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This manuscript describes an early childhood educator working collaboratively with a speech language pathologist and using an augmentative and alternative (AAC) device (iPad™ application) to label target vocabulary during shared book reading as an inclusive practice. The child throughout the vignettes includes a young boy identified with autism spectrum disorder who has limited verbal communication. The focus of this manuscript is using traditional wh- questions within level one of dialogic reading paired with an AAC device during shared book reading sessions. Step-by-step procedures that can be used widely including adaptations and considerations for individualizing instructions are provided. Resources and additional supports are discussed.

Augmentative and alternative communication (AAC) systems can support communication skills for people with significant developmental disabilities who experience complex communication needs (CCNs). There is a need to tailor best practices in AAC assessment and intervention to create individualized communication systems with this population. In this article, we outline the important components of AAC systems that can be implemented in authentic settings. However, given the limited evidence on AAC interventions specific to people with CCNs, we also identify some priority areas for future inquiry. Among these involve strategies to enhance decision making regarding (a) matching communication mode(s) to learner skills and contextual demands, (b) identifying communicative opportunities and obligations, (c) individualizing aided communication display features, (d) selection of vocabulary specificity, and (e) considering dosage parameters needed to acquire and maintain a communicative repertoire. In addition, we briefly discuss the use of telehealth to enhance intervention capability.

We propose a SAGE model for social psychological research. Encapsulated in our acronym is a proposal to have a synthetic approach to social psychological research, in which qualitative methods are augmentative to quantitative ones, qualitative methods can be generative of new experimental hypotheses, and qualitative methods can capture experiences that evade experimental reductionism. We remind social psychological researchers that psychology was founded in multiple methods of investigation at multiple levels of analysis. We discuss historical examples and our own research as contemporary examples of how a SAGE model can operate in part or as an integrated whole. The implications of our model are discussed.

Students with autism spectrum disorder (ASD) have difficulties in communication that limit their opportunities to participate in daily living and educational activities. Augmentative alternative communication is one of the strategies used to strengthen the communication skills of students with limited communication skills. Students with ASD commonly use handheld devices for communication. This article provides guidelines for special education teachers to support the implementation of tablet-based speech-generating devices in their classrooms. These guidelines may help special education teachers through the process of creating a student’s profile, conducting preference assessments, programming devices, and providing instruction in natural contexts.

Autologous cartilages or synthetic nasal implants have been utilized in augmentative rhinoplasty to reconstruct the nasal shape for therapeutic and cosmetic purposes. Autologous cartilage is considered to be an ideal graft, but has drawbacks, such as limited cartilage source, requirements of additional surgery for obtaining autologous cartilage, and donor site morbidity. In contrast, synthetic nasal implants are abundantly available but have low biocompatibility than the autologous cartilages. Moreover, the currently used nasal cartilage grafts involve additional reshaping processes, by meticulous manual carving during surgery to fit the diverse nose shape of each patient. The final shapes of the manually tailored implants are highly dependent on the surgeons’ proficiency and often result in patient dissatisfaction and even undesired separation of the implant. This study describes a new process of rhinoplasty, which integrates three-dimensional printing and tissue engineering approaches. We established a serial procedure based on computer-aided design to generate a three-dimensional model of customized nasal implant, and the model was fabricated through three-dimensional printing. An engineered nasal cartilage implant was generated by injecting cartilage-derived hydrogel containing human adipose-derived stem cells into the implant containing the octahedral interior architecture. We observed remarkable expression levels of chondrogenic markers from the human adipose-derived stem cells grown in the engineered nasal cartilage with the cartilage-derived hydrogel. In addition, the engineered nasal cartilage, which was implanted into mouse subcutaneous region, exhibited maintenance of the exquisite shape and structure, and striking formation of the cartilaginous tissues for 12 weeks. We expect that the developed process, which combines computer-aided design, three-dimensional printing, and tissue-derived hydrogel, would be beneficial in generating implants of other types of tissue.

