Parent education in AAC has been linked to positive changes in children’s communication [1-4] including improvements in spontaneous communicative utterances, novel words, and comments. Furthermore, increases in family confidence with using a speech generating device [SGD], increased frequency of device use at home, increased parent responsiveness to communication, and parent feelings of successful communication with their children [1, 4, 6] have been seen following training.
There is evidence suggesting that parent education provided by telepractice can be as effective as in-person parent training [26] and can successfully be used with parents of children who use AAC [2, 17]. The benefits of telepractice are numerous and include increased access to well-trained and experienced AAC professionals [28], allowing parent involvement which increases the likelihood of maintenance and generalization of children’s skills [26], enabling therapists to work with families in the natural environment (i.e., home) and implementation in intervention in everyday, meaningful routines and activities [27, 29-30].
An 8-step training program was used that focuses on teaching communication partners to provide partner-augmented input (PAI) on children’s existing SGDs both at home [4] and in the classroom [31]. [PK1] Natural routines within the home are predictable, functional, and provide meaningful contexts for children to learn new skills [33]. In addition, families are more likely to adhere to home programs when they are contextualized, i.e., embedded into natural routines [34]. Finally, the training program incorporates children’s existing SGDs, thus increasing the likelihood of generalization.
The objectives of this study were to (a) Examine the effects of using the training program via tele-practice on parent use of PAI and child SGD use and (b) To determine whether 10 coaching sessions are sufficient to maintain partner skills after the completion of the training. This project was approved by the IRB of Midwestern University.
Training began with parents participating in a 3.5-hour group instruction session via video conferencing. During this session, parents completed Step 1, Pretest and Commitment to Instructional Program. Each of the parents was asked to individually watch a pretest videotape of her interaction with her child and to reflect on her own use of the child’s SGD. Parents also signed a written commitment to training acknowledging that they were committed to learning to provide PAI. Step 2, Strategy Description, was also conducted during the group training session via a PowerPoint presentation on partner-augmented input. Step 3, Strategy Demonstration, was conducted with videotaped samples of PAI being used by families at home.
Step 4, Verbal Practice of the Strategy Steps, was completed using the SMoRRES (slow rate, model, respect and reflect, repeat, expand, stop) mnemonic [60] to aid in memorizing steps involved. The parents labeled and described each step aloud during the training with guidance from the instructors to confirm that they understood the strategies.
Each family member had an SGD with the child’s page set to participate in Controlled Practice and Feedback (Step 5). Parents were asked to generate a variety of practice phrases on the devices based on scenarios presented. Following the in-service, families attended ten, once weekly 30-min coaching sessions via video conferencing. Two parent-child dyads self-selected to participate in the study.
Dyad B
The child was a 6 year, 9 month-old male with autism. He had used WordPower 60 Basic for less than 6 months. The parent was his mother, a white, married female with a bachelor’s degree.
Dyad D
The child was an 8 year, 5 month-old female with Prader Willi. She had used LAMP Words for Life between 6-12 months. The parent was her mother, a white, married female with a doctorate degree.
Both mothers worked outside of the home. Both children had other siblings living at home.
Both parents increased percentage of utterances modeled between pre- and post-test measures. Both children increased the percentage of SGD use between pre- and post-test measures and increased unique words used. Both parents strongly agreed (M = 5.0, SD = 0) with all of the items on a social validity questionnaire, indicating that they felt that the training was useful and relevant to their ongoing daily activities at home. Parent likes about the instructional program included the repetitive practice with the same activities, practicing the SMoRRES mnemonic, real-time coaching focusing on just a few activities, receiving “some practical and beneficial advice,” and the reduced pressure on the child to communicate. One parent maintained modeling at 7 weeks post completion of training, however one parent did not, suggesting that some families may benefit from more than 10 coaching sessions.
