Incorporating Visual Scene Display Augmentative and Alternative Communication Supports Into Naturalistic Developmental Behavioral Interventions.

This study looked at helping autistic children who have trouble speaking by combining two approaches: natural play-based therapy (NDBI) with picture-based communication devices (VSD AAC) during story time. Children showed more communication attempts and learned new ways to express themselves when both methods were used together, compared to using just the play-based therapy alone. Results varied between different children.

This single-case study examined whether adding Visual Scene Display (VSD) augmentative and alternative communication (AAC) supports to Naturalistic Developmental Behavioral Interventions (NDBIs) could improve communication outcomes for autistic children with minimal speech. The intervention combined VSD AAC with just-in-time programming and aided AAC input during interactive storybook reading. Results showed all participants demonstrated increases in symbolic communicative turns and more rapid acquisition of new expressive vocabulary when VSD AAC supports were added to NDBI procedures, compared to NDBI alone. However, there was notable variation across individual participants in their response to the combined intervention approach.

Combining VSD AAC supports with NDBI procedures may enhance communication outcomes for autistic children with minimal speech beyond traditional NDBI alone. Individual variation suggests need for personalized implementation. Approach shows promise for addressing communication needs of children traditionally least likely to benefit from speech-focused interventions.

Single-case design with unspecified sample size limits generalizability. Notable individual variation in responses suggests the approach may not be equally effective for all children with minimal speech. Long-term effects and maintenance of gains not reported.

Naturalistic developmental behavioral interventions (NDBIs) are a promising approach for supporting early language and communication development for young children on the autism spectrum.However, the children with the greatest need of language supports-those with minimal speech-have limited means to participate within these interventions and are therefore the least likely to benefit from traditional NDBIs that focus primarily on speech production. Using a single-case, multiple-probe across participants design, the current study investigated whether adding visual scene display (VSD) augmentative and alternative communication (AAC) supports with just-in-time programming and aided AAC input to NDBI procedures within an interactive storybook reading context resulted in (a) an increase in the number of symbolic communicative turns or (b) an increase in the rate of the number of different unique concepts expressed by young children on the autism spectrum with minimal speech. All participants tended to take more symbolic communicative turns each session and add new expressive vocabulary more rapidly with the addition of VSD AAC supports as compared to NDBI procedures alone, although with notable variation across participants. The results of this study indicate that including VSD-based aided AAC systems and strategies designed to support beginning communicators within the framework of an NDBI can increase both the communication frequency and expressive vocabulary of children on the autism spectrum with minimal speech, beyond the effects of NDBI procedures alone. https://doi.org/10.23641/asha.29374061.