A Speech Generating Device Intervention with Peer Partners: Effects on Functional Communication of Preschoolers with Autism

Background: Communication is the most targeted outcome of AAC interventions, with positive outcomes reported in studies that incorporate speech-generating devices for individuals with ASD. There is a lack of studies reporting interventions to improve communication with peers without disabilities. Our recent studies fill this void by reporting positive outcomes of integrating peer-mediated and SGD approaches on communication of preschoolers with ASD (Thiemann-Bourque et al., 2017; 2018).

Objectives:

To describe instructional peer training and SGD strategies documented to increase communication between children with ASD and peers, including generalization and maintenance of gains.

Methods: Effects were examined using a multiple-baseline design across six dyads (i.e., one child with ASD; one peer). We taught peers to be responsive partners using Stay-Play-Talk with SGD strategies (Thiemann-Bourque et al., 2017). To decrease time in baseline, the six dyads were split into three groups. Following a stable rate and no upward trend in communication measures, peers in the first group started treatment while baseline continued for the other two pairs. Peer training (PT) was conducted for 90 min, then the peers joined their buddy with ASD in 15-min classroom activities. The next pair then entered PT and began the weekly sessions; this was repeated until all peers were trained. Data was collected 2-3 times/week across baseline (range 4-10), treatment (range 20-31), generalization (6), and follow up (3) phases. Dependent measures included rates of child and peer communication acts, means (gestures, SGD, speech, and speech+SGD), and functions (request objects, request actions, comments, and request attention). Social validity was assessed by naïve judge’s ratings of pre- and post-treatment video clips.

Results: Positive intervention effects for the children with ASD and peers were noted, and replicated across all six dyads. Across all dyads, children with ASD improved from a baseline average of 2 acts to 22 in treatment; peers improved from an average of 4 acts to 25 in treatment. Both partners generalized improvements (16 acts for focus; 16 acts for peers) and were able to maintain progress post-treatment (23 acts for focus; 25 acts for peers). Calculation of Tau-U revealed large effect sizes, with a combined Tau-U of .99 for the focus children and .94 for the peers. Treatment fidelity was 89% (average) for school staff and 83% for peers. Three children began to use different means including greater speech and speech+SGD; and three children used more gestures and SGD. Greatest changes were observed in functions to requests objects, followed by comments, then requests for actions with minimal changes in requesting attention. Social validity outcomes were positive, showing improved social ratings for children with ASD and peers.

Conclusions: Communication rates improved markedly for both partners, and the children with ASD used varied means following treatment with half beginning to use more speech. Future research is needed to examine strategies to increase other communicative means and functions that will maximize social success of minimally verbal children with ASD in inclusive environments.