Session 4: Augmentative and Alternative Communication
Augmentative and Alternative Communication (AAC) Intervention Research and Young Children with Down Syndrome: Exploring Opportunities
MaryAnn Romski, Regents Professor of Communication, Psychology, and Communication Sciences & Disorders; Rose A. Sevcik
Georgia State University, Atlanta, GA USA
Contact: Maryann Romski mromski@gsu.edu
Young children with Down syndrome (DS) present with speech and language impairments very early in childhood. Historically, early language intervention for children with DS often included unaided augmentative and alternative communication (AAC) interventions in the form of manual signs. Recently, there also has been interest in the use of aided AAC (i.e., speech-generating devices (SGDs)) with young children with DS. This keynote presentation offers an overview of the research literature on the inclusion of a range of unaided and aided AAC interventions for young children with DS. It highlights how SGD interventions do not hinder the children's spoken vocabulary development and can facilitate the communication abilities of young children with DS as they are emerging spoken communicators. Implications for practice are discussed.
Staff perceptions and experiences' of using key word signing with children with Down syndrome and their peers, in the first year of mainstream primary education.
Department of Speech and Hearing Sciences, University College Cork, Republic of Ireland.1
Norma O' Leary1, https://orcid.org/0009-0002-7084-9862
Caoimhe Lyons1
Pauline Frizelle, PhD1, https://orcid.org/0000-0002-9715-3788
Corresponding author: P.Frizelle@ucc.ie
Background: Lámh is a Key Word Signing system which can be used to support the communication needs of children with Down Syndrome (DS) who attend mainstream school. However, the success of using Lámh in schools is mediated by staff experiences and perceptions of key word signing.
Aim: The current study aimed to explore the perceptions and experiences of teachers and Special Needs Assistants (SNAs), using Lámh with children with DS and their peers, in the first year of mainstream primary school. Secondly, we aimed to explore how those perceptions and experiences evolved throughout the year.
Method: Five mainstream schools were recruited where children with DS attended. An SLT taught twenty-five Lámh signs to the relevant class in each school at four time points across the year. Five teachers and 8 SNAs from participating schools were interviewed about their perceptions / experiences of using Lámh over the course of the year. Data were analysed using inductive qualitative content analysis.
Results: Four categories were generated from the data: Challenges, Facilitators, Benefits, and Incorporation into Whole School Environment. Findings suggest that the supported introduction of Lámh in schools can assist inclusive educational practices; facilitate children's comprehension and expression; reduce frustration in children with DS; and facilitate interaction with peers. Results also indicate an increasingly positive attitude, among teachers and SNAs, towards Lámh as the year progressed.
Teachers reported the absence of a pedagogical framework as an obstacle to the integration of Lámh signs into the curriculum, while SNAs highlighted inconsistent access to funded entry-level training.
Conclusion: Overall, using Lamh was a positive experience that supported communication in children with DS in mainstream school. However, future training should embed knowledge on key facilitators and consider how challenges can be addressed, to maximise the potential of all children with communication needs attending mainstream primary school.
Exploring the use of AAC by children and young people with Down syndrome and their communication partners
Elaine Scougal, Professor Alissa Melinger, & Professor Annalu Waller
University of Dundee
Individuals with Down syndrome can experience verbal communication challenges across their lifespan, impacting daily interactions. Augmentative and alternative communication (AAC) can be beneficial; that is, ways of communicating alongside, or in the absence of, speech. This includes unaided AAC modalities, such as keyword signing and gesture, and aided modalities, such as the use of symbols, writing, photographs, and the use of voice output communication aids (VOCAs, also known as speech generating devices, or SGDs). To date, research involving the use of unaided and aided AAC by children and young people (C&YP) with Down syndrome has focussed on intervention studies. How AAC is accessed, supported, and experienced in everyday life by this group is relatively unreported.
This presentation will discuss the results of a UK-wide survey completed by 264 caregivers of C&YP with Down syndrome (3-18 years), reporting on perceived verbal communication abilities, AAC currently used, support received, and contextual influences on communication, including communication partner familiarity. Further, preliminary insights from a series of follow-up case studies (in progress) involving families of C&YP with Down syndrome who have experience of using aided AAC modalities and keyword signing will be briefly presented, exploring 1) How do C&YP with Down syndrome and stakeholders perceive and manage AAC to facilitate communication involving familiar and unfamiliar communication partners? and 2) What are C&YP with Down syndrome and stakeholders' experiences of support relating to communication and AAC? This data was gained using observational methods and Talking Mats™ with C&YP with Down syndrome, and interviews with caregivers, siblings, and wider stakeholders such as grandparents, education staff, and speech and language therapists. Together, the findings offer useful insights relating to the assessment, provision, support, and use of AAC, providing opportunities to enhance the social participation and independence of C&YP with Down syndrome.
A pilot feasibility case-series study of a customised parent-child interaction intervention for children with Down syndrome: The J-EMT + Sign Ireland Project.
Authors: Hannah Moloney1, Chloe O'Donovan McCarthy1, Deirdre Flynn2, Susanna Stokes2, Emily D. Quinn3, Pauline Frizelle1 & Ciara O'Toole1
- Department of Speech and Hearing Sciences, University College Cork, Ireland
- Speech and Language Therapy Department, Down Syndrome Ireland
- Department of Paediatrics, Oregon Health & Science University, Portland, US
Email: 120336546@umail.ucc.ie; 120330151@umail.ucc.ie
Background
Parent-child interaction therapy is a key element of early communication intervention for children with Down syndrome. Although studies have shown that the intervention improves parental responsivity and language, effects on child language are unclear (O'Toole et al., 2018). This study aimed to pilot an intervention that combines Joint Attention, Symbolic Play, Engagement, Regulation, Enhanced Milieu Teaching and Sign (J-EMT+sign), into an intensive intervention that has shown positive effects on language in children with Down syndrome in the US.
Research Questions
Did intervention increase accuracy and/or frequency of parent J-EMT+sign strategy use?
Are increases in parent J-EMT+sign strategy use associated with child communication outcomes?
Methods
We used a multiple baseline single case research design. Four mothers and their children with Down syndrome aged between 2;0 and 4;6 were coached by two clinicians using a hybrid telepractice model twice weekly for 11 weeks. Parents were taught to use five J-EMT strategies: matched turns, target talk, joint attention, expansions and time delay/prompting. The Teach-Model-Coach-Review method was used to train parents and fidelity monitored throughout. Parent outcomes included accuracy and frequency of J-EMT strategy use. Child outcomes included number of communication acts and vocabulary outcomes.
Results
Preliminary structured visual analysis indicates that parents increased in accuracy and frequency of strategy use, with some individual variation. Child communication outcomes showed more individual variation. Most demonstrated an increase in the number of words used. Children who had more signs/words at baseline demonstrated greater increases.
Conclusions
This study showed that it is possible to implement an intensive individualised intervention in a real-world clinical context. The acceptability of the intervention to clinicians and families compared to other interventions needs to be determined. Finally, further research is needed to determine the preliminary skills necessary for children to benefit from this intervention.
