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Autism Spectrum Disorders and AAC / Edition 1

Autism Spectrum Disorders and AAC / Edition 1

by Pat Mirenda, Teresa Iacono


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Product Details

ISBN-13: 9781557669537
Publisher: Brookes Publishing
Publication date: 11/01/2008
Edition description: New Edition
Pages: 504
Sales rank: 570,582
Product dimensions: 6.20(w) x 9.10(h) x 1.30(d)

About the Author

Dr. Mirenda earned her doctorate in behavioral disabilities from the University of Wisconsin–Madison. For 8 years, she was a faculty member in the Department of Special Education and Communication Disorders, University of Nebraska–Lincoln. From 1992 to 1996, she provided a variety of training, research, and support services to individuals with severe disabilities through CBI Consultants, Ltd., in Vancouver, British Columbia. She is now Professor in the Department of Educational and Counseling Psychology and Special Education at the University of British Columbia. From 1998 to 2001, she was editor of the journal Augmentative and Alternative Communication. In 2004, she was named a Fellow of the American Speech-Language-Hearing Association and was awarded the Killam Teaching Prize at the University of British Columbia. In 2008, she was named a Fellow of the International Society for Augmentative and Alternative Communication. Dr. Mirenda is the author of numerous book chapters and research publications; she lectures widely and teaches courses on augmentative and alternative communication, inclusive education, developmental disabilities, autism, and positive behavior support. Her current research focuses on describing the developmental trajectories of young children with autism and factors that predict the outcomes of early intervention.

Teresa Iacono, Ph.D.,Associate Professor and Senior Research Fellow, Director of Research, Centre for Developmental Disability Health Victoria, Monash University, 270 Ferntree Gully Road Building 1, Notting Hill, Victoria, 3166, Australia Dr. Iacono earned her doctorate in Special Education and Communication Disorders at the University of Nebraska-Lincoln. She is a speechlanguage pathologist, having received her B.App.Sc. and M.App.Sc. 00Mirenda(F)-FM 10/21/08 1:48 PM Page xiii degrees in speech pathology in Australia. For 9 years she was an academic member of Macquarie University, where she co-convened a Masters in Communication Disorders within the Department of Linguistics and taught within the Institute of Early Childhood; she also held an honorary position within Macquarie University Special Education Centre. Her clinical, teaching, and research work has focused on developmental disabilities and complex communication needs. In her position at the Centre for Developmental Disability Health Victoria, this focus has extended to physical and mental health issues of adults with developmental disabilities. Dr. Iacono is the author of chapters and research publications concerning communication and health and well-being in developmental disabilities. She was editor of the journal Augmentative and Alternative Communication from 2002 to 2004. In 2007, she was a recipient of the inaugural National Health and Medical Research Council (Australia) Ethics Award for her work addressing ethical concerns of including people with developmental disabilities in research.

David R. Beukelman, Ph.D is the Barkley Professor of Communication Disorders at the University of Nebraska-Lincoln, Director of Research and Education of the Communication Disorders Division, Munroe/Meyer Institute of Genetics and Rehabilitation at the University of Nebraska Medical Center, A research partner in the Rehabilitation Engineering and Research Center in Augmentative and Alternative Communication, and a senior researcher in the Institute for Rehabilitation Science and Engineering at the Madonna Rehabilitation Hospital. With Pat Mirenda, he co-authored the textbook, Augmentative and Alternative Communication: Management of Severe Communication Disorders in Children and Adults. He served as editor of the Augmentative and Alternative Communication Journal for four years.

Joe Reichle, Ph.D., Professor, Speech-Language-Hearing Sciences, 115 Shevlin Hall, 164 Pillsbury Drive Southeast, University of Minnesota, Minneapolis, Minnesota 55455

Dr. Joe Reichle holds appointments in the Departments of Speech-Language-Hearing Sciences and Educational Psychology at the University of Minnesota. He is an internationally recognized expert in the areas of augmentative communication and communication intervention for persons with significant developmental disabilities and has written over 100 articles and chapters. Dr. Reichle has co-edited 10 books focused on his areas of expertise. He has served as a co-editor of the flagship journal (Journal of Speech-Language-Hearing Research) of the American Speech-Language and Hearing Association. Dr. Reichle was a former Associate Chair of the Department of Speech-Language-Hearing Sciences. During his 33-year career he has served as a PI, co-PI, and investigator on numerous federally funded projects. Currently, he is the Director of the University of Minnesota's Leadership Training Program in Neurodevelopmental Disabilities.