In this article the author shares his experience doing life history research with people with disabilities. Berger begins with a brief explanation of how his biographical trajectory brought him to an interest in disability. He then considers the tradition of emancipatory disability research in the context of qualitative inquiry more generally, then his research with Melvin Juette and the world of wheelchair basketball, and last his work with Jon Feucht and the world of augmentative communication.

Surveying 15 states and 39,837 students, this study examined the extent to which students who took an alternate assessment based on alternate achievement standards in the 2010–2011 school year had access to regular education settings and the extent to which that access correlated with expressive communication, use of an augmentative or alternative communication (AAC) system, and reading and math skill levels. The vast majority (93%) of students were served in self-contained classrooms, separate schools, or home settings, whereas only 7% were served in regular education or resource room placements. There was a significant, positive correlation between expressive communication and reading and math skill levels with increasingly inclusive classroom settings and a significant, negative correlation between use of AAC and more inclusive settings. Implications of these findings are discussed.

Augmentative Alternative Communication (AAC) aids are devices that help individuals with speech impairments communicate. Currently, the design and development of AAC devices does not follow a usercentered design philosophy. This affects the quality of life of individuals who are in need of AAC devices. Individuals with the progressive disease Amyotrophic Lateral Sclerosis (ALS) are a population for which AAC is of critical importance. Due to the ALS individuals’ physical capabilities and constraints, there are challenges in involving the user population in a user-centered design process. This paper recommends the application of the methodology of persona development derived from the field of interaction design/usercentered design to solve some of the existing problems in the design of AAC devices for this population. This research demonstrates how current user-centered design methodologies can be adapted to develop personas of individuals with ALS and more generally, how user-centered design should be integrated into the design of AAC devices to enhance the quality of life of individuals with communication impairments.

This essay describes the first author's personal and professional journey to and through the Eighth International Congress of Qualitative Inquiry. The story is told in Ron Berger's voice but is written in the context of his friendship and professional collaboration with Jon Feucht, who uses a computerized augmentative communication device to speak. From the very beginning, the authors anticipated that their experiences at the Congress would contain possibilities for collecting ethnographic data and writing an article that would illuminate the lived experience of disability and augmentative communication. After arriving at the Congress, additional possibilities for a multilayered essay unfolded as well.

The Picture Exchange Communication System (PECS) has emerged as the augmentative communication intervention of choice for individuals with autism spectrum disorder (ASD), with a supporting body of single-participant studies. This report describes a meta-analysis of 16 single-participant studies on PECS with percentage of nonoverlapping data (PND) as the metric of effect size. Results suggest that PECS was moderately effective in establishing mands (PND = 80.1) for 41 participants up to Phase IV of the system. Higher levels of manding were found when PECS was taught to individuals without ASD diagnoses versus those with ASD diagnoses and in single settings versus multiple settings; however, these differences were not statistically significant. For a smaller subset of participants for whom vocalizations were recorded, PECS appeared to facilitate speech, though considerable variability in speech acquisition was evident. While these results support PECS as an evidenced-based communication intervention, they indicate that more research is needed on speech with PECS, to establish the efficacy of PECS when implemented across settings and communicative partners, and to confirm efficacy of Phases IV, V, and VI.

