Abstract
Purpose of the Review
We review the evidence-based POWR intervention which provides training to communication partners to support children with complex communication needs (CCN) by teaching steps to support child communication: Prepare the activity and AAC, Offer opportunities for communication, Wait for the child’s communication, and Respond to child’s communication.
Recent Findings
POWR intervention studies show benefits for communication partners (increased communication opportunities, waiting, and responding) and the children with CCN (increased communication turns). Communication partners also found the POWR intervention to be socially valid.
Summary
The POWR intervention is effective and future research is being conducted to further refine it (e.g., adding coaching support, addition of AAC modeling), adjust for other languages and cultures, and explore its use and effectiveness with various communication partners.
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References
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American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5th ed. Washington, DC: Author; 2013.
• Biggs EE, Carter EW, Gilson CB. Systematic review of interventions involving aided AAC modeling for children with complex communication needs. Am J Intellect Dev Disabil. 2018;123:443–73. https://doi.org/10.1352/1944-7558-123.5.443. (This systematic review evaluated interventions involving the use of AAC modeling for children with CCN.)
• Light J, McNaughton D, Caron J. New and emerging AAC technology supports for children with complex communication needs and their communication partners: State of the science and future research directions. Augment Altern Commun. 2019;35:26–41. https://doi.org/10.1080/07434618.2018.1557251. (This commentary provides an overview of AAC technologies for children with complex communication needs and where the field is moving in the future with new technologies.)
Koegel LK, Bryan KM, Su PL, Vaidya M, Camarata S. Definitions of nonverbal and minimally verbal in research for autism: a systematic review of the literature. J Autism Dev Dis. 2020;50:2957–72. https://doi.org/10.1007/s10803-020-04402-w.
Carnett A, Martin C, Gevarter C. Evaluating augmentative and alternative communication modalities for individuals with developmental disabilities: a brief review of the last 5 years. Curr Dev Disord Rep. 2021;8:133–41. https://doi.org/10.1007/s40474-021-00226-0.
Beukelman D, Light J. Augmentative and alternative communication for children and adults. 5th ed. Baltimore: Brookes; 2020.
• Ganz JB, Earles-Vollrath TL, Heath AK, Parker RI, Rispoli MJ, Duran JB. A meta-analysis of single case research studies on aided augmentative and alternative communication systems with individuals with autism spectrum disorders. J Autism Dev Disord. 2012;42:60–74. (This meta-analysis evaluates the use of AAC technologies to support communication for individual with ASD.)
• Iacono T, Douglas SN, Garcia-Melgar A, Goldbart J. A scoping review of AAC research conducted in segregated school settings. Research in Developmental Disabilities in press.(This scoping review provides a summary of AAC research conducted in segregated school settings.)
• Iacono T, Goldbart J, Douglas SN, Melga AG. The effectiveness of AAC systems in supporting inclusive school education.Journal of Developmental and Physical Disabilities in press. (This scoping review provides a summary of AAC research conducted in inclusive school settings.)
• O’Neill T, Wilkinson KM. Preliminary investigation of the perspectives of parents of children with cerebral palsy on the supports, challenges, and realities of integrating augmentative and alternative communication into everyday life. Am J Speech Lang Pathol. 2020;29:238–54. https://doi.org/10.1044/2019_AJSLP-19-00103. (This study provides insights into the perspectives of parents of children with cerebral palsy related to the use of AAC.)
• Douglas SN. Teaching paraeducators to support the communication of individuals who use augmentative and alternative communication: a literature review. Current Issues in Education 2012: 15. http://cie.asu.edu/ojs/index.php/cieatasu/article/view/906. Accessed 2/15/22. (This review looks into interventions where instruction was provided to paraeducators to support the communication of individuals who use AAC.)
Johnston SS. Considering response efficiency in the selection and use of AAC systems. J Speech Lang Pathol Appl Behav Anal. 2006;1:193. https://doi.org/10.1037/h0100195.
•• Sun T, Bowles RP, Douglas SN, Plavnick J. Response time of children with complex communication needs following a communication opportunity. Poster presented at the 2022 Biennial Conference on Research Innovations in Early Intervention; 2022 Feb; San Diego, CA. (This study uses survival analysis to understand the response time of children with CCN following a communication opportunity in preschool classrooms.)
Mathis H, Sutherland D, McAuliffe M. The effect of pause time upon the communication interactions of young people who use augmentative and alternative communication. Int J Speech Lang Pathol. 2011;13:411–21. https://doi.org/10.3109/17549507.2011.524709.
Brady NC, Bruce S, Goldman A, Erickson K, Mineo B, Ogletree BT, et al. Communication services and supports for individuals with severe disabilities: guidance for assessment and intervention. Am J Intellect Dev Disabil. 2016;121:121–38. https://doi.org/10.1352/1944-7558-121.2.121.
Erickson KA, Geist LA. The profiles of students with significant cognitive disabilities and complex communication needs. Augment Altern Commun. 2016;32:187–97. https://doi.org/10.1080/07434618/2016.1213312.
• Mandak K, Light J. Family-centered services for children with ASD and limited speech: the experiences of parents and speech-language pathologists. J Autism Dev Disord. 2018;48:1311–24. https://doi.org/10.1007/s10803-017-3241-y. (This study explores family centered services for children with ASD though the perspectives of parents and speech language pathologists.)
Sun T, Bowles RP, Douglas SN, Goodwin S. The perspectives and experience of AAC communication in Chinese-English speaking families. Poster presented at the 2022 International Conference on Autism, Intellectual Disability and Developmental Disabilities; 2022 Jan; Clearwater Beach, FL
Walker VL, Lyon KJ, Loman SL, Sennott S. A systematic review of Functional Communication Training (FCT) interventions involving augmentative and alternative communication in school settings. Augment Altern Commun. 2018;34:118–29. https://doi.org/10.1080/07434618.2018.1461240.
