Naturalistic Speech-Generating Device Interventions for Children With Complex Communication Needs: A Systematic Review of Single-Subject Studies Purpose This article presents a systematic review that aimed to synthesize single-subject–design studies that have examined naturalistic interventions for teaching the expressive use of speech-generating devices (SGDs) to children with complex communication needs. Specifically, this review describes what intervention strategies are most commonly applied in studies with positive effects and ... Review Article
Review Article  |   August 06, 2018
Naturalistic Speech-Generating Device Interventions for Children With Complex Communication Needs: A Systematic Review of Single-Subject Studies
 
Author Affiliations & Notes
  • Cindy Gevarter
    The University of New Mexico Speech and Hearing Center, Albuquerque
  • Claudia Zamora
    University of Texas at Austin
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Cindy Gevarter: cgevarter@unm.edu
  • Editor-in-Chief: Julie Barkmeier-Kraemer
    Editor-in-Chief: Julie Barkmeier-Kraemer×
  • Editor: Erinn Finke
    Editor: Erinn Finke×
Article Information
Augmentative & Alternative Communication / Research Issues, Methods & Evidence-Based Practice / Review Article
Review Article   |   August 06, 2018
Naturalistic Speech-Generating Device Interventions for Children With Complex Communication Needs: A Systematic Review of Single-Subject Studies
American Journal of Speech-Language Pathology, August 2018, Vol. 27, 1073-1090. doi:10.1044/2018_AJSLP-17-0128
History: Received August 18, 2017 , Revised November 30, 2017 , Accepted March 7, 2018
 
American Journal of Speech-Language Pathology, August 2018, Vol. 27, 1073-1090. doi:10.1044/2018_AJSLP-17-0128
History: Received August 18, 2017; Revised November 30, 2017; Accepted March 7, 2018

Purpose This article presents a systematic review that aimed to synthesize single-subject–design studies that have examined naturalistic interventions for teaching the expressive use of speech-generating devices (SGDs) to children with complex communication needs. Specifically, this review describes what intervention strategies are most commonly applied in studies with positive effects and minimal methodological flaws and examines the populations and outcomes for which these strategies have been effective.

Method A systematic approach was used to qualitatively code variables of interest to this review. Results were summarized via both visual analysis and effect size methods, and a certainty of evidence methodology was adopted to describe the quality of the evidence.

Results Thirty-two unique studies met inclusion criteria, with 19 having consistent positive results and meeting minimum requirements for certainty of evidence. Although studies used a variety of titles to describe intervention packages (e.g., milieu teaching, interaction strategies), certain strategies were common across studies. These included (a) creating and capturing communication opportunities via methods such as time delay and questioning; (b) providing feedback via methods such as reinforcement of requests, praise, or expansions; (c) prompting (verbal, physical, gestural); (d) modeling; and (e) training communication partners.

Conclusions Findings regarding these intervention components help to provide practical guidelines for naturalistic SGD intervention. Limitations of the current body of research (e.g., need to include more home-based studies and more intermediate to advanced SGDs, need to critically analyze the most critical intervention components) provide suggestions for future research.

Supplemental Material https://doi.org/10.23641/asha.6615332

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