Teaching Language Stimulation Strategies to Parents of AAC Users: An Exploratory A-B Single-Case Study

Abstract

Background and rationale

Communication partners play a pivotal role in supporting language development in children who use Augmentative and Alternative Communication (AAC). Despite growing evidence on the effectiveness of partner training programs (Kent-Walsh et al., 2015), there remains a need for exploratory research examining the feasibility, cultural adaptation, and functional impact of structured parent training in naturalistic settings. This study investigates the implementation of an aided language stimulation program targeting parents of young AAC users.

Objectives

This study aimed to: (1) explore the feasibility of a structured parent training program in aided language stimulation strategies using dynamic voice output communication aids; (2) assess fidelity and reliability of strategy implementation by parents; (3) examine the impact of strategy use on the communicative behaviour of children who use AAC; and (4) evaluate the social validity and cultural adaptation of the program from the families’ perspective.

Method

An A-B single-case design with multiple cases (N = 3 families) was used. Each parent–child dyad completed two baseline sessions (Phase A) and between three and five intervention sessions (Phase B), followed by two follow-up sessions. Sessions lasted approximately 10 minutes and were video-recorded in naturalistic play contexts. The intervention was introduced simultaneously across all three families.

The intervention was structured in three phases based on Senner et al. (2016): (1) a group training day including theoretical explanation, video modelling, and verbal practice of strategies; (2) individual online coaching sessions with controlled practice and feedback; and (3) video-based feedback sessions with progressive fading of instructor support. Target strategies included aided modelling, expansion, reformulation, responsive interaction, expectant delay, environmental arrangement, and a prompting hierarchy.

Sessions were coded using ELAN software with a validated observation system. Effect sizes were calculated using three non-overlap statistics: Percentage of Non-Overlapping Data (PND; Scruggs & Mastropieri, 1998), Non-overlap of All Pairs (NAP; Parker & Vannest, 2009), and Tau-U with baseline trend correction (Parker et al., 2011). Social validity and cultural adaptation were assessed through a purpose-designed questionnaire administered to participating families after the intervention.

Results

Preliminary results from two families indicate differentiated acquisition patterns across strategies. Aided modelling showed large effect sizes in both families (NAP ≥ 90%). Prompting frequency showed a statistically significant change in one family (Tau-U = 1.10, p = .033). Child communicative responses via AAC increased substantially in one dyad (PND = 100%, NAP = 100%), with maintenance at follow-up. Families reported high levels of satisfaction with the program and perceived it as culturally responsive and applicable to their everyday routines. Results from the third family are currently under analysis.

Conclusions and implications

Findings suggest that a structured, coaching-based parent training program is feasible and produces meaningful changes in aided modelling and prompting behaviours. The cultural adaptation questionnaire highlights the importance of incorporating family perspectives and everyday contexts from the earliest stages of program design. The impact on child AAC use varied across dyads, underscoring the relevance of baseline communicative profiles when planning intervention intensity. Implications for family-centred, culturally responsive AAC clinical practice will be discussed.

References

Kent-Walsh, J., Murza, K. A., Malani, M. D., & Binger, C. (2015). Effects of communication partner instruction on the communication of individuals using AAC: A meta-analysis. Augmentative and alternative communication, 31(4), 271-284

Parker, R. I., & Vannest, K. (2009). An improved effect size for single-case research: Nonoverlap of all pairs. Behavior therapy, 40(4), 357-367.

Parker, R. I., Vannest, K. J., & Davis, J. L. (2011). Effect size in single-case research: A review of nine nonoverlap techniques. Behavior modification, 35(4), 303-322.

Scruggs, T. E., & Mastropieri, M. A. (1998). Summarizing single-subject research: Issues and applications. Behavior modification, 22(3), 221-242.

Senner, J. E., & Baud, M. R. (2016). The use of an eight-step instructional model to train school staff in partner-augmented input. Communication Disorders Quarterly, 38(2), 89-95.