Teaching Mands: Correspondence among Acquisition, Recommendations of the Essential for Living Communication Modality Assessment, and Preference
EFL-recommended AAC did not produce faster mand acquisition than other AAC options; trial all modalities and let the child’s preference guide the final selection.
01Research in Context
What this study did
Four autistic children with almost no speech joined the study.
Each child tried three ways to ask for things: manual signs, picture cards, and the AAC that the Essential for Living (EFL) test said was best.
Sessions rotated across the three tools every day so speed of learning could be fairