Teaching Adults with Developmental Disability to Use an iPad for Communication Purposes

Augmentative and Alternative Communication (AAC) intervention involves teaching individuals to use non-speech modes of communication, such as using manual signs, picture-based communication boards, or computer-based speech-generating devices. AAC intervention is indicated for individuals who have limited speech and language development, a temporary loss of speech, and/or unintelligible speech. Many individuals with developmental disabilities (e.g., intellectual disability, autism spectrum disorder, and/or cerebral palsy) lack speech and are therefore candidates for learning to use an AAC device. AAC intervention for individuals with developmental disabilities can begin be teaching individuals to use AAC to first recruit the attention of a listener and then make a request of that listener. The present intervention involves teaching adults with developmental disabilities to use AAC to first recruit the attention of a listener and then make a request of that listener. The AAC device will involve the use of an Apple iPad with a special application (i.e., Proloquo2Go® software) that allows the iPad to be used as a picture-based speech-generating device. Each participant will be provided with an iPad that will be configured with two picture symbols. One symbol will be a line drawing picture showing the outline of a person. Tapping this symbol will result in corresponding synthetic speech output (i.e., Excuse me. Can I talk to you?). The other symbol will be a line drawing picture of a preferred item, such as a line drawing of a water glass or a apple. Tapping these symbols will result in corresponding synthetic speech output (i.e., Can I have a drink of water please? or Can I have an apple please?). The intervention will involve creating opportunities for communication by having a listener present but not attending and then teaching the person to tap the two line drawings to first recruit the listener's attention and then request a preferred item from that listener. The instructional procedures will involve using the least amount of physical guidance necessary to assist the person in tapping the symbols and then fading out the need for prompting by waiting 10 seconds before prompting. The intervention will be delivered by the lead researcher and two university students who will be serving as research assistants. The mode of delivery will be individuals, face to face and one-on-one teaching sessions that will each last 10 minutes. It is anticipated that from 30 to 40 such sessions will be required for the participants to reach proficiency with the iPad-based AAC device. Sessions will occur 1-2 days per week for approximately 20-30 weeks. The duration of the intervention will be decided based on the level of proficiency shown by the participants. Specifically, intervention will continue until participants obtain the 80 to 100% correct level for three successive sessions. The intervention will be delivered in the participant's residential care facility. During each session, data will be collected on the number of opportunities that were conduction and the for each opportunity we will record whether the person use the iPad to communication independently or if the person had to be prompted. For each session, we will graph the percentage of opportunities with independent use of the iPad and continue intervention until the 80 to 100% level is reached and maintained over at least 3 successive sessions. The interventionist will record these data using pen and paper data sheets. Reliability of data collection will be assessed by an independent observer on at least 20% of the sessions. Procedural fidelity using a checklist of the procedural steps will be assessed by the ndependent observer on at least 20% of the sessions. We also plan to conduct a follow-up session, which would be identical to an intervention session, at 3 and/or 6 months post-intervention provided that the participant is available.