This study investigated the intelligibility and comprehensibility of natural speech in comparison to synthetic speech. The results demonstrate the type of errors; the relationship between intelligibility and comprehensibility; and the correlation between intelligibility and comprehensibility and key factors, such as the frequency of use of text-to-speech systems. ********** Recent technological progress in electronic augmentative communication devices has expanded the possibilities for communication for people who previously faced severe communication difficulties, such as individuals with visual impairments. As Mirenda and Beukelman (1990) noted, the most common method used to generate synthetic speech in modern communication devices is text-to-speech (TTS) systems. TTS systems use a flexible mathematic algorithm that represents rules for combining acoustic properties and rules for pronunciation (Mirenda & Beukelman, 1990). The perception of synthetic speech is usually discussed with regard to intelligibility and comprehension (Koul, 2003). Intelligibility is the listener's ability to recognize phonemes and words when they are presented in isolation (Ralston, Pisoni, & Mullennix, 1989), whereas comprehension involves the extraction of the underlying meaning from the acoustic signals of speech (Duffy & Pisoni, 1992). The comprehension of synthetic speech involves recognizing the stimuli presented and then performing higher-level processing to obtain meaning. The term discourse comprehension is an automatic process that is used to encode and integrate passages, explanations, and conversations (Higginbotham, Drazek, Kowarsky, Scally, & Segal, 1994). Despite the substantial data on the intelligibility and comprehension of synthetic speech systems by people with no disabilities (see, for example, Koul, 2003; Koul & Hanners, 1997; Mirenda & Beukelman, 1987, 1990), there has been limited research on the intelligibility and comprehension of synthetic speech systems by people with visual impairments (see, for example, Hensil & Whittaker, 2000). Numerous studies have found that natural speech is significantly more intelligible than that produced by TTS synthesis systems (Clark, 1983; Greene, Logan, & Pisoni, 1986; Hoover, Reichle, VanTasell, & Cole, 1987; Kangas & Allen, 1990; Koul & Allen, 1993; Logan, Greene, & Pisoni, 1989; Mirenda & Beukelman, 1987, 1990; Mitchell & Atkins, 1989; Ralston, Pisoni, Lively, Greene, & Mullennix, 1991). For example, the percentage of intelligibility for high-quality synthesizers, such as DECtalk (a high-quality form of synthetic speech manufactured by Digital Equipment Corporation) in a single-word intelligibility task ranged from 81.7% correct with an open-response format (Mirenda & Beukelman, 1987) to 96.7% correct with a closed-response format (Greene, Manous, & Pisoni, 1984, cited in Koul & Hanners, 1997). In contrast, word-intelligibility scores for natural speech ranged from 97.2% correct with an open-response format to 99% correct with a closed-response format (Logan et al., 1989). Moreover, a review of relevant research on the perception of sentences produced by synthetic speech revealed a differentiated pattern of results, depending on the type of sentence spoken. According to Mirenda and Beukelman (1987), accuracy scores ranged from 96.7% for sentences presented via the DECtalk synthesizer to 99.3% for meaningful sentences presented via natural speech. However, for anomalous sentences, accuracy scores ranged from 78.7% for synthetic speech to 97.7% for natural speech (Pisoni & Hunnicutt, 1980, cited in Koul, 2003). Thus, similar to the trend for words, there is remarkably greater intelligibility for natural speech than for TTS speech for sentences. Furthermore, comprehension of sentences and narratives has been found to be slower and less accurate when materials are presented in synthetic rather than in natural speech (Higginbotham et al. …

Background. Effective use of augmentative communication requires an individual to manage its technical aspects. Motor-skill limitations in cerebral palsy (i.e., individual constraints) can influence this ability as can demands imposed by communication devices (i.e., task constraints). Purpose. This paper emphasizes the importance of analyzing the confluence of task and individual constraints in promoting a functional fit between the individual with cerebral palsy and the communication device. We demonstrate the utility of current principles of motor control in analyzing this confluence. Key Issues. Task constraints imposed by target selection and individual constraints imposed by cerebral palsy are introduced prior to an analysis of their confluence using the degrees of freedom of the potential planes of limb motion. Implications. Occupational therapists should look beyond motor-skill assessment to the confluence of task and individual constraints when customizing target selection in augmentative communication.

The current study investigated the effectiveness of an integrated word identification and communication intervention for children with complex communication needs. Using a nonconcurrent, multiple baseline design, the study involved three participants who completed 75 lessons across 4 to 6 weeks of instruction. All three participants improved their skills of word identification, developmental spelling, icon sequencing, and expressive communication. Generalization was documented through increases in the frequency of communication using icon sequencing and spelling outside of the instructional program. Implications for the development of integrated word study programs that combine systematic, sequential phonics instruction with instruction in the use of augmentative communication are discussed, along with directions for future research.

In the study reported on here, the authors used computer-based video instruction (CBVI) to teach 3 high school students with moderate or severe intellectual disabilities how to order in fast-food restaurants by using an augmentative, alternative communication device. The study employed a multiple probe design to institute CBVI as the only intervention tool and measured generalization of skills to community restaurants. For 2 of the 3 students, the ability to order their meals dramatically increased immediately following CBVI; for the third student, the ability to perform this task increased during a second generalization condition. Performance was maintained for each student. The authors discuss their results as support for this approach, which would be one solution for providing instruction in a simulated environment when community-based instruction is limited.

