A demonstration of incorporating discriminative stimuli into an AAC device during functional communication training.
Shannon M Angley, Daniel R Mitteer, Brian D Greer and 2 others
PMID 38588641WHAT IT FOUND
Adding colored icons to an AAC app helped one non-speaking teen with severe behaviors distinguish when requests would be honored.
He reduced aggression and increased correct requests, but this was a single case and requires more testing before generalizing.
Key findings
01The intervention involved using color-coded icons on the AAC device to signal when reinforcement was available versus unavailable.
02Challenging behavior decreased and correct communication increased across tangible and edible contexts when the discriminative stimuli were implemented.
03The participant generalized the use of the AAC system to novel clinic contexts and his home environment with his mother.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a single case report, so the results cannot be generalized to other individuals. The design for the tangible function was nonconcurrent, which makes it harder to rule out other factors causing the behavior change. The study did not test how to fade out the artificial color cues, so it is unclear if the user could transfer this skill to natural social contexts without the colored icons. The participant had access to a highly specialized clinical team and intensive therapy hours, which may not be available in typical school or community settings.
Declared interests
The study was supported by NIH grants. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume this AAC modification will work for all patients with challenging behavior. This was a single case in a specialized setting, and the participant had profound intellectual disability and autism; the outcome may not apply to patients with different communication profiles or less intensive support needs.