Topics in AAC, Part 1

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We know that the AAC world is full of deeply entrenched myths, common practices without strong evidence bases, controversial methods, and disagreements between professionals with different beliefs, backgrounds, and theoretical orientations. In this course, we’ve put together some of the best, recent, clinically-relevant research to help you work through some of that thorny tangle. Whether you’re an AAC specialist, a newbie, or somewhere in between, the newest research is your friend. It can fill in the gaps in your knowledge, make you reconsider an aspect of your current practice, or help a parent, coworker, or administrator understand your methods. 

We start off with a set of reviews that look broadly at principles behind intervention with children who use AAC. The papers discussed here are mostly systematic reviews or meta-analyses that compile all the recent, relevant, quality research on a topic to look for overlapping findings and areas of consensus. Topics include aided language input (AKA modeling, ALgS, and an assortment of other names), increasing communicative functions “beyond requesting” in children with autism who use AAC, and interventions that incorporate AAC and Functional Communication Training to replace unwanted behavior with more formal communication. Some of these articles are great “back pocket” papers that may be useful for you in the future. We see a lot of clinicians seeking published evidence behind their practices—you know what you’re doing is good practice, but just don’t have the citations to hand. These are the types of articles you’re looking for!

Next, we’ve included a few reviews that look specifically at assessment-related issues. Have you considered evaluating narrative abilities with your AAC users? Thought about how you could collect a valid language sample through the data-collection feature in many devices? Used dynamic assessment to help you evaluate syntactic ability? If not yet—get ready! 

The final group of reviews look at issues related to system selection and design, including vocabulary selection, the possible role for visual scene displays with older emergent communicators, and more. This isn’t a comprehensive guide to feature matching, and it won’t tell you what system is “best,” but it can help inform your mental pro/con list when you’re in the process.

Something you won’t read a lot about here? Interventions in the form of communication partner training, where the SLP works directly with peers or adults to help them support the AAC learner in their everyday environments. But why?—you say—That sounds like great stuff! It totally is. So great that we made a whole Part Two of this course devoted just to that idea. Head on over there if you’re interested in a deeper dive.  


Using a child’s AAC device to instruct them on AAC

“Augmented input” is when the clinician or communication partner uses the child’s AAC system to communicate with the child (aka: aided language stimulation, aided language modeling, aided AAC modeling… not perfect synonyms, but all meaning nearly the same thing).

So, what do we know about the impact of augmented input? This article reviews data from many studies to examine both receptive and expressive outcomes (from kids ages 2–25; wide variety of disorders and communication abilities). Findings indicate that, “…augmented input can improve single-word vocabulary skills and expression of multi-symbol utterances…”.

Additional important points from this study:

  1. The authors discuss how, though plenty of data show that augmented input supports expressive skill acquisition, we know very little about whether it supports comprehension, with some studies on receptive vocabulary but not receptive syntax. The authors state, “Remarkably, there is not yet evidence regarding the effect of augmented input on receptive syntax skills…” Overall, “… receptive skills are an overlooked outcome of AAC interventions…” (by both clinicians and researchers) and, “The uneven focus on output over input among AAC clinicians (Trudeau et al., 2014) means that children from any diagnostic population who use AAC are at risk for receptive grammar deficits (Binger & Light, 2008).”

  2. Not all versions of augmented input are identical. If you’re looking to the literature to replicate techniques, the two with the strongest evidence are: AAC modeling and Aided Language Modeling (ALM). These have “well-defined dosages”, too. For example, from AAC modeling studies, “… at least 30 models should be provided in a 15-min session (Binger & Light, 2007).” Also, ALM studies have shown that, “…when combining symbols or pointing to referents, there should be no more than a 2-s delay (Drager et al., 2006).”

Allen, A.A, Schlosser, R.W., Brock, K.L., Shane, H.C. (2017). The effectiveness of aided augmented input techniques for persons with developmental disabilities: a systematic review. Augmentative and Alternative Communication. doi: 10.1080/07434618.2017.1338752.

