Does implementation of Augmentative/Alternative Communication support speech development?
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The Impact of Augmentative and Alternative Communication (AAC) on Speech Development
Introduction to Augmentative and Alternative Communication (AAC)
Augmentative and Alternative Communication (AAC) encompasses various methods and tools used to support or replace spoken language for individuals with speech and language impairments. These methods can include manual signs, picture symbols, and speech-generating devices. AAC is particularly beneficial for individuals with developmental disabilities, autism spectrum disorders (ASD), and other conditions that affect communication abilities.
AAC and Speech Production in Autism Spectrum Disorders (ASD)
Research has consistently shown that AAC interventions can positively impact speech production in children with ASD. A systematic review of 25 single-case design articles and three group design articles found that AAC interventions led to improved speech production in children with ASD, although the gains did not surpass the use of AAC itself. Another review focusing on children with autism or pervasive developmental disorder-not otherwise specified also reported that AAC interventions do not impede speech production and often result in modest increases in speech.
AAC and Developmental Disabilities
A meta-analysis examining the effects of AAC on individuals with developmental disabilities revealed that AAC interventions generally lead to gains in speech production. Out of 27 cases with sufficient methodological rigor, 89% demonstrated improvements in speech, while none showed a decrease in speech production. This suggests that AAC can be a valuable tool for enhancing speech in individuals with developmental disabilities.
Early Intervention and Speech Development
Early intervention using AAC has been shown to support both receptive and expressive language skills in toddlers with developmental delays. A study comparing parent-implemented AAC interventions with traditional spoken language interventions found that children in the AAC group produced significantly more spoken target vocabulary words without any significant differences in speech sound errors. This indicates that AAC can be effectively used in early intervention without delaying speech development.
AAC Technology and Adolescent Language Skills
For adolescents with intellectual and developmental disabilities (IDD) and limited speech capabilities, AAC technologies can play a crucial role in both compensating for language limitations and building language skills. These technologies help adolescents achieve greater participation in educational and social activities, similar to their peers without disabilities.
Receptive Language Skills and AAC
The impact of AAC on receptive language skills has also been explored. A scoping review of 16 studies found positive associations between AAC interventions and improvements in vocabulary acquisition and symbol comprehension in children with developmental disabilities. This highlights the broader benefits of AAC beyond just speech production.
Speech-Language Pathologists' Practices and Barriers
A survey of speech-language pathologists (SLPs) in early intervention settings revealed that AAC is more likely to be introduced to children without spoken language abilities. However, SLPs identified caregiver buy-in and carryover across providers as significant barriers to AAC implementation. Addressing these barriers is essential for the successful adoption of AAC interventions.
Conclusion
The implementation of AAC supports speech development across various populations, including children with ASD, developmental disabilities, and other speech impairments. Research consistently shows that AAC interventions do not hinder speech production and often lead to modest gains in speech. Early intervention and the use of AAC technologies can further enhance language skills and participation in daily activities. Despite some barriers to implementation, the benefits of AAC in supporting speech and language development are well-documented, making it a valuable tool in speech-language therapy.
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