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

Storybook reading has been recognized as a way to support the language development of children who are pre-literate or with emergent literacy skills. Many children with complex communication needs who use AAC may be less involved in reading activities compared to their peers without disabilities. Training communication partners on how to promote communication during storybook reading activities may be a useful way to teach these skills to complex communicators. The effectiveness of this type of training is explored in this study by Kent-Walsh et al.

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

Effects of Parent Instruction on the Symbolic Communication of Children Using Augmentative and Alternative Communication During Storybook Reading

Aided AAC Model: a communication strategy where a communication partner teaches symbol meaning and models language by combining their verbal input with a selection of vocabulary or symbols on the Augmentative and Alternative Communication (AAC) system; this is done by selecting vocabulary on the AAC system and speaking at the same time

Contingent Response: responding to and acting upon the message of the AAC learner, no matter what he/she communicates

Emergent Literacy Skills: recognizing books by their covers, how to turn pages, knowing at which end a book starts

Expectant Delay: providing an AAC learner extra pause/wait time (10-15 seconds) to increase opportunities for communication

Joint Attention: the shared focus of two individuals on an object or activity

Least-to-Most Promoting: the least amount of prompting is provided at first when completing a task with additional support added if necessary

Pre-literate: before a child develops literacy skills (reading skills)

The researchers were looking to answer the following two questions:

1. What is the effect of the instructional program on parents’ use and carryover of the communication partner interaction strategy during book-reading activities?

2. What is the impact of the parents’ use of the least-to-most prompting strategy on the turn-taking skills of their children?

Storybook reading activities can be rich language learning opportunities for AAC users. Storybook reading can be beneficial, as vocabulary can be predicted and programmed into a child’s communication device. It also provides an opportunity for joint attention with a communication partner. The focus of reading activities is on communication, rather than other skills like fine motor skills in an arts and crafts activity. However, during storybook reading activities with complex communicators, adults may take the majority of conversational turns, ask yes/no questions (rather than wh- or open-ended questions), provide fewer opportunities for communication, and interrupt the AAC user. Therefore, communication partner training during these activities can be beneficial to increase communication opportunities for AAC users.

The researchers in this study used a program by Kent-Walsh and colleagues (Binger et al., 2008; Kent-Walsh, 2003; Rosa-Lugo & Kent-Walsh, 2008) called the ImPAACT (Improving Partner Applications of Augmentative Communication Techniques) Program, which teaches communication partners to support early language and communication skills of children who use AAC. The parents were trained using this eight-step communication partner instruction model described in Kent-Walsh and McNaughton (2005):

1. Pretest and determine the parent’s commitment to learning the targeted strategy

2. Describe the communication partner interaction strategy

3. Demonstrate the use of the strategy

4. Verbal practice of the interaction steps

5. Practice implementing the strategy in a controlled context (e.g., role play with the authors)

6. Practice implementing the strategy in natural contexts (e.g., book reading with the children)

7. Posttest and determine the parents' long-term commitment to using the strategy

8. Demonstrate carryover of the communication partner interaction strategy 

The sessions included shared storybook reading activities. Communication boards were created for each of the children for each book that included wh-questions (e.g., who, what, where), as well as characters, actions, descriptors, and objects from the books. The researchers trained the parents using a cueing hierarchy and strategy outlined in Kent-Walsh’s original research paper (2003) and described below:

1. Read and provide an aided AAC model

2. Ask a wh-question and provide an aided AAC model

3. Answer the wh-question and provide an aided AAC model

Each step of the hierarchy was followed by an expectant delay and communication turns of the children were followed by contingent responses by the parents. The researchers measured the parents’ use of the strategies (AAC models, expectant delay, wh-questions, and contingent responses) and the number of the communicative turns that the child took during each 10-minute session with their children.

Results indicated that the parents learned to use the communication partner strategy over a relatively short period of instruction (2-2.5 hours). All 6 children had a significant increase in their turn-taking skills after their parents began using the communication partner instruction strategy with them during storybook reading activities.

The number of people involved in this study was small, but the results of this study built on previous research on training communication partners to improve their interaction skills with AAC learners using the ImPAACT (Improving Partner Applications of Augmentative Communication Techniques) Program. Also, the context was limited to storybook reading in the home environment and did not provide communication partner training in other types of activities (e.g., play, meals).  

Parent instruction using this program was found to be an effective way to increase the use of symbolic communication in their children. Storybooks were a useful way for the parents to support the communication skills of their AAC users, as the books included predictable language, and were an easy way for parents to learn the strategies. The parents quickly learned the instructional strategies (AAC models, expectant delay, wh-questions, and contingent responses) and used them to give communication opportunities for their children. These strategies helped the parents in the study to break patterns of communication that are not useful (e.g., asking yes/no questions, dominating the conversation). The children were then able to make speedy, meaningful improvements in their expressive communication skills.

Please comment with any thoughts or questions!  

Full article link:  https://doi.org/10.1044/1058-0360(2010/09-0014)

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

References:

Binger, C., Kent-Walsh, J., Berens, J., DelCampo, S., & Rivera, D. (2008). Teaching Latino parents to support the multi-symbol message productions of their children who require AAC. Augmentative and Alternative Communication, 24, 323–338.

Kent-Walsh, J. (2003). The effects of an educational assistant instructional program on the communicative turns of students who use augmentative and alternative communication during book-reading activities (Unpublished doctoral dissertation). Penn State University, University Park.

Kent-Walsh, J., Binger, C & Hasham, Z. (2010). Effects of Parent Instruction on the Symbolic Communication of Children Using Augmentative and Alternative Communication During Storybook Reading. American journal of speech-language pathology / American Speech-Language-Hearing Association. 19. 97-107. 10.1044/1058-0360(2010/09-0014).

Kent-Walsh, J., & McNaughton, D. (2005). Communication partner instruction in AAC: Present practices and future directions. Augmentative and Alternative Communication, 21, 195–204.

Rosa-Lugo, L. I., & Kent-Walsh, J. (2008). Effects of parent instruction on communicative turns of Latino children using AAC during storybook reading. Communication Disorders Quarterly, 30, 49–61

You can read other posts about research HERE