., Sutherland, D., Lang, R., Marschik, P.B., Green, V.A., & Sigafoos, J. (2012). Teaching advanced operation of an iPod-based speech-generating device to two students with autism spectrum disorders. Research in Autism Spectrum Disorders, 6, 1258-1264.

  • *Achmadi, D., Sigafoos, J., van der Meer, L., Sutherland, D., Lancioni, G., O'Reilly, M., Hodis, F., Green, V., McLay, L., & Marschik, P. (2014). Acquisition, preference, and follow up data on the use of three AAC options by four boys with developmental disability/delay. Journal of Developmental and Physical Disabilities, 26, 565- 583.https://doi.org/10.1007/s10882-014-9379-z

  • *Agius, M. M., & Vance, M. (2016). A comparison of PECS and iPad to teach requesting to pre-schoolers with autistic spectrum disorders. Augmentative and Alternative Communication, 32(1), 58-68.

  • *Alzrayer, N.M., Banda, D.R., & Koul, R. (2017). Teaching children with autism spectrum disorder and other developmental disabilities to perform multistep requesting using an iPad. Augmentative and Alternative Communication, 33, 65-76.

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

  • Beukelman D. R., & Light J. C. (2020). Augmentative & Alternative Communication [VitalSource Bookshelf]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781681253046/

  • *Carnett, A., Bravo, A., & Waddington, H. (2019). Teaching mands for actions to children with autism spectrum disorder using systematic instruction, behavior chain interruption, and a speech-generating device. International Journal of Developmental Disabilities, 65(2), 98-107.

  • *Caron, J., Holyfield, C., Light, J., & McNaughton, D. (2018). “What have you been doing?”: Supporting displaced talk through augmentative and alternative communication video visual scene display technology. Perspectives of the ASHA Special Interest Group, SIG 12 Vol 3 (3), 123–135.

  • *Couper, L., van der Meer, L., Schäfer, M. C., McKenzie, E., McLay, L., O’Reilly, M. F., Lancioni, G., Marschik, P., Sigafoos, J., & Sutherland, D. (2014). Comparing acquisition of and preference for manual signs, picture exchange, and speech-generating devices in nine children with autism spectrum disorder. Developmental Neurorehabilitation, 17(2), 99-109.

  • *Dundon, M., McLaughlin, T. F., Neyman, J., & Clark, A. (2013). The effects of a model, lead, and test procedure to teach correct requesting using two apps on an iPad with a 5-year-old student with autism spectrum disorder. Educational Research International, 1(3), 1-10.

  • Ganz, J. B. (2015). AAC interventions for individuals with autism spectrum disorders: State of the science and future research directions. Augmentative and Alternative Communication, 31(3), 203–214. https://doi.org/10.3109/07434618.2015.1047532

    Article  PubMed  Google Scholar 

  • *Genc-Tosun, D., & Kurt, O. (2017). Teaching multi-step requesting to children with autism spectrum disorder using systematic instruction and a speech-generating device. Augmentative and Alternative Communication, 33(4), 213-223.

  • Holyfield, C., Drager, K., Light, J., & Caron, J. G. (2017). Typical toddlers’ participation in “just-in-time” programming of vocabulary for visual scene display augmentative and alternative communication apps on mobile technology: A descriptive study. American Journal of Speech-Language Pathology, 26(3), 737–749. https://doi.org/10.1044/2017_AJSLP-15-0197

    Article  PubMed  PubMed Central  Google Scholar 

  • Holyfield, C., Drager, K. D., Kremkow, J. M., & Light, J. (2017). Systematic review of AAC intervention research for adolescents and adults with autism spectrum disorder. Augmentative and Alternative Communication, 33(4), 201–212. https://doi.org/10.1080/07434618.2017.1370495

    Article  PubMed  Google Scholar 

  • *Holyfield, C. (2021). Comparative effects of picture symbol with paired text and text-only augmentative and alternative communication representations on communication from children with autism spectrum disorder. American Journal of Speech-Language Pathology, 30(2), 584-597. https://doi.org/10.1044/2020_AJSLP-20-00099

  • 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(2), 165–179. https://doi.org/10.1177/001440290507100203

    Article  Google Scholar 

  • *Kagohara, D.M., van der Meer, L., Achmadi, D., Green, V.A., O’Reilly, M.F., Mulloy, A., Lancioni, G.E., Lang, R., & Sigafoos, J. (2010). Behavioral intervention promotes successful use of iPod-based communication device by an adolescent with autism. Clinical Case Studies, 9(5), 328-338.

