A scoping review of communication outcomes measures in augmentative and alternative communication

Figures & data

Figure 1. PRISMA flowchart.

Table 1. Communication outcome assessments used across research studies.

Assessment Type	Research Study (ies)
Standardized Assessments
Autism Diagnostic Observation Measure	Lerna et al. (2014)
Clinical Evaluation of Language Fundamentals	King et al. (2020), Meinzen-Derr et al. (2021)
Communication and Symbolic Behavior Scale	Parsons et al. (2020)
Expressive One-Word Picture Vocabulary Test	King et al. (2020), Olive et al. (2008)
Gray Silent Reading Test	Lund and Light (2006)
Griffiths’ Mental Developmental Scale	Lerna et al. (2014)
MacArthur Bates Communicative Developmental Inventory	Boesch et al. (2013), King et al. (2020), Romski et al. (2008)
Mullen Scales of Early Learning	Barker et al. (2013), King et al. (2020), Parsons et al. (2020), Rose et al. (2020)
Peabody Picture Vocabulary Test-4^th Edition	Barker et al. (2013), Lund and Light (2006), Olive et al. (2008), King et al. (2020)
Preschool Language Scale	Hampton et al. (2020), King et al. (2020)
Preschool & Primary Inventory of Phonological Awareness Scale	Mathisen et al. (2009)
Receptive one-word picture vocabulary test	Olive et al. (2008)
Reynell Developmental Language Scale	Mathisen et al. (2009)
Sequenced Inventory of Communication Development	Romski et al. (2008)
Test of Auditory Comprehension of Language	Lund and Light (2006)
Vineland Adaptive Behavior Scales	King et al. (2020), Lerna et al. (2014), Thunberg et al. (2009)
Western Aphasia Battery	Johnson et al. (2008)
Surveys, Questionnaires, & Structured Observations
Structured Observation
ASHA Functional Assessment of Communication Skills	Johnson et al. (2008), Lund and Light (2006)
Clinical Assessment of Language Comprehension	Romski et al. (2008)
Early Social Communication Scale	Almirall et al. (2016), Hampton et al. (2020), Yoder and Lieberman (2010)
Pragmatic Observation Measure	Parsons et al. (2020)
Structured Play Assessment	Almirall et al. (2016)
Test of Playfulness	Parsons et al. (2020)
Caregiver observation
Diary of Communicative Development	Sevcik et al. (2004)
Survey or Questionnaire
Quebec User Evaluation of Satisfaction with Assistive Technology − 2nd edition	Chan et al. (2010), Desai et al. (2014), Borgestig et al. (2021)
Communicative Effectiveness Survey	Childes et al. (2017)
Communication Survey	Hamm and Mirenda (2006)
Health-Related Quality of Life – KIDSCREEN 10 version	Borgestig et al. (2021)
Psychosocial Impact of Assistive Devices Scale	Borgestig et al. (2021)
School Function Assessment	Desai et al. (2014)
Ages and Stages Questionnaire	Thomas-Stonell et al. (2016)
Communication Matrix	Borgestig et al. (2021), Desai et al. (2014), Mohan et al. (2019), Sreekumar et al. (2019)
Focus on Communication Outcomes Under Six	Thomas-Stonell et al. (2016)
Pragmatics Checklist	Meinzen-Derr et al. (2019)
Interviews
The Pragmatics Profile of Everyday Communication Skills in Children	King et al. (2020)
Social Network: A Communication Inventory for Individuals with Complex Communication Needs and their Communication Partners
Other
ASHA Quality of Communication Life Scale	Johnson et al. (2008)
Augmentative Communication Employment Training and Supports Survey	Bryen et al. (2004)
Communication Effectiveness Index	Johnson et al. (2008)
Effectiveness Framework of Functional Communication	Ferm et al. (2010)
Goal Attainment Scaling	Desai et al. (2014)
Quality of Life Profile: People with Sensory and Physical Disabilities	Hamm and Mirenda (2006), Lund and Light (2006)
Nonstandardized Assessments
Trained observation	Alzrayer (2020), Alzrayer et al. (2021), Babb et al. (2019, 2020, 2021), Baker et al. (2022), Bayldon et al. (2021), Bock et al. (2005), Boesch et al. (2013), Brock et al. (2017), Caron et al. (2020), Chan et al. (2010), Chapin et al. (2022), Conklin and Mayer (2011), Diehl and Wallace (2018), Falk et al. (2010), Flores et al. (2012), Ganz and Simpson (2004), Ganz et al. (2008, 2009), Gevarter, Groll, et al. (2020), Gevarter, Horan, et al. (2020), Gevarter et al. (2021), Hagan and Thompson (2014), Icht et al. (2020), Ivy et al. (2020), Johnson et al. (2008), Lancioni et al. (2009), Lerna et al. (2014), Light et al. (2021), McMillan and Renzaglia (2014), Mohan et al. (2019), Mongeau and Lussier-Desrochers (2017), Olive et al. (2008), Quinn et al. (2020), Ricci et al. (2017), Seale et al. (2020), Snodgrass et al. (2013), Son et al. (2006), Tan and Alant (2018), Therrien and Light (2016), Thunberg et al. (2007, 2009, 2011), Timpe et al. (2021), Trembath et al. (2009), Snodgrass et al. (2013), Walters et al. (2021), Wandin et al. (2021)
