Background: Some autistic children experience challenges with understanding and following instructions containing abstract concepts like prepositions. Previous research has supported the use of augmented input, combining speech with augmentative and alternative communication, to improve responses to sentence-level instructions containing prepositions in autistic children (Allen et al., 2021; Remner et al., 2016; Schlosser et al., 2013). However, the optimal augmented input mode as well as the best level of augmented input needed to improve understanding are unknown. In this study, the two modes of augmented input conditions included (a) speech combined with graphic symbols (i.e., Picture Communication Symbols; Mayer-Johnson LLC, 2007) and (b) speech combined with manual signs (i.e., South African Sign Language), respectively. The two levels of augmented input included (c) key word augmented input (i.e., augmenting only the preposition) and (d) symbolate (i.e., augmenting each part of speech of a sentence). The purpose of this study was to compare the accuracy of responses to instructions containing prepositions by autistic children under four augmented input conditions.
Method: An experimental Latin-square research design (Wu & Hamada, 2021) was used involving 40 autistic participants, including five girls and 35 boys, aged between 5,4 years and 12,5 years. The participants were exposed to four different sets of 12 instructions (in differing order), as follows: (a) graphic symbol – key word; (b) graphic symbol – symbolate; (c) manual sign – key word; and (d) manual sign – symbolate. Their instruction-following was measured across conditions. A secondary purpose involved the measurement of transfer from augmented input to speech alone.
Results: Results revealed no statistically significant difference between the four conditions of augmented input. However, even though it did not reach the level of statistical significance, more participants benefitted from key word aided augmented input than the other conditions. Additionally, a statistically significant positive change in the number of accurate responses was observed for the instructions containing prepositions presented without augmented input (i.e., with speech alone), when comparing results from before the exposure and following exposure to two augmented input conditions.
Conclusions: These findings suggest that providing aided augmented input for the preposition alone (key word), effectively improves the number of accurate responses. There is a need for further studies to identify additional moderators that might affect how autistic children respond to instructions containing prepositions. These findings contribute evidence-based practice by augmented input as supports to receptive language development in autistic children.
References
Allen, A. A., Shane, H. C., Schlosser, R. W., & Haynes, C. W. (2021). The effect of cue type on directive-following in children with moderate to severe autism spectrum disorder. Augmentative and Alternative Communication, 37(3), 168–179. doi:10.1080/07434618.2021.1930154
Mayer-Johnson LLC. (2007). Boardmaker Software Family. www.mayer-johnson.com
Remner, R., Baker, M., Karter, C., Kearns, K., & Shane, H. C. (2016). Use of augmented input to improve understanding of spoken directives by children with moderate to severe Autism Spectrum Disorder. EHearsay: Electronic Journal of the Ohio Speech-Language Association, 6 (3), 4–10.
Schlosser, R. W., Laubscher, E., Sorce, J., Koul, R., Flynn, S., Hotz, L., Abramson, J., Fadie, H., & Shane, H. (2013). Implementing directives that involve prepositions with children with autism: A comparison of spoken cues with two types of augmented input. Augmentative and Alternative Communication, 29(2), 132–145. doi:10.3109/07434618.2013.784928
Wu, C. F. J., & Hamada, M. S. (2021). Experiments – planning, analysis and optimization (3rd ed.). John Wiley & Sons. doi:10.1002/9781119470007.ch3
Accessible Summary
* The benefits of aided augmented input for instruction-following in children with autism are well documented, however, the optimal level and mode of augmented input are still unknown.
* This study measured the number of accurate responses to instructions containing prepositions under four augmented input conditions.
* Providing graphic symbol aided augmented input of the preposition alone appears to yield the most benefits, although not statistically significant.
