Comparing Picture Exchange, Manual Signs and iPad

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Laurie McLay, University of Canterbury
Larah van der Meer, Victoria University of
Wellington
New Zealand
100
90
80
70
60
50
40
30
20
10
0
Speech
Non-Verbal
(Osterling, Dawson, & McPartland, 2001)
Manual Signs (MS)
Speech-Generating Devices (SGD)
Picture Exchange (PE)
Which AAC system is best suited to individuals
with autism?


All three systems have been taught

No major or consistent differences
(Lancioni et al., 2007; Mirenda, 2003)

Can we let the child decide?

Teach two or more systems

Ensure comparable experience

Provide opportunities to choose
1.
2.
3.
4.
5.
Do individual children with autism show
idiosyncratic preferences for MS v. PE v. SGD?
Can preferences be identified at the
beginning stages of intervention?
Are preferences stable over time and across
contexts?
Does preference influence how quickly and
efficiently children learn to use AAC?
Does preference influence the maintenance
of communication skills; that is, the extent to
which children continue to use their newly
acquired AAC skills after the intervention has
ended?

Children will show idiosyncratic preferences for
different forms of alternative communication

Use of the child's most preferred option will
improve the acquisition and maintenance of
alternative communication skills





Multiple baseline across participants
Alternating treatments
Baseline
› Opportunities to request, no prompting
Acquisition training
› Prompted to use each system until
acquisition criterion
Preference Assessment
› All systems available to choose from
Assessments
2. Freeplay
3. Baseline
4. Intervention
5. Preference Assessment
6. Post-Intervention
7. Follow-Up
1.

Participants
› Six participants with autism
Age Gender Communication
Receptive
Communication
Expressive
Pene
7:0
Male
1:5
1:6
Mika
8:0
Female
O:10
0:9
Hemi
10:1
Male
0:6
0:9
Manu
10:3
Male
1:0
0:3
Lomu
5:4
Male
1:2
0:9
Afasa
5:2
Male
3:7
1:8
(Sparrow, Cicchetti, & Balla, 2005)
Context
› General request for “more” toys
 Materials
›SGD using iPad Mini™ with Proloquo2Go™
›PE using PECS symbol (Pyramid Educational
Products, 2009)
›MS using Makaton (Makaton New
Zealand/Aotearoa, 1998-99)


Systematic instruction
› Time delay
› Graduated guidance
› Error correction
› Tangible and social reinforcement

Non-teaching probes conducted pre- and postintervention
In a novel (non-teaching) setting
2. Using a novel person (not involved in teaching)
1.
Figure 3. Total number of times each AAC system
was chosen across study phases and across
participants

Table 1. Percentage of correct requests
using each AAC system in a novel setting
Pre-Intervention
Post-Intervention
SGD
PE
MS
SGD
PE
MS
Pene
20%
0%
0%
0%
100%
0%
Mika
20%
0%
0%
100%
80%
0%
0%
40%
0%
80%
0%
0%
100%
80%
0%
Hemi
Afasa
20%
0%
0%
40%
0%
0%
100%
100%
100%
40%
0%
0%
100%
100%
100%

Table 2. Percentage of correct requests
using each AAC system with a novel
person
Pre-Intervention
Post-Intervention
SGD
PE
MS
SGD
PE
MS
Pene
20%
0%
0%
0%
0%
0%
Mika
0%
0%
0%
100%
0%
0%
Hemi
0%
0%
0%
80%
60%
0%
80%
60%
0%
Afasa
80%
0%
0%
100%
100%
100%
80%
0%
0%
100%
100%
100%
1.
2.
3.
4.
5.
Couper et al. (2014)
› 9 participants
McLay et al. (in progress)
› 6 participants
van der Meer, Didden, et al. (2012)
› 4 participants
van der Meer, Kagohara, et al. (2012)
› 4 participants
van der Meer, Sutherland, et al. (2012)
› 4 participants

27 Participants
› 4 girls, 23 boys
› Aged 4:2 – 13:2 (M = 7:3) years
› ASD and a range of developmental
disorders
› Vineland-II (Sparrow et al., 2005) scores
 ≤ 2:5 years for expressive communication

