Abstract
Introduction: Social participation for emerging symbolic communicators on the autism spectrum is often restricted. This is due in part to the time and effort required for both children and partners to use traditional augmentative and alternative communication (AAC) technologies during fast-paced social routines. Innovations in artificial intelligence provide the potential for context-aware AAC technology that can provide just-in-time communication options based on linguistic input from partners to minimize the time and effort needed to use AAC technologies for social participation. Methods: This preliminary study used an alternating treatment design to compare the effects of a context-aware AAC prototype with automated cloze phrase response options to traditional AAC for supporting three young children who were emerging symbolic communicators on the autism spectrum in participating within a social routine. Results: Visual analysis and effect size estimates suggest the context-aware AAC condition resulted in increases in linguistic participation, vocal approximations, and visual attention for all three children. Conclusion: While this study was only an initial exploration and results are preliminary, context-aware AAC technologies have the potential to enhance participation and communication outcomes for young emerging symbolic communicators on the autism spectrum and more research is needed.
Journal Section:
Research Article
References
1.
Schreibman
L
, Dawson
G
, Stahmer
AC
, Landa
R
, Rogers
SJ
, McGee
GG
, et al. Naturalistic developmental behavioral interventions: empirically validated treatments for autism spectrum disorder
. J Autism Dev Disord
. 2015
;45
(8
):2411
–28
. 2.
Kuhl
PK
. Is speech learning ‘gated’ by the social brain
. Dev Sci
. 2007
;10
(1
):110
–20
. 3.
Adamson
LB
, Bakeman
R
, Suma
K
, Robins
DL
. An expanded view of joint attention: skill, engagement, and language in typical development and autism
. Child Dev
. 2019
;90
(1
):e1
–18
. 4.
Mundy
P
, Sigman
M
, Kasari
C
. A longitudinal study of joint attention and language development in autistic children
. J Autism Dev Disord
. 1990
;20
(1
):115
–28
. 5.
Ratner
NB
, Bruner
J
. Games, social exchange, and the acquisition of language
. J Child Lang
. 1978
;5
(3
):391
–401
. 6.
Wallander
JL
, Koot
HM
. Quality of life in children: a critical examination of concepts, approaches, issues, and future directions
. Clin Psychol Rev
. 2016
;45
:131
–43
. 7.
Romski
M
, Sevcik
RA
, Hyatt
AM
, Cheslock
M
. A continuum of AAC language intervention strategies for beginning communicators
. In: Reichle
J
, Beukelman
D
, Light
J
, editors. Exemplary practices for beginning communicators: implications for AAC
. Baltimore
: Brookes
; 2002
. p. 187
–218
.8.
Adamson
LB
, Bakeman
R
. Development of displaced speech in early mother–child conversations
. Child Dev
. 2006
;77
(1
):186
–200
. 9.
Light
J
. “Let’s go star fishing”: reflections on the contexts of language learning for children who use aided AAC
. Augment Altern Commun
. 1997
;13
(3
):158
–71
. 10.
Light
J
, Parsons
AR
, Drager
K
. “There’s more to life than cookies:” Developing interactions for social closeness with beginning communicators who use AAC
. In: Reichle
J
, Beukelman
D
, Light
J
, editors. Exemplary practices for beginning communicators: implications for AAC
. Baltimore
: Brookes
; 2002
. p. 187
–218
.11.
Wong
TP
, Moran
C
, Foster-Cohen
S
. The effects of expansions, questions and cloze procedures on children’s conversational skills
. Clin Linguist Phon
. 2012
;26
(3
):273
–87
. 12.
Dubin
AH
, Lieberman-Betz
RG
. Naturalistic interventions to improve prelinguistic communication for children with autism spectrum disorder: a systematic review
. Rev J Autism Dev Disord
. 2020
;7
(2
):151
–67
. 13.
Dawson
G
, Toth
K
, Abbott
R
, Osterling
J
, Munson
J
, Estes
A
, et al. Early social attention impairments in autism: social orienting, joint attention, and attention to distress
. Dev Psychol
. 2004
;40
(2
):271
–83
. 14.
Charman
T
. Why is joint attention a pivotal skill in autism
. Philos Trans R Soc Lond
. 2003
;358
(1430
):315
–24
. 15.
Light
J
, McNaughton
D
, Caron
J
. New and emerging AAC technology supports for children with complex communication needs and their communication partners: state of the science and future research directions
. Augment Altern Commun
. 2019
;35
(1
):26
–41
. 16.
Logan
K
, Iacono
T
, Trembath
D
. A systematic review of research into aided AAC to increase social-communication functions in children with autism spectrum disorder
. Augment Altern Commun
. 2017
;33
(1
):51
–64
. 17.
