Effects of parent instruction on the symbolic communication of children using augmentative and alternative communication during storybook reading (summary)


Story books are very important in developing early language skills for all children. Children with telling than children without disabilities due to adult communication partners not facilitating their communication behaviours.

What was the aim of the study?
The authors wanted to study the effects of instruction for parents of children who use AAC in use of the Improving Partner Applications of Augmentative Communication Techniques (ImPAACT) program and to research how this influenced the use of communicative turn-taking of their children when reading story books together.

ImPAACT is an 8 stage program teaching communication partners to facilitate the early language and communication skills of children who use AAC by supplementing the adult's spoken language with use of the child's speech generating device (SGD) and building pauses into interactions to allow the child time to respond.

What did the authors do?
Six mother/child pairs took part in the study, the children were selected by a number of criteria including: having severe, congenital motor speech impairment without significant hearing or visual difficulties, using AAC systems with at least 10 symbols, being able to listen to simple stories and answer wh-questions based on these, showing low levels of communicative turn-taking during book reading.

Three sets of books were used throughout the study and individualised communication boards were produced for each. These varied slightly between the children depending on which SGD they used and their individual needs.

Baseline information was gathered about the mother's interaction strategies and the children's number of communication turns when story books were shared in the pair's usual way.

The mothers were offered individual instruction sessions in ImPAACT program and ways to encourage increased communicative turn-taking by their children.

Following the instructional sessions the intervention sessions were 10-minute long story-reading sessions for each pair, without any feedback being given to the mothers. These continued until each child took at least twice as many communication turns as their highest number in the baseline assessment, for three consecutive sessions.

After intervention there was a generalisation phase of two sessions 1 to 2 weeks after completion of the intervention phase.
In an additional maintenance phase the mothers use of the taught strategies and the children's turn-taking patterns were monitored up to 8 weeks after the generalisation.

What did they find?
None of the mothers had used the strategies that were being investigated at the baseline assessment, but all used it with at least 90% accuracy during the intervention, generalisation and maintenance sessions.

All of the children at least doubled their baseline number of communication turns within three intervention sessions and continued to do so throughout all phases of the study.

All of the children showed improved communicative turn-taking skills, with most needing only the minimal level of prompting, if any. Only one child needed a slightly higher level of prompting.

The number of participants was small and the study had a narrow scope, it only looked at story book reading at home.
Giving parents access to these strategies also means they need support to develop other skills such as how to create additional boards to continue to be able to use the strategy.

The strategies used benefitted all of the participants in the study, however the rapid rate of improvement in the children's skills indicates that the improvement might be because the children were given additional opportunities to demonstrate abilities they already had rather than learning brand new skills. Communication partners were taught to provide the children with 'expectations' and 'opportunities' to take turns, they did not necessarily teach them how turn-taking works.

The parents felt that the instruction was beneficial and would have liked support in developing the use of the strategy to other contexts and activities.

Things you may want to look into:

Barriers to Participation in Kindergarten Literacy Instruction for a Student with Augmentative and Alternative Communication Needs

Clinical discourse and engagement during shared storybook reading in preschool groups

Home literacy predictors of early reading development in children with cerebral palsy

Added to site July 2014