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    Empowering parents to use a core board with children who have complex communication needs : a multiple case study : a thesis presented in fulfilment of the requirements for Doctor of Philosophy in Speech and Language Therapy at Massey University, Albany Campus, Aotearoa New Zealand
    (Massey University, 2023) Brydon, Sam
    Augmentative and alternative communication (AAC) for children with complex communication needs is an area that has seen rapid recent change, both in the AAC systems that are provided, and the methods used to support implementation. AAC is recognised as an evidence-based approach in early intervention that can increase successful communication outcomes for children with complex communication needs. There is increasing awareness that for implementation to be successful, the child’s communication partners need to be supported to learn strategies that will help the child to use their new AAC system. The 77-cell core board with fringe vocabulary used in this study is widely used in Aotearoa New Zealand, but there has been little research conducted to provide evidence that it is an effective or appropriate tool for beginning communicators. This thesis describes a multiple case study with a mixed methods research design, capturing the implementation of an AAC support intervention that was carried out over a year. The study sought to explore the effectiveness of a training and coaching intervention for parents to support the implementation of a core board with their pre-school children who had complex communication needs and used less than 10 spoken words. The intervention described in this study, named Empowering Parents for AAC (EP-AAC), took place over a year, and included an intervention phase of 9 weeks and a long maintenance phase. Six families were recruited, and one parent from each family participated. The children had no prior experience with using AAC. After an initial intervention phase consisting of group workshops and in-home coaching to learn evidence-based strategies to support their child’s communication through AAC, parents continued to receive bi-monthly maintenance coaching sessions for the remainder of the year. Quantitative data were collected on both the adults’ use of the taught AAC strategies and the children’s use of the core board and spoken language. Additionally, qualitative data were collected through a variety of sources including two surveys and a final semi-structured interview aimed at gaining deeper insights into the supports and barriers to AAC use, and how the family had experienced the intervention and implementation of AAC. The findings suggested that the intervention was successful, with all the adults learning and maintaining the supportive strategies alongside all the children making significant gains in their communication. Five children learned to use the core board to communicate within the first few weeks of the intervention, and all six children were able to communicate using a core board by the end of the year. Family retention over the duration of the study period exceeded expectations, despite a challenging year during the pandemic. Four children used spoken language as their main form of communication by the end of the intervention, whilst the other two continued to use AAC to communicate. The parents reported positively about the intervention, in particular the on-going coaching. The core board was viewed as a helpful tool, but not as a long-term AAC solution. For the children who still required AAC for communication, parents wanted to explore high tech AAC options. The findings from this study provided additional evidence that parents are a key component to ensuring the success of an AAC system. Initial training and ongoing personalised coaching proved to be a successful combination for this group of parents to learn and maintain the supportive AAC strategies. Core boards were found to be an adequate initial AAC system when implemented within this supportive framework and were a contributing factor in the improved communication skills of all the participating children. The EP-AAC intervention was a useful framework that could be used in the future by service providers to support the implementation of a range of AAC options with young children who have complex communication needs.
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    A dialogic reading intervention incorporating AAC modelling and increased communication partner responsiveness during shared storybook reading with children with complex physical, cognitive, and sensory needs who use partner assisted scanning : a thesis presented in partial fulfilment of the requirements for the degree of Master of Speech and Language Therapy at Massey University, Albany, New Zealand
    (Massey University, 2018) Bayldon, Helen Jane
    Children with complex physical, cognitive and sensory needs (CPCSN) who use augmentative and alternative communication (AAC) may use partner assisted scanning (PAS) as their access method. This access method is not well understood and rarely features in existing literature. Children with CPCSN also seldom appear in the literature on aided language. Children who use AAC require significant intervention to build their receptive and expressive language skills and develop communicative competence. This research examined an evidence based dialogic shared reading strategy which incorporated aided language modelling and increased communication partner responsiveness with two children with CPCSN who use PAS to access a Pragmatic Organised Dynamic Display (PODD; Porter, 2012) communication book. The dialogic reading strategy prompted the communication partner to comment on the story, invite a communication turn, and respond contingently to the child. Aided language modelling and increased responsiveness are widely recognised as strategies which support language development in children who use AAC. Data were collected via communication frequency measures, field notes, and observations throughout the intervention process and an interview with the children’s teacher was conducted after the intervention was complete. The quantitative data were analysed using descriptive statistics and graphs, while the qualitative data were analysed using a general inductive approach. In an effort to integrate all of the data sources, the quantitative communication frequency measures were treated as deductive codes and embedded within the qualitative analysis. Two major themes emerged from the data. One theme described the practical challenges associated with the health and physical needs of the children that required consideration when providing intervention, as well as the changes to the clinical protocol that became necessary in response. In addition, the second theme outlined the effects of the intervention on the children’s communication skills. This included positive outcomes in skill areas such as turn taking, efficiency and conveying meaning. Recommendations for further research and clinical practice as a result of the research are presented.