• Chung YC, Carter EW, Sisco LG. Social interactions of students with disabilities who use augmentative and alternative communication in inclusive classrooms. Am J Intellect Dev Disabil. 2012;117:349–67. https://doi.org/10.1352/1944-7558-117.5.349. (This observational study explored the social interactions in inclusive classrooms for children who use AAC.)
Cole-Lade GM, Bailey LE. Examining the role of paraeducators when supporting children with complex communication needs: a multiple case study. Teach Educ Spec Educ. 2020;43:144–61. https://doi.org/10.1177/0888406419852778.
Sievers SB, Trembath D, Westerveld M. A systematic review of predictors, moderators, and mediators of augmentative and alternative communication (AAC) outcomes for children with autism spectrum disorder. Augment Altern Commun. 2018;34:219–29. https://doi.org/10.1080/07434618.2018.1462849.
•• Douglas SN, Gerde HK. A strategy to support the communication of students with autism spectrum disorder. Interv Sch Clin. 2019;55:32–8. https://doi.org/10.1177/0022466918771707. (This article details the POWR strategy as an approach educators can use to support the communication of children with ASD.)
• Kent-Walsh J, Murza KA, Malanai MD, Binger C. Effects of communication partner instruction on the communication of individuals using AAC: a meta-analysis. Augment Altern Commun. 2015;31:271–84. https://doi.org/10.3109/07434618.2015.1052153. (This meta-analysis evaluated interventions provided to communication partners and their effect on communication partner behavior.)
• Midtlin HS, Naess KB, Taxt T, Karlsen AV. What communication strategies do AAC users want their communication partners to use? A preliminary study. Disabil Rehabil. 2015;37:1260–7. https://doi.org/10.3109/09638288.2014.961659. (This qualitative study evaluated the communication strategies individuals who use AAC prefer their communication partners to use.)
Binger C, Maguire-Marshall M, Kent-Walsh J. Using aided AAC models, recasts, and contrastive targets to teach grammatical morphemes to children who use AAC. J Speech Lang Hear Res. 2011;54:160–76. https://doi.org/10.1044/1092-4388(2010/09-0163).
Cress CJ, Marvin CA. Common questions about AAC services in early intervention. Augment Altern Commun. 2003;19:254–72. https://doi.org/10.1080/07434610310001598242.
McCarthy J, Light J. Instructional effectiveness of an integrated theater arts program for children using augmentative and alternative communication and their nondisabled peers: Preliminary study. Augment Altern Commun. 2001;17:88–98. https://doi.org/10.1080/aac.17.2.88.98.
Downing J, Hanreddy A, Peckham-Hardin KD. Teaching communication skills to students with severe disabilities. 3rd ed. Baltimore: Brookes; 2005.
Binger C, Kent-Walsh J, Ewing C, Taylor S. Teaching educational assistants to facilitate multi-symbol message productions of young students who require AAC. Am J Speech Lang Pathol. 2010;19:108–20. https://doi.org/10.1044/1058-0360(2009/09-0015).
Calculator SN. Augmentative and alternative communication (AAC) and inclusive education for students with the most severe disabilities. Int J Incl Educ. 2009;13:93–113. https://doi.org/10.1080/13603110701284656.
•• Douglas SN, Light JC, McNaughton DB. Teaching paraeducators to support the communication of young children with complex communication needs. Top Early Child Spec Educ. 2013;33:91–101. https://doi.org/10.1177/0271121412467074. This single-case study evaluated the effects of in a person paraeducator training to support young children with CCN.
•• Douglas SN, McNaughton DB, Light JC. Online training for paraeducators to support the communication of young children. J Early Interv. 2014;35:223–42. https://doi.org/10.1177/1053815114526782. (This single-case study evaluated the effects of an online paraeducator training intervention to support young children with CCN.)
•• Douglas SN, Nordquist E, Kammes R, Gerde H. Online parent communication training for young children with complex communication needs. Infants Young Child. 2017;30:288–303. https://doi.org/10.1097/IYC.0000000000000101. (This single-case study evaluated the effects of an online parent training intervention to support young children with CCN.)
•• Douglas SN, Kammes R, Nordquist E. Online communication training for parents of children with autism spectrum disorders. Commun Disord Q. 2018;39:415–25. https://doi.org/10.1177/1525740117727491. (This single-case study evaluated the effects of an online parent training intervention to support young children with ASD.)
••Douglas SN, Kammes R, Nordquist E, D’Agostino S. A pilot study to teach siblings to support children with complex communication needs. Commun Disord Q 2018: 39, 346–355. https://doi.org/10.1177/1525740117703366. (This single-case study evaluated the effects of a sibling training intervention to support interactions between typically developing children and their siblings with CCN.)
Ledford JR, Gast DL. Single case research methodology: applications in special education and behavioral sciences. 3rd ed. New York: Routledge; 2018.
Kent-Walsh J, McNaughton D. Communication partner instruction in AAC: Present practice and future directions. Augment Altern Commun. 2005;21:195–204. https://doi.org/10.1080/0743610400006646.
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Douglas, S.N., Dunkel-Jackson, S., Sun, T. et al. A Review of Research Related to the POWR Intervention: a Communication Partner Intervention to Support Children with Neurodevelopmental Disorders. Curr Dev Disord Rep 9, 45–52 (2022). https://doi.org/10.1007/s40474-022-00244-6
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DOI: https://doi.org/10.1007/s40474-022-00244-6