  • *Kagohara, D. M., van der Meer, L., Achmadi, D., Green, V. A., O’Reilly, M. F., Lancioni, G. E., Sutherland, D., Lang, R., Marschik, P.B., & Sigafoos, J. (2012). Teaching picture naming to two adolescents with autism spectrum disorders using systematic instruction and speech-generating devices. Research in Autism Spectrum Disorders, 6, 1224- 1233.

  • *King, M. L., Takeguchi, K., Barry, S. E., Rehfeldt, R. A., Boyer, V. E., & Mathews, T. L. (2014). Evaluation of the iPad in the acquisition of requesting skills for children with autism spectrum disorder. Research in Autism Spectrum Disorders, 8, 1107–1120.

  • Ledford, J. R., & Gast, D. L. (Eds.). (2018). Single case research methodology: Applications in special education and behavioral sciences. Routledge.

  • Light, J. C., Roberts, B., Dimarco, R., & Greiner, N. (1998). Augmentative and alternative communication to support receptive and expressive communication for people with autism. Journal of Communication Disorders, 31(2), 153–180. https://doi.org/10.1016/S0021-9924(97)00087-7

    Article  CAS  PubMed  Google Scholar 

  • Light, J., McNaughton, D., Beukelman, D., Fager, S. K., Fried-Oken, M., Jakobs, T., & Jakobs, E. (2019). Challenges and opportunities in augmentative and alternative communication: Research and technology development to enhance communication and participation for individuals with complex communication needs. Augmentative and Alternative Communication, 35(1), 1–12. https://doi.org/10.1080/07434618.2018.1556732

    Article  PubMed  Google Scholar 

  • Light, J., Wilkinson, K. M., Thiessen, A., Beukelman, D. R., & Fager, S. K. (2019). Designing effective AAC displays for individuals with developmental or acquired disabilities: State of the science and future research directions. Augmentative and Alternative Communication, 35(1), 42–55. https://doi.org/10.1080/07434618.2018.1558283

    Article  PubMed  PubMed Central  Google Scholar 

  • *Lorah, E.R., & Parnell, A. (2017). Acquisition of tacting using a speech-generating device in group learning environments for preschoolers with autism. Journal of Developmental and Physical Disabilities, 29, 597-609.

  • *Lorah, E.R., Tincani, M., Dodge, J., Gilroy, S., Hickey, A., & Hantula, D. (2013). Evaluating picture exchange and the iPad as a speech-generating device to teach communication to young children with autism. Journal of Developmental and Physical Disabilities, 25, 637-649.

  • *Lorah, E.R., Crouser, J., Gilroy, S.P., Tincani, M., & Hantula, D. (2014a). Within stimulus prompting to teach symbol discrimination using an iPad speech generating device. Journal of Developmental and Physical Disabilities, 26, 335-346.

  • *Lorah, E. R., Parnell, A., & Speight, D. R. (2014b). Acquisition of sentence frame discrimination using the iPad as a speech generating device in young children with developmental disabilities. Research in Autism Spectrum Disorders, 8, 1734–1740.

  • *Lorah, E.R., Karnes, A., & Speight, D.R. (2015). The acquisition of intraverbal responding using a speech-generating device in school aged children with autism. Journal of Developmental and Physical Disabilities, 27, 557-568.

  • Lorah, E.R., Holyfield, C., Miller, J., Griffen, B., & Lindbloom, C. (2021). A systematic review of research comparing mobile technology speech-generating devices to other AAC modes with individuals with autism spectrum disorders. Journal of Developmental and Physical Disabilities, online publication, 2021https://doi.org/10.1007/s10882-021-09803-y

  • *Lorah, E. R. (2018). Evaluating the iPad Mini as a speech-generating device in the acquisition of a discriminative mand repertoire for young children with autism. Focus on Autism & Other Developmental Disabilities, 33, 47–54.