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    The impact of a parent-implemented naturalistic social communication intervention for pre-schoolers on the autism spectrum : a training plus coaching approach : a thesis presented in fulfilment of the requirements for the degree of Masters of Speech and Language Therapy, Massey University, Albany, New Zealand
    (Massey University, 2018) Pretorius, Estelle
    Family-centred approaches are recommended as best practice in the field of early intervention. Interventions that offer training and coaching to parents of pre-schoolers on the autism spectrum are becoming increasingly common, and a growing body of research is examining their impact on child outcomes and parent behaviour. The present study investigates the effects of a training plus coaching intervention in a small sample population to gain preliminary insight into its efficacy. The research sought to answer the following research questions: (1) What impact does a training plus coaching intervention have on parents’ use of naturalistic interactive strategies, with pre-schoolers on the autism spectrum? (2) What is the effect of parent-implemented naturalistic instruction on the acquisition of early social communication skills in pre-schoolers on the autism spectrum? and (3) What are the parents' experiences and perceptions of the intervention? Three parent-child dyads participated in the study. Child-participants presented with a clinical diagnosis of autism spectrum disorder (ASD) and were waiting for services from an early intervention centre. The training plus coaching intervention consisted of four workshops and eight in-home coaching visits. Workshops included purpose-developed training material; parents were provided with education on interaction promoting strategies and implementing complete learning trials (CLTs) informed by literature on Embedded Instruction and Naturalistic Instruction. In-home coaching visits followed a coaching protocol using video feedback informed by several coaching models in the early intervention literature. Through in-home coaching, the parents gained experience in implementing embedded learning opportunities and CLTs, and using interaction promoting strategies. In-situ supports were given during these visits when requested by the parent (e.g., to model strategies or the implementation of CLT components, or to join in the interaction to support the parent in the implementation of these strategies). A single group pre-test/post-test design was adopted for this study. Data was collected though purpose-developed observational coding systems for both parent and child behaviour, parent-completed rating scales and informal verbal feedback from parents. The findings demonstrated that a brief training plus coaching intervention was effective in increasing parents’ use of naturalistic strategies and interaction promoting strategies. Through explicit training and supportive coaching, parents not only gained skill and experience, but also confidence, capacity and empowerment. Findings from this study also showed that parent-implemented naturalistic instruction has the potential to facilitate social communication development in pre-schoolers on the autism spectrum and promotes sustained parent-child interactions. Parent-completed rating scales and parent narratives provided evidence that the training plus coaching intervention was effective and appropriate in improving parent, child and family outcomes.
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    Early childood educators' perspectives on children's communication development : a thesis presented in partial fulfilment of the requirements for the degree of Master of Speech and Language Therapy at Massey University, Albany, New Zealand
    (Massey University, 2018) Smith, Suanna Helen Jane
    In New Zealand (NZ), Speech-language Therapists (SLTs) work collaboratively with Early Childhood Educators (educators), empowering them to apply their knowledge and skills to interactions with children with communication difficulties within their early childhood education setting (ECE setting). There is limited information about NZ educators’ perspectives about children’s communication development within ECE settings. The aim of this research was to engage with educators in a way that could empower them to share their beliefs, ideas, and perceptions about their everyday communication interactions with young children. This qualitative study used semi-structured interviews to gather the lived experiences and perspectives from 10 educators working in NZ. Iterative coding of transcripts and rigorous Thematic Network Analysis preserved educator voice, while revealing common themes relevant across the sector. These four global themes were 1) communicative environment, 2) coming to know, 3) alignment, and 4) enactment. Findings suggested that when there is convergence among the elements included in the themes, educators believed that children’s communication outcomes were positively enhanced; when there was misalignment, educator frustration, distrust, and/or disengagement occurred, and children’s reported communication outcomes were not optimised. This information may be useful for SLTs wanting to engage with educators in a collaborative manner, enhancing teamwork through understanding, and facilitating robust communication interactions. It may also inform educators and their management teams about the multitude of factors that contribute to educators’ convergent enactment of communication practice, positively influencing children’s communication development in ECE settings.