Using AAC to unlock communicative potential in late-talking toddlers.
Isabel I Navarro, Sarah R Cretcher, Angelica R McCarron and 2 others
PMID 32673863WHAT IT FOUND
Two late-talking toddlers who did not improve with input-based therapy alone showed immediate gains in spoken words and multi-word phrases when low-tech AAC devices and output demands were added.
This suggests AAC may help non-responders bypass speech motor difficulties.
Key findings
01Adding low-tech AAC devices and requiring output before reward led to immediate improvements in spoken word count and the emergence of multi-word phrases for both toddlers.
02The toddlers had previously failed to respond to a high-density input-based treatment protocol (VAULT), producing few or no target words during that phase.
03The study design changed two variables at once (adding AAC and increasing output demands), so it is impossible to know which change caused the improvement.
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 case report of only two children, so results cannot be generalized to all late talkers. The trial therapy was brief (3-4 sessions) and exploratory, not a full course of treatment. Two major variables were changed at once (adding AAC and increasing output demands), so neither can be isolated as the sole cause of improvement. Data collection for LM's trial therapy was discontinued after proof of concept was established, so the total word count may be underestimated. Different clinicians delivered the VAULT and trial therapy phases, so a clinician effect cannot be ruled out. No final MCDI was collected for CP, and no final MCDI was collected for LM after the trial therapy.
Declared interests
The study was supported by N.I.H. Extramural funding. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that AAC alone caused the improvement. The study changed two things at once: it added AAC devices and it increased the demands for the children to produce words before receiving rewards. It is possible that simply requiring more output would have led to the same result without any technology.