Systematic Review of Reading Interventions for Adolescents and Adults Using Augmentative and Alternative Communication

Abstract

Literacy, like communication, is a critical enabler of independence and lifelong achievement. Despite its benefits, access to evidence-based reading instruction remains inequitable (Batorowicz et al., 2025; Light et al., 2025; Mandak et al., 2018). Individuals with complex communication needs (CCN) often face barriers when literacy instruction relies on spoken language (Light et al., 2019). Older learners with CCN are frequently excluded from comprehensive reading instruction or are provided instruction that is narrow, repetitive, or not developmentally appropriate (Light et al., 2025). As a result, up to 90% of students with CCN exit high school without developing functional literacy skills (Erickson & Geist, 2016; Foley & Wolter, 2010). The combined impact of limited speech and inequitable access to literacy contributes to long-standing developmental disadvantages in education, employment, and social participation (Light et al., 2019).

Three systematic reviews have examined effective literacy interventions for students with CCN (Hudler et al., 2025; Mandak et al., 2018; Yorke et al., 2021). Existing research and practice have provided valuable insight, but often emphasize early childhood populations. The lack of research on transition-age learners restricts insight into lifelong literacy development and leaves practitioners with minimal direction for supporting older augmentative and alternative communication (AAC) users. Specifically, there are gaps in how reading instruction should be designed, delivered, and measured for adolescents and adults who use aided AAC.

This presentation will share findings from a systematic literature review examining reading interventions for AAC users aged 11 and older and identify common instructional approaches, outcome measures, and gaps in the literature. Specifically, this study sought to answer the following research questions:

1. What reading content is targeted in interventions for middle school through adult individuals with CCN who use aided AAC?
2. What instructional methods and intervention strategies are implemented in literacy interventions, and how are these components delivered?
3. What outcome measures are used to assess literacy progress, and how are these outcomes defined and reported?

This study utilized a systematic review methodology to identify, evaluate, and synthesize existing research on reading interventions for adolescents and adults who use aided AAC. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines (Page et al., 2021). The study selection included two double-blind phases: title and abstract screening for relevance, followed by full-text review for inclusion criteria and evaluation using What Works Clearinghouse single-case design quality indicators. Coding domains included single-case design (SCD) quality indicators, participant information, instructional content aligned with the five components of reading, instructional methods, intervention strategies, intervention delivery features, outcome measures, and social validity.

Findings suggest that targeted reading instruction can lead to literacy improvements for older learners who use aided AAC. However, the evidence base remains limited by the small number of available studies and the narrow range of reading components addressed. Of the five essential components of reading identified by the National Reading Panel (year), not allhave been studied with adolescents and adults who use aided AAC, representing a critical gap in the evidence base for comprehensive literacy instruction (National Institute of Child Health and Human Development, 2000). Implications for practice and future research will be discussed, with attention to how practitioners can support meaningful, developmentally appropriate literacy instruction.