Language sample analysis	Almirall et al. (2016), Barker et al. (2013), Brock et al. (2017), Ganz and Simpson (2004), Griffith et al. (2014), Hampton et al. (2020), Hayes and Traughber (2021), Hux et al. (2010), Kasari et al. (2014), Light et al. (2021), Lund and Light (2006, 2006), Mathisen et al. (2009), Meinzen-Derr et al., (2017, 2019, 2021), Mooney et al. (2018), Romski et al. (2008), Senner et al. (2019), Sevcik et al. (2004), Soto et al. (2020)
Semi-structured interviews/Quesstionnaires	Clarke et al. (2011), Griffith et al. (2014), Hagan and Thompson (2014), Hampton et al. (2020), Keskinen et al. (2012), Timpe et al. (2021)

Table

Author (year)	Study design	Age group/sex	Participant Characteristics	Study Target	Communication Competence Classification	Outcome (Measurement tool)
Almirall et al. (2016)	analytical, interventional, randomized control trials	age range = 5–8 years of age/10 females, 51 males	autism	social-comm.	linguistic	total social communicative utterances (language sample) number of direct root words (language sample)
					social	initiating joint attention (ESCS) initiating behavior regulation (ESCS) unique play acts (Structured Play Assessment)
Alzrayer et al. (2021)	analytical, interventional pre-post studies	age range = 4–5 years/1 female, 3 males	autism	requesting	social	number of requests per minute (observation)
Alzrayer (2020)	analytical, interventional pre-post studies	mean age = 3 years, 8 months (range = 3–5 years)/1 female, 3 males	autism	requesting	social	PECS based requests (observation) SGD based requests (observation)
Babb et al. (2019)	analytical, interventional, pre-post studies (longitudinal study)	18 years/1 male	autism	comm.	social	number of communication acts during vocational tasks (observation)
Babb et al. (2020)	analytical, interventional pre-post studies	mean age = 17 years, 3 months (range = 14–20 years)/4 males	Down syndrome, autism	task analysis	social	percent of task analysis completed individually (observation)
Babb et al. (2021)	analytical, interventional pre-post studies	age = 19 years/1 male	Down syndrome	language output	linguistic	number of intelligible words per minute (observation) average number of intelligible words per minute (observation)
Baker et al. (2021)	analytical, observational, cohort	mean age = 7 years, 7 months (range = 8 years–10 years, 4 months)/8 females, 6 males	autism	device access	social	time of device use (observation)
Barker et al. (2013)	analytical, interventional, pre-post studies (longitudinal study)	mean = 4 years, 1 month (range = 36–71 months)/17 females, 66 males	autism, down syndrome, global developmental delay, spina bifida, cerebral palsy, TBI, other disorders	language growth	linguistic	receptive language (Mullen & Peabody Picture Vocabulary Test-4^th Ed.) expressive language (Mullen) number of different words (language sample)
Bayldon et al. (2021)	analytical, interventional pre-post studies	ages = 8 years, 2 months, 8 years, 11 month/1 female, 1 male	cerebral palsy	pragmatics	social	Initiations (observation) turn taking (observation)
Bock et al. (2005)	analytical, interventional, cross-over (alternating)	4-year-olds/6 males	non-verbal with developmental delay	acquisition and generalization of requesting	social	correct response (observation)
Boesch et al. (2013)	analytical, interventional, cross-over	ages = 6 years, 7 years, 10 years/1 female, 2 males	autism	social-comm. & natural speech production	linguistic	expressive language (MCDI) receptive language (MCDI)
					social	total number of social communicative behaviors (observation) requesting (observation) gesture use (MCDI)
Borgestig et al. (2021)	analytical, interventional pre-post studies	mean age = 11 years, 4 months (range = 3–26 years)/10 females, 7 males	Cerebral palsy, Rett syndrome, metabolic disorder	comm.	linguistic	expressive comm. (Communication Matrix)
					psychosocial	quality of life (KIDSCREEN-10) functional independence with and without device (Psychosocial Impact of Assistive Devices Scale) Device satisfaction (QUEST 2.0) Communication Matrix
					operational	question response accuracy designed to assess navigational errors (observation)
					psychosocial	instances of frustration (observation)
					social	total conversation time (language sample analysis) number of conversational turns (language sample analysis) number of discourse units (language sample analysis)