Michael Arthur-Kelly, Ph.D., is Senior Lecturer, Centre for Special Education and Disability Studies and The University of Newcastle in Australia.

Andy Bondy, Ph.D., Co-founder, Pyramid Educational Consultants, Inc., 13 Garfield Way, Suite 1, Newark, Delaware 19713. Dr. Bondy has more than 35 years of experience in applied behavior analysis and autism. He directed a statewide program for students with autism for 14 years and co-developed the Picture Exchange Communication System. He also co-founded (with his wife, Lori Frost) Pyramid Educational Consultants, which provides parent and staff training around the world.

Karen A. Erickson, Ph.D., David E. and Dolores J. Yoder Distinguished Professor, Director, Center for Literacy and Disability Studies, University of North Carolina at Chapel Hill, 321 S. Columbia Street, Suite 1100 Bondurant Hall, Chapel Hill, North Carolina 27599

Karen A. Erickson is Yoder Distinguished Professor and Director of the Center for Literacy and Disability Studies at the University of North Carolina at Chapel Hill. A former teacher of children with significant disabilities, Dr. Erickson's current research addresses literacy and communication assessment and intervention for students with a range of disabilities, including significant disabilities. Dr. Erickson is codeveloper of the Tar Heel Reader online library of accessible books for beginning readers as well as several other assistive, learning, and communication technologies.

Lori Frost, Co-founder, Pyramid Educational Consultants, Inc., 13 Garfield Way, Suite 1, Newark, Delaware 19713. Ms. Frost is Vice-President and Co-founder of Pyramid Educational Consultants, Inc., as well as a coauthor of the Picture Exchange Communication System (PECS) Training Manual. Ms. Frost has been the driving force behind creating PECS, a unique system that allows children with limited communication abilities to initiate communication with teachers, parents, and peers. She has a wealth of background in functional communication training and applied behavior analysis.

Cheryl M. Jorgensen is Research Associate Professor and Project Coordinator with the Institute on Disability, a University Affiliated Program at the University of New Hampshire, Durham. Since 1985, she has worked with New Hampshire schools to help them increase their commitment and capacity to include students with disabilities within the mainstream of general education. More recently, her research and systems change efforts have focused on the inclusion of students with disabilities within school reform efforts, especially at the high school level. She was Editor of the Equity and Excellence newsletter and is a coauthor of Including Students with Severe Disabilities in Schools (Singular Publishing Group, 1994) and author of numerous chapters on inclusive curriculum design.

David A. Koppenhaver, Ph.D., Professor, Department of Reading Education and Special Education, Appalachian State University, ASU Box 32085, 151 College Street, Boone, North Carolina 28608

David A. Koppenhaver is Professor in the Reading Education and Special Education Department at Appalachian State University. His Dr. Koppenhaver's research focuses on literacy in individuals with signifi cant disabilities, including those with complex communication needs. He and David Yoder cofounded the Center for Literacy and Disability Studies at the University of North Carolina at Chapel Hill in 1990.

Amy C. Laurent is a pediatric occupational therapist who holds a master's degree in special education. Currently in private practice, she is a New England affiliate of Communication Crossroads and of Childhood Communication Services. Ms. Laurent specializes in the education of children with autism spectrum disorders (ASD) and related developmental disabilities. Through her practice, she provides comprehensive evaluations, direct therapeutic services, and consultations to educational programs for children with ASD. She also provides extensive educational and emotional support for families of children with ASD. Ms. Laurent has co-authored several journal articles and frequently lectures throughout the United States on topics related to therapeutic and educational intervention for children with ASD. Her areas of clinical interest include therapeutic intervention as it relates to the development of self-regulation and social-adaptive functioning across contexts (e.g. school, home, and community settings).

Janice Light, Ph.D., is a Professor in the Department of Communication Disorders at the Pennsylvania State University. She is actively involved in research, personnel preparation, and service delivery in the area of augmentative and alternative communication (AAC). Her primary interest has been furthering understanding of the development of communicative competence and self-determination by individuals who require AAC.

Dr. Light is the principal investigator on several federally-funded research grants to improve outcomes for individuals who have significant communication disabilities through the use of augmentative and alternative communication. She is one of the project directors in the Augmentative and Alternative Communication Rehabilitation Engineering Research Center (AAC-RERC), a virtual research consortium funded by the National Institute for Disability and Rehabilitation Research.

