Assessment & Research

Systematic Review of Interventions Involving Aided AAC Modeling for Children With Complex Communication Needs.

Biggs et al. (2018) · American journal on intellectual and developmental disabilities 2018
★ The Verdict

Model AAC every time you talk to a child with complex needs—48 studies say it reliably grows their expressive language.

✓ Read this if BCBAs running early-intervention or school programs for non-speaking kids.
✗ Skip if BCBAs focused only on severe problem behavior with no communication goals.

01Research in Context

01

What this study did

The team read every paper they could find on aided AAC modeling. They pulled 48 studies that used picture boards, voice output devices, or sign-plus-speech to teach kids to talk.

The kids had autism, Down syndrome, cerebral palsy, or other complex needs. Ages ranged from toddlers to teens.

The review asked one question: does showing a child how to use AAC actually help them speak more?

02

What they found

Yes, it works. Across all 48 studies, kids used more words, signs, or device hits after adults or peers modeled the AAC.

The gains stuck. Most studies showed the new words kept showing up weeks or months later.

No single method won. Augmented input, model-as-prompt, and demo-plus-practice all moved the needle.

03

How this fits with other research

Honig et al. (1988) and Landry et al. (1989) are inside this big picture. Those early single-case trials showed peer models work just as well as adults. The 2018 review adds weight by finding the same trend across dozens more kids.

Farmer-Dougan (1994) and Castañe et al. (1993) also line up. Both used peers or teachers to model correct responses. The review shows these small studies were not flukes—modeling keeps winning across ages, settings, and diagnoses.

Kaufman et al. (2010) looks at a different puzzle: how to get people with ID into research. It does not clash with the 2018 findings; it simply reminds us that the 48 studies may have missed harder-to-reach families.

04

Why it matters

You do not need fancy tech to start. Hold up the picture, press the device button, or sign while you speak—then wait. One clear model per opportunity is enough. Track if the child copies within three tries. If not, model again and give a gentle prompt. This simple loop is now backed by 48 studies and three decades of smaller trials.

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→ Action — try this Monday

Pick one AAC symbol the child already knows. Use it in every natural routine—snack, circle time, play—then count how often the child uses it back.

02At a glance

Intervention
augmentative alternative communication
Design
systematic review
Sample size
267
Population
mixed clinical
Finding
positive

03Original abstract

Building the communicative competence of individuals who use augmentative and alternative communication (AAC) requires intervention and support. This systematic review examined experimental studies involving aided AAC modeling to promote the expressive communication of children and youth (i.e., birth to age 21) with complex communication needs. A search yielded 48 studies involving 267 participants. Interventions were categorized according to three different approaches to aided AAC modeling-augmented input, models as prompts, and models within instructional demonstrations. Although the procedures varied, interventions were generally effective at improving diverse measures of expressive communication. This review provides insight for both researchers and practitioners by describing interventions involving three distinct approaches to aided AAC modeling, highlighting areas needing future research, and offering implications for practice.

American journal on intellectual and developmental disabilities, 2018 · doi:10.1352/1944-7558-123.5.443