Bryen et al. (2004)	analytical, interventional, pre-post studies	mean age = 30 years, 6 months (range = 24–37 years)/1 female, 5 males	Not reported	employment	linguistic	employment communication skills (ACETS Employment Survey)
					social	employment communication skills (ACETS Employment Survey)
Caron et al. (2020)	analytical, interventional pre-post studies	mean age = 12 years, 2 months (range = 7 years, 5 months–20 years, 7 months/1 female, 4 males	Down syndrome, Intellectual and developmental disability	vocabulary	linguistic	number of target words identified (observation)
Chan et al. (2010)	analytical, interventional, cross-over studies	19 years/1 male	hypotonia	utterances	operational	types of errors (observation) speed (observation)
					psychosocial	level of fatigue (questions adapted from Borg scale) satisfaction with device (QUEST 2.0)
Chapin et al. (2022)	analytical, interventional, pre-post studies	age range = 3 years, 11 months, 4 years, 11 months, 5 years, 6 months/1 female, 2 males	autism	turn-taking	social	number of communicative turns taken (observation)
Childes et al. (2017)	analytical, interventional, nonrandomized controlled trials	mean age = 64 years (range = 47–81 years)/12 females, 22 males	laryngectomy	AT use	psychosocial	positive and negative experiences with the device (self-report)
					social	communication effectiveness score across a range of contexts (Communicative Effectiveness Survey)
					strategic	number of communication repair strategies (self-report)
Clarke et al. (2011)	analytical, interventional, pre-post studies	mean age = 11 years, 4 months (range = 7–16 years)/3 females, 7 males	Cerebral palsy, Trisomy 8, Worester Drought syndrome, dyspraxia	children’s view on short-term impact of new comm. aid	psychosocial	self-efficacy (self-report) self-esteem (self-report) other’s attitudes (self-report)
Conklin and Mayer (2011)	analytical, interventional, pre-post studies (longitudinal study)	Ages = 23 years, 38 years, 51 years/2 females, 1 male	severe mental retardation, Cerebral palsy, Down syndrome	PECS use	social	percentage of independent initiations (observation) percent of off-task behavior (observation)
Desai et al. (2014)	analytical, interventional, pre-post studies (longitudinal study)	13 years/1 male	Cerebral palsy and autism	comm. and participation in school activities	linguistic	communication modality (Communication Matrix) attainment of communication goals identified by SLP (Goal Attainment Scaling)
					psychosocial	teacher satisfaction with device (QUEST 2.0)
					social	participation in non-academic and social aspects of school (School Function Assessment) communication function (Communication Matrix)
Diehl and Wallace (2018)	analytical, interventional, pre-post studies (longitudinal study)	ages = 21 years, 62 years/2 males	TBI	comm. modalities and breakdowns	Linguistic social	number of modalities used to produce target words (observation) communication repair (observation)
Falk et al. (2010)	analytical, interventional, pre-post studies	2 adults (age and gender not reported), 1 child (age and gender not reported), 1 adolescent (age and gender not reported)	adults had no diagnosis, child and adolescent had hypotonic Cerebral palsy and have severe phonatory impairment	comparing performance of prototype device to commercial devices	linguistic operational	percentage of correctly identified vocalizations by the system (observation) percentage of correctly rejected user-generated artifacts (observation) average task time (observation)
					psychosocial	Fatigue (observation and self-report)
Ferm et al. (2010)	analytical, interventional, nonrandomized controlled trials	mean age = 61 years (range = 51–71 years)/2 females, 3 males	Huntington’s disease	comm. effectiveness	linguistic	participant’s understanding of options presented (Effectiveness Framework of Functional Communication)
					social	comm. effectiveness (Effectiveness Framework of Functional Communication) comm. duration (observation)
Flores et al. (2012)	qualitative, case series	mean age = 9 years (range = 8–11 years)/5 males	autism, Intellectual disability	Utility of iPAd for making requests	social	number of requests (observation)
Ganz and Simpson (2004)	analytical, interventional, pre-post	Ages = 5 years, 8 months, 7 years, 2 months, 3 years, 9 months years/1 female, 2 males	autism, developmental delay	evaluate the utility of PECS to increase the number of words spoken and complexity of word utterances	linguistic	average number of intelligible words per trial (language sample analysis) percentage of trials in which non-vocalizations occurred (language sample analysis) syntax (language sample analysis) expressive vocabulary (language sample analysis)