This study reports descriptive findings regarding the scaffolding strategies used by an experienced practitioner during a shared book reading session with a student who uses augmentative and alternative communication (AAC). Specific scaffolding strategies are described and, in addition, the level of semantic complexity targeted by the practitioner during the session was examined. The majority of scaffolding strategies targeted higher levels of semantic complexity such as metalanguage, inference and interpretation. Results of this work may contribute to the design of storybook reading as a context for narrative language intervention for children who use AAC.

We describe evidence and intervention strategies for parents, educators, and researchers who seek to enhance communication and literacy in children with Rett syndrome (RS). Four girls with RS and their mothers videotaped their storybook interactions at home for 4 months. Parent-child storybook interactions were coded for child behaviors (e.g., use of augmentative communication devices, attention to book, or vocalizations) and parent behaviors (e.g., pointing in the book or asking predictive questions). Correlation and multiple regression analyses of these variables revealed that girls with RS can learn to communicate in meaningful ways through storybooks; however, mothers may need to engage in different strategies to facilitate better use of augmentative strategies. Successful strategies are discussed for the mother-daughter dyads.

The increase in students with disabilities from Asian backgrounds who receive special education and related services places greater responsibility on professionals providing augmentative and alternative communication (AAC) services to children and families. Numerous values that are deeply embedded in Asian American families may influence the success of family involvement in team decision-making processes as well as subsequent AAC interventions. Contrasting Euro-American and Asian values are examined with particular emphasis on differences exhibited by these families with regard to (a) perspectives on disability, health care, family life, and education/intervention; (b) communication styles; and (c) reactions to AAC. Specific suggestions are offered to practitioners who may be working with this growing minority population in contemporary society.

Research in the area of behavior support has repeatedly demonstrated the positive effects of learning more effective and efficient communication on the challenging behaviors of individuals with developmental disabilities. More recently, augmentative and alternative communication strategies have been receiving increased attention as primary teaching goals for young children with autism. Use of picture exchange and choice-making opportunities has been reported to facilitate speech acquisition and/or result in increased communicative attempts across daily routines. The case study discussed in this article examines the effects of picture exchange on the severe aggressive behavior of a preschooler with autism who was at risk of losing his integrated school placement. Picture exchange was introduced within two play routines in the classroom. The effects of picture exchange on the student's aggression were evaluated within a multiple baseline design. Results indicated that the student's aggressive behavior was eliminated in a brief amount of time when picture exchanges were in place. These findings are discussed in terms of integrating augmentative communication into behavioral support planning and future research in this area.

This classroom intervention describes a nonverbal and behaviorally and cognitively challenged adolescent with autism who participates in a data-based, total immersion, augmentative communication intervention. Using a natural aided language approach and picture communication boards, the student was provided with intense visual-paired-with-verbal-language input in each activity and environment of his school day. Without training or prompting, the young man's picture language receptive and expressive vocabulary increased during the intervention. In addition, his positive behaviors increased. The increases in communication and positive behaviors dramatically altered the classroom staff's perception of the student, and as a result, his curriculum and IEP were made more complex, academic, and challenging.

This article provides a review of the empirical literature on a number of topics related to augmentative and alternative communication (AAC) and assistive technology as they have been used to support communication and learning in individuals with autism/PDD-NOS. The review is presented in six main topic areas: Assessment, Staff/ Family Training, Supports for Augmented Input, Supports for Augmented Input + Output, Supports for Augmented Output, and Assistive Technology for Communication and Learning. Finally, recommendations for future research are provided.

A multiple baseline study evaluated the effects of using voice output devices to facilitate communicative initiation behaviors of 2 young children who were developmentally delayed and nonverbal. Data were collected during snack time on specific communication behaviors. Both children increased their specific initiations. In addition, unclear initiations and adult prompted communication behaviors decreased when the voice output devices were used. Comparisons with a typically developing peer suggested the voice output device enabled both children to increase their specific initiated communication behavior closer to that of the peer. Results support the use of augmentative voice output devices with young nonverbal children. Areas for future research to more thoroughly evaluate the potential utility of voice output devices are noted.

