Navigating High-Tech AAC: The Accessibility of Toddlers' First Words on Widely Used Speech-Generating Device Systems

Abstract

Access to AAC during early intervention (i.e., birth-to-three programs) facilitates language growth (Romski et al., 2010). One high-tech form of AAC is speech-generating devices (SGDs). Improvements in technology has increased accessibility of SGDs (Ganz et al., 2017). Many SGD programs can be accessed via lower cost options such as an Apple iPad compared to using insurance to fund dedicated devices. However, clinicians and families experience difficulties deciding which programs to buy and which programs meet their child’s needs. Although AAC during early intervention is reported (Lorang et al., 2022), evidence is sparse in early intervention implementation of AAC (Romski et al., 2015), particularly related to implementing SGDs.

Aim: This study measures the number of navigational hits (i.e., number of selected icons) required to access typically developing toddlers’ first 100 words using a variety of SGD programs downloaded to iPads.

Method: Typically developing toddlers’ first 100 words were selected from the Wordbank database (Frank et al., 2017). Wordbank contains information from thousands of administrations of the MacArthur-Bates Communicative Development Inventory (MB-CDI), a commonly used assessment for early intervention. Five widely used SGD apps were selected and downloaded on an Apple iPad: TD Snap Core, LAMP Words for Life, Proloquo2go, TouchChat, and GRID. Navigational hits were tallied for each vocabulary word on each SGD program with grid sizes containing between 70-80 buttons. Programs were not modified or customized; page layouts were the preloaded templates.

Results: Navigational hits for two of the five systems (i.e., LAMP Words for Life and Proloquo2go) have been tallied. The remaining three systems will be tallied prior to this presentation. Of the first 100 words, 10 words are animal sounds and 1 is the child’s name. None of these words are preprogrammed on LAMP or Proloquo2go. Additionally, modifications to vocabulary words are required for certain vocabulary that do not match exactly (i.e., accessed “mom” for “mommy”). Only one word is typically pre-programmed for vocabulary corresponding to two labels (i.e., “cat” but not “kitty”). Planned analyses include describing variance between programs using descriptive statistics (i.e., range of hits per words, averages number of hits), determining if there is a statistically significant difference between the number of hits across programs and words, and determining overlap between core vocabulary words and the first 100 words. Although all systems to be evaluated are taxonomically organized (i.e., categories), the author hypothesizes significant variance between programs in the number of navigational hits required to access the vocabulary.

Conclusion: Typically developing children do not start mastering 2-step directions until between 24 and 36 months of age. If SGD systems require greater than 2 hits to navigate to select common age-appropriate vocabulary, this could suggest that first words for typically developing peers are inaccessible on SGD systems. Findings may support the use of visual scene display systems or low-tech AAC with younger children requiring AAC to communicate, particularly during early intervention.

References

Frank, M. C., Braginsky, M., Yurovsky, D., & Marchman, V. A. (2017). Wordbank: An open repository for developmental vocabulary data. Journal of Child Language, 44(3), 677–694. https://doi.org/10.1017/S0305000916000209

Ganz, J. B., Morin, K. L., Foster, M. J., Vannest, K. J., Genç Tosun, D., Gregori, E. V., & Gerow, S. L. (2017). High-technology augmentative and alternative communication for individuals with intellectual and developmental disabilities and complex communication needs: A meta-analysis. Augmentative and Alternative Communication, 33(4), 224-238.

Lorang, E., Maltman, N., Venker, C., Eith, A., & Sterling, A. (2022). Speech-language pathologists’ practices in augmentative and alternative communication during early intervention. Augmentative and Alternative Communication, 38(1), 41-52.

Romski, M., Sevcik, R. A., Adamson, L. B., Cheslock, M., Smith, A., Barker, R. M., & Bakeman, R. (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech, Language, and Hearing Research, 53(2), 350-364.

Romski, M., Sevcik, R. A., Barton-Hulsey, A., & Whitmore, A. S. (2015). Early intervention and AAC: What a difference 30 years makes. Augmentative and Alternative Communication, 31(3), 181-202.