“Black white zebra orange orange”: How children with autism make use of computer-based voice output communication aids in their language and communication at school.

Purpose - This naturalistic study adapted exploratory school practice in order to support empirically-informed decision making in the provision of augmentative and alternative communication (AAC) technologies for children with autism.

Design - Research was conducted with three boys with autism and little speech, as part of a curricular literacy lesson. A mixed method approach, involving observational coding and staff diaries, identified how the boys used computer-based voice output communication aids (VOCAs), also called speech generating devices (SGDs) and how the technology impacted on their communication and language. The boys were observed in initial lessons (‘baseline’ sessions), without the VOCA present and in sessions in which the VOCA was available (‘intervention’ sessions).

Findings - VOCAs were used for two main communicative purposes; naming and giving information; with aids being used primarily to support curricular, task-related communication. Existing modes of communication continued to be used when access to the VOCA was available. In addition, all three boys showed an increase in Mean Length of Utterance (MLU) after the VOCA was introduced. The findings suggest that computer-based VOCA technology can augment children’s communicative participation in lesson activities. Specific patterns of change were also recorded in the boys’ communication, suggesting individualised responses to this technology.

Originality - This paper extends the empirical base for clinical decision making by reporting the use of high tech VOCAs by school age children with autism for additional forms of communication, beyond those described elsewhere. It adds to the evidence that interventions which include access to a computer VOCA can have a positive impact on the language complexity of children with autism. It describes the potential of VOCAs to provide an enabling and inclusive technology in a classroom setting.