Augmentative communication (AC) systems with synthesized speech output have been developed for nonspeaking people. Most AC devices that aim to support social conversation have been designed to help the user generate novel utterances as quickly as possible. However, they remain too slow to support effective, real-time conversation. Preconstructed phrases have been shown capable of supporting socially effective conversations with a succession of new partners when the phrases are stored within a structure that models pragmatic aspects of natural conversation. The extent to which prestored text can be effective in repeated conversations with the same person, where most phrases are not reusable, was investigated in a single-case experimental design. Results indicated that the AC user’s conversational rate with a repeat partner was faster, without any accompanying loss of social effectiveness. Furthermore, the user did not need to resort to on-line entry of text more frequently with the repeat partner than with new partners. Implications for the design of AC systems and for the understanding of the pragmatics of conversation are discussed.

Abstract: The field of augmentative and alternative communication (AAC) continues to struggle with issues relating to generalization and maintenance. Current methods of modifying instructional practices and teaching skills directly to the communication partner have contributed to developing successful treatment outcomes. However, few studies have examined AAC in the home setting during daily routines with parents. This study examined whether teaching parents a problem-solving intervention that considered the family's lifestyle would promote child spontaneous picture card use and parent-provided communication opportunities during daily routines. Data were collected in the context of a multiple baseline design across child and parent behavior. The results showed increases in the child's use of cards and in the parent's use of communication opportunities across multiple routines, parent and child behavior maintenance over time, and increases in the parent's perception of their child's communication skill and of their own ability to promote communication. The findings support the use of a problem-solving intervention that incorporates the family's lifestyle as a method to promote augmentative communication during daily routines.

This research project examined the context and interaction variables that were associated with reciprocity in communication interaction between adolescents using augmentative/alternative communication (AAC) systems and their non-disabled peers. The participants were five adolescents with physical and/or cognitive disabilities who communicated with various AAC systems and the non-disabled peers in their high school homeroom classes. Six interactive and communicative behaviors were coded on-line by investigators during 15 minute unstructured homeroom sessions. These interactions were coded for reciprocity, and situational variables that distinguished episodes of high and low reciprocity were compared. Results indicated clusters of context/interaction patterns that tended to co-occur with more balanced levels of communication behaviors between the interactants observed. Results are discussed in terms of seven specific guidelines that provide implications for clinical practice.

A statewide survey was conducted in cooperation with the Pennsylvania Assistive Technology Center of Harrisburg to identify the stressors and family supports of 59 families with young children between the ages of 3 and 12 years who use AAC technology and technology services. Descriptive statistics and correlations were used to analyze the data. Parenting Stress Index results revealed both fathers and mothers perceived the child-related variables of acceptance and demandingness as stressful. Results revealed differences for parent-related variables for mothers and fathers. Data derived from the Family Support Scale revealed significant differences for mothers and fathers with regard to the helpfulness of social supports. Implications for family-centered intervention and future research are discussed.

The Picture Exchange Communication System (PECS) has become a widely known and used augmentative system for teaching functional communication skills and potentially providing a bridge to speech acquisition. Unfortunately, although there is a great deal of anecdotal clinical evidence about the PECS, there is little empirical information about its efficacy. We present two studies documenting the use of PECS for preschool children with severe disabilities. The first study analyzed the PECS acquisition data for 31 preschool children and demonstrated that young children with severe communication delays and disorders can learn to use PECS quickly and efficiently. The second study followed 18 preschool PECS users for a year. The results of language samples taken at snack time and during free-choice activities indicated that PECS use generalizes to untrained settings and may have concomitant effects on untrained language functions. Directions for future research are discussed.

