Conversation-based intervention for adolescents using augmentative and alternative communication.
Gloria Soto, Michael T Clarke
PMID 30043650WHAT IT FOUND
In conversations that combined several supports, including a personal collage, recasts, prompts, and vocabulary targets, four adolescents using speech-generating devices increased some verbs, pronouns, bound morphemes, or clauses, but no target improved consistently across all four.
Peer conversations did not show clear improvement.
Key findings
01No single language target improved clearly across all four participants.
02Nadia increased all four language targets during intervention.
03Peer generalization probes for Nadia showed overlap and no clear improving trend, and for Maddie production was very low and inconsistent.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only four adolescents were studied, so the findings cannot show what will happen for most AAC users. No single language target improved clearly across all four participants. The intervention bundled several components, including personal collage, recasts, prompts, and targeted vocabulary, so the contribution of any one part cannot be separated. Generalization was tested with untrained peers and only a few probes, and the authors could not establish a functional relationship with intervention. There was no maintenance check after intervention ended. The language measures combined prompted and unprompted targets, so spontaneous use was not separated from prompted use. Two participants had no formal cognitive assessment because parents declined permission. Clinician compliance ranged from 86% to 100%, and the 90% threshold was missed on nine occasions. Fidelity raters were not blinded to the type of session they were observing.
Declared interests
The article is listed as supported by NIH extramural research. The supplied text does not include author conflict declarations or state whether the funder designed or wrote the study.
The easy way to misread this
Do not conclude that this conversation intervention reliably improves grammar or transfers to peer conversation. Four adolescents showed inconsistent gains, and the intervention bundled several components.