Co-Principal Investigator: Meadan-Kaplansky, Hedda 

Purpose: The purpose of this project is to develop and pilot test the Family Telepractice AAC Modeling Intervention (FamTAM). Family members are critical communication partners for children who use augmentative and alternative communication (AAC). Evidence suggests that children who use AAC experience the best outcomes when family members are well-trained and highly engaged in AAC use. However, families are rarely provided with the training necessary to support AAC. The FamTAM intervention will address this need and include online professional development for school-based speech language pathologists (SLPs) so that they can train and coach family members to support a target child’s use of AAC. Expected outcomes of this intervention include increased knowledge, self-efficacy and use of strategies and coaching practices by school-based SLPs; improved knowledge and use of AAC strategies and quality of life among families; and increased independent communication and use of aided AAC by children with disabilities.  

Project Activities: The project will use focus groups, interviews, observations, and single-case experimental designs to iteratively develop FamTAM and test the promise of the intervention for improving SLP, family, and child outcomes.

Products: This project will result in a fully developed digital learning platform that includes professional development for SLPs and an online training and telepractice intervention for families of children who use aided AAC. The project will also result in peer-reviewed publications and presentations as well as additional dissemination products that reach education stakeholders, such as practitioners and policymakers.   

Structured Abstract

Setting: The research will take place in Michigan and Illinois in families’ homes.

Sample: At least 10 school-based SLPs and 10 family members will participate in focus groups during Phase I. At least 10 school-based 10 SLPs, 10 children between ages four and eight who use AAC, and 10 of their family members will participate in Phase II. In Phase III, 5 SLPs, 5 target children, and 20 family members (4 family members per SLP/child dyads) will participate. Child participants will likely include those with autism and other developmental delays and disorders.  

Intervention: The FamTAM intervention begins with individually paced online training for SLPs and adult and child family members, which can be completed in a week or less. This training will focus on aided language modeling strategies. Specifically, family members will be coached to use a Prepare-Show-Wait-Respond strategy, where they will prepare to embed AAC practice into highly motivating naturally occurring activities, model AAC use with the target child, pause after modeling so the child can respond with the AAC device, and finally respond to the child’s use of AAC to communicate. Trainings will include video models, questions, application activities and feedback. After completing the training, the SLP will coach family members via videoconference as they implement the strategy in their home with the target child. Each coaching session will last approximately 20 minutes, and will include pre-observation reflection and planning, observation of the family member and child interaction, and post-observation reflection and feedback.  

Research Design and Methods: In Phase I, the team will iteratively develop the FamTAM intervention with feedback from a panel of expert advisors that includes professors, school-based service providers, and parents, and from four online focus groups including SLPs and family members of children who use AAC. In Phase II, researchers will test the usability, feasibility, and social validity of the FamTAM intervention by implementing the training in a multiple-baseline across participants single-case design, measuring coaching fidelity, and conducting pre- and post-training interviews with SLP and family member participants. In Phase III, researchers will test the promise of the FamTAM intervention for improving SLP, family, and child outcomes in a multiple-baseline across participants single-case design.  

Control Condition: Participants will serve as their own controls in the single-case designs where SLPs, family members, and children will interact as normal.  

Key Measures: SLP practice will be assessed by evaluating fidelity of coaching using event recording from online observations. Family member use of strategies will be measured with event recording from online observations. Family member outcomes will be assessed with the Family Quality of Life Scale, the Family Empowerment Scale, and the Family-Professional Partnership Scale. Target child outcomes will be measured by event recording of independent communication and AAC use from online observations, the Communication Matrix, and the Vineland Adaptive Behavior Scales 3. The research team will use questionnaires including the Social Validity Interview and the Usage Rating Profile—Intervention as well as interviews to assess the usability, feasibility, and social validity of the FamTAM intervention.

Data Analytic Strategy: Focus groups and individual interviews will be transcribed and analyzed for main ideas and themes using content analysis. Outcomes in the single-case designs (coaching fidelity and child communication) will be visually analyzed for level, trend, variability, immediacy of effects, overlap, and consistency of patterns and statistically analyzed by calculating the log response ratio.

Cost Analysis: Costs of the FamTAM intervention will be estimated using the ingredients method, with monetary values assigned based on the CostOut Tool Kit. The actual cost of the FamTAM intervention will be compared to a hypothetical in-person instruction and coaching intervention, to quantify the resources saved with the online administration.