Developing an Augmentative and Alternative Communication (AAC) Intervention for Preschool Children with Severe Disabilities

The purpose of the research plan is to iteratively develop, refine, and evaluate CAI across a series of studies. During Year 1, the PI will develop and revise CAI through focus groups with early childhood teachers (Study 1) and observations of typical preschool instruction (Study 2). In Year 2, the PI will revise CAI based on findings from Study 1 and Study 2 and test the effect of CAI on teachers' use of communication support strategies and students' communication skills in a single-case design study (Study 3). In Year 3, CAI will be revised based on the findings from Study 3, and another single-case design study will be used to determine the best frequency and method for providing coaching to teachers, such as bug-in-ear or annotated video performance feedback (Study 4). In Year 4, the PI will conduct a small randomized controlled trial with 24 teachers and their students to determine the promise of the final version of the intervention for improving teachers' use of communication support strategies and students' communication outcomes (Study 5). Fidelity will be assessed through direct observation throughout the single-case design studies and the randomized controlled trial. Feasibility and acceptability of the intervention procedures will be assessed in Study 3 and 4 through observation of video recordings and teacher surveys. Data from the single-case design studies will be analyzed using visual and statistical analysis. Data from Study 5 will be analyzed using multiple regression to determine the main effects of the intervention. The PI will also conduct a cost analysis to determine the cost of implementing the final version of the intervention.