A Systematic Review of Research Comparing Mobile Technology Speech-Generating Devices to Other AAC Modes With Individuals With Autism Spectrum Disorder

Journal of Developmental & Physical Disabilities

Lorah, E. R., Holyfield, C., et al. (2022).

Journal of Developmental & Physical Disabilities, 34(2), 187-210.

This systematic review investigates the effects of treatment with varied modes of augmentative and alternative communication (AAC) on communication outcomes for children on the autism spectrum.

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Peer-reviewed studies with alternating treatment designs (with or without baseline)

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<div>During the baseline phase of the studies, children on the autism spectrum communicated with limited success via AAC without instruction. Even in the absence of instruction, more children benefited from speech-generating devices (SGDs) than picture exchange or manual sign. "When using a high-tech SGD, participants across all studies demonstrated a mean baseline performance level of 11.4% (SD=23.9; range: 0&ndash;100%) overall. When using low-tech picture exchange, participants demonstrated a mean baseline performance level of 0.8% (SD=3.8; range: 0&ndash;30%) overall. When using no-tech manual sign, participants demonstrated a mean baseline performance level of 2.8% (SD=16.1; range: 0&ndash;100%) overall" (p. 201).</div> <p>During the intervention phase, performance across all three AAC modes was higher than at baseline. Instructional strategies used included: reinforcement, prompting, time delay, discrete-trial training, and task analysis. "When using a high-tech SGD, participants across all studies demonstrated a mean intervention performance level of 63.8% (SD=34.8; range: 0%-100%) overall. When using low-tech picture exchange, participants demonstrated a mean intervention performance level of 53.1% (SD=38.1; range: 0%-100%) overall. When using no-tech manual sign, participants demonstrated a mean intervention performance level of 22.9% (SD=33.5; range: 0%-100%) overall" (p. 201).</p> <p>Effect size estimations showed mixed results for the comparative effects of high-tech SGDs versus low-tech picture exchange communication. Moderate or strong positive effects were found for the use of SGDs as compared to manual sign. Moderate or strong effects were also found for the effects of picture exchange as compared to manual sign.</p>

<div>Across studies, 31 of 35 participants preferred interacting using a speech-generating device while 4 of 35 preferred interacting using picture exchange. No participants preferred interacting using manual sign.</div>