					operational	participants proficiency using PECS (observation)
Ganz et al. (2008)	analytical, interventional, pre-post studies	ages = 4 years, 5 months, 3 years, 1 month, 5 years, 1 month/1 female, 2 males	autism, developmental delay	impact of PECS on comm.	linguistic operational	intelligible words (observation) word approximations (observation) independent and prompted exchanges to request (observation)
					social	independent exchange to request (observation)
Ganz et al. (2009)	analytical, interventional, pre-post studies	ages = 3 years, 2 months, 6 years, 5 years, 6 months/3 males	autism	impact of PECS on comm.	social	number of times spoken words used to request (observation) number of times pictures used to request (observation) maladaptive behaviors (observation)
Gevarter, Horan, et al. (2020)	analytical, interventional, cross-over	mean age = 3 years, 4 months (range = 3 years–5 years)/1 female, 4 males	autism	vocabulary	linguistic	number of functional vocabulary words (observation)
Gevarter, Groll, et al. (2020)	analytical, interventional, pre-post studies	mean age = 4 years, 2 months (range = 3 years,1 month–5 years, 7 months)/6 males	autism, deaf	social language production	social linguistic	Number of requests (observation) Number of action/social words (observation)
Gevarter et al. (2021)	analytical, interventional, pre-post studies	ages = 3 years, 8 months, 4 years, 5 months, 4 years, 10 months/3 males	autism	requesting and responding	social	item requests (observation) functional responses (observation)
Griffith et al. (2014)	analytical, interventional, case series	mean age = 58 years (range = 42 years–70 years)/3 females, 1 male	Broca’s aphasia	how the type of visual supports and the presence of linguistic supports influence the comm.	linguistic psychosocial strategic	expressive modality units (language sample analysis) perceived helpfulness of AT support (informal interviews – self report) percentage of repaired trouble sources (language sample analysis)
Hagan and Thompson (2014)	qualitative, interventional, case report	40 years/1 female	ADHD, Intellectual disability, nonverbal	impact of using an SGD on the comm. abilities and pragmatic skills	linguistic	comm. modality (semi-structured interview) expressive language (semi-structured interview) receptive language (semi-structured interview)
					social	conversation skills (semi-structured interview) community participation (semi-structured interview)
					strategic	repairs communication topic (observation)
Hampton et al. (2020)	analytical, interventional, randomized controlled trials	mean age = 43 months (range = 36–55 months)/15 females, 53 males	autism	language production and pragmatics,	linguistic	expressive language (Preschool Language Scale-5^th edition) receptive language (Preschool Language Scale-5^th edition)
					social	joint attention (Early Social Communication Scale) social communicative utterances (language sample analysis)
Hamm and Mirenda (2006)	qualitative, case series	mean age = 28 years, 8 months (range = 19 years, 9 months −24 years, 9 months)/2 females, 6 males	autism, Intellectual disability, Cerebral palsy, Rett syndrome, deaf/blindness	post-school outcomes of individuals with complex comm. needs	linguistic psychosocial social	communication modality (Communication Survey) quality of life (Quality of Life Profile: People with Sensory and Physical Disabilities) quality of communication (Communication survey)
Hayes and Traughber (2021)	analytical, interventional pre-post studies	19 school age children/not reported	Not reported	language output	linguistic	mlu (language sample analysis) total utterances (language sample analysis)
Hux et al. (2010)	analytical, interventional, cross-over	61 years/1 male	1 participant with aphasia (9 neurotypical participants served as communication partners)	conversational skills	linguistic social	conceptual complexity level (language sample analysis) number conversational turns (language sample analysis) number utterances serving as initiations and responses (language sample analysis) number of content units successfully transmitted during conversational exchange (language sample analysis)
Icht et al. (2020)	analytical, interventional, non-randomized controlled trials	mean age = 20 years (range = 9–32 years)/4 female, 8 males	SMA, cerebral palsy, Rubinstein-Taybi syndrome, Pelizaeus-Merzbacher syndrome	memory	linguistic	hit rates (observation)
