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Session ID: 18
Objectives:
Participants will be able to:
1. Describe results of a burst of therapy
2. Identify the benefits of having a burst after first receiving an AAC device
3. Discuss implications of a burst of therapy
Augmentative and alternative communication (AAC) intervention techniques, such as aided language modeling, responsivity, feedback, expansions, and wait time have been well documented (Anderson et al., 2016; Douglas et al., 2023). Literature supports the practice of a family-centered intervention, including caregiver and sibling training that is implemented in natural contexts, such as in the home and via telepractice (Douglas et al., 2021; Douglas et al., 2023). Speech-language pathologists (SLPs) and parents have expressed a need for more education focusing on the operational skills needed to manage a speech generating device (SGD), as well as language modeling skills when their child receives their communication device (Anderson et al., 2016). Frequency of AAC exposure during therapy sessions has been reported as a mediator of intervention success (Sieversa et al., 2018), however, few studies have investigated high frequency AAC intervention for children. Researchers have called for future studies to include details on the number and frequency of therapy sessions in relation to therapy outcomes (O’Neill et al, 2018).
Case studies will be presented to discuss increased frequency of direct therapy when a child receives an SGD in relation to caregiver confidence and knowledge, and patient usage. Case studies have been utilized in the field of AAC to inform clinical practice (Stuart & Rithaler, 2008).
Two homecare SLPs identified two patients receiving insurance funded SGDs. The patients participated in weekly home-based speech-language therapy sessions at the time of funding. Upon device delivery, frequency of intervention increased from one to two times per week for three weeks (“burst”) with a planned 3-week period of no direct SLP intervention.
Alex (pseudonym) is a 4-year-old male with Autism Spectrum Disorder (ASD) using an Accent 800 with LAMP. Therapy targeted the number of times he used the device during a therapy session, the number of different words he used, and caregiver education. Device use increased from 8 to 58 times per session and number of different words increased from 7 to 12 words. His caregiver independently managed charging, updates, using vocabulary builder, personalizing vocabulary, and implementing aided language modeling. Following, therapy transitioned to an episodic model of care (i.e. episodic scheduling refers to delivering therapy services by cycling through periods of direct therapy and periods of no direct therapy). Alex’s episodes are 4 weeks in length.
Ania (pseudonym) is 4-year-old female with a diagnosis of Rubenstein-Tuybi Syndrome, who is exposed to English and Spanish. Ania received the TD Navio Maxi with TD Snap Core First vocabulary. Frequency increased from 1 time per week to 2 times per week for a 3-week burst. Before the burst, Ania was using 13 different words with unclear intent. After the burst, she was using 16 different words with 30 activations within a session. Ania’s mother demonstrated independent operational use of the device and Ania was able to locate the app icon on the device independently.
This presentation will share the impact of a burst of therapy after receiving AAC devices. Authors will discuss how to modify frequency of direct services to meet the needs of patients. More information on the frequency of services and various models of care is needed to develop best practices in AAC intervention.
References
Anderson, K. L., Balandin, S., & Stancliffe, R. J. (2016). “It’s got to be more than that”. Parents and speech-language pathologists discuss training content for families with a new speech generating device. Disability and rehabilitation. Assistive technology, 11(5), 375–384. https://doi.org/10.3109/17483107.2014.967314
Douglas, S. N., Biggs, E. E., Meadan, H., & Bagawan, A. (2021). The Effects of Telepractice to Support Family Members in Modeling a Speech-Generating Device in the Home. American journal of speech-language pathology, 30(3), 1157–1169. https://doi.org/10.1044/2021_AJSLP-20-00230
Douglas, S. N., Meadan, H., Biggs, E. E., Bagawan, A., & Terol, A. K. (2023). Building Family Capacity: supporting multiple family members to implement aided Language modeling. Journal of autism and developmental disorders, 53(7), 2587–2599. https://doi.org/10.1007/s10803-022-05492-4
O’Neill, T., Light, J., & Pope, L. (2018). Effects of Interventions That Include Aided Augmentative and Alternative Communication Input on the Communication of Individuals with Complex Communication Needs: A Meta-Analysis. Journal of speech, language, and hearing research: JSLHR, 61(7), 1743–1765. https://doi.org/10.1044/2018_JSLHR-L-17-0132
Sievers, S. B., Trembath, D., & Westerveld, M. (2018). A systematic review of predictors, moderators, and mediators of augmentative and alternative communication (AAC) outcomes for children with autism spectrum disorder. Augmentative and alternative communication (Baltimore, Md.: 1985), 34(3), 219–229. https://doi.org/10.1080/07434618.2018.1462849
Stuart, S. & Rithaler, C. (2008). Case studies of intermediate steps between AAC evaluations and implementation. Perspectives on Augmentative and Alternative Communication, 17(4), 150-155. https://doi.org/10.1044/aac17.4.150
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