A meta-synthesis of team members' voices: what we need and what we do to support students who use AAC.

The ultimate goal of AAC provision is to promote students' active participation across settings through interactions involving a variety of partners and functions. To achieve such outcomes, educational teams must collaborate and consider the characteristics of students, their families, and relevant environments during AAC assessment and intervention. To date, AAC team collaboration has rarely been evaluated collectively outside intervention or case study research. In this investigation, a meta-synthesis was conducted to review qualitative studies of perspectives of team members on supporting students who used AAC, ranging in age from kindergarten to post-secondary, in public schools in the United States. Analyses yielded three primary themes necessary for effective AAC services; inputs, activities, and outcomes. Implications and recommendations for service providers and future researchers are described.

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.

Experiences of siblings of individuals with autism spectrum disorders.

The purpose of this study was to explore the experiences of siblings of individuals with autism spectrum disorders (ASDs) and identify their self-reported support needs. We conducted in-person semi-structured interviews with 12 siblings aged 7 to 15 of children aged 6 to 15 with ASDs. Employing a qualitative collective case study research method, we conducted cross-case analyses to address our research questions. Three major themes emerged: (a) descriptions of the sibling subsystem (b) cohesion between and among the siblings, and (c) adaptability of the participant siblings to having family members with ASDs. Discussion of these findings and recommendations for future research contributes to the existing literature on siblings of children with disabilities.

Implementing augmentative and alternative communication in inclusive educational settings: a case study.

The purpose of this study was to describe a single case of augmentative and alternative communication (AAC) implementation. Case study methodology was used to describe the perspectives of educational team members regarding AAC implementation for Joey, a high school junior with athetoid cerebral palsy. Benefits included greater intelligibility for Joey and subsequent comfort of the staff. Facilitators of Joey's AAC system use included the team's student-focused disposition and willingness to implement use of the device, Joey's increased intelligibility, peers' acceptance of the technology, and the resulting increase in Joey's socialization. Limited team cohesiveness, problem solving, and communication were the true barriers in this case. Implications of these facilitators and barriers are discussed and recommendations for school-based AAC implementation are made.

An investigation of aided language stimulation: does it increase AAC use with adults with developmental disabilities and complex communication needs?

A single subject ABAB design was used to determine the efficacy of aided language stimulation to teach the use of AAC techniques to adults with developmental disabilities. Sixteen participants were divided into two equal groups. In each group, half of the participants were able to communicate functionally using spoken language and half had complex communication needs and did not have functional, symbolic communication systems. Each group met twice weekly for 30 min per session. Researchers modeled the use of AAC and followed scripts during music-based interventions. Sessions focused on social greetings, choosing songs to play, learning words and movements for the songs, and discussing the songs. Participants were encouraged to interact with each other and to facilitate each other's communications. Results suggest that responsiveness and use of AAC increased for all participants with complex communication needs.

School-based speech-language pathologists' perspectives on dysphagia management in the schools.

PURPOSE: Although provision of dysphagia services is within the scope of practice of speech-language pathologists (SLPs), little is known about the perspectives of school-based SLPs in relation to these services. The purpose of this study was to examine SLPs' perspectives related to school-based management of students with dysphagia. METHOD: Focus group interviews were conducted with 33 SLPs who were employed by a large school district in the Midwest before development of district-supported policies and protocols related to dysphagia management. The interviews were analyzed using qualitative analysis methods. RESULTS: A variety of common perspectives emerged from the data, including a primary perceived difficulty in adapting practice in dysphagia from medical to educational service delivery models and settings. Additionally, 3 thematic categories of concerns emerged that were related to child characteristics, training, and support. IMPLICATIONS: Information gained in this investigation may be used to develop effective service delivery models, policies, and protocols, as well as to identify necessary supports related to the management of students with dysphagia in school settings.

Family perceptions of facilitators and inhibitors of effective school-based dysphagia management.

PURPOSE: This qualitative study focused on the perceptions of family members of children with dysphagia by asking what the family-identified factors are that facilitate or inhibit effective school-based management of pediatric dysphagia. METHOD: Semistructured interviews of 7 family members of 6 children with dysphagia, ages 2 through 11 years, were conducted. Collective case study and cross-case analyses were conducted. The findings were confirmed through triangulation, respondent validation, and member checking. RESULTS: Interviewees identified 5 facilitating factors that enhance school-based dysphagia programs: (a) setting, (b) therapist and/or program, (c) capitalizing on positive child characteristics, (d) home-school interactions, and (e) external supports. Four factors that inhibit effectiveness also emerged: (a) setting, (b) therapist and/or program, (c) limiting child characteristics, and (d) home-school interactions. CONCLUSION: Practitioners may consider addressing the factors that were identified as facilitators of effective programs. More research is needed concerning (a) factors promoting effective parent-professional relationships, (b) methods for increasing professional preparation in pediatric dysphagia, and (c) the efficacy of school-based pediatric dysphagia management programs.

Family members' perceptions of augmentative and alternative communication device use.

PURPOSE: Although advancements in technology have expanded the use of augmentative and alternative communication (AAC) devices for children with disabilities, the use of AAC devices in school and home settings is often inconsistent. The purpose of this study was to examine family members' perceptions regarding the use of AAC devices. Factors that were perceived to affect student's use of AAC devices, family expectations, and benefits of AAC device use were explored. METHOD: Semistructured interviews were conducted with 6 family members (primary caregivers) of 7 youth who primarily use AAC devices to communicate in the school environment. The interviews were analyzed using cross-case analysis. RESULTS: A variety of common perspectives emerged from the data, including four thematic categories: expectations, facilitators, barriers, and benefits of AAC device use. IMPLICATIONS: Information gained in this investigation may be used to improve professional-family and teaming relationships and serve to benefit AAC users in school and home settings.