The Effectiveness of Speech Generating Devices for Children with ASD

Background:  Children with ASD who have little or no functional speech have the potential to benefit from the use of Augmentative and Alternative Communication (AAC) intervention. The aim of AAC intervention is to support the development of symbolic communication and possibly natural speech. In recent years, and following the advent of cheaper technology, there has been widespread interest in the possibility that one type of AAC, speech generating devices (SGDs), may provide expressive and receptive communication support for children with ASD who have little or no functional speech. To this end, a small number of studies have provided preliminary support for the use of SGDs in promoting communication with parents, peers, and educators. However, further research is needed to better understand the individual outcomes of providing SGD-based treatments to children with ASD, and to compare the relative effectiveness of treatment with, and without, a SGD.

Objectives:  The aim of this study was to examine the effectiveness of a SGD-based treatment in supporting the expressive communication of three preschool aged children with ASD.

Methods:  An alternating treatments single case experimental design was used to assess the treatment outcomes for each of three children, aged 3-5 years. Each child attended a series of 16 clinic-based play sessions with a treating clinician, including 3 baseline, 12 intervention, and 1 follow-up session. Each session lasted 30 minutes, during which the treating clinician attempted to engage the child in a series of play activities. The two treatments were naturalistic teaching with, and without, a SGD. The SGD was a Talara 32^© containing eight frequently and commonly used words (e.g., help, more, finished) chosen for their relevance across a range of play activities. All sessions were video-recorded to assist with coding and analysis.

Results:  Blind coding of the videos for the children’s use of the SGD and production of natural speech is currently underway. The treating clinician’s delivery of the intervention, including the creation of communicative opportunities and modelling of the SGD, is also being coded for all videos as a measure of fidelity. Preliminary analysis indicates varied outcomes for each of the three children, with all children responding to both treatment conditions (with and without a SGD). Detailed analyses of changes in the children’s communication across baseline, intervention, and follow-up sessions, including a comparison of performance under each treatment condition, will be completed using visual and statistical analyses (Tau-U) and reported in the presentation.  

Conclusions:  The results of this study will provide preliminary evidence regarding the effectiveness of SGD-based treatments for preschool aged children with ASD. Importantly, the use of an alternating treatments single case experimental design will allow for a detailed analysis of individual outcomes for each child, under each treatment condition. These individual outcomes, including the children’s use of the SGD and changes in natural speech over time, will be discussed along with the implications for parents, educators, and researchers attempting to provide effective, evidence-based treatments for children with ASD who have little or no functional speech.