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This study examined the effects of an intervention package using high-tech augmentative and alternative communication (AAC) with Naturalistic Instruction (NI), time delay, and prompting during social routines for preschoolers on the autism spectrum. The AAC was a communication application on a tablet programmed with color photo representations of participants and communication partners engaged in social routines. The primary dependent measure was a linguistic communication turn on the AAC device completing the instructor's cloze phrase related to the routine. A secondary dependent measure was prelinguistic communication –nonspecific vocalizations and smiling – within each turn of the routine. Results indicated that all communication types increased and maintained for all three participants with two participants meeting mastery criteria within the minimal number of sessions. These results are significant in providing additional evidence for the effectiveness of AAC intervention beyond teaching simple object requests and in teaching more socially meaningful communication to children on the autism spectrum. Additionally, this study supports the use of color photo representations to promote social interaction. Future research should continue to evaluate such interventions on a larger scale and include naturally occurring communication partners, such as siblings and peers. [ABSTRACT FROM AUTHOR]

We conducted a multi-pronged investigation of different types of reporting bias in autism early childhood intervention research. First, we investigated the prevalence of reporting failures of completed trials registered on clinicaltrials.gov, and found that only 7% of registered trials were updated with results on the registration platform and only 64% had associated published reports. Next, we investigated the extent to which inadequate reporting prevents inclusion in meta-analytic summary estimates by identifying reports of studies that were eligible for inclusion in a prior meta-analysis, and found that 25% were excluded due to inadequate reporting. Finally, we investigated selective reporting practices by analyzing the protocols of the studies included in the meta-analysis which had been registered on any trial registry and coding their timing, completeness, and consistency. We found that 23% of studies were pre-registered, 71% were late-registered, and 5% were registered at an unclear date. Only 8% of registrations specified all of the necessary components. Evidence of selective reporting was common; 36% failed to report a registered outcome, 61% reported unregistered outcomes, 23% switched primary and secondary outcomes, and 43% had assessment timepoints that differed from registration specification. Given the inadequacy of registration and reporting practices, we offer practical recommendations to facilitate improvement for the field of autism research. When researchers fail to report their findings or only report some of their findings, it can make it difficult for clinicians to provide effective intervention recommendations. However, no one has examined whether this is a problem in studies of early childhood autism interventions. We studied how researchers that study early childhood autism interventions report their findings. We found that most researchers did not register their studies when they were supposed to (before the start of the study), and that many researchers did not provide all of the needed information in the registration. We also found that researchers frequently did not publish their findings when their studies were complete. When we looked at published reports, we found that many of the studies did not report enough information, and that many studies were reported differently from their registrations, suggesting that researchers were selectively reporting positive outcomes and ignoring or misrepresenting less positive outcomes. Because we found so much evidence that researchers are failing to report their findings quickly and correctly, we suggested some practical changes to make it better. [ABSTRACT FROM AUTHOR]

Introduction: Augmentative and alternative communication (AAC) intervention research is rarely focused on school-age beginning communicators, despite the urgent need to ensure individuals in this population have access to the fundamental human right of communication. Methods: Four school-age children with multiple disabilities who were primarily prelinguistic communicators participated in the current study. The study used a single-subject research design to explore the effects of two interaction approaches – a social routine approach and a directive approach – on prelinguistic communication, compared to independent play and to one another. This study then evaluated the added effects of high-tech AAC within the most effective interaction approach for each participant. Results: All participants demonstrated prelinguistic communication indicating positive affect most frequently when interacting within a social routine. Furthermore, all participants increased linguistic communication while either maintaining or increasing prelinguistic communication when high-tech AAC was added to the social routine interaction. Conclusions: Clinicians should consider building accessible, predictable, engaging, and age-respectful social routines into leisure contexts to promote prelinguistic communication from school-age beginning communicators. Clinicians should also provide access to linguistic communication through high-tech AAC while continuing to honor and promote prelinguistic communication. [ABSTRACT FROM AUTHOR]

Purpose: Augmentative and alternative communication (AAC) technology innovation is urgently needed to improve outcomes for children on the autism spectrum who are minimally verbal. One potential technology innovation is applying artificial intelligence (AI) to automate strategies such as augmented input to increase language learning opportunities while mitigating communication partner time and learning barriers. Innovation in AAC research and design methodology is also needed to empirically explore this and other applications of AI to AAC. The purpose of this report was to describe (a) the development of an AAC prototype using a design methodology new to AAC research and (b) a preliminary investigation of the efficacy of this potential new AAC capability. Method: The prototype was developed using a Wizard-of-Oz prototyping approach that allows for initial exploration of a new technology capability without the time and effort required for full-scale development. The preliminary investigation with three children on the autism spectrum who were minimally verbal used an adapted alternating treatment design to compare the effects of a Wizard-of-Oz prototype that provided automated augmented input (i.e., pairing color photos with speech) to a standard topic display (i.e., a grid display with line drawings) on visual attention, linguistic participation, and (for one participant) word learning during a circle activity. Results: Preliminary investigation results were variable, but overall participants increased visual attention and linguistic participation when using the prototype. Conclusions: Wizard-of-Oz prototyping could be a valuable approach to spur much needed innovation in AAC. Further research into efficacy, reliability, validity, and attitudes is required to more comprehensively evaluate the use of AI to automate augmented input in AAC. [ABSTRACT FROM AUTHOR]

