Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


48th Annual Convention; Boston, MA; 2022

Event Details

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Symposium #534
CE Offered: BACB
Augmentative and Alternative Communication in Clinical Settings: A Discussion on Clinical Outcomes
Monday, May 30, 2022
3:00 PM–3:50 PM
Meeting Level 2; Room 257B
Area: AUT/DDA; Domain: Service Delivery
Chair: Daphne Hartzheim (Autism and Behavioral Interventions)
CE Instructor: Daphne Hartzheim, Ph.D.

Augmentative and Alternative Communication (AAC) consists of techniques that range from low-tech (e.g. picture exchange systems) to high-tech (e.g. communication devices) systems. These systems are useful in teaching non-vocal client’s functional communication skills. Although research supports the use of AAC systems in teaching verbal behavior, the implementation of high-tech devices poses a challenge to Board Certified Behavior Analysts (BCBA) due to a lack of knowledge, experience and understanding of how the devices can be implemented to reach communication goals. The purpose of this symposium is to demonstrate how the proper use of AAC devices can increase verbal behaviors, reduce challenging behavior and increase functional communication for nonvocal or minimally vocal children and adolescents with autism spectrum disorders (ASD). The first speaker will present an overview of AAC systems and common features of such systems. The speaker will also present a single case study of the implementation of an AAC device to reduce challenging behavior. The second speaker will present a single case study on increasing vocalizations with the implementation of a high-tech AAC system. The third speaker will focus on a single case study in which the participant was able to increase verbal behaviors with a change in how AAC was utilized. Implications for AAC in everyday clinical settings will be discussed.

Instruction Level: Basic
Keyword(s): alternative modalities, behavior reduction, FCT, verbal behavior
Target Audience:

Applied Behavior Analysts, Behavior Analytic Practitioners, Researchers, Educators

Learning Objectives: At the conclusion of the presentations, participants will be able to: (1) describe the difference between at least two AAC systems; (2) list at least two benefits of implementing AAC as a method of functional communication with minimally vocal individuals; (3) explain how AAC can be implemented in a clinical setting to increase verbal behaviors in non-vocal individuals.

Brief Overview of Augmentative and Alternative Communication and its Impact on Reducing Maladaptive Behavior

Daphne Hartzheim (Autism and Behavioral Interventions), Anika Hoybjerg (Endicott College; Autism and Behavioral Interventions), MIRANDA THORNLEY (Autism and Behavioral Intervention)

The aim of this presentation is to give the participants a brief overview of AAC systems and some of the most common programming features of high-quality systems. The features that will be discussed include grid/button sizes, button feedback, and organization. The author will also discuss rationales for getting a designated speech-generating device funded as opposed to using a device for supplemental use. The aim of the single case study was to reduce maladaptive behavior in an 8-year-old female with the use of an Augmentative and Alternative Communication (AAC) system. Prior to implementing an AAC system, the participant was engaging in aggression towards staff, self-injurious behavior, property destruction, and public urination. She demonstrated no functional communication. She was able to imitate words but did not use words independently. Data will be presented that demonstrates the decrease in maladaptive behavior with the inception of the AAC system. Use of the system was generalized to multiple settings with multiple people. Results indicate that AAC was successful in increasing functional communication, reducing maladaptive behavior, and growing manding and tacting repertoires.


Use of Augmentative and Alternative Communication to Supplement Vocal Verbal Behaviors in a Minimally Functional Communicator

CASEY BARRON (Autism and Behavioral Interventions), Daphne Hartzheim (Autism and Behavioral Interventions), Anika Hoybjerg (Endicott College; Autism and Behavioral Interventions)

The aim of this single case study was to increase the use of vocal mands in a young male with autism spectrum disorder. The participant was selected for this intervention due to his inability to functionally communicate his wants and needs using vocal communication. While he did demonstrate some vocal abilities at baseline, he often required multiple prompts to mand. An augmentative and alternative communication (AAC) device was implemented as a supplemental way to mand for preferred activities and items. The AAC application, SnapCoreFirst, was loaded onto an iPad that was used while in the clinical setting. Pages with a 4x4 grid were created that included symbols of his preferred activities and items. Errorless teaching was implemented to teach navigation to those pages and buttons. Data collected from December 2020 to January 2021 shows an average of 24 spontaneous vocal mands per day and 5% accuracy using the sentence starter “I want” (January 2021). By August of 2021, the client's vocal mands stayed consistent with an average of 24 mands and sentence complexity accuracy increased to 91%. The results from this case study indicate that using an AAC system to supplement communication can have a favorable impact on vocal communication.


Increasing Skill Acquisition of Verbal Operants With the Use of a Communication System

BLAKE R INOUYE (Utah Valley University; Autism and Behavioral Interventions), Daphne Hartzheim (Autism and Behavioral Interventions), Anika Hoybjerg (Endicott College; Autism and Behavioral Interventions)

Augmentative and Alternative Communication (AAC) is a viable option for individuals with autism spectrum disorder (ASD) who do not develop vocal speech. Research indicates that about 30% of individuals with ASD remain non-vocal throughout their life. Implementing AAC properly can influence skill acquisition and the formation of relational frames of an individual. The aim of this single-subject case study was to increase rate of skill acquisition in a non-vocal adolescent who uses an AAC device. The participant was included in this study because he had a history of using AAC to communicate. However, communication was not efficient and skill acquisition occurred at a slow rate. At baseline, the participant was spelling out tacts and intraverbals to the communication partner. During Phase 1 of the intervention, the participant was taught to use symbols to tact and produce intraverbals. Phase 2 of the intervention included generalization of the use of a variety of verbal operants into a more naturalistic setting with new communication partners. Data will also be collected on potential relations that were incidentally taught during this process. The results of this study indicate that with the proper implementation of AAC, non-vocal individuals can substantially increase skill acquisition and learn relational frames in the process.




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