Visual language and augmentative communication systems for individuals with pervasive developmental disorders and autism are presented as both a legitimate language and an effective strategy. Using the natural aided language paradigm and picture symbols or printed words, language stimulation is implemented in natural environments to increase communication, interaction, participation, and compliance. Methods for choosing target environments, generating appropriate vocabulary, creating interactive language boards, and implementing them with appropriate communication partners are described. Samples of environmentally specific language boards are included. Effective strategies for inclusion, behavior management, leisure skills, and cognitive activities are targeted through visual language systems and augmentative communication.

Landau-Kleffner syndrome is a rare and unique syndrome that is most often characterized by difficulty in receptive or expressive language ability, abnormal electroencephalograms (EEGs), and seizures. It is important for educators to understand this distinct syndrome because children with Landau-Kleffner syndrome are often misdiagnosed. In this article we synthesize the literature on the primary and secondary characteristics of children with Landau-Kleffner syndrome (e.g., behavior problems). A framework for intervention techniques is then provided based on the literature on appropriate techniques for children with language difficulties. Interventions discussed include using predictable language, creating the need to communicate, and using alternative and augmentative communication techniques.

This longitudinal case study examined the communication and literacy learning progress of an 11-year-old boy with severe speech and physical impairments related to cerebral palsy. Theoretically driven literacy assessments revealed unforeseen literacy capabilities. Integrated use of voice-output augmentative communication technology led to improved communication skills as well as increased demonstrations of literacy capability. Systematic instruction addressing the child's weaknesses and strengths resulted in literacy gains across 2 school years.

This article summarizes areas of progress made in meeting the communicative needs of individuals with severe disabilities. Evidence supporting best practices in the selection of (a) communicative functions, (b) communicative modes and symbols, and (c) instructional formats is presented. Evidence suggests that approaches to intervention that incorporate careful consideration of social motivations for behavior and recent advances in augmentative communication modes have had a significant impact on success in establishing beginning communicative repertoires. Inherent in this orientation is the belief that nearly all individuals attempt to communicate. This means that literature describing best practices in establishing functionally equivalent and maximally efficient new communicative forms to replace old forms is extremely relevant to communication interventionists. Finally, recent literature suggests that interventionists consider generalization as part of the acquisition process and carefully select a range of contexts in which to implement opportunities to teach new communicative repertoires.

Augmentative and alternative communication (AAC) users often have limited literacy skills due to many factors, including restricted opportunities to demonstrate cognitive and communication abilities, as well as limited reading instruction and practice time. This case study evaluates the efficacy of a barrier task as a teaching tool to improve literacy skills in a young AAC user. Adaptations were made to keep barrier tasks within the subject's physical and communication limita tions. Post-treatment results indicate that the subject demonstrated increased sight-word recognition as well as increased letter recognition. This barrier task proved to be a motivating, effective technique to increase literacy skills via a communication framework.

This article summarizes the results of a survey of teachers in Pennsylvania who have educational responsibility for one or more students who use assistive technology in the classroom. The majority of these students had some type of physical disability and used an augmentative communication device. The teachers who responded to this survey were highly educated and experienced in the use of computers and assistive technology. Issues surrounding the complexity of the equipment were among the greatest barriers to the use of assistive technology reported by these teachers. When asked to rate both the importance and availability of specific technology supports, training and maintenance issues were rated most highly. Teachers consistently rated supports as being more important than they were readily available.

Persons with Rett syndrome experience multiple disabilities including a severe movement disorder, motor planning difficulties, impaired cognitive functioning, and a severe language disorder. Until recently, persons with severe multiple disabilities often were denied access to critical skill training programs, such as augmentative communication instruction, due to unfounded beliefs in the poor prognosis of such intervention. The present study explores the use of a computer-based requesting system, employing animated graphics and touch-sensitive screen input, with three girls having a primary diagnosis of Rett syndrome. Results indicate that all three girls displayed increased item requesting when provided computer-based requesting instruction. Two of the students met and exceeded acquisition criteria for all training lexigrams, while the third student acquired only one of the initial three lexigrams. When provided the opportunity to differentially request liked and disliked foods, all three girls were found to display the ability to discriminate the preferred items above chance levels.

Amyotrophic lateral sclerosis (ALS) is often associated with oropharyngeal weakness, which impairs oral communication. Augmentative/alternative communication (AAC) is sometimes used to compensate f...