Modeling AAC is an evidence-based practice (officially)

Before you say anything— we know. This is an obvious fact to anyone who’s been paying attention in the AAC world for quite some time. However, there are still times when it’s helpful to have clear, scientific evidence to share with those who aren’t, shall we say, on board. Evidence like a recent systematic review, for instance? Voilà!

This new study synthesized the available research on direct teaching strategies** that support symbol learning and aided language expression for AAC users, and found four strategies they identify as “potentially effective.” They looked at 15 studies that met their criteria for participants, intervention type, outcome measures, and study quality.

Important noteThey specifically did not look at AAC users with autism.  The studies in the review included children up to age 18, with better receptive than expressive language, and “no more than a moderate intellectual disability.” The most frequent diagnoses represented were cerebral palsy and Down Syndrome.

These four strategies were supported by the evidence:

  1. Aided AAC modeling (8 studies)

  2. Narrative-based interventions (4 studies, limited by small number of participants and variation among studies)

  3. An “eclectic” approach, including increased communication opportunities, modeling, and least-to-most prompting (1 study)

  4. Mand–Model (2 studies) E.g., Child is interested in a ball. Clinician models, “That’s a BALL.” Prompts child to say “Ball,” possibly using a cueing hierarchy. Child gets the ball.

A few things to keep in mind: First, these strategies are not mutually exclusive, and overlap to some degree; they all include some aspect of modeling. Second, we can’t say anything at this point about whether one of these methods is more effective than another, and it could be that certain strategies might work better at specific stages (when a device is first introduced, for example, to teach a specific language skill, or with a very young child). Finally, it’s pretty tricky to make comparisons between studies, since so many different terms can be used for the same, or similar, procedures (modeling, aided language input, aided language stimulation, etc.). Different people define these procedures in different ways—a fixed ratio of statements to questions, for example, or a minimum expectation of how many utterances are also modeled on the device.

Fun Fact! Did you know that there’s a rule of thumb to determine if an intervention can be *officially* considered evidence-based, on the basis of single-subject or small studies? Horner et al. (2005) say you want to find:

  • At least five peer-reviewed studies (well-designed ones!)

  • By at least three different people

  • In at least three geographic locations

  • With at least 20 subjects total

Based on these criteria, and the findings of the review, aided AAC modeling is an evidence-based practice. There wasn’t enough evidence available for the narrative-based, eclectic, or mand–model strategies to meet this threshold.

For systematic review articles like this one, the gold for clinicians is often the big ol’ summary table(Table 1). It’s a quick way to see which of the included studies are directly relevant to YOU, by breaking out details like who the participants were, the AAC systems they used, the type and dosage of the intervention, and the outcome measures. Plus, the authors have already screened these studies for quality, which can be reassuring if you aren’t super confident about assessing this yourself. If you want to learn more about specific intervention procedures for specific clients, this paper has done your searching for you.

**So—not things like communication partner training, which is also good.

Lynch, Y., McCleary, M., & Smith, M. (2018). Instructional strategies used in direct AAC interventions with children to support graphic symbol learning: A systematic review. Child Language Teaching and Therapy. doi: 10.1177/0265659018755524.

Autism and AAC: moving beyond object requesting

Many SLPs who’ve spent time working with children with autism who use AAC know that these children often have a particular strength in learning object requests. This communicative function actually represents the bulk of research on AAC and autism to date, as well (as if we need more help with teaching that...)

However, many SLPs get stuck when it’s time to move beyond requesting objects. What should be taught next? How? And what have the outcomes been for teaching the other various communicative functions?
This review article examines the research literature to-date, and identified 30 relevant studies that touch on these questions (that tells you just how little research has been done on this! Yikes!)Here are some highlights of what they found:

The communication functions targeted in the studies (other than object requesting) included: requests for action, protests, requests for social routines, greetings, calls, acknowledgments (which was mostly answering wh questions), comments, and requests for information.