Lorah
ER
, Holyfield
C
, Miller
J
, Griffen
B
, Lindbloom
C
. A systematic review of research comparing mobile technology speech-generating devices to other AAC modes with individuals with autism spectrum disorder
. J Dev Phys Disabil
. 2022
;34
(2
):187
–210
. 18.
Griffen
B
, Holyfield
C
, Lorah
E
, Caldwell
N
. Increasing linguistic and prelinguistic communication for social closeness during naturalistic AAC instruction with young children on the autism spectrum
. Augment Altern Commun
. 2024
;40
(3
):168
–81
. 19.
Waddington
H
, Carnett
A
, van der Meer
L
, Sigafoos
J
. Teaching two autistic children to request continuation of social routines with their parents using an iPad- based speech-generating device
. Adv Neurodev Disord
. 2021
;7
:353
–63
. 20.
Taheri
A
, Perry
A
, Minnes
P
. Examining the social participation of children and adolescents with intellectual disabilities and autism spectrum disorder in relation to peers
. J Intellect Disabil Res
. 2016
;60
(5
):435
–43
. 21.
O’Neill
T
, Wilkinson
KM
. Designing developmentally sensitive AAC technologies for young children with complex communication needs: considerations of communication, working memory, attention, motor skills, and sensory-perception
. Semin Speech Lang
. 2019
;40
(4
):320
–32
. 22.
Holyfield
C
. Comparative effects of picture symbol with paired text and text-only augmentative and alternative communication representations on communication from children with autism spectrum disorder
. Am J Speech Lang Pathol
. 2021
;30
(2
):584
–97
. 23.
Pope
L
, Holyfield
C
. Biennial Conference of the International Society of augmentative and alternative communication
. Cancun, Mexico
: Oral Presentation
; 2023
.24.
Thistle
JJ
, Wilkinson
KM
. Working memory demands of aided augmentative and alternative communication for individuals with developmental disabilities
. Augment Altern Commun
. 2013
;29
(3
):235
–45
. 25.
26.
Holyfield
C
, Brooks
S
, Schluterman
A
. Comparative effects of high-tech visual scene displays and low-tech isolated picture symbols on engagement from students with multiple disabilities
. Lang Speech Hear Serv Sch
. 2019
;50
(4
):693
–702
. 27.
Holyfield
C
, Lorah
E
. Effects of high-tech versus low-tech AAC on indices of happiness for school-aged children with multiple disabilities
. J Dev Phys Disabil
. 2023
;35
(2
):209
–25
. 28.
Chapin
SE
, McNaughton
D
, Light
J
, McCoy
A
, Caron
J
, Lee
DL
. The effects of AAC video visual scene display technology on the communicative turns of preschoolers with autism spectrum disorder
. Assist Technol
. 2022
;34
(5
):577
–87
. 29.
Caldwell
N
, Holyfield
C
, Zimmerman
TO
. Effects of interaction approaches and added high-tech augmentative and alternative communication on prelinguistic and linguistic communication from school-age beginning communicators
. Folia Phoniatr
. 2024
;76
(3
):281
–94
. 30.
Caron
J
, Light
J
, Drager
K
. Operational demands of AAC mobile technology applications on programming vocabulary and engagement during professional and child interactions
. Augment Altern Commun
. 2016
;32
(1
):12
–24
. 31.
Holyfield
C
, Caron
J
, Light
J
. Programing AAC just-in-time for beginning communicators: the process
. Augment Altern Commun
. 2019
;35
(4
):309
–18
. 32.
Drager
KD
, Light
J
, Currall
J
, Muttiah
N
, Smith
V
, Kreis
D
, et al. AAC technologies with visual scene displays and “just in time” programming and symbolic communication turns expressed by students with severe disability
. J Intellect Dev Disabil
. 2019
;44
(3
):321
–36
. 33.
Holyfield
C
, Caron
JG
, Drager
K
, Light
J
. Effect of mobile technology featuring visual scene displays and just-in-time programming on communication turns by preadolescent and adolescent beginning communicators
. Int J Speech Lang Pathol
. 2019
;21
(2
):201
–11
. 34.
Holyfield
C
, MacNeil
S
, Vucetic
S
, Dragut
E
, Rackensperger
T
, Lorah
E
, et al. Presentation at the Annual Conference for the assistive technology industry association
. Orlando, FL
; 2023
.35.
Shen
J
, Yang
B
, Dudley
JJ
, Kristensson
PO
. KWickChat: a multi-turn dialogue system for AAC using context-aware sentence generation by bag-of-keywords
. 2022
:853
–867
. 36.
Holyfield
C
, Drager
K
. Integrating familiar listeners and speech recognition technologies into augmentative and alternative communication intervention for adults with down syndrome: descriptive exploration
. Assist Technol
. 2022
;34
(6
):734
–44
. 37.
