Exploring the Effectiveness of Non-Symbolic Augmentative Communication for Adults With Intellectual Disability, Autism Spectrum Disorder and Challenging Behaviour

Aims: This study aims to evaluate the effectiveness of individualized non-symbolic augmentative communication strategies for adults with intellectual disability and autism spectrum disorder (ASD). Method: Five minimally verbal adults with ASD and severe intellectual disability participated in our replicated single-case experiment study. Based on the administration of the ComFor (Verpoorten et al., 2016) and a video observation, an individualized intervention plan for augmentative communication was designed for one activity. Transitions between activities, different steps or choices within the activity were communicated by recognizable sensations, presenting functional objects, or by assembling or matching methods. The single-case experiments comprised a baseline (1-2 weeks) and intervention phase (1-3 months). The outcome variables – level of independence, quality of mood, and severity of challenging behaviour – were measured daily based on an observation form for caregivers. Additionally, semi-structured interviews were administered from clinicians (n = 10) to evaluate experienced feasibility and effectiveness of the intervention.Results: For all participants, improvement on one or more outcome measures was seen during the activity after augmentative communication was implemented. Effect size measures showed stronger results for level of independence compared to mood and challenging behaviour. By using HLMs to aggregate the single-case results, significant effects for all three outcome measures were found at the group level. Based on the interviews, several challenges and facilitating factors of the implementation of this intervention will be discussed.Conclusions: This study provides the first empirical evidence to support the use of non-symbolic communication strategies for minimally verbal adults with ASD and intellectual disability.

Publication year:2017