Ivy et al. (2020)	analytical, interventional pre-post studies	ages = 4 years, 5 months, 5 years, 3 months, 7 years, 2 months/1 female, 2 males	Baraitser-Winter syndrome, developmental delay, hearing loss, cytomegalovirus, Lennox-Gastaut syndrome, hydrocephalus, movement disorder	independent exchanges and operational skills	social operational	independent requests (observation) percentage of trials with independent completions of three phases pickup, reach, release (observation)
Johnson et al. (2008)	analytical, interventional, pre-post studies	ages = 57 years, 67 years, 77 years/2 females, 1 male	aphasia and apraxia of Speech	functional comm. skills	linguistic	symbol identification (observation) symbol production (observation) sentence production (observation) comprehension (Western Aphasia Battery) repetition (Western Aphasia Battery) naming (Western Aphasia Battery) reading/writing (Western Aphasia Battery) spontaneous speech (Western Aphasia Battery)
					psychosocial	impact of communication disorder from perspective of communicatively-impaired person (American Speech-Language Hearing Association Quality of Communication Life Scale)
					social	everyday comm. activities (American Speech-Language Hearing Association Functional Assessment of Communication skills) comm. effectiveness (Communicative Effectiveness Index)
Kasari et al. (2014)	analytical, interventional, pre-post study, randomized control, longitudinal Study	mean age = 6 years,3 months(range = 5 years–8 years)/10 females, 51 males	autism	spontaneous comm.	linguistic	number of unique word combinations (language sample) total number of different root words mlu (language sample)
					social	spontaneous communicative utterances (language sample) socially communicative utterances (language sample) comments (language sample) requests (language sample) protests (language sample)
Keskinen et al. (2012)	analytical, interventional, pre-post studies	mean age = 26 years (range = 14 years–37 years)/9 males	autism. speech, physical, intellectual and hearing disability, visual impairment, behavior disorders	comm.	psychosocial	user experience with the device (interview)
King et al. (2020)	analytical, observational, longitudinal	15 years/1male	apraxia, hearing loss, dysarthria	language and functioning	linguistic	Receptive/expressive language (Clinical Evaluation of Language Fundamentals, Preschool Language Scale) receptive language (Clinical Evaluation of Language Fundamentals, Preschool Language Scale) Receptive/expressive vocabulary (Expressive One-Word Picture Vocabulary Test) Receptive/expressive vocabulary (Expressive One-Word Picture Vocabulary Test, Expressive Vocabulary Test, MCDI) receptive vocabulary MCDI, Peabody Picture Vocabulary Test
					social	adaptive functioning (Vineland, Social Network: A Communication Inventory for Individuals with Complex Communication Needs and their Communication Partners
Lancioni et al. (2009)	analytical, interventional, cross-over studies	mean age = 10 years,7 months (range = 5 years–18 years)/gender not reported	Encephalopathy, blindness, severe visual impairment, minimal residual vision, total blindness, typical visual functioning	requesting	social	number of requests (observation)
Lerna et al. (2014)	analytical, interventional, nonrandomized control trials, pre-post studies	age range = 18–60 months/gender not specified	autism	social-comm.	linguistic	expressive language (Griffiths’ Mental Developmental Scale) receptive language (Griffiths’ Mental Developmental Scale) comm. (Vineland & ADOS)
					social	personal/social (Griffiths’ Mental Developmental Scale) reciprocal social interaction (ADOS) social skills (Vineland) during unstructured free-play with examiner the following were measured: cooperative play, eye contact, joint attention, verbal requests, nonverbal requests, initiations
Light et al. (2021)	analytical, observational, case study	38 months/1 female	developmental delays, strabismus intermittent esotropia, rotational nystagmus	language production and pragmatics	linguistic	mean length of message (language sample analysis) number of letter correspondences acquired (observation) sound blending (observation)
					social	turns per minute (language sample analysis)
