Views of Speech-Language Pathologists on Telepractice for Children Who Use Augmentative and Alternative Communication.

Telepractice has become increasingly utilized in disability services, particularly with recent and ongoing measures to slow the spread of the novel coronavirus (COVID-19). In this study, 361 speech-language pathologists (SLPs) responded to a national, web-based survey about their views on utilizing telepractice with children aged 3 to 21 who used aided augmentative and alternative communication (AAC), such as picture symbols or speech-generating devices. The views of SLPs varied, and SLPs who received training on AAC telepractice within the last 12 months had more positive views about telepractice than those who did not. Several factors were associated with when and how SLPs thought telepractice was beneficial to serve children who use aided AAC, including SLPs' foundational perspectives about telepractice, service delivery options, considerations related to the child and family, and broader resources and constraints.

Preparedness, Training, and Support for Augmentative and Alternative Communication Telepractice During the COVID-19 Pandemic.

PURPOSE: The global COVID-19 pandemic brought about widespread use of telepractice to provide services to children with communication disorders, including students who use aided augmentative and alternative communication (AAC) such as speech-generating devices. This descriptive quantitative study utilized network analysis to investigate the nature of speech-language pathologists' (SLPs') professional resource networks during the pandemic, including what aspects of their professional networks were associated with their confidence to use telepractice to serve students who use aided AAC and whether there were differences for school-based compared to nonschool-based SLPs. METHOD: Participants were 283 SLPs who responded to an online survey that consisted of closed- and open-ended survey items. A resource generator approach was used to gather data about SLPs' professional resource networks for AAC telepractice. RESULTS: SLPs varied widely in their confidence for AAC telepractice. School-based SLPs and SLPs who had 3 years or fewer of AAC experience reported lower confidence, whereas SLPs who spent more work time each week using telepractice and who accessed a greater number of different types of training reported higher confidence. The number of people in different roles providing personal support and the number of different electronic/print resources accessed were not significant predictors of SLPs' confidence. The majority of SLPs wanted additional training, support, or resources related to AAC telepractice. CONCLUSION: The findings from this research suggest the importance of SLPs' access to quality training and support in the areas of AAC and telepractice, particularly for school-based SLPs.

Graphing the Intersection of Rate and Fidelity in Single-Case Research.

Single-case research is a prevalent and useful method for evaluating the effects of interventions in special education research. A single-case graph "should make available all of the data that permit evaluation of the criteria for visual inspection, at the very least," while not misleading inspectors (Kazdin, 2011, p. 335). Although this is widely known, it poses challenges for multifaceted dependent variables, such as those that address both rate and a measure of quality, such as fidelity. Both factors may be important to accurately interpret intervention effects, such as those within cascading interventions implemented by natural change agents. However, representing both in a single graph is challenging. In response to this challenge, we present a single data set from a multiple-baseline design graphed in six distinct formats. Across these graphs, we discuss implications for visual analysis and interpretation and invite discussion of this important area of single-case research in search of recommendations for best practice.

Augmentative and Alternative Communication Telepractice During the COVID-19 Pandemic: A National Survey of Speech-Language Pathologists.

PURPOSE: The novel coronavirus (COVID-19) pandemic has led to sudden, widespread use of telepractice, including providing services to children who use aided augmentative and alternative communication (AAC). This exploratory study examined speech-language pathologists' (SLPs) experiences using telepractice to provide services to children and youth aged 3-21 years who used aided AAC during the earlier months of the pandemic (May-June 2020). METHOD: Three hundred thirty-one SLPs responded to an online survey. Closed- and open-ended survey items were analyzed quantitatively and qualitatively and mixed at the point of interpretation to understand the experiences of SLPs related to the use of telepractice with children who use aided AAC, including how they perceived effectiveness. RESULTS: Most SLPs were using telepractice to provide both direct and consultation/coaching services to children who used aided AAC. There was fairly wide variation in perceptions of effectiveness of both types of services, but SLPs were more likely to rate consultation/coaching services as being more effective than direct services. SLPs identified factors impacting effectiveness across five dimensions: broader factors, practice-based factors (i.e., technology, the type of services), the child, parents and family members, and professionals. School-based SLPs perceived telepractice as being less effective than non-school-based SLPs. CONCLUSIONS: The use of telepractice during the COVID-19 pandemic has unfolded quite differently for different SLPs and the children who use aided AAC that they serve. Although AAC telepractice offers promise for the future, particularly for partnering with families, further research is needed to know how to overcome challenges experienced by SLPs. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.17139434.

A boy and his AAC team: building instructional competence across team members.

Families and education professionals face unique challenges when working together to support augmentative and alternative communication (AAC) for a child who does not use speech and has only prelinguistic forms of communication. For this study, a family-school team was provided with a specially designed support package comprising training and one-on-one coaching in evidence-based instructional strategies. As part of a larger mixed methods investigation, a single-case experimental design was conducted to explore the effectiveness of the support package on facilitating team members' competence in AAC instruction and communication. In the case reported here, the support package improved instructional competence across all team members, which led to small, positive changes in the child's communication using AAC. However, it was not sufficient for overcoming contextual barriers and supporting adults' ongoing instructional adjustment to the level necessary to promote the child's independent communication via AAC. Implications of these findings for both practice and research are discussed.

Social validity in single-case research: A systematic literature review of prevalence and application.

BACKGROUND: Single-case research (SCR) has been a valuable methodology in special education research. Montrose Wolf (1978), an early pioneer in single-case methodology, coined the term "social validity" to refer to the social importance of the goals selected, the acceptability of procedures employed, and the effectiveness of the outcomes produced in applied investigations. Since 1978, many contributors to SCR have included social validity as a feature of their articles and several authors have examined the prevalence and role of social validity in SCR. AIM AND METHODS: We systematically reviewed all SCR published in six highly-ranked special education journals from 2005 to 2016 to establish the prevalence of social validity assessments and to evaluate their scientific rigor. RESULTS: We found relatively low, but stable prevalence with only 28 publications addressing all three factors of the social validity construct (i.e., goals, procedures, outcomes). We conducted an in-depth analysis of the scientific rigor of these 28 publications. CONCLUSIONS: Social validity remains an understudied construct in SCR, and the scientific rigor of social validity assessments is often lacking. Implications and future directions are discussed.

Teaching conceptually referenced core vocabulary for initial augmentative and alternative communication.

Individuals with significant intellectual disabilities who use augmentative and alternative communication (AAC) often fail to acquire large vocabularies. To maximize the functionality of a small vocabulary, AAC users' initial vocabulary typically consists of words that can be used frequently across contexts and functions (i.e., core vocabulary). For many AAC users, core vocabulary often references concepts rather than concrete items. For individuals with severe intellectual disabilities, however, initial AAC vocabulary often consists of concretely referenced words instead. There is little evidence that these individuals can learn to use conceptually referenced words in initial AAC. A variation of a single subject multiple baseline design across four stimuli was used to demonstrate that an individual with severe intellectual disabilities could learn to use conceptually referenced words as an initial AAC vocabulary. As a result of the intervention (a modified PECS procedure), a 9-year-old boy with multiple disabilities, including intellectual disability and deaf-blindness, learned to make appropriate use of three conceptually referenced tactile symbols for the concepts of more, done, and new as an initial communication vocabulary.