Context
› Requesting access to preferred stimuli with
SGD, PE, and MS
(van
der Meer, Sigafoos, O'Reilly, & Lancioni, 2011)

SGD and PE learned at comparable rates

MS slower to learn

Prefer AAC system that more proficient at using

Majority preferred SGD

Social communicative interactions

Preference-enhanced communication
intervention

Social validity

Effects on other behaviours, communication
skills, and speech

This choice-making approach appears useful in
assessing children’s preferences for different
AAC options

Children may be able to self-determine which
AAC option they would like to use





Principal Investigators
›
›
Jeff Sigafoos, Ph.D. Victoria University of Wellington
Dean Sutherland, Ph.D. University of Canterbury
›
›
Laurie McLay, Ph.D. University of Canterbury
Larah van der Meer, Ph.D. Victoria University of Wellington
›
›
Mark F. O’Reilly, Ph.D. The University of Texas at Austin, USA
Giulio E. Lancioni, Ph.D. University of Bari, Italy
›
›
Donna Achmadi, Victoria University of Wellington
Llyween Couper, University of Canterbury
›
›
›
›
›
›
›
›
Martina Schaefer
Emma McKenzie
Debora Morita Kagohara
Michelle Stevens
Laura Roche
Amarie Carnett
Hannah Waddington
Ruth James
Collaborative Researchers
Contributors
Scholarship Students
Research Assistants
Couper, L., van der Meer, L., Schafer, M. C. M., McKenzie, E., McLay, L., O'Reilly, M. F., . . . Sutherland, D.
(2014). Comparing acquisition of and preference for manual signs, picture, exchange, and speechgenerating devices in nine children with autism spectrum disorder. Developmental Neurorehabilitation.
doi: 10.3109/17518423.2013.870244
Lancioni, G. E., O’Reilly, M. F., Cuvo, A. J., Singh, N. N., Sigafoos, J., & Didden, R. (2007). PECS and VOCAs
to enable students to make requests: An overview of the literature. Research in Developmental Disabilities,
28, 468-488.
Makaton New Zealand/Aotearoa. (1998-99). Sign illustrations for Makaton core vocabulary. Auckland:
Westprint.
Mirenda, P. (2003). Toward functional augmentative and alternative communication for students with
autism: Manual signs, graphic symbols, and voice output communication aids. Language, Speech, and
Hearing Services in Schools, 34, 203-216.
Osterling, J., Dawson, G., & McPartland, J. (2001). Autism. In C. E. Walker & M. C. Roberts (Eds.), Handbook
of clinical child psychology (3rd ed.) (pp. 432-452). New York: John Wiley & Sons.
Sparrow, S. S., Cicchetti, D. V., & Balla, D. A. (2005). Vineland Adaptive Behavior Scales, Second Edition,
Survey Forms Manual. Minneapolis: Pearson.
Pyramid Educational Products Inc. (2009). PICS for PECS 2009. Newport: Author.
van der Meer, L., Sigafoos, J., O'Reilly, M. F., & Lancioni, G. E. (2011). Assessing preferences for AAC options
in communication interventions for individuals with developmental disabilities: A review of the literature.
Research in Developmental Disabilities, 32, 1422-1431.
van der Meer, L., Sutherland, D., O'Reilly, M. F., Lancioni, G. E., & Sigafoos, J. (2012). A further comparison
of manual signing, picture exchange, and speech-generating devices as communication modes for
children with autism spectrum disorders. Research in Autism Spectrum Disorders, 6, 1247-1257. doi:
10.1016/j.rasd.2012.04.005
van der Meer, L., Kagohara, D., Achmadi, D., O'Reilly, M. F., Lancioni, G. E., Sutherland, D., & Sigafoos, J.
(2012). Speech-generating devices versus manual signing for children with developmental disabilities.
Research in Developmental Disabilities, 33, 1658-1669. doi: 10.1016/j.ridd.2012.04.004
van der Meer, L., Didden, R., Sutherland, D., O'Reilly, M. F., Lancioni, G. E., & Sigafoos, J. (2012). Comparing
three augmentative and alternative communication modes for children with developmental disabilities.
Journal of Developmental and Physical Disabilities, 24, 451-468. doi: 10.1007/s10882-012-9283-3
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