In 1996, Dr. Light was recognized as the Don Johnston Distinguished Lecturer by the International Society of Augmentative and Alternative Communication for her leadership in the AAC field. In 1999, she received the Dorothy Jones Barnes Outstanding Teaching Award at the Pennsylvania State University.

Barry M. Prizant, Ph.D., has more than 25 years experience as a clinical scholar, researcher, and consultant to young children with autism spectrum disorders (ASD) and related communication disabilities and their families. He is an American Speech-Language-Hearing Association fellow and is a member of the Interdisciplinary Council on Developmental and Learning Disabilities. Formerly, he was Associate Professor of Psychiatry in the Brown University Program in Medicine, Professor in the School of Communication Sciences and Disorders at Emerson College, and Advanced Post-Doctoral Fellow in Early Intervention at University of North Carolina at Chapel Hill. He has developed family-centered programs for newly diagnosed toddlers with ASD and their families in hospital and university clinic environments. He has been an invited presenter at two State of the Science Conferences on ASD at the National Institutes of Health (NIH) and has contributed to the NIH Clinical Practice Guidelines for early identification and diagnosis of ASD. Dr. Prizant's current research and clinical interests include identification and family-centered treatment of infants, toddlers, and young children who have or are at risk for sociocommunicative difficulties, including ASD.

MaryAnn Romski, Ph.D., Regents Professor of Communication, Psychology, and Communication Disorders, Associate Dean for Research and Graduate Studies, College of Arts and Sciences, Georgia State University, Post Office Box 4038, Atlanta, Georgia 30302

MaryAnn Romski is Regents Professor of Communication, Psychology, and Communication Disorders at Georgia State University, Atlanta, and serves as Associate Dean for Research and Graduate Studies in the College of Arts and Sciences. She is a certified speech-language pathologist with more than 30 years of clinical experience. Her well-recognized and continuously funded research program focuses on the language and communication development of children and adults with intellectual and developmental disabilities who encounter difficulty speaking, particularly the development and evaluation of computerized communication interventions.

Charity Mary Rowland, Ph.D., Professor, Institute on Disability and Development, Oregon Health and Science University, 707 Southwest Gaines Street, Portland, Oregon 97239

Dr. Charity Rowland directs the Design to Learn Projects at Oregon Health and Science University in Portland, OR. Trained in developmental and experimental psychology, she has conducted extensive research related to communication and cognitive development in individuals with complex communication needs. She is the author of The Communication Matrix.

Emily Rubin is Director of Communication Crossroads, a private practice in Carmel, California. She is a speech-language pathologist specializing in autism, Asperger syndrome, and related social learning disabilities. As an adjunct faculty member and lecturer at Yale University, she has served as a member of its Autism and Developmental Disabilities Clinic. She has also served as an instructor for the Communication Sciences and Disorders Department of Emerson College in Boston, Massachusetts, where she has developed courses to prepare graduate-level students to address the needs of children with autism and their families. Her publications have focused on early identification of autism, contemporary intervention models, and programming guidelines for high-functioning autism and Asperger syndrome. She has participated as a member of the American Speech-Language-Hearing Association's Ad Hoc Committee on Autism Spectrum Disorders (ASD), a committee charged with developing guidelines related to the role of speech-language pathologists in the diagnosis, assessment, and treatment of ASD. She lectures internationally and provides consultation to educational programs serving children and adolescents with autism and related developmental disorders.

Dr. Rydell has ben in the field of autism and communication disorders for more than 24 years in public school, hospital, university, administration, and private practice settings. Dr. Rydell is the owner and director of Rocky Mountain Autism Center, a private center dedicated solely to working with children with autism spectrum disorders and their families. The center provides comprehensive center-, community-, and home-based assessments, programs, interventions, and training to individuals with autism, their families, and professionals. Dr. Rydell earned his doctoral and master's degrees in the field of communication disorders and special education, with a primary program emphasis in autism and early childhood education. Dr. Rydell is a Fulbright Senior Specialist grant recipient (2005) and has previously co-authored five book chapters and numerous research articles on autism and unconventional verbal behaviors. In addition, he frequently speaks at international, national, and state levels on topics related to autism.