Lund and Light (2006)	analytical, observational, case report	mean age = 21 years, 7 months (range = 19 years–23 years)/7 males	Cerebral palsy	language, reading, pragmatics and educational and vocational achieve	linguistic	receptive language (Peabody Picture Vocabulary Test-Revised & Test of Auditory Comprehension of Language) reading Comprehension (Gray Silent Reading Test) linguistic complexity (language sample)
					psychosocial	vocational goals (interview) self-determination (Arc’s Self-Determination Scale) quality of life (Quality of Life Profile for People with Physical and Sensory Disabilities)
					social	communicative Interaction: turn reciprocity (language sample) fulfilled turn opportunities (language sample) percentage of turns containing more than one concept (language sample) number of concepts on multi-concept turns (language sample) functional communication-base needs (Functional Assessment of Communication Skills for Adults) functional communication – social (Functional Assessment of Communication Skills for Adults) adequacy of communication (Functional Assessment of Communication Skills for Adults) appropriateness of communication (Functional Assessment of Communication Skills for Adults) communication sharing (Functional Assessment of Communication Skills for Adults) educational Placement (level of participation) (Functional Assessment of Communication Skills for Adults)
Mathisen et al. (2009)	analytical, interventional, pre-post studies	3 years, 10 months/1 female	Cerebral palsy	emergent literacy and language	linguistic	receptive language (Reynell Developmental Language Scale) communication form (The Pragmatics Profile of Everyday Communication Skills in Children) emergent literacy skills (The Preschool and Primary Inventory of Phonological Awareness & The Sheffield Early literacy development profile) communication form (The Pragmatics Profile of Everyday Communication Skills in Children) response to communicative input (The Pragmatics Profile of Everyday Communication Skills in Children) verbal utterances (language sample analysis) non-verbal utterances (language sample) response questions (language sample analysis) 1-word utterances (language sample analysis) intelligible words (language sample analysis) mlu (language sample analysis) Brown’s stages (language sample analysis) type-token ratio (language sample analysis)
					Social	communication function (The Pragmatics Profile of Everyday Communication Skills in Children) interaction and conversation The Pragmatics Profile of Everyday Communication Skills in Children) contextual variation The Pragmatics Profile of Everyday Communication Skills in Children) mean turn length (language sample analysis)
McMillan and Renzaglia (2014)	analytical, interventional, pre-post studies	mean age = 9 years, 7 months (range = 8 years–11 years)/4 males	Intellectual disability, autism	frequency of device use	social	number of independent initiations (observation) number of independent responses (observation)
Meinzen-Derr et al. (2017)	analytical, interventional, pre-post studies	mean age = 7 years, 3 months (range = 5 years 4 months–9 years, 9 months)/5 females	deaf, hard of hearing	comm. competence	linguistic	mlu (language sample) number of different words (language sample) number of total words (language sample)
					social	mean turn length (language sample)
Meinzen-Derr et al. (2019)	analytical, interventional, pre-post studies	mean age = 5 years, 7 months (range = 3 years–10 years)/5 females, 6 males	bilateral hearing loss, autism	spoken language	linguistic	mlu (language sample) number of different words (language sample) number of total words (language sample)
					social	mean turn length (language sample) pragmatics (Pragmatics Checklist)
Meinzen-Derr et al. (2021)	analytical, interventional, randomized control studies	mean age = 6 years, 2 months/20 females, 21 males	Deaf and language deficits	Syntax, Semantics, Language production	linguistic	expressive language (Clinical Evaluation of Language Fundamentals 5^th edition) receptive language (Clinical Evaluation of Language Fundamentals 5^th edition) mlu (language sample analysis) number of different words (language sample analysis)
					social	mean turn length (language sample analysis)
Mohan et al. (2019)	qualitative, case report	4 years/1 male	autism	language skills	linguistic	ask questions (observation) answer questions (observation) proper punctuation in written language (observation) adaptive literacy skills (observation)
					operational	typing speed (observation)
					social	refuse (Communication Matrix) obtain (Communication Matrix) social (Communication Matrix) information (Communication Matrix) use of polite forms (observation)