  • Across studies, they found that, “all targeted communication functions improved to some extent.”

  • About half of the studies measured generalization, “all demonstrating it to some degree” (doesn’t that just scream publication bias?)

Because of the relatively small number of studies, not a ton can be concluded from this review. The authors suggest building on the strengths of children with autism by capitalizing on what they’re good at (e.g object requesting), but “…directing these towards more socially oriented outcomes (e.g. requests for social games/routines)…”. The authors also suggest that clinicians consider, “…the application of ABA principles in naturalistic contexts…”, which is a common theme among intervention studies published.
Note that one of the most clinically-useful parts of this review is their summary table, where they highlight each of the studies included in the review, and you can quickly scan it to look for samples and methods that match what you're interested in. This is great, because even though the review doesn’t give you explicit strategies for instruction, many of the individual articles will, and this gives you a quick and easy way to identify them.
Logan, K., Iacono, T., & Trembath, D. (2017). A systematic review of research into aided AAC to increase social-communication functions in children with autism spectrum disorder. Augmentative and Alternative Communication. doi: 10.1080/07434618.2016.1267795.

O’Neill et al.’s meta-analysis reminds us that interventions that include aided input have been highly effective in improving expression and comprehension among people who use AAC. The majority of participants in studies included in the meta-analysis were preschool- or elementary-aged children with developmental disabilities.

O’Neill, T., Light, J., & Pope, L. (2018). Effects of Interventions That Include Aided Augmentative and Alternative Communication Input on the Communication of Individuals with Complex Communication Needs: A Meta-Analysis. Journal of Speech, Language, and Hearing Research. doi: 10.1044/2018_JSLHR-L-17-0132.


Problem behavior sending a message? Replace it with communication

We know that behavior is a form of communication, and that inadequate communication skills and problem behavior go hand-in-hand. This holds true for typically-developing toddlers (just ask any parent!) and also for individuals with communication disabilities, who may have had years (or decades) to develop disruptive, destructive, or dangerous behavior patterns. These are tough students, and tough situations, but also can be some of the most rewarding— when we can help a client learn a new way to communicate what they could only say through behavior.


A well-known intervention for doing just this is Functional Communication Training—an approach where you study the behavior to learn its function (generally by doing a functional behavioral assessment, or FBA; you may call these ABCs or some other fun acronym), and systematically teach a new, more socially-acceptable way to communicate that message. Instead of head-banging to escape challenging academic tasks, maybe the student can ask for help or a break instead. Sounds obvious, but the trick is in getting everyone to recognize the communication behind the behaviors and follow through with prompting and reinforcing the replacement. This is why we advocate!

This new systematic review of FCT intervention studies specifically targeted situations where FCT was used in schools, with AAC in the mix. They found 17 studies that met the eligibility and quality guidelines. Subjects were school-aged and had a range of disabilities. Overall, FCT resulted in less problem behavior and more AAC use, with large effect sizes*. The authors found that larger effects were seen with less intense behavior, and that destructive behaviors may simply take more time to eliminate. They also noticed that FCT tended to be more effective in inclusive school settings (more integration with students without disabilities) and that interventions informed by descriptive, rather than experimental, FBAs had better results. This last point is interesting; less-rigorous FBAs carried out by regular school personnel may be as good, or better, in these situations than the type you might hire an outside specialist to perform.

A range of different specific strategies (how communication was prompted and reinforced, etc.) seemed to be effective, so a student-centered approach, where you develop the intervention protocol with the individual in mind, looks like the way to go. The authors also include some helpful references for readers who need specifics on implementing FCT.

*This is great, but remember publication bias. It’s less likely that someone would write up and publish a case study of an intervention that didn’t do anything.

