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Writer's pictureKatie Threlkeld, M.S., CCC-SLP

AAC Interventions for Children Aged 0 to 6 Years – Highlights from a Review Article

Updated: Jun 6, 2023


A systematic review of AAC interventions for children aged 0 to 6 years was completed by Leonet and colleagues (2022). The review looked at 29 studies of AAC-based interventions for infants, toddlers, and preschool-age children.


Through the analysis, they found that AAC interventions for children aged 0 to 6 years old with many different diagnoses show improvement in:

  • Receptive communication

  • Expressive communication

  • Functional communication behaviors

  • Participation skills

  • Symbol production and comprehension

  • Multisymbol production and comprehension

Here are some of the takeaways from this review!


One of the findings from the review is that there is a growing body of research supporting multimodal communication.

  • Multimodal communication is all of the different ways we communicate. Individuals may use unaided AAC, such as body language or gestures, and may use aided AAC, such as a high-tech speech generating device.

  • For example, Taylor and Iacono (2003) found communication improvements increased when a multimodal AAC approach was used with modeling then when signing was used alone.

  • Communication is a multimodal process! We all use multimodal communication.

  • For AAC users, they will often use the fastest and most efficient means of communication available to them in the moment. Regardless of the method, all forms of communication should be respected, acknowledged, and responded to.

There is no age requirement for AAC, however more research into AAC intervention strategies for infants and toddlers is needed (Leonet et al., 2022)

  • There is no evidence that children must be a certain chronological age to benefit from AAC interventions (Romski & Sevcik, 2005).

  • Results from several studies in this review article suggests including parents and/or caregivers in the AAC assessment and intervention process, specifically for children in this age range.

  • For example, Romski et al. (2011) found that interventions that included caregivers increased the caregiver's perceptions of success while decreasing their perceptions of their child's impaired language development.

The evidence from the 29 studies examined in this review concluded that various types of AAC systems can be effective for children aged 0 to 6 years (Leonet et al., 2022)

  • Interventions focused on improving children's matching abilities, communication initiation and number of times they communicated, grammatical competence, and behavioral issues.

  • Seven of the studies focused on both aided and unaided systems and 22 focused on use of low-tech and high-tech AAC systems suggesting aided AAC for children 0-6 is effective for this age group (Leonet et al., 2022).

Finally, and most importantly, the review article concluded that there are a significant number of studies that report positive effects of AAC intervention for children in the age range of 0 to 6 years (Leonet et al., 2022).

  • Although previously debunked, it is an ongoing myth that early introduction of AAC will prevent natural speech development (Romski & Sevcik, 2005).

  • In a meta-analysis by Millar, Light, and Schlosser (2006), they examined 27 cases and among these 27 cases, none demonstrated decreases in speech production as a result of AAC intervention, 11% showed no change, and the majority (89%) demonstrated gains in speech supporting.

For children who are at risk for speech and language impairments, introduction of AAC early is supported by research. A wide range of AAC approaches are effective for children in this age range!


References:

  • American Speech-Language-Hearing Association (n.d.). Augmentative and Alternative Communication (Practice Portal). www.asha.org/Practice-Portal/Professional-Issues/Augmentative-and-Alternative-Communication/

  • Beukelman, D. R., & Light, J. C. (2020). Augmentative & alternative communication: Supporting children and adults with complex communication needs (5th ed.). Brookes.

  • Leonet, O., Orcasitas-Vicandi, M., Langarika-Rocafort, A., Mondragon, N. I., & Etxebarrieta, G. R. (2022). A Systematic Review of Augmentative and Alternative Communication Interventions for Children Aged From 0 to 6 Years. Language, Speech, and Hearing Services in Schools, 53(3), 894-920. https://doi.org/10.1044/2022_LSHSS-21-00191

  • Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review. Journal of Speech, Language, and Hearing Research, 49(2), 248–264. https://doi.org/10.1044/1092-4388(2006/021)

  • Romski, M., & Sevcik, R. A. (2005). Augmentative communication and early intervention: Myths and realities. Infants & Young Children, 18(3), 174–185. https://doi.org/10.1097/00001163-200507000-00002

  • Romski, M., Sevcik, R. A., Adamson, L. B., Smith, A., Cheslock, M., & Bakeman, R.(2011). Parent perceptions of the language development of toddlers with developmental delays before and after participation in parent-coached language interventions. American Journal of Speech-Language Pathology, 20(2),111–118. https://doi.org/10.1044/1058-0360(2011/09-0087)

  • Taylor, R., & Iacono, T. (2003). AAC and Scripting Activities to Facilitate Communication and Play. Advances in Speech Language Pathology, 5(2), 79–93. https://doi.org/10.1080/14417040510001669111

Katie Threlkeld, M.S., CCC-SLP is a licensed, ASHA-certified speech-language pathologist and the Educational Program Developer at Forbes AAC. She has over eight years of experience in AT and AAC assessment and treatment with both the pediatric and adult populations. Katie has presented at the state and national level on AAC topics and she has University teaching experience at the undergraduate and graduate level.

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