The Use of Augmentative and Alternative Communication Methods with Infants and Toddlers with Disabilities: A Research Review

Figures & data

Table 1  Summary of Experimental Studies of AAC use in Early Intervention: Study Number, Authors, and Year of Publication; Dependent Variable (DV); Effect Size Statistic (and its Interpretation shown in Parenthesis); Appraisal of the Study (see Appendix C for Details Concerning Study Participants, Method, and Findings).

Study	Dependent variable	Effect size	Appraisal
1. Anderson (2001)	Requesting toys/foods using PECS	PND 60 (Q)	Conclusive
	Requesting toys/food using signs	PND 0 (I)
2. Chen et al. (2007)	Unaided: Vocalizations and body movements; caregiver use of cues; child use of intentional communication acts	Effect size measure not possible	Inconclusive
3. DiCarlo et al. (2001)	Intervals with sign	PND 33 (I)	Inconclusive
	Frequency of sign	PND 29 (I)
4. Fey et al. (2006)	Rate of intentional communicative acts (i.e., requesting, commenting, and total rate of intentional acts)	Cohen's d = 0.40–0.68 (medium)	Conclusive
5. Iacono & Duncum (1995)	Total number of words produced: sign only	PND 0 (I)	Conclusive
	Total number of words produced: sign + VOCA	PND 66 (Q)
	Number of different words: sign only	PND 0 (I)
	Number of different words: sign + VOCA	PND 83 (F)
6. Kouri (1988)	Frequency of spontaneous signs (label, request, protest, play)	PND 42 (I)	Conclusive
	Frequency responsive signs (e.g., for “What do you want?”)	PND 60 (Q)
	Frequency of informal meaningful gestures or to augment a linguistic form	PND 86 (F)
7. Pennington &  McConachie (1999)	Child's use of different communicative functions and modes for expressive communication in conversational exchanges	Effect size measure not possible	Inconclusive
8. Salmon et al. (1998)	Initiations and responsive requests and comments	PND measure not possible	Inconclusive
9. Stahmer & Ingersoll (2004)	Various measures, including functional communication emphasizing requesting, labeling, and information sharing	Effect size measure not possible	Inconclusive
10. Tait et al. (2004)	Request “more”	PND = 96 (H)	Conclusive
	Choice making	PND = 70 (F)
	Protest	PND = 94 (H)
	Request “help”	PND = 100 (H)
11. Warren, Yoder, Gazdag,  Kim, & Jones (1993)	Experiment 1RequestsCommentsExperiment 2	PND = 92 (H)PND = 100 (H)	Conclusive
	RequestsComments	PND = 96 (H)PND = 93 (H)
12. Yoder & Warren (1998)	Rate of intentional communication acts of requesting and focusing joint attention	Cohen's d = .5–.55 (Medium)	Conclusive

Note. Percentage of Non-overlapping Data (PND) is interpreted as follows I = ineffective (< 50); Q = questionable (50–70); F = fairly effective (70–90); H = highly effective (> 90) (Scruggs et al., 1986). PECS, Picture Exchange Communication System; PDD, Pervasive Developmental Disorders; VOCA, Voice Output Communication Aid.

Table

Coding category	Operational definition
Study identification	Record the names of the authors of the study and the year it was conducted or published.
Goal of the study	List the AAC outcome for the study.
Participants	Record the following for each study: (a) number of participants, (b) each participant's age, (c) each participant's gender, (d) each participant's disability classification.
Target of intervention	Record the primary target of the intervention: (a) child, (b) communication partner (parent, teacher, peer).
Intervention design	For group designs: (a) randomized pre-test/post-test control group, (b) one group pretest/post-test. For single-subject designs: (a) single-participant, alternating treatment design; (b) single-participant, multiple baseline designs (across behaviours or settings); (c) single-participant withdrawal design; (d) multiple participant, multiple baseline.
Setting	Record where the intervention occurred: (a) home, (b) childcare, (c) clinic, (d) pre-school.
AAC system	Record all types of AAC system(s) used in the intervention according to the following categories: (a) unaided AAC (i.e., communication system that only uses the communicator's body, such as manual signs); (b) aided AAC systems without voice output (e.g., communication board, PECS); (c) aided AAC systems with voice output (i.e., electronic AAC systems that produce either digitized or synthetic speech).
Treatment fidelity	Record measures used to ensure treatment fidelity: (a) documentation of training for treatment providers, (b) documentation of observation of treatment sessions by trained observers.
Interrater reliability	Record measures used to ensure reliability of coding treatment data.
Effect of intervention	Calculate the effect of AAC intervention using data provided by the study. For single-subject experimental designs, report the percentage of nonoverlapping data (PND; Scruggs et al., 1987). Calculate the PND by dividing the total number of data points in the intervention that do not overlap the data points in baseline by the total number of data points in the intervention and multiply by 100. For studies with multiple participants, calculate the mean

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