Ralf W. Schlosser, PhD, is a Professor in the Department of Speech-Language Pathology and Audiology at Northeastern University and the Director of Clinical Research in the Center for Communication Enhancement, Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital. As a fellow of ASHA and AAIDD, Ralf has published extensively on communication interventions for children with developmental disabilities in general and autism in particular. Ralf is a two-time recipient of the most significant research article published in Augmentative and Alternative Communication. He is an editor-in-chief of Evidence-Based Communication Assessment and Intervention.

Rose A. Sevcik, Ph.D., Distinguished University Professor, Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, Georgia 30302

Dr. Sevcik is Distinguished Professor of Psychology and Chair of the Developmental Psychology Doctoral Program. She is the founding co-director of the university's Area of Focus: Research on Challenges to Acquiring Language and Literacy and a member of the Center for Research on Atypical Development and Learning (CRADL). She has made significant contributions to the field of developmental and learning disabilities and language and reading intervention research through more than 100 peer-reviewed publications, chapters, and books and numerous presentations at national and international conferences. She has been an investigator on 12 federally funded projects (NIH, IES) with a long history of working with schools. Dr. Sevcik is a Fellow of the American Speech-Language-Hearing Association and the International Society of Augmentative and Alternative Communication. She also is a Fellow of the American Association on Intellectual and Developmental Disabilities and past President of its Communication Disorders Division. A member of the National Joint Committee on the Communication Needs of Persons with Severe Disabilities, she is also on the Board of Directors for the United States Society for Augmentative and Alternative Communication.

Jeff Sigafoos, Ph.D., is Professor in the School of Education at the University of Tasmania in Australia.

Rae M. Sonnenmeier, Ph.D., CCC-SLP, is Clinical Associate Professor in the Department of Communication Sciences and Disorders and with the Institute on Disability/UCED at the University of New Hampshire and is an adjunct assistant professor of pediatrics with the Dartmouth Medical School. She served as Interdisciplinary Training Director for the New Hampshire Leadership Education in Neurodevelopmental Disabilities (LEND) program at the University of New Hampshire from 1999 to 2009. Dr. Sonnenmeier is an expert in the areas of inter - disciplinary practice, augmentative communication techniques, and the inclusion of students who experience significant disabilities, including students with autism spectrum disorders. Currently, she is collaborating on an Office of Special Education Programs project that prepares speech-language pathologists in the area of augmentative and alternative communication to support the academic learning of students with significant disabilities. She regularly presents at state, national, and international conferences and does technical assistance in the New England region.

Krista M. Wilkinson, Ph.D., Professor, Department of Communication Sciences and Disorders, The Pennsylvania State University, 308 Ford Building, University Park, Pennsylvania, 16802

Dr. Krista Wilkinson is Professor at the Pennsylvania State University and Editor of the American Journal of Speech-Language Pathology (2014-2016). Dr. Wilkinson's research applies the tools of neuroscience to understand visual and cognitive processing of individuals with severe disabilities, in order to optimize visual augmentative and alternative communication interventions used to support their communication functioning.

Read an Excerpt

Excerpted from Autism Spectrum Disorders and AAC
Edited by Pat Mirenda, Ph.D., & Teresa Iacono, Ph.D.
©2009. Brookes Publishing. All rights reserved.


A relatively recent development in the field of AAC is an increased emphasis on evidence-based practice (EBP) for assessment, intervention planning, and implementation. EBP is “the integration of best and current research evidence with clinical/educational expertise and relevant stakeholder perspectives to facilitate decisions for assessment and intervention that are deemed effective and efficient for a given stakeholder” (Schlosser & Raghavendra, 2003, p. 263). EBP does not mean that either clinical reasoning or the perspectives of individuals who use AAC and their families are discounted during the AAC assessment or decisionmaking processes. Rather, in addition to these important elements, a third component—current research evidence—is added to the mix.

The EBP process, described by Schlosser and Raghavendra (2003), can be used to make decisions about the intervention components that are most likely to lead to positive outcomes for a given individual. The six steps of this process are

  1. Ask a well-built question, such as “Should we use manual signing or should we use graphic symbols to teach requesting to this adolescent with autism?” or “Should we use an SGD to teach social interaction skills to this child with Rett syndrome?”
  2. Select evidence sources (e.g., textbooks, research databases, journals).
  3. Search the literature.
  4. Examine the evidence systematically.
  5. Apply the evidence to make decisions on behalf of the specific individual who requires AAC.
  6. Evaluate the outcome of the decision over time.