Walker, V.L., Lyon, K.J., Loman, S.L.  & Sennott, S. (2018). A systematic review of Functional Communication Training (FCT) interventions involving augmentative and alternative communication in school settings. Augmentative and Alternative Communication. doi: 10.1080/07434618.2018.1461240.


Language sampling in children who use AAC

Ever tried to take a language sample with a child who uses AAC? You probably experienced a few challenges along the way. Read on for how to address two major challenges of language sample analysis with children who use SGDs (speech generating devices).

Challenge #1: Obtaining a valid and representative language sample. Twins who use SGDs participated in this study. Researchers had access to existing language data collected automatically by the participants’ SGDs across multiple years, at 7;3 years old and also age 8;5–12;5.

The researchers found that a one-day sample window did not provide enough utterances for analysis. A one-month sample window consistently provided a sample of more than 50 multimorpheme utterances needed for analysis. For children who use AAC, if the target is 50 multimorpheme utterances, you may need to adjust the length of your current sample window in order to obtain a representative sample using data tracked automatically by the SGD.

Challenge #2: Transcribing short utterances out of context. If you have a string of single-morpheme noun utterances, and no context for the conversation, it can be difficult to interpret where one utterance begins and another ends. Enter: Mean Syntactic Length (MSL). MSL is the average number of morphemes per utterance, excluding one-morpheme utterances. Kovacs and Hill propose using MLUm (mean length of utterance in morphemes) when the context is known; however, MSL appears to have promise for decontextualized samples. Take a look at Figure 2 in the study for a list of rules to assist you when calculating MSL. 

Note: This is a small study, not meant to prescribe what to do broadly, for children who use AAC. Rather, it provides clinicians with some evidence-based options to consider within their clinical practice.

Kovacs, T., & Hill, K. (2017). Language samples from children who use speech-generating devices: Making sense of small samples and utterance length. American Journal of Speech–Language Pathology. doi: 10.1044/2017_AJSLP-16-0114.

Narrative skills of children who use AAC

Telling stories is an important social skill, and one that may be challenging for children who use AAC. This study looked atstories told by 8- to 15-year-old children who use AAC with the support of a familiar communication partner. Children watched short, wordless videos that featured some sort of problem (like a person slipping on a banana peel) and then explained the story to someone who hadn’t seen it. Overall, children who used AAC produced narratives that were shorter and contained fewer important elements than those of same-age speaking peers, although “[t]opic maintenance and setting or character descriptions” were relative areas of strength. Communication partners typically elaborated on what children were saying without taking over the interaction, and there were no significant differences in story quality between types of communication partners (peers, parents, and professionals).

Some implications of the study:

  • Think about using narrative tasks to assess the ease and complexity of communication for children who use AAC—and remember to teach narrative structure, too!

  • Observe interactions with peers, parents, teachers, or other familiar communication partners to see how their assistance affects the child’s communication. You could also see what functions the partner is taking on—filling in details, compensating for lack of available vocabulary, etc.—and target those areas to increase independence.

Note that all children in this study had cerebral palsy and good receptive language and cognitive abilities per teacher report; it’s not clear how these findings would apply to children with different language and cognitive profiles.

Smith, M. M., Batorowicz, B., Dahlgren Sandberg, A., Murray, J., Stadskleiv, K., van Balkom, H., Neuvonen, K., & von Tetzchner, S. (2018). Constructing narratives to describe video events using aided communication. Augmentative and Alternative Communication. doi: 10.1080/07434618.2017.1422018.

AAC assessment and intervention for preschoolers with severe speech impairment

This review covers two research papers in one, from the same research group and measuring the same students; the first paper on dynamic assessment of AAC users, and the second paper on intervention for AAC users.

In both studies, the participants were 10 three–four-year-old children with receptive language within normal limits, but severe speech impairment (< 50% intelligible). The children were provided an iPad with Proloquo2Go to use for AAC.

