by Julia Wynne, MA, CCC-SLP (Speech-Language Pathologist); NWACS Contributor

Many children with Autism present with delayed speech and language development, with many being minimally verbal after age five. These children are often given Augmentative and Alternative Communication (AAC) systems as a tool to communicate. Often, these AAC users do not use their devices at home and school consistently when compared with verbal peers. This inconsistency can result in device abandonment. Identifying the factors that lead to device abandonment in students with Autism is beneficial to determine what areas should be targeted by Speech-Language Pathologists and to increase overall device use.

This article looked at two areas that may impact the use of the communication system: Parent and Teacher Operational Competency with the AAC System and Parent and Teacher AAC Buy-In. Parents and teachers are key players in teaching a child to use an AAC system at school and home. Their ability to use the system, as well as attitudes toward the system, are explored by the researchers to determine whether training for these individuals impacts device use.

Below you will find definitions of some key terms. Keywords will be bolded throughout the blog. You’ll then find the research question, the importance of the research, a summary of the findings, followed by the most important takeaways from the research article below. Enjoy!

The Relationship Between Operational Competency, Buy-In, and Augmentative and Alternative Communication Use in School-Age Children With Autism

Buy-in: belief that AAC devices offer users increased opportunities and advantages

Data-logging: feature on the AAC device that records, timestamps, and graphs device use

Device abandonment: the person using AAC discontinuing use of the device, despite potentially benefitting from continued use

Operational competency: the skills needed to operate AAC systems accurately and efficiently, such as the ability to navigate the device through different pages, program vocabulary, customize software settings, and select the desired icon

The researchers were looking to answer the following 3 essential questions:

1. Are there differences between teachers and parents in terms of levels of operational competency and buy-in?

2. Are there differences between the amount of training/educational time needed to address operational competency and buy-in?

3. Are operational competency and buy-in correlated with minutes of device use in the home and at school?

Parents and teachers play a vital role in the implementation of AAC in the school and home environments. Lack of parent and teacher training on how to operate a child’s AAC device can be a barrier to the successful use of the device in the home and at school. Positive attitudes of families and teachers toward the AAC system can result in improvements in device use, while negative attitudes can prevent individuals from effectively using their device. Exploring the effects of operational competency and buy-in by teachers and families of children with Autism who use AAC is essential to determine factors that can increase device use and decrease device abandonment.

29 students, aged 3-16 years old, whose main mode of communication were communication devices, were included in the study. These students' families owned their devices and they had access to them at school and home. Parents and teachers took a survey that assessed operational competency and buy-in, as well as clinical expertise. Questions were posed on the survey that addressed how comfortable parents and teachers were with their ability to navigate and program the student’s device (operational competency) and how frequently the student’s device was available to them throughout the day (buy-in). Researchers enabled data-logging on the students’ devices. Device use was measured during a random week for 3 days at school and during the weekend at home.

The results of the study indicated that there were no significant differences in the operational competency of parents and teachers, but teachers had higher buy-in scores than parents (Research Question 1). Teacher buy-in scores were much higher than teacher operational competency scores, but there was no significant difference between parent operational competency and buy-in scores (Research Question 2). The students used their devices more often at school than at home. Teachers with higher operational competency actually had students who used their device less than teachers with lower operational competency (Research Question 3). The researchers attributed this to too much focus on learning the device technology rather than how to teach these students to communicate. Device use was limited during the weekends with 10 of 29 students using their devices over the weekend.

The researchers indicate that the results of this study should be interpreted with caution since the children all went to one school, parents volunteered for the study, and operational competency and buy-in were broadly defined. They also noted that children with Autism typically have reduced social interaction and communication, so training in operational competency and buy-in may not be enough to increase device use of children with Autism. Creating goals focused on operational competency may not address the ultimate goal of increasing communication and may result in reduced device use.

Parents in the study had relatively high buy-in scores, but the children did not use their devices often at home. This suggests that operational competency and buy-in may not alone be enough to support device use in this population. However, through this study, it was unclear how children were communicating with their parents using verbal and non-verbal communication.

The results of the study indicate that training which focuses only on how to navigate and program the device may not give enough attention to creating communication opportunities for children, as teachers with higher competency scores had students that used devices less. Therefore, parents and teachers may be more concerned with technology than communication. It is important that AAC intervention and therapy focus on creating communication opportunities rather than just on the technology. This focus will help teachers and parents understand how the device can support a child's communication.

Please comment with any thoughts or questions!  

Full article link:  https://doi.org/10.1044/2018_AJSLP-17-0175

Images include Boardmaker PCS. The Picture Communication Symbols ©1981–2018 by Mayer-Johnson LLC. All Rights Reserved Worldwide. Used with permission.

Reference:

Decarlo, J., Bean, A., Lyle, S., & Cargill, L. P. M. (2019). The Relationship Between Operational Competency, Buy-In, and Augmentative and Alternative Communication Use in School-Age Children With Autism. American Journal of Speech-Language Pathology, 28(2), 469–484. doi: 10.1044/2018_ajslp-17-0175

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