One of the practical outcomes of the emphasis on EBP has been the generation of a number of integrative reviews of AAC research. In such reviews, authors examine research related to a specific type of AAC intervention (e.g., SGDs) with a specific population (e.g., children with ASDs), using either statistical or narrative techniques. They also provide summary statements regarding, for example, the benefits that have been shown to result from the use of a specific intervention or the optimum conditions for generating positive outcomes. Many authors in this book have used this process or a variation thereof to integrate existing research on specific aspects of AAC. In addition, integrative reviews on AAC for individuals with ASDs have addressed topics such as manual signing (Goldstein, 2002; Mirenda, 2001, 2003b; Wendt, Schlosser, & Lloyd, 2005), graphic symbols (Mirenda, 2001, 2003b; Wendt et al., 2005), SGDs and computers with speech output (Schlosser & Blischak, 2001; Wendt et al., 2005), functional communication training (Bopp, Brown, & Mirenda, 2004; Wendt et al., 2005), and visual schedules that use graphic symbols (Bopp et al., 2004).

Decision making that incorporates research evidence is important when designing AAC interventions for individuals with ASDs for a number of reasons. First, these individuals constitute an extremely heterogeneous group with regard to the social, cognitive, motivational, and motor abilities that underlie successful communication. Thus, AAC decisions must be made on the basis of individual skill and preference profiles, rather than on the basis of an ASD diagnosis alone. Researchers have therefore examined strategies for incorporating the modality preferences of individuals with ASDs into the decisionmaking process (Sigafoos, O’Reilly, Ganz, Lancioni, & Schlosser, 2005; Son, Sigafoos, O’Reilly, & Lancioni, 2006).

Second, the field of ASDs in general is “littered with the debris of dead ends, crushed hopes, ineffective treatments, and false starts” (Schreibman, 2005, p. 7). With regard to AAC, this was highlighted in 1970s by the wholesale adoption of total communication as “the answer” for all individuals with ASDs who were unable to speak; in the 1990s, a similar furor focused on facilitated communication. The tendency of many professionals and families to adopt the latest fad intervention, regardless of the quantity or quality of research evidence to support it, can be counteracted by the adoption of an EBP approach to decision making.

Third, for professionals in the field, EBPs are guaranteed to keep us humble by making us aware of just how much we still have to learn. The fact is that we do not know even more than we do know about AAC for individuals with ASD. We do not know how to select the combination of AAC modalities that will result in optimal communication for each individual; how to design comprehensive AAC instructional interventions that truly build on each person’s abilities and strengths; or how to maximally support social, language, and literacy development through AAC. If it is indeed true that with humility comes wisdom, the systematic examination of research evidence for decision making is essential for the field to move forward.


The Merriam-Webster Online Dictionary (2007) defines a conundrum as “an intricate and difficult problem.” In the field of AAC, as in all other fields of scientific endeavor, a number of conundrums have come and gone over the years, while several have lingered and are still active today. Many of the currently controversial issues as they pertain to individuals with ASDs are examined in individual chapters of this book, including the use of SGDs for individuals with ASDs (Chapter 5) and how various AAC modalities affect the likelihood of speech production (Chapter 6). Additional chapters examine the use and effectiveness of both behavioral and social/developmental instructional approaches, including the Picture Exchange Communication System (Chapter 10; see also Frost & Bondy, 2002); the Social Communication, Emotional Regulation, and Transactional Support (SCERTS®) Model (Chapter 8; see also Prizant, Wetherby, Rubin, Laurent, & Rydell, 2005a, 2005b); and various aided language models (Chapters 7 and 9). Chapters on the use of AAC techniques for problem behavior (Chapters 12 and 13), literacy development (Chapter 14), and inclusive education (Chapter 15) also address conundrums that confront and challenge many families and AAC professionals who support individuals with ASDs. This chapter explores three additional controversial issues: 1) integrating AAC with other early intervention approaches for young children with ASDs, 2) deciding whether or not AAC is appropriate and choosing individualized AAC techniques, and 3) critically reexamining conventional assumptions about ASDs as they apply to AAC.

