Mand Modality Preference Assessments among High- and Low-Tech Options for Individuals with Intellectual and Developmental Disabilities: A Systematic Review
High-tech AAC usually wins the popularity vote, but quick individual preference tests still decide the best mand tool.
01Research in Context
What this study did
O’Brien and team read 27 studies that compared high-tech and low-tech AAC for manding.
They looked at how people with intellectual or developmental disabilities chose between tablets, speech devices, or picture cards.
All studies used a mand modality preference assessment: each learner tried several tools and picked the favorite.
What they found
Most learners reached for the high-tech option when they could choose.
Picture cards still worked, but tablets and speech devices won the popularity contest.
Because each study used slightly different rules, the authors say the trend is clear but not set in stone.
How this fits with other research
Orozco et al. (2023) ran a small test with four autistic children. Every child learned to mand with every AAC type at the same speed, and each child liked a different tool. The review agrees that high-tech is usually picked, but Orozco shows you still must test the individual.
EScior et al. (2023) taught three girls with Rett syndrome to request with both high- and low-tech AAC. All mastered both, yet response styles were personal. Again, the review’s “high-tech wins” rule bends when you look at single cases.
Urrea et al. (2024) reviewed tech for vocabulary in autism and found mixed results: half of studies showed small or no gain. Their caution matches O’Brien’s: tablets can shine, but only if you check fit first.
Why it matters
Before you write “iPad” in the plan, run a five-minute mand modality preference assessment. Hand the learner a tablet, a card array, and a Big Mac switch. Let them mand for bubbles three times each. Pick the tool they go back to. You save weeks of later resistance and you honor the first rule of our field: the learner leads.
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02At a glance
03Original abstract
The extant literature demonstrates that individuals with intellectual and developmental disabilities (IDD) exhibit preferences among communication modalities when multiple modalities are available and produce reinforcement on identical reinforcement schedules. High- and low-tech communication options, such as voice output devices and picture cards, are commonly recommended for individuals with limited vocal communication skills. In this study, we conducted a systematic literature review of research studies that implemented mand modality preference assessments (MMPAs) that included both a high- and low-tech communication option with individuals with IDD. We identified 27 studies meeting our inclusion criteria and summarized the participant demographics, MMPA design and procedural variations, and MMPA outcomes. The results suggested that high-tech communication options were generally more preferred over low-tech options. However, there was a high degree of variability in how the studies were conducted and conclusions were reached. We discuss some of the current research gaps and the implications for clinical practice.
Behavior Analysis in Practice, 2024 · doi:10.1007/s40617-023-00829-6