자료유형  

 학위논문

Control Number  

0017164407

International Standard Book Number  

9798346382843

Dewey Decimal Classification Number  

300

Main Entry-Personal Name  

Brittlebank, Savanna.

Publication, Distribution, etc. (Imprint  

[S.l.] : The Pennsylvania State University., 2024

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2024

Physical Description  

210 p.

General Note  

Source: Dissertations Abstracts International, Volume: 86-05, Section: B.

General Note  

Advisor: Light, Janice C.

Dissertation Note  

Thesis (Ph.D.)--The Pennsylvania State University, 2024.

Summary, Etc.  

요약Children with multiple disabilities may experience significant disabilities in two or more areas of functioning including vision, motor, hearing, and communication such that they face limitations in social interactions throughout their daily lives (Bruce & Ivy, 2017). Many children have complex communication needs and evidence indicates that those with multiple disabilities benefit from augmentative and alternative communication (AAC; Simacek et al., 2018). AAC encompasses any and all means of communication besides speech including sign, gesture, photographs, or high-tech speech-generating systems (ASHA, n.d.). However, the few AAC interventions that have been implemented with this population to date have focused on requesting and choice-making skills to the neglect of social communication (Brittlebank et al., 2024), despite the importance of social interaction for language development (Kuhl et al., 2003). Primary caregivers, such as parents, play a critical role in both providing enriched linguistic input and responding to early communicative acts to establish meaning and build vocabulary (Warren & Brady, 2007). Research supports the effectiveness of training parents of young children with developmental disabilities and minimal functional speech to successfully implement trained strategies (Dodge-Chin et al., 2022; Kent-Walsh et al., 2010). Furthermore, by training parents in supportive communication strategies, improvements in turn taking and expression of different vocabulary concepts are observed in young AAC users (Kent-Walsh et al., 2010).In the current study, a single case multiple-probe design (Kratochwill et al., 2010) was implemented remotely with six parent-child dyads to teach parents an evidence-based strategy to support child communication during interactive shared reading (Justice & Pence, 2005) and the implementation of an AAC app with just-in-time programming of vocabulary. All children had multiple disabilities including concomitant motor and communication impairments with some children having an additional diagnosis of autism spectrum disorder. Child participants were all at the "first words" stage (Tager-Flusberg et al., 2009) of language development. Parent-child dyads were provided with visual scene display (VSD) based AAC systems that contained an individualized set of five books. VSD-based AAC systems have been shown to be support early language development by maintaining the context in which language learning occurs and embedding language concepts as hotspots with voice output directly onto the scenes (Light et al., 2019). VSD-based AAC systems also support just-in-time programming whereby partners can add vocabulary with voice output in the moment directly into the book displays. In the study, parents were taught via teletraining to (1) read the book and model AAC, (2) wait for five seconds (or until the child takes a turn), and (3) respond to the child and model AAC/add a hotspot. Data were collected on parent accuracy implementing the target strategy and on the total number of child communication turns taken per session, including the modality of these turns. Additional analyses were completed to explore (1) the parent just-in-time programmed vocabulary and (2) the characteristics of this vocabulary used by the children.Parent accuracy with implementation of the target strategy greatly increased following the teletraining to greater than 80% accuracy (e.g., gains of +46 to +72%) and was maintained up to two months past the teletraining sessions. All parents successfully used the just-in-time programming feature of the VSD-based AAC app to add personalized vocabulary for their children at the start of the study. The child participants took limited communication turns in 8-minute interactions at baseline (e.g., 0-34 turns), but all showed significant increase in the number of communication turns taken in the intervention phase (e.g., 7-70 turns), number of unique vocabulary concepts expressed, and increased use of aided AAC as a communication modality with no negative impact on other communication modalities. Interestingly, although parent programmed vocabulary varied in utterance length (e.g., single word, phrase) most parents programmed single words or two-word phrases with the exception of one parent who programmed some longer sentences. Parent programmed vocabulary mostly consisted of people, action words, and sound effects which closely aligns with language development patterns of neurotypical children (Fenson et al., 2007). The child participants used between 44%-86% of the vocabulary programmed by parents just-in-time and appeared to show a preference for using single words/units and expressed mostly nouns, action words, and sound effects. Overall, the parents' use of the target strategy with just-in-time programming, following teletraining, appeared to be effective at increasing child language and communication.The current study filled several important gaps in the evidence base to date. This study extended the prior communication partner training research to include parents of young children with multiple disabilities and complex communication needs. This study also demonstrated the effectiveness, efficiency, and appropriateness of telepractice as a format for AAC intervention for geographically dispersed individuals with complex needs. Additionally, this research added to the evidence base on the benefits of shared reading as a socio-communicative context for enriched language and communication development by demonstrating the effectiveness with young children with multiple disabilities at the first words stage expressively and their families. Furthermore, this study demonstrated the effectiveness of VSD-based AAC systems with just-in-time programming implemented by parents at home with their young children with multiple disabilities. In addition, this study was the first to demonstrate the effectiveness of training parents to program VSD-based AAC vocabulary in response to their child's interest, with minimal instruction, and to analyze the characteristics of this vocabulary added by parents. These results lay the foundation for important future research to continue to improve language and communication outcomes for a population that has been lacking from the evidence-base for too long.

Subject Added Entry-Topical Term  

Parents & parenting.

Subject Added Entry-Topical Term  

Reading instruction.

Subject Added Entry-Topical Term  

Language acquisition.

Subject Added Entry-Topical Term  

Autistic children.

Subject Added Entry-Topical Term  

Families & family life.

Subject Added Entry-Topical Term  

Blindness.

Subject Added Entry-Topical Term  

Cognitive ability.

Subject Added Entry-Topical Term  

Intellectual disabilities.

Subject Added Entry-Topical Term  

Mobility.

Subject Added Entry-Topical Term  

Cognition & reasoning.

Subject Added Entry-Topical Term  

Visual impairment.

Subject Added Entry-Topical Term  

Young adults.

Subject Added Entry-Topical Term  

Early intervention.

Subject Added Entry-Topical Term  

Social interaction.

Subject Added Entry-Topical Term  

Augmentative and alternative communication.

Subject Added Entry-Topical Term  

Cerebral palsy.

Subject Added Entry-Topical Term  

Linguistics.

Subject Added Entry-Topical Term  

Speech.

Subject Added Entry-Topical Term  

Semantics.

Subject Added Entry-Topical Term  

Cognitive psychology.

Subject Added Entry-Topical Term  

Communication.

Subject Added Entry-Topical Term  

Disability studies.

Subject Added Entry-Topical Term  

Early childhood education.

Subject Added Entry-Topical Term  

Individual & family studies.

Subject Added Entry-Topical Term  

Language.

Subject Added Entry-Topical Term  

Logic.

Subject Added Entry-Topical Term  

Ophthalmology.

Subject Added Entry-Topical Term  

Social psychology.

Added Entry-Corporate Name  

The Pennsylvania State University.

Host Item Entry  

Dissertations Abstracts International. 86-05B.

Electronic Location and Access  

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Control Number  

joongbu:656976