Holyfield
C
, O’Neill Zimmerman
T
. A scoping review of research evaluating physiological information for individuals with developmental disabilities: augmentative and alternative communication research considerations
. J Speech Lang Hear Res
. 2022
;65
(11
):4306
–26
. 38.
Sennott
SC
, Akagi
L
, Lee
M
, Rhodes
A
. AAC and artificial intelligence (AI)
. Top Lang Disord
. 2019
;39
(4
):389
–403
. 39.
Cai
S
, Venugopalan
S
, Tomanek
K
, Narayanan
A
, Morris
MR
, Brenner
MP
. Context-aware abbreviation expansion using large language models
. arXiv preprint
. 40.
Holyfield
C
, MacNeil
S
, Caldwell
N
, O’Neill Zimmerman
T
, Lorah
E
, Dragut
E
, et al. Leveraging communication partner speech to automate augmented input for children on the autism spectrum who are minimally verbal: prototype development and preliminary efficacy investigation
. Am J Speech Lang Pathol
. 2024
;33
(3
):1174
–92
. 41.
Light
J
, Drager
K
. AAC technologies for young children with complex communication needs: state of the science and future research directions
. Augment Altern Commun
. 2007
;23
(3
):204
–16
. 42.
Binger
C
, Berens
J
, Kent-Walsh
J
, Taylor
S
. The effects of aided AAC interventions on AAC use, speech, and symbolic gestures
. Semin Speech Lang
. 2008
;29
(2
):101
–11
. 43.
Blischak
D
, Lombardino
L
, Dyson
A
. Use of speech-generating devices: in support of natural speech
. Augment Altern Commun
. 2003
;19
(1
):29
–35
. 44.
Jagaroo
V
, Wilkinson
K
. Further considerations of visual cognitive neuroscience in aided AAC: the potential role of motion perception systems in maximizing design display
. Augment Altern Commun
. 2008
;24
(1
):29
–42
. 45.
Brady
N
, Fleming
K
, Thiemann-Borque
K
, Olswang
L
, Dowden
P
, Saunders
M
. Development of the communication complexity scale
. Am J Speech Lang Pathol
. 2012
;21
(1
):16
–28
. 46.
Barlow
DH
, Hayes
SC
. Alternating treatments design: one strategy for comparing the effects of two treatments in a single subject
. J Appl Behav Anal
. 1979
;12
(2
):199
–210
. 47.
Kratochwill
TR
, Hitchcock
JH
, Horner
RH
, Levin
JR
, Odom
SL
, Rindskopf
DM
, et al. Single-case intervention research design standards
. Remedial Spec Educ
. 2013
;34
(1
):26
–38
. 48.
Göttgens
I
, Oertelt-Prigione
S
. The application of human-centered design approaches in health research and innovation: a narrative review of current practices
. JMIR Mhealth Uhealth
. 2021
;9
(12
):e28102
. 49.
MacNeil
S
, Holyfield
C
. American speech-language-hearing association conference
. Boston, MA
: Oral Presentation
; 2023
.50.
Dahlbäck
N
, Jönsson
A
, Ahrenberg
L
. Wizard of Oz studies: why and how
. Knowl Based Syst
. 1993
;6
(4
):258
–66
. 51.
Maulsby
D
, Greenberg
S
, Mander
R
. Conference on human factors in computing systems: proceedings of the INTERACT ’93 and CHI ’93 conference on human factors in computing systems
. 1993
:277
–84
. 52.
Holyfield
C
. Preliminary investigation of the effects of a prelinguistic AAC intervention on social gaze behaviors from school-age children with multiple disabilities
. Augment Altern Commun
. 2019
;35
(4
):285
–98
. 53.
O’Neill
T
, Light
J
, Pope
L
. Effects of interventions that include aided augmentative and alternative communication input on the communication of individuals with complex communication needs: a meta-analysis
. J Speech Lang Hear Res
. 2018
;61
(7
):1743
–65
. 54.
Romski
MA
, Sevcik
R
. Augmentative and alternative communication systems: considerations for individuals with severe intellectual disabilities
. Augment Altern Commun
. 1988
;4
(2
):83
–93
. 55.
Parker
RI
, Vannest
K
. An improved effect size for single-case research: nonoverlap of all pairs
. Behav Ther
. 2009
;40
(4
):357
–67
. 56.
Lorah
ER
, Holyfield
C
, Griffen
B
, Caldwell
N
. A systematic review of evidence-based instruction for individuals with autism using mobile augmentative and alternative communication technology
. Rev J Autism Dev Disord
. 2024
;11
(1
):210
–24
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