Enhancing the Language Skills of Toddlers with Severe Communication Difficulties Who Benefit from AAC: A Comparison of Two Language Intervention Approaches by Patti Lynn Solomon-Rice A dissertation submitted in partial satisfaction of the requirements for the degree of Joint Doctor of Philosophy with San Francisco State University in Special Education in the Graduate Division of the University of California, Berkeley Committee in charge: Professor Gloria Soto, Co-Chair Professor Susan Holloway, Co-Chair Professor Carla Hudson Kam Fall 2010 Enhancing the Language Skills of Toddlers with Severe Communication Difficulties Who Benefit from AAC: A Comparison of Two Language Intervention Approaches © 2010 By Patti Lynn Solomon-Rice i TABLE OF CONTENTS TABLE OF CONTENTS ................................................................................................................. i LIST OF FIGURES ...................................................................................................................... vii LIST OF TABLES ....................................................................................................................... viii ACKNOWLEDGEMENTS ........................................................................................................... ix ABSTRACT .................................................................................................................................... 1 CHAPTER 1 Introduction............................................................................................................... 1 CHAPTER 2 Review of the Literature ........................................................................................... 4 Theoretical Frameworks for Language Acquisition in AAC ...................................................... 4 Nativist theories of language acquisition and AAC. ............................................................... 4 Behaviorist theories of language acquisition and AAC. ......................................................... 4 Emergentist theories of language acquisition and AAC. ......................................................... 5 Social constructivist theories of language acquisition and AAC. ........................................... 5 Joint Attending Issues, Memory and Attention Issues, and Input-Output Asymmetry in AAC . 7 Joint attending issues in AAC. ................................................................................................ 7 Memory and attention issues in AAC. .................................................................................... 9 Input-output asymmetry in AAC. .......................................................................................... 10 Language Intervention Approaches for Language Delayed Toddlers and Older Preschoolers 13 Responsivity education. ......................................................................................................... 13 Focused stimulation. .............................................................................................................. 15 Responsivity education combined with focused stimulation. ............................................... 17 Language Intervention Approaches for Children with Severe Communication Difficulties .... 17 Aided AAC modeling. ........................................................................................................... 18 Responsivity education combined with aided AAC modeling. ............................................. 20 AAC Intervention with Children under Age Three Years ........................................................ 26 Comparative AAC Intervention Studies Using Single Subject Experimental Designs ............ 32 Limitations of the Alternating Treatment Design and of Past Research ................................... 34 Limitations of the alternating treatment design. .................................................................... 34 Limitation of past research. ................................................................................................... 34 Research Questions ................................................................................................................... 36 CHAPTER 3 Methods .................................................................................................................. 37 ii Research Design ........................................................................................................................ 37 Participants ................................................................................................................................ 38 Toddler participants and inclusion criteria. ........................................................................... 38 Adult participants and inclusion criteria................................................................................ 38 Assessment of toddler participant inclusion criteria. ............................................................ 39 Participant demographics. ..................................................................................................... 40 Toddler participant profiles. .................................................................................................. 44 Karl. .................................................................................................................................. 44 Carol. ................................................................................................................................. 46 Mick. ................................................................................................................................. 47 Marty. ................................................................................................................................ 49 Adult participant profiles. ...................................................................................................... 51 Katherine. .......................................................................................................................... 51 Nancy. ............................................................................................................................... 51 Elizabeth. .......................................................................................................................... 51 Susie. ................................................................................................................................. 52 Deena. ............................................................................................................................... 52 Patti. .................................................................................................................................. 52 Brenna. .............................................................................................................................. 52 Procedures ................................................................................................................................. 52 Settings. ................................................................................................................................. 53 Activities and materials. ........................................................................................................ 53 Unaided and aided AAC systems. ......................................................................................... 53 Karl’s AAC system. .......................................................................................................... 53 Carol’s AAC system. ........................................................................................................ 54 Mick’s AAC system. ......................................................................................................... 54 Marty’s AAC system. ....................................................................................................... 55 Language intervention approaches. ....................................................................................... 55 Responsivity education and focused stimulation. ............................................................. 55 Responsivity education and focused stimulation with the addition of AAC modeling. ... 56 Vocabulary sets. .................................................................................................................... 56 iii Phases of the study. ............................................................................................................... 57 Assessment. ....................................................................................................................... 57 Baseline. ............................................................................................................................ 61 Language intervention. ..................................................................................................... 62 Intervention probes. .......................................................................................................... 63 Generalization probes. ...................................................................................................... 63 Maintenance probes. ......................................................................................................... 64 Learning criterion. ................................................................................................................. 64 Teaching criterion. 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