Early Intervention and AAC

The importance of early intervention for young children with ASDs is not a matter for debate. In a comprehensive, evidence-based report, the U.S. National Research Council (NRC) Committee on Educational Interventions for Children with Autism (2001) strongly recommended that entry into intervention programs should begin as soon as an ASD diagnosis is seriously considered, rather than waiting until it is confirmed. The NRC Committee also concurred that “active engagement in intensive instructional programming” (p. 219) should be provided to children at least up to age 8 years for a minimum of 25 hours per week on a year-round basis, and should consist of “repeated, planned teaching opportunities” (p. 219) conducted in both one-to-one and very small group sessions. They also recommended that emphasis be placed on the use of evidence-based instructional techniques in six main instructional areas: 1) functional, spontaneous communication using speech and/or AAC; 2) developmentally appropriate social skills with parents and peers; 3) play skills with peers; 4) various goals for cognitive development, with emphasis on generalization; 5) positive behavior supports for problem behaviors; and 6) functional academic skills, as appropriate.

The NRC Committee (2001) acknowledged that a wide range of instructional approaches may be used to accomplish these goals. These approaches include structured teaching based on the principles of applied behavior analysis such as discrete trial teaching (Smith, 2001), incidental teaching (McGee, Morrier, & Daly, 1999), applied verbal behavior (Sundberg & Partington, 1998), and pivotal response training (Koegel & Koegel, 2006). They also include social/developmental approaches such as the Developmental, Individual-Difference, Relationship-Based (DIR) model (Greenspan & Weider, 1999) and the SCERTS Model (Prizant et al., 2005a, 2005b). Although the NRC Committee did not recommend a specific curriculum or approach, they stressed the importance of goal-directed, evidence-based, individualized programs that meet the needs of both children with ASDs and their families.

Because of these recommendations, immediately after receiving a diagnosis for their child, families are faced with the daunting task of deciding what to do for their child with ASD and how best to do it. Some of their decisions may affect the extent to which AAC techniques of various types will be accepted and used (e.g., in an applied verbal behavior approach, manual signing may be accepted but graphic symbols may not be; see Mirenda, 2003b; Sundberg, 1993). Even when there is agreement about the techniques to implement, AAC practitioners will almost always need to work with other professionals whose views may be quite divergent from (and perhaps even incompatible with) their own. The potential for controversy is considerable and the potential for conflict is high; therefore, the ability to negotiate and collaborate is required of all involved.

To AAC or Not to AAC?

If the goal of an AAC system is to “enable individuals to efficiently and effectively engage in a variety of interactions and participate in activities of their choice” (Beukelman & Mirenda, 2005, p. 8), it is critical that AAC interventions be maximally individualized. This principle raises a number of contentious issues, the first and foremost of which is that many parents of young children (and some practitioners as well) are reluctant to implement AAC interventions out of concern that they will prevent speech production (Cress & Marvin, 2003). Despite credible research evidence to the contrary (Chapter 6; see also Millar, Light, & Schlosser, 2006), this reluctance continues to limit the extent to which individuals who can benefit from AAC have access to it. In addition, AAC is no less immune to “one-size-fits-all” thinking than is any other type of educational intervention. Some practitioners who ascribe to this way of thinking institute one or more AAC techniques with everyone whose social-communication interactions are lacking, regardless of whether AAC is actually required. Other practitioners espouse the superiority of a particular instructional technique over all others, regardless of the abilities and preferences of individuals with ASDs or their families. Still others may always prescribe the specific AAC modality with which they have experience, rather than considering the entire range of available options. For example, some practitioners claim that manual signing is the best AAC technique for all individuals with ASDs, based largely on theoretical arguments rather than on empirical evidence (Mirenda, 2003b). Regardless, this one-size-fits-all thinking invariably limits the communication options that are available to individuals with ASDs and can be avoided by adopting the general EBP approach that was described in a previous section of this chapter.

(Mis)conceptions About ASDs and AAC

Research has called into question at least two of the assumptions that most people accept about ASDs in general: 1) motor impairments are not part of the disorder and 2) in most cases, intellectual disability is. Mirenda (2008) noted that these two assumptions directly affect both the design and the goals of AAC interventions for many individuals with ASDs. Alternative access or instructional supports are rarely provided to compensate for the types of motor planning or coordination problems that appear to be more common than previously thought (e.g., Dziuk et al., 2007; Hardan, Kilpatrick, Keshavan, & Minshew, 2003; Ming, Brimacombe, & Wagner, 2007; Minshew, Sung, Jones, & Furman, 2004). AAC goals are often focused solely on basic requesting skills, under the assumption that most individuals with ASDs will be unable to acquire a broad range of communicative functions because of limited cognitive capacity. Edelson (2006) and others (e.g., Dawson, Soulières, Gernsbacher, & Mottron, 2007), however, have provided empirical evidence to challenge the conventional presumption that intellectual disability usually co-occurs with ASDs. In addition, some researchers have started to demonstrate that individuals with ASDs can become much more communicatively competent through the use of AAC than might be expected in the presence of intellectual disability (e.g., Light et al., 2005). Given all of this, Mirenda (2008) urged AAC clinicians and researchers to “question what we think we know about people with ASD in general and how we support those individuals whose speech does not develop to communicate through AAC in particular.” It remains to be seen whether the AAC community will take up this challenge both to reconceptualize ASDs in general and to design innovative AAC interventions that push traditional boundaries and presume the potential for competence.


