Incorporating Visual Scene Display Augmentative and Alternative Communication Supports Into Naturalistic Developmental Behavioral Interventions.

Purpose: Naturalistic developmental behavioral interventions (NDBIs) are a promising approach for supporting early language and communication development for young children on the autism spectrum.¹ However, the children with the greatest need of language supports-those with minimal speech-have limited means to participate within these interventions and are therefore the least likely to benefit from traditional NDBIs that focus primarily on speech production.

Method: Using a single-case, multiple-probe across participants design, the current study investigated whether adding visual scene display (VSD) augmentative and alternative communication (AAC) supports with just-in-time programming and aided AAC input to NDBI procedures within an interactive storybook reading context resulted in (a) an increase in the number of symbolic communicative turns or (b) an increase in the rate of the number of different unique concepts expressed by young children on the autism spectrum with minimal speech.

Results: All participants tended to take more symbolic communicative turns each session and add new expressive vocabulary more rapidly with the addition of VSD AAC supports as compared to NDBI procedures alone, although with notable variation across participants.

Conclusions: The results of this study indicate that including VSD-based aided AAC systems and strategies designed to support beginning communicators within the framework of an NDBI can increase both the communication frequency and expressive vocabulary of children on the autism spectrum with minimal speech, beyond the effects of NDBI procedures alone.

Supplemental material: https://doi.org/10.23641/asha.29374061.