Mongeau and Lussier-Desrochers (2017)	qualitative, case reports	mean age = 36 years, 8 months (range = 23–54 years)/4 females, 3 males	Intellectual disability, ataxia, Cerebral palsy	comm. skills and adaptive behaviors	linguistic	comprehend word combinations (observation) comprehend sentences [(observation) forming word combinations (observation) forming sentences (observation)
Mooney et al. (2018)	analytical, interventional, cross-over studies	mean age = 68 years (range = 58–80 years)/3 females, 3 males	primary progressive aphasia	lexical retrieval	linguistic	word production (story retell)
Olive et al. (2008)	analytical, interventional, pre-post studies	4 years/1 female	autism	requesting and general language	linguistic	expressive language (Expressive one-word picture vocabulary test-R & Expressive Vocabulary test) receptive language (Receptive one-word picture vocabulary test & Peabody Picture vocabulary test) Correct/Incorrect pronoun use (observation)
					social	challenging behavior (observation) requesting attention (observation)
Parsons et al. (2020)	analytical, interventional pre-post studies	mean age = 79 years/4 females, 11 males	autism	language, device use, and pragmatics	linguistic	expressive language (Mullen) receptive language (Mullen) speech (Communication and Symbolic Behavior Scale)
					social	pragmatics (Pragmatic Observation Measure) social skills (Communication and Symbolic Behavior Scale) play skills (Test of Playfulness)
						rate of symbolic communication acts (observation)
Ricci et al. (2017)	analytical, interventional, pre-post studies	mean age = 20 years, 6 months (range = 11 years–60 years)/gender not reported	Intellectual disability, blindness, deafness	requesting	social	frequency and types of requests (observation)
Romski et al. (2008)	analytical, interventional, pre-post study, longitudinal study	40 months/1 male	Cerebral palsy, intellectual disability, speech delay	expressive and receptive comm. gains	linguistic	vocalizations (language sample) intentional symbol use (language sample) receptive language (Sequenced Inventory of Communication Development & MCDI) expressive language (Sequenced Inventory of Communication Development & MCDI) emerging language skills (Clinical Assessment of Language Comprehension)
					social	joint attention (Clinical Assessment of Language Comprehension)
Rose et al. (2020)	analytical, interventional pre-post studies	mean age = 46.88 months (range = 31–67 months)/11 females, 37 males	autism	expressive language	linguistic	Expressive language (Mullen)
Seale et al. (2020)	analytical, interventional, non-randomized controlled trials	age range = 38 years–77 years/25 females, 15 males	ALS	communicative contexts	social	talk time (observation) presentation rate (observation) acceptance rates (observation) main talk rates (observation) repair talk rates (observation) symmetry (observation) task completion (observation)
Senner et al. (2019)	analytical, interventional, pre-post study	mean age = 7 years (range = 5 years–9 years, 6 months)/1 female, 3 males	autism, dysgenesis of the corpus callosum, tracheostomy, vocal fold paralysis, developmental delay	vocabulary	linguistic	unique words (language sample analysis)
Sevcik et al. (2004)	analytical, observational, case report	4 years/1 male	generalized developmental delay, seizure disorder	comm., engagement and utterance attempts	linguistic	vocabulary (Diary of Communicative Development) communicative use (Diary of Communicative Development) child utterance attempts (language sample analysis)
					social	engagement (language sample analysis) nonverbal communication (language sample analysis)
Snodgrass et al. (2013)	analytical, interventional, pre-post studies	9 years/1 male	Down syndrome, deaf-blindness, and severe intellectual disability.	symbol learning	linguistic social operational	generalization of symbol to novel stimuli (observation) requests (observation) reaching for symbol rather than engaging in non-communicative behavior (observation)
Son et al. (2006)	analytical, interventional, pre-post studies	ages = 5 years, 5 months, 3 years, 8 months, 3 years/2 females, 1 male	autism, developmental disorder, pervasive developmental disorder	acquisition of requesting	social	requesting (observation)
Soto et al. (2020)	analytical, interventional pre-post studies	mean age = 9 years, 9 months age (range = 8 years, 8 month–13 years, 9 months)/3 females, 5 males	Cerebral palsy, Pfeiffer syndrome, apraxia	conversational repair	social	recast/repair (language sample analysis)