Millions of individuals who have limited or no functional speech use augmentative and alternative communication (AAC) technology to participate in daily life and exercise the human right to communication. While advances in AAC technology lag significantly behind those in other technology sectors, mainstream technology innovations such as artificial intelligence (AI) present potential for the future of AAC. However, a new future of AAC will only be as effective as it is responsive to the needs and dreams of the people who rely upon it every day. AAC innovation must reflect an iterative, collaborative process with AAC users. To do this, we worked collaboratively with AAC users to complete participatory qualitative research about AAC innovation through AI. We interviewed 13 AAC users regarding (1) their current AAC engagement; (2) the barriers they experience in using AAC; (3) their dreams regarding future AAC development; and (4) reflections on potential AAC innovations. To analyze these data, a rapid research evaluation and appraisal was used. Within this article, the themes that emerged during interviews and their implications for future AAC development will be discussed. Strengths, barriers, and considerations for participatory design will also be described., Competing Interests: The authors declare no conflict of interest., (Thieme. All rights reserved.)

This study examined the effects of an intervention package using high-tech augmentative and alternative communication (AAC) with Naturalistic Instruction (NI), time delay, and prompting during social routines for preschoolers on the autism spectrum. The AAC was a communication application on a tablet programmed with color photo representations of participants and communication partners engaged in social routines. The primary dependent measure was a linguistic communication turn on the AAC device completing the instructor's cloze phrase related to the routine. A secondary dependent measure was prelinguistic communication -nonspecific vocalizations and smiling - within each turn of the routine. Results indicated that all communication types increased and maintained for all three participants with two participants meeting mastery criteria within the minimal number of sessions. These results are significant in providing additional evidence for the effectiveness of AAC intervention beyond teaching simple object requests and in teaching more socially meaningful communication to children on the autism spectrum. Additionally, this study supports the use of color photo representations to promote social interaction. Future research should continue to evaluate such interventions on a larger scale and include naturally occurring communication partners, such as siblings and peers.

Lay Abstract: When researchers fail to report their findings or only report some of their findings, it can make it difficult for clinicians to provide effective intervention recommendations. However, no one has examined whether this is a problem in studies of early childhood autism interventions. We studied how researchers that study early childhood autism interventions report their findings. We found that most researchers did not register their studies when they were supposed to (before the start of the study), and that many researchers did not provide all of the needed information in the registration. We also found that researchers frequently did not publish their findings when their studies were complete. When we looked at published reports, we found that many of the studies did not report enough information, and that many studies were reported differently from their registrations, suggesting that researchers were selectively reporting positive outcomes and ignoring or misrepresenting less positive outcomes. Because we found so much evidence that researchers are failing to report their findings quickly and correctly, we suggested some practical changes to make it better., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.S. has received fees for presenting research findings in invited talks and providing expert evidence on the topic of early childhood autism interventions in court hearings. She previously taught courses in a program that was accredited by the Behavior Analyst Certification Board on both behavioral and NDBI early childhood interventions. K.B.-B. has previously received fees for consulting with school districts on intervention practices for autistic children and teaches courses on autism interventions in her role as an Associate Professor of Special Education. She has also accepted speaker fees to discuss her work on research quality, adverse events, and researcher conflicts of interest as they pertain to autism intervention research. She also receives royalties for a co-edited book titled Clinical Guide to Early Interventions for Children with Autism, published by Springer. J.I.F. has been paid to provide adaptive horseback riding lessons and has received grant funding from the National Institutes of Health to study the efficacy interventions geared toward infant siblings of autistic children. He is employed in a department that teaches students to provide early communication therapies. Nicolette Caldwell is a Board-Certified Behavior Analyst at the Doctoral level (BCBA-D) and is the current president-elect of the Arkansas Association for Behavior Analysis. She teaches courses in a university program accredited by the Behavior Analyst Certification Board and formerly provided quality assurance and consultation services for the Arkansas Medicaid waiver program which provides behavioral based services for children with autism ages 0 to 8. T.W. has previously been paid to provide traditional behavioral, naturalistic developmental behavioral, and developmental interventions to young children on the autism spectrum; has received grant funding from internal and external agencies, including the National Institutes of Health and the Vanderbilt Institute for Clinical and Translational Research, to study the efficacy of various interventions geared toward young children with autism; and is employed by the Department of Hearing and Speech Sciences at Vanderbilt University Medical Center, which offers intervention services for autistic children via their outpatient clinics and trains clinical students in the provision of treatments delivered over the course of early childhood. All other authors have no conflict of interests to declare.