Decision making related to AAC interventions for individuals with ASDs is a complex and challenging endeavor. Because of the wide heterogeneity of this population, decisions about appropriate AAC techniques cannot and should not be made in the abstract; rather, they must be made for specific learners, in specific contexts, to meet specific needs (Beukelman & Mirenda, 2005). It is clear that that the success or failure of any AAC intervention is not simply a matter of choosing symbols or devices; instructional variables are also critically important. Indeed, when AAC fails to result in spontaneous, functional communication, this failure usually reflects limitations in the procedures and methods used for instruction rather than an inherent problem with AAC itself. In the end, the combination of research-based modality selection, excellent instruction, and goodness-of-fit (Bailey et al., 1990) with regard to environments, communication partners, and communication needs are all needed to maximize the possibility of successful communication for individuals with ASDs.

Table of Contents

Series Preface
Series Editors, Editorial Advisor, and Editorial Advisory Board
Volume Preface
About the Editors

I: Overview and Assessment

1. Introduction to AAC for Individuals with Autism Spectrum Disorders
Pat Mirenda

2: Assessment Issues
Teresa Iacono and Teena Caithness

II: Communication Modalities

3: Presymbolic Communicators with Autism Spectrum Disorders
Charity M. Rowland

4: Research on the Use of Manual Signs and Graphic Symbols in Autism Spectrum Disorders: A Systematic Review
Oliver Wendt

Appendix A: Overview and Appraisal of Studies Involving Manual Signs and Gestures

Appendix B: Overview and Appraisal of Studies Involving Graphic Symbols

5: Speech Output and Speech-Generating Devices in Autism Spectrum Disorders
Ralf W. Schlosser, Jeff Sigafoos, & Rajinder K. Koul

6: Effects of AAC on the Natural Speech Development of Individuals with Autism Spectrum Disorders
Diane C. Millar

III: AAC Interventions

7: AAC and the SCERTS® Model: Incorporating AAC within a Comprehensive, Multidisciplinary Educational Program
Emily Rubin, Amy C. Laurent, Barry M. Prizant, & Amy M. Wetherby

8: The System for Augmenting Language: Implications for Young Children with Autism Spectrum Disorders
MaryAnn Romski, Rose A. Sevcik, Ashlyn Smith, R. Micheal Barker, Stephanie Folan, & Andrea Barton-Hulsey

9: Using AAC Technologies to Build Social Interaction with Young Children with Autism Spectrum Disorders
Kathryn D.R. Drager, Janice C. Light, & Erinn H. Finke

10: The Picture Exchange Communication System: Clinical and Research Applications
Andy Bondy & Lori Frost

11: A Picture Is Worth a Thousand Words: Using Visual Supports for Augmented Input with Individuals with Autism Spectrum Disorders
Pat Mirenda & Kenneth E. Brown

12: Functional Communication Training and Choice-Making Interventions for the Treatment of Problem Behavior in Individuals with Autism Spectrum Disorders
Jeff Sigafoos, Mark F. O'Reilly, & Giulio E. Lancioni

13: The Role of Aided AAC in Replacing Unconventional Communicative Acts with More Conventional Ones
Krista M. Wilkinson & Joe Reichle

IV: AAC-Related Issues

14: Literacy in Individuals with Autism Spectrum Disorders Who Use AAC
David A. Koppenhaver & Karen A. Erickson

15: Membership, Participation, and Learning in General Education Classrooms for Students with Autism Spectrum Disorders Who Use AAC
Michael McSheehan, Rae M. Sonnenmeier, & Cheryl M. Jorgensen

Appendix: Beyond Access Model Best Practices

16: Supporting the Participation of Adolescents and Adults with Complex Communication Needs
Teresa Iacono, Hilary Johnson, & Sheridan Forster


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