Study #1 (Dynamic Assessment):

Dynamic assessment “uses a teach-test approach”, as opposed to static assessment, which simply tests the child’s current skill set. The researchers state, “… using DA may enable clinicians to improve their ability to predict when children are ready to focus on early syntax when using AAC.”

For the DA procedure, the researchers assessed as much as they could of the following four targets:

  • agent-action-object (e.g. “Pig chase cow.”)

  • possessor-entity (e.g. “Pig plate.”)

  • entity-locative (e.g. “Pig under trash.”)

  • entity-attribute (e.g. “Pig is happy.”)

First, using graduated prompting, they provided the student with increasing support as needed (e.g. moving from “Tell me about this one.” “Look… Lion in car… now tell me about this one (target = Pig under trash.) “See, pig is under the trash. Now you tell me.” “Tell me pig is under the trash. Pig under trash.”). Also, note that the only grammatical marker required to be used by the children during DA was “is” in the entity-attribute sentences. All the others—“IS, THE, possessive –‘s, and third person singular –s… were included as independent symbols,” but weren’t required to be produced by the children within DA (that came later, in intervention). Vocabulary targeted was all within the children’s receptive vocabulary; a full list of the vocabulary, plus pictures of how they arranged and labeled vocabulary within Proloquo2Go is in the article appendices. Toys, puppets, and figurines were used to demonstrate the target sentences. Ten trials per target (e.g. 10 possessor–entity sentences) were administered.

The researchers found that, not only were the young children able to participate in the DA, but they even learned some expressive syntax types within DA as well. There was some variability in which sentence structure types were difficult for individual children, however, emphasizing that, “… a broad range of targets must be investigated before concluding that a child is not capable of creating rule-based utterances when using graphic symbols to communicate.” Thus, it’s not adequate to test just one or two short sentence types when trying to decide if a child is ready to work on multi-word sentences.

Study #2 (Intervention):

The same 10 children (above) participated in intervention as well. The same four targets (above), with each intervention session focused on one of the four targets. Activities included:

concentrated modeling

  • Ten sentence pairs of one sentence type served as targets, and were “designed to highlight key features of the target”. For example, one pair was “Pig in car” vs. “Pig under car”. The clinician would teach this by first saying Pig is under the car, while acting it out with toys, then providing augmented input on the child’s device. Next, the clinician would repeat the process with the contrasted sentence (Pig under car).

play (20 minutes)

  • After concentrated modeling, they switched to play-based instruction, which was more child-led, but still included adult instruction—“For example, for entity–locative, the examiner could make Cow hide her eyes, place Penguin under the trash can, and then ask the child to tell Cow where Penguin was (Penguin under trash).”

  • Features of the play session included “setting up opportunities for communication… providing spoken and aided models of the target using a range of exemplars… providing indirect and direct spoken prompts… assisting with message productions…”

Results showed that, “the majority of the participants mastered the majority of the targets and did so quickly.” Possessor-entity sentences were the easiest; agent-action-object were the most difficult. The researchers also found that students generalized the new syntactic structures with novel vocabulary, as well.

A really interesting part of the study was that, “nine participants spontaneously used the possessive marker accurately at least once with no aided models provided…”. Only four of the ten students were explicitly taught the grammatical markers (IS, THE, possessive –‘s, and third person singular –s) and these students, “…required only one or two intervention sessions to demonstrate consistent use of the markers.”

Binger, C., Kent-Walsh, J., & King, M. (2017). Dynamic assessment for 3- and 4-year-old children who use augmentative and alternative communication: evaluating expressive syntax. Journal of Speech, Language, and Hearing Research. doi: 10.1044/2017_JSLHR-L-15-0269.

Binger, C., Kent-Walsh, J., King, M., & Mansfield, L. (2017). Early sentence productions of 3- and 4-year-old children who use augmentative and alternative communication. Journal of Speech, Language, and Hearing Research. doi: 10.1044/2017_JSLHR-L-15-0408.


