Please listen, it's my turn: Instructional approaches, curricula and contexts for supporting communication and increasing access to inclusion (summary)

young children

Children who use AAC are often believed to have fewer opportunities to interact with literacy materials than their speaking peers for many different reasons; physical, environmental, technological and social. They have also often been found to be rather passive communicators, responding to others rather than initiating interactions.

What was the aim of the study?
The study aimed carry out a language and literacy programme for children with complex communication needs (CCN) that included an integrated approach to communication including oral language, literacy and technology skills, constant modelling of AAC use, family involvement and follow up visits to schools, and to consider the effects this had on children's language and literacy skills and use of technology.

What did the authors do?
Four children with severe speech and physical impairments (SSPI) were selected to take part in a 4 week summer school. The participants were aged between 5 and 9 years old, used AAC and were classed as 'beginner' or 'non-fluent' readers. They and their families had to commit to attending five 2-hours sessions a week for four weeks, with four follow-up visits to their schools.

Prior to the intervention information was gathered from the parents, by questionnaire, about the children's language and literacy experiences and other interests, preference and friends. School staff also provided information and were invited to visit and take part in the study programme.

The children's oral language, literacy and technology skills were assessed and they were surveyed about their perceptions of themselves as communicators.

The project was staffed by a researcher/teacher, a speech and language therapist, an adult AAC user, an educational assistant and 3 speech and language therapy students.

The focus of the sessions was to promote communication, including verbal communication skills, supporting literacy skills and group reading and writing activities and developing independence with technology.

Several themes were covered with vocabulary relevant to these being provided in symbol form and on speech generating devices (SGDs). The themes were; 'conversations', 'feelings', 'ourselves' and 'others'. There was emphasis on the importance of conversational control and reducing the dominance of speaking partners in interactions with AAC users, self-expression of feelings and emotions, initiating and maintaining interactions.

The intervention was in the form of 'total language immersion' with individual teaching sessions and group work. The adults used AAC alongside spoken language at all times.

Six to eight weeks after the summer school follow up sessions were undertaken to support the carryover of newly acquired skills into the children's schools and to information with school staff.

What did they find?
The results indicate that the 'mixed-methods' approach, combining language, literacy and technology skills in individual teaching and group activities, with consistent modelling of AAC use, can be beneficial in developing all of these areas, possibly partly by increasing adult communication partner's awareness of the need to provide AAC users with appropriate vocabulary in a suitable format, and in slowing adults rate of communication, thus giving the children more time to respond.

All four children made progress during the intervention, but only two maintained this at follow-up.

The author is not able to give definite reasons for this but makes several possible suggestions; the parents of the children who maintained progress were successful advocates for their children's needs in school, these children also had typically developing siblings, meaning their parents were familiar with typical language and literacy development and they were returning to schools they attended prior to the intervention. The children who did not maintain the progress changed school and so the school staff were not familiar with their needs and abilities. The children who maintained the progress also had no recognisable words, possibly increasing staff's motivation to continue to support SGD use, and they used computers with communication software as their SGD which might be less threatening to unfamiliar people than dedicated communication systems.

The study was very small meaning the results cannot be generalised more widely, and the combined use of several strategies means that it is possible to identify the specific effects of individual elements. Only one child's school took part in the intervention period and teachers were not often available to attend meetings in the follow up sessions meaning they were not necessarily able to then support carryover into settings.

While the methods used in the study can be beneficial maintenance of progress is dependent on the AAC user having someone to advocate for them to ensure their educational needs are met, and their school's willingness to work closely with their parents and ensure staff are trained to support them in the systems they use.

Things you may want to look into:

Immersive Communication Intervention for Speaking and Non-speaking Children with Intellectual Disabilities

Supporting the Communication, Language, and Literacy Development of Children with Complex Communication Needs

Teacher literacy expectations for kindergarten children with cerebral palsy in special education

Evidence-based literacy instruction for individuals who require augmentative and alternative communication: a case study of a student with multiple disabilities

Added to site July 2014