  • *McLay, L., van der Meer, L., Schäfer, M.C., Couper, L., McKenzie, E., O’Reilly, M.F., Lancioni, G.E., Marschik, P.B., Sigafoos, J. & Sutherland, D. (2015). Comparing acquisition, generalization, maintenance, and preference across three AAC options in four children with autism spectrum disorder. Journal of Developmental and Physical Disabilities, 27, 323-339.

  • *McLay, L., Schäfer, M. C., van der Meer, L., Couper, L., McKenzie, E., O’Reilly, M.F., Lancioni, G.E., Marschik, P.B., Sigafoos, J. & Sutherland, D. (2017). Acquisition, preference and follow-up comparison across three AAC modalities taught to two children with autism spectrum disorder. International Journal of Disability, Development and Education, 64(2), 117-130.

  • McNaughton, D., & Light, J. (2013). The iPad and mobile technology revolution: Benefits and challenges for individuals who require augmentative and alternative communication. Augmentative and Alternative Communication, 29(2), 107–116.

    Article  PubMed  Google Scholar 

  • *Meeks, J.H. (2017). Using an Apple iPad and communication application to increase communication in students with autism spectrum disorder. Georgia Educational Researcher, 14(1), 159-193.

  • *van der Meer, L., Sutherland, D., O’Reilly, M. F., Lancioni, G. E., & Sigafoos, J. (2012). A further comparison of manual signing, picture exchange, and speech-generating devices as communication modes for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 6, 1247–1257.

  • *van der Meer, L., Kagohara, D., Roche, L., Sutherland, D., Balandin, S., Green, V. A., O’Reilly, M.F., Lancioni, G.E., Marschik, P.B. & Sigafoos, J. (2013). Teaching multi-step requesting and social communication to two children with autism spectrum disorders with three AAC options. Augmentative and Alternative Communication, 29, 222-234.

  • Mirenda, P. (2003). Toward a functional and augmentative and alternative communication for students with autism: Manual signs, graphic symbols, and voice output communication aids. Learning, Speech, and Hearing Services in Schools, 34, 203–216.

    Article  Google Scholar 

  • *Nepo, K., Tincani, M., Axelrod, S., & Meszaros, L. (2017). iPod Touch® to increase functional communication of adults with autism spectrum disorder and significant intellectual. Focus on Autism and Other Developmental Disabilities, 32, 209-217.

  • Page, M. J., Moher, D., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hrobjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S. M., & J.E. (2021a). The PRISMA 2020 explanation and elaboration: Updated guidance and exemplars for reporting systematic reviews. British Medical Journal, 372(160), 1–36. https://doi.org/10.1136/bmj.n71

    Article  Google Scholar 

  • Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., et al. (2021b). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71

  • *Roche, L., Sigafoos, J., Lancioni, G. E., O’Reilly, M. F., Schlosser, R. W., Stevens, M., van der Meer, L., Achmadi, D., Kagohara, D., James, R., Carnett, A., Hodis, F., Green, V.A., Sutherland, D., Lang, R., Rispoli, M., Machalicek, W, & Marschik, P.B. (2014). An evaluation of speech production in two boys with neurodevelopmental disorders who received communication intervention with a speech-generating device. International Journal of Developmental Neuroscience, 38, 10-16.

  • Schlosser, R. W., & Wendt, O. (2008). Effects of augmentative and alternative communication intervention on speech production in children with autism: A systematic review. American Journal of Speech-Language Pathology, 17(3), 212–230. https://doi.org/10.1044/1058-0360(2008/021)

    Article  PubMed  Google Scholar 

  • Schlosser, R. W., Wendt, O., & Sigafoos, J. (2007). Not all systematic reviews are created equal: Considerations for appraisal. Evidence-Based Communication Assessment and Intervention, 1(3), 138–150. https://doi.org/10.1080/17489530701560831

    Article  Google Scholar 

  • *Schlosser, R.W., Sigafoos, J., Luiselli, J.K., Angermeier, K., Harasymowyz, U., Schooley, K., & Belfoire, P.J. (2007a). Effects of synthetic speech output on requesting and natural speech production in children with autism: A preliminary study. Research in Autism Spectrum Disorders, 1(2007), 139-163.