Choosing words for preschoolers who use AAC

A preschooler on your caseload just received a new AAC device. You’re excited, motivated, and eager to get started! You know that the child will only benefit if appropriate vocabulary is available, but you have no idea where to begin. If only there was one comprehensive tool to assist with vocabulary selection for preschoolers who require AAC...

In this project, the authors describe two studies designed to address the challenges of vocabulary selection and develop an effective vocabulary selection tool for preschoolers who use AAC. First things first—why is this such a challenge? In order to be effective, vocabulary must be meaningfulmotivatingfunctionalindividualizedappropriate to child’s agegenderbackgroundpersonality, and environment, and must support a broad range of communicative functions. That’s A LOT to think about.

The authors first needed to know, “What do preschoolers talk about?” They found that, during normal activities, most typically developing preschoolers used a limited number of words most of the time (i.e., the 250 most frequently occurring words accounted for 89% of the total sample); however, they talked about a WIDE variety of topics, using both structure (e.g., conjunctions and prepositions) and content words (e.g., nouns and verbs). With this in mind, the authors emphasized the importance of including core AND fringe words in children’s systems.

The authors then developed and field-tested a vocabulary selection questionnaire with multiple informants (parents, teachers, SLPs, etc.). They found that all informants contributed unique vocabulary, but parents contributed more unique vocabulary than anyone else. There was also a lot of overlap among the informants’ responses, suggesting that a more efficient use of the questionnaire may be ONE questionnaire passed among the multiple informants.

The take-away? This questionnaire may be an effective and efficient vocabulary selection tool to use with preschoolers who use AAC. BUT, this is only the first step of a dynamic process. SLPs need to continually review whether the available vocabulary is meeting the child’s daily communication needs.

But what about older individuals who use AAC? You could use this questionnaire as a template and make modifications to meet the needs of those individuals—including age-appropriate categories and vocabulary.

Disclosure: Kelsey Mandak, author of this review, is affiliated with the institution where this research study was completed, as a doctoral student and as an advisee of the second author.

Fallon, K. A., Light, J. C., Paige, T. K., (2001). Enhancing vocabulary selection for preschoolers who require augmentative and alternative communication (AAC). American Journal of Speech–Language Pathology. doi: 10.1044/1058-0360(2001/010).

Thinking outside the box(es) for older beginning communicators

Unfortunate but true: Despite the advances our field has seen in AAC awareness, knowledge, and technologies, too many children with complex communication needs remain “emergent” or “pre-symbolic” communicators into adolescence and beyond. Older beginning communicators encounter huge restrictions to their participation across environments. There are lots of reasons for this, and many individual factors at play, but it’s definitely a problem.

The authors of this study argue that some part of this skill gap—and one reason that gains from AAC interventions with this population have been modest—is that the available high-tech AAC options have just been too cumbersome: difficult and slow to program, with high cognitive, linguistic, and motoric demands for the user. They suggest a different approach, now possible thanks to evolving technology: visual scene displays (VSDs), based on photographs snapped by device’s onboard cameras, programmed “just-in-time” with voice-output hotspots. And yes, “just-in-time” means “you’re programming hotspots right then and there during the interaction.” Remember that the next level up from “emergent” communicator is “context-dependent.” These technologies are intended to help learners make that leap, by giving them quick and easy access to that context, right when it’s relevant.

The researchers used a tablet and mobile app* with these features during high-interest leisure activities with 9–18 year-old beginning communicators. During the activity, a communication partner snapped a picture and programmed in a couple of relevant hotspots. (By the way, they say they needed only 25 SECONDS to program a VSD with two hotspots.) The article has some great descriptions of how the interactions were structured and how the partners chose what to program. Compared to a baseline condition (using the participants’ current AAC systems), the beginning communicators averaged over 20 additional conversational turns within 15 minutes using the just-in-time approach.

