Throwback (2015): AAC and verbal speech–language therapy: a perfect multimodal pairing?

We all know that teaching minimally verbal children with ASD to use AAC doesn’t equate to giving up on spoken communication, but sometimes it feels that way. And to many parents, shifting all of our efforts to teaching a new mode of communication looks like we are waving a white flag. But what if, rather than choosing only one modality to focus on, there was a way to integrate spoken language and AAC instruction into one multimodal intervention to improve speech and language outcomes? And what if we had clear indicators of which children would respond well to this? That’s what these researchers aimed to explore. 

In this pilot study, the researchers targeted both high-tech AAC use and spoken language for 10 children with ASD ages 6­–11 who used fewer than 20 spoken words spontaneously. The intervention consisted of choosing 30 target words and practicing them in the following ways:

  • massed trial speech sound practice,

    i.e. providing models, physical prompts, and corrective feedback for specific speech sounds within the target words

  • joint book reading,

    i.e. reading books that included the target words and using cloze prompts to elicit productions

  • interactive routines with embedded AAC,

    i.e. modeling and encouraging production of target words on the child’s AAC device within a fun activity

  • and receptive matching trials

    i.e. completing multiple choice target word comprehension questions on a computer


And exciting news–the researchers found strong results! These minimally verbal school-age children with ASD learned to say new words over the course of the intervention. The children who responded best to the intervention were (no surprises here) those who at baseline communicated intentionally and frequently, had larger consonant inventories, and had higher verbal and oral imitation abilities. Rather than needing to choose either spoken or AAC, these researchers are finding promising results that incorporating both spoken and AAC modalities into intervention may lead to the best speech and communication outcomes for our students.

For further descriptions of intervention activities and their process for choosing target words, check out the full article!

Brady, N. C., Storkel, H. L., Bushnell, P., Barker, R. M., Saunders, K., Daniels, D., & Fleming, K. (2015). Investigating a multimodal intervention for children with limited expressive vocabularies associated with autism. American Journal of Speech-Language Pathology, 24(3), 438–459.