  • *Shillingsburg, A., Marya, V., Bartlett, B., Thompson, T., & Walters, D. (2019). Teaching children with autism spectrum disorder to report past behavior with the use of a speech-generating device. The Analysis of Verbal Behavior, 35(2), 258-269.

  • *Sigafoos, J., Lancioni, G. E., O’Reilly, M. F., Achmadi, D., Stevens, M., Roche, L., Kagohara, D.M., van der Meer, L., Sutherland, D., Lang, R., Marschik, P. B., McLay, L., Hodis, F., & Green, V.A. (2013). Teaching two boys with autism spectrum disorders to request the continuation of toy play using an iPad®-based speech-generating device. Research in Autism Spectrum Disorders, 7, 923-930.

  • Skinner, B.F. (1957). Verbal Behavior. Appleton-Century-Crofts.

  • Steinbrenner, J. R., Hume, K., Odom, S. L., Morin, K. L., Nowell, S. W., Tomaszewski, B., Szendrey, S., McIntyre, N. S., Yücesoy-Özkan, S., & Savage, M. N. (2020). Evidence-Based Practices for Children, Youth, and Young Adults with Autism. The University of North Carolina at Chapel Hill, Frank Porter Graham Child Development Institute, National Clearinghouse on Autism Evidence and Practice Review Team.

  • *Stephenson, J. (2016). Using the Choiceboard Creator™ app on an iPad© to teach choice making to a student with severe disabilities. Augmentative and Alternative Communication, 32(1), 49-57.

  • *Strasberger, S. K., & Ferreri, S. J. (2014). The effects of peer assisted communication application training on the communicative and social behaviors of children with autism. Journal of Developmental and Physical Disabilities, 26(5), 513-526.

  • *Tan, P., & Alant, E. (2018). Using peer-mediated instruction to support communication involving a student with autism during mathematics activities: A case study. Assistive Technology, 30(1), 9-15.

  • *Therrien, M. C., & Light, J. C. (2018). Promoting peer interaction for preschool children with complex communication needs and autism spectrum disorder. American Journal of Speech-Language Pathology, 27(1), 207-221.

  • *Trottier, N., Kamp, L., & Mirenda, P.A.T. (2011). Effects of peer-mediated instruction to teach use of speech-generating devices to students with autism in social game routines. Augmentative and Alternative Communication, 27(1), 26-39.

  • van der Meer, L. A., & Rispoli, M. (2010). Communication interventions involving speech-generating devices for children with autism: A review of the literature. Developmental Neurorehabilitation, 13, 294–306.

    Article  PubMed  Google Scholar 

  • *Waddington, H., Sigafoos, J., Lancioni, G. E., O’Reilly, M. F., van der Meer, L., Carnett, A., Stevens, M., Roche, L., Hodis, F., Green, V.A., Sutherland, D., Lang, R., & Marschik, P.B. (2014). Three children with autism spectrum disorder learn to perform a three-step communication sequence using an iPad-based speech-generating device. International Journal of Developmental Neuroscience, 39, 59-67.

  • *Waddington, H., van der Meer, L., Carnett, A., & Sigafoos, J. (2017). Teaching a child with ASD to approach communication partners and use a speech-generating device across settings: Clinic, school, and home. Canadian Journal of School Psychology, 32, 228–243.

  • *Ward, M., McLaughlin, T. F., Neyman, J., & Clark, A. (2013). Use of an iPad application as functional communication for a five-year-old preschool student with autism spectrum disorder. International Journal of English & Education, 4, 231–238.

  • *Xin, J. F., & Leonard, D. A. (2015). Using iPads to teach communication skills of students with autism. Journal of Autism and Developmental Disorders, 45(12), 4154-4164.

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Correspondence to Elizabeth R. Lorah.

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Lorah, E.R., Holyfield, C., Griffen, B. et al. A Systematic Review of Evidence-based Instruction for Individuals with Autism Using Mobile Augmentative and Alternative Communication Technology. Rev J Autism Dev Disord 11, 210–224 (2024). https://doi.org/10.1007/s40489-022-00334-6

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