What was the magic ingredient here? There are a number of possibilities, but the authors highlight a few:

  • Access to the immediate context of the activity

  • Potential advantages of using photographs vs. symbols

  • Contextualized vocabulary, for a reduced cognitive demand

  • Use of mainstream technology (tablets)

*The specific mobile app they used, EasyVSD, is not commercially available, but Snap Scene is based on the same technology.

Holyfield, C., Caron, J. G., Drager, K., & Light, J. (2018). Effect of mobile technology featuring visual scene displays and just-in-time programming on communication turns by preadolescent and adolescent beginning communicators. International Journal of Speech-Language Pathology. doi: 10.1080/17549507.2018.1441440.

Vocabulary to assist AAC users in expressing pain

How many times have you been in an IEP meeting with the parent of a minimally-verbal child, who says, “I just want him to be able to tell me when he’s hurting…”? And you want to cry, because—goodness sakes—every kid needs to be able to tell someone when they're hurting!


The authors of this study help tackle this very issue. They recruited nearly 200 participants (children, parents, teachers, and adult AAC users) to respond to hypothetical situations designed to elicit pain responses (e.g. having a medical procedure, or running into a thorn bush). The authors took the resultant language, compiled a list of the most frequently-occurring pain-related words and phrases, then divided these into descriptive categories and subcategories to analyze target types (e.g. vocabulary to describe pain, to direct others’ actions, to describe pain location, etc.). The result is a list of core and fringe vocabulary most likely needed for a young AAC user to communicate pain.
Now—before you head straight for the list—note that it was compiled from participants in South Africa. The study was done in English, but cultural differences make it impossible to simply take the list and apply it to your caseload if you're not working in South Africa. For example, an American child says “band-aid”, whereas the list calls it a “plaster”. And there are non-English words in there, too, such as “Eina” (the Afrikaans word for ‘ouch’).
Nonetheless, the cultural differences do not entirely limit the utility for readers from other English-speaking countries. First, this study provides a strategy for collecting data in order to inform AAC programming. Their data confirmed that children and adults use different words to describe pain. Thus, it’s not appropriate for an SLP to rely upon input only from adults when programming devices. Second, you’ll find the categories and subcategories quite useful for ensuring that you’re considering all types of communication inherent to these situations.
Readers may be wondering why these types of words aren’t already in more devices. The authors predict it may be because, “... activities that were unlikely to result in painful experiences" were used to collect data for programming these devices. And—suddenly—you imagine other communication scenarios, too, that may be missing from your students' devices.

Johnson, E., Bornman, J., & Tönsing K.M. (2016) An exploration of pain-related vocabulary: implications for AAC use in children. Augmentative and Alternative Communication. doi: 10.1080/07434618.2016.1233998.

A bit more! 

Dada et al. analyzed the reactions of 9- to 12-year-old children watching videos of a child using an iPad w/ Proloquo2Go vs. a low-tech communication board. The children had a more positive attitude toward the user of the higher-tech AAC, and generally viewed this child as more communicatively competent.  

Dada, S., Horn, T., Samuels, A., & Schlosser, R.W. (2016). Children's attitudes toward interaction with an unfamiliar peer with complex communication needs: comparing high- and low-technology devices. Augmentative and Alternative Communication. doi: 10.1080/07434618.2016.1216597.

Thistle et al. found that preschoolers without disabilities selected symbols on AAC display more quickly when the locations were consistent, rather than variable. The authors remind us that we need to replicate these findings with children with disabilities, but in the meantime the study provides evidence we can use to remind our co-workers about the importance of consistency in motor learning. 

Thistle, J. J., Holmes, S. A., Horn, M. M., & Reum, A. M. (2018). Consistent Symbol Location Affects Motor Learning in Preschoolers Without Disabilities: Implications for Designing Augmentative and Alternative Communication Displays. American Journal of Speech-Language Pathology. doi:10.1044/2018_AJSLP-17-0129.

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