Sreekumar et al. (2019)	analytical, interventional pre-post studies	7 years/1 female	spastic quadriplegic cerebral palsy, hearing loss	comm. skills	social	percentage of skill attainment (Communication Matrix)
Tan and Alant (2018)	analytical, interventional, pre-post studies	7 years/2 males	neurotypical communication partner, autism and speech disorder	comm.	social	communicative acts per minute (observation) relevance of communicative acts (observation)
Therrien and Light (2016)	analytical, interventional, pre-post studies	ages 4 years, 2 months, 4 years, 10 months/2 males	Prader Willi syndrome, developmental delay, 22q11.2 deletion syndrome, apraxia	social interaction	social	frequency in turn taking (observation)
Thomas-Stonell et al. (2016)	analytical, observational, case Reports	mean age = 2 years, 6 months age (range = 1 year, 4 months −4 years, 9 months)/1 female, 7 males	autism, oral motor/dyspraxia, cerebral palsy, downs syndrome, developmental delay, premature	comm.	linguistic	expressive language (Focus on Communication Outcomes Under Six) receptive language (Focus on Communication Outcomes Under Six) intelligibility (Focus on Communication Outcomes Under Six)
					psychosocial	confidence (Focus on Communication Outcomes Under Six)
					social	comm. (Focus on Communication Outcomes Under Six; Ages and Stages Questionnaire – Social/Emotional subtest) participation (Focus on Communication Outcomes Under Six)
Thunberg et al. (2007)	analytical, interventional, case control studies	mean age = 6 years (range = 5 years–7 years)/4 males	autism, oral motor/dyspraxia, Cerebral palsy, Down syndrome, developmental delay, premature	comm.	linguistic	mode of communication (observation)
					social	degree of engagement (observation) role in turn-taking (observation) comm. function (observation) comm. effectiveness (observation)
Thunberg et al. (2009)	analytical, interventional, pre-post studies	ages = 4 years, 11 months, 5 years, 6 months, 7 years, 6 months/3 males	autism, pervasive developmental disorder- not otherwise specified	comm.	linguistic social	communication mode (observation) communication (Vineland) comm. (Vineland) engagement (observation) rate of communication role in turn] (observation) comm. effectiveness (observation)
Thunberg et al. (2011)	analytical, interventional, case study, pre-post study	7 years/1 male	autism and learning disability	comm. across contexts	linguistic social	mode of communication (observation) degree of engagement (observation) role in turn-taking (observation) comm. function (observation) comm. effectiveness (observation)
Timpe et al. (2021)	analytical, interventional pre-post studies	ages = 3 years, 4 years, 5 months, 5 years 6 months/1 female, 2 males	Down syndrome, autism	turn taking and strategy use	linguistic psychosocial social	novel semantic concepts rates (observation) social validation (questionnaire) turn taking rates (observation)
Trembath et al. (2009)?	analytical, interventional, randomized controlled trials	age range = 3–5 years/(comm. partners 3 females, 3 males), 3 males (with autism)	3 (with autism), 6 (comm. partners)	comm.	social	successful comm. behaviors per minute (observation)
Walters et al. (2021)	analytical, interventional, pre-post studies	age range = 24–36 months/12 females, 33 males	developmental delay	language	linguistic	communication mode (observation) target words (observation)
Wandin et al. (2021)	analytical, interventional, pre-post studies	ages = 27 years, 29 years, 31 years/3 females	Rett syndrome	word production	linguistic	unique Synthesized words per minute (observation) synthesized words per minute (observation)
Yoder and Lieberman (2010)	analytical, interventional, randomized controlled trials	age range = 18–60 months/sex not specified	autism and developmental disorders	generalization	social	PECS exchanges (ESCS)

Note. ACETS = Augmentative Communication Employment Training and Supports; ADHD = attention deficit hyperactivity disorder; ADOS = Autism Diagnostic Observation Scale; Comm. = communication; AT = assistive technology; ESCS =  Early Social Communication Scales; MCDI = MacArthur Bates Communication Developmental Inventory; MLU = mean length of utterance; Mullen = Mullen Scales of Early Learning; PECS = Picture exchange communication system; TBI = traumatic brain injury; QUEST 2.0 = Quebec User Evaluation of Satisfaction with Assistive Technology − 2nd edition; SGD = speech generating device; Vineland = Vineland Adaptive Behavior Scales.

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