Communication and ASD

Ganz, J., et al. (2011). "A Meta-Analysis of Single Case Research Studies on Aided Augmentative and Alternative Communication Systems with Individuals with Autism Spectrum Disorders." Journal of Autism and Developmental Disabilities. 42, 60-74.

Because many people with ASD may not have the ability to use verbal communication functionally, educators, clinicians and families turn to augmentative and alternative forms of communication. These can include unaided forms of AAC, such as sign language, and aided forms such as PECS and high tech voice output communication aids, or VOCAs. Despite the large number of individuals with ASD who struggle with verbal communication, very little research has been dedicated to AAC and ASD. The majority of studies are single case studies or with very few participants. In an effort to understand the role AAC has in an evidence-based approach, this study meta-analyzed these small studies and investigated the overall impact and effect of AAC on behavioral outcomes, as well as the effects of three specific types of AAC. The results of the meta-analysis suggest that AAC, as a whole, can have a positive impact on behavioral outcomes; however, speech generating devices produced more positive results than picture-based systems.

Mirenda, P. (2008). "A Back Door Approach to Autism and AAC." Augmentative and Alternative Communication. 24, 219-233.

Despite the significant advances in the field of AAC for those with ASD, it is crucial that practitioners and researchers continue to study the advantages for these individuals. This is especially true for those considered to also have intellectual disabilities. It is assumed that these individuals are unlikely to develop literacy or academic skills, and will only ever learn to use simple AAC systems to communicate basic wants and needs. However, Mirenda considers motor challenges to be more common than previously thought in the ASD population. While motor challenges are not currently part of the diagnostic criteria for ASD, there are many descriptions of impairment with voluntary and involuntary movements, as well as challenges with motor planning. Mirenda also suggests that current intellectual testing is largely inadequate for those with ASD. Research indicates that an alternative test known as Raven’s Progressive Matrices is able to accurately identify normal and above normal test scores for those with ASD as compared to lower scores with traditional tests such as the WISC-R. Mirenda suggests presuming competence when it comes to intellectual ability in regards to higher forms of AAC, and that the consideration of motor planning must be taken into account when understanding why an individual may not succeed when first provided with an opportunity to use high tech AAC systems.

Mirenda, P. (2001). "Autism, Augmentative Communication, and Assistive Technology: What Do We Really Know?" Focus on Autism and Other Developmental Disabilities. 16, 141-151.

This review article discusses the literature on the use of AAC and assistive technology for those with ASD up to 1999. The review examined only English language, peer-reviewed empirical studies of how aided (i.e. a device or aid that is outside of the body) AAC improved functional, interactive use among those with ASD. The review focused on assessment, staff / family training, supports for augmented input, schedules, visual symbols for choicemaking, supports for augmented input and output, Aided Language Stimulation (ALS), System for Augmenting Language (SAL), AAC supports for output including visual-spatial symbols, PECS, Functional Communication Training (FCT), assistive technology for communication and learning, VOCAs, and Computer Aided Instruction. Future recommendations from the study suggest that more is needed in autism specific AAC assessment and staff / family training. The review also reveals a wide assortment of studies on the use of schedules, SAL, visual-spatial symbols, and FCT interventions, and a distinct lack of a single method of to provide communicative supports to every person with ASD. Due to the individual nature of ASD and abilities, the review suggests a single method may not be possible and that more research is needed in comparing the high tech versus low tech methods of AAC.