Social Positioning to Increase Communication of Adults With Extensive Support Needs.

Rieth et al. (2022) worked with adults who have extensive support needs.

The team changed only three things: where the adult sat, which way they faced, and where the speech device was placed.

They used a multiple-baseline design across participants to see if these small moves would spark more eye contact and device use.

When the adult faced their partner and the device stayed within easy reach, eye gaze and SGD activations shot up.

The gains held for some adults but not for others, so maintenance was mixed.

Still, the authors showed a clear functional relation: better positioning led to more communication.

Fischbacher et al. (2024) extends this work. They moved the same SGD strategies into family homes using online parent training instead of adult positioning.

Weissman-Fogel et al. (2015) used eye gaze as a tool to pick reinforcers. R et al. flip that idea: they make eye gaze happen first, then communication follows.

Yaw et al. (2014) also worked with adults with IDD, but they conditioned staff attention as reinforcement. R et al. show you can get social gains without extra reinforcers—just by rearranging the chairs.

You can boost communication today without new programs or extra staff. Walk into the room, turn the chair so the client faces you, and slide the SGD within arm’s reach. These two moves cost nothing and often double device activations. Start there, then watch for which clients need more help to keep the gains.