Increasing communicative interactions of young children with autism using a voice output communication aid and naturalistic teaching.
A talking button plus plain wait-prompt-praise in preschool routines lifts functional communication without hurting speech.
01Research in Context
What this study did
Four preschoolers with autism got a voice output communication aid, or VOCA.
The device spoke a single word each time the child pressed a picture.
Teachers used naturalistic teaching during snack and play.
They waited, prompted, and praised any VOCA press.
What they found
All four kids pressed the VOCA more often.
Their old speech and gestures stayed the same.
No one lost any skills.
The gains showed up in regular class routines.
How this fits with other research
Gevarter et al. (2016) added vocal prompts to speech tablets.
Their kids started saying word sounds, not just pressing buttons.
The two studies fit together: first get the child talking with the device, then add vocal cues.
Barnes Ross et al. (2024) swapped the VOCA for simple reflections.
They repeated the child’s words during play and saw big language jumps.
The 2024 paper updates the 1998 idea: low-tech echoes can work as well as high-tech voice buttons.
Beaumont et al. (2008) kept the preschool play setting but used picture cards instead of a VOCA.
All three studies show the place, not the tool, may matter most.
Why it matters
You do not need to pick one tool forever.
Start with a VOCA if the child is silent.
Once the child presses to talk, layer in short vocal prompts like Gevarter et al. (2016).
If the child already makes any sounds, try reflections first like Barnes Ross et al. (2024).
Keep snack, play, and circle time as your stage.
The routine anchors the new skill, no matter which aid you hold.
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02At a glance
03Original abstract
We evaluated the effects of a voice output communication aid (VOCA) and naturalistic teaching procedures on the communicative interactions of young children with autism. A teacher and three assistants were taught to use naturalistic teaching strategies to provide opportunities for VOCA use in the context of regularly occurring classroom routines. Naturalistic teaching procedures and VOCA use were introduced in multiple probe fashion across 4 children and two classroom routines (snack and play). As the procedures were implemented, all children showed increases in communicative interactions using VOCAs. Also, there was no apparent reductive effect of VOCA use within the naturalistic teaching paradigm on other communicative behaviors. Teachers' ratings of children's VOCA communication, as well as ratings of a person unfamiliar with the children, supported the contextual appropriateness of the VOCA. Probes likewise indicated that the children used the VOCAs for a variety of different messages including requests, yes and no responses, statements, and social comments. Results are discussed in regard to the potential benefits of a VOCA when combined with naturalistic teaching procedures. Future research needs are also discussed, focusing on more precise identification of the attributes of VOCA use for children with autism, as well as for their support personnel.
Journal of applied behavior analysis, 1998 · doi:10.1901/jaba.1998.31-561