This study examined the effectiveness of a microcomputer-operated video-game format in training nonvocal students with severe physical handicaps to make scan and selection responses similar to those needed for operating linear scanning augmentative communication aids. The video scanning and selection game systematically shaped scanning on more complex screens by slowly increasing the number of boxes presented simultaneously on the screen (i.e., from one to three boxes). Three children participated in a multiple probe across-subjects design to evaluate the effectiveness of the video game. Results indicated that all three children showed substantial increases in the number of correct scan and selection responses made at all three levels of difficulty. Generalization data indicated that all three children were able to transfer use of the skill to a Zygo 100 communication device. Maintenance of the effects also was demonstrated.

Children who are severely physically handicapped and non-speaking may be assessed for recommendation of an augmentative communica tion system. A working model of assessment, developed at the Com munication Aids Centre at The Wolfson Centre, London, is presented and illustrated with three case studies. The paper includes discussion of the prerequisite skills for use of a communication aid, and consideration of important factors in the child's environment, such as training opportunities and the expectations of communication partners, which affect the success of the outcome.

A discussion of augmentative communication aids for non-reading severely physically handicapped children is presented. Three specific topics are discussed: factors in movement to electronic communication aids, basic components of electronic aids, criteria for selection of aids, and specific training suggestions. The importance of maintaining flexibility is stressed. Augmentative communication aids for this population should reflect a dynamic rather than static philosophy. They must meet the needs and abilities of the student in present and future environments.

Many children who are unable to communicate orally now have new opportunities available to them due to technological advances in the development of augmentative communication systems. Communication aids that enhance social/communicative interaction are being designed for even the most severely physically disabled children. In spite of these developments, many problems still exist in the qualitative aspects of communication that affect both speaker and listener roles. This article addresses some of the primary problems in augmentative communication systems and aids from an interdisciplinary assessment/intervention model.

This article describes three follow-up assessment models explored by an interdisciplinary augmentative communication team located at a regional center. It also addresses the relationship between the team's experiences with the models and the evolution of team expertise in making recommendations for augmentative communication techniques. The three models are characterized in Table 1 in terms of services offered, training provided, cost, advantages, and disadvantages. Perspectives on assessment and team development are discussed, with case studies included to illustrate major points. We conclude that all three models were beneficial to the process of developing sound assessment techniques.

Several authors have used the EEG as a diagnostic tool to identify distinctive patterns of cerebral dysfunction in autistic children. However, evidence is needed to support the hypothesis that their level of functioning correlates with their EEG profile. In this study EEG's were obtained in 17 autistic children without sedation and following sleep deprivation. These children were also evaluated in a double blind procedure with regard to their speech and communication abilities. We did not find a statistically significant correlation between EEG changes and speech performance. None of the autistic children using an augmentative system of communication had any EEG abnormalities. However, a normal EEG is not sufficient to predict successful response to communication therapy. Since the effect of sedative drugs on brain electrical activity limits the value of tracings, we recommend the sleep deprivation techniques when “difficult” children have to undergo EEG testing. Parents' or guardians' participation during the procedure is encouraged.

This paper traces the purpose, histoy, and development of augmentative communication and describes the state ofthe art in assessment, system/symbol selection, and range of technology available in aids. Pethaps the most important part of augmentative communication, hever, is communicative function and the facilitation of interaction. In the last 3 years, this aspect of the field bas received greater attention in both research and clinical settings. Recent comparisons of augmentative communication with spoken language and cultural gestures have identified new areas for study and application to nmspeaking individuals.

Sets of augmentative decision rules used to determine a learner's candidacy for an augmentative communication system were reviewed and critiqued. Particular scrutiny was given to criteria addressing certain cognitive acquisitions and the identification of a significant communication deficit(s) as prerequisites to system implementation. A case is presented to support the use of an augmentative communication system as a preventive treatment and a potential facilitator of language comprehension skills. An alternative approach to traditional decision rules that involves the implementation of procedures that allow the simultaneous scrutiny of graphic (communication board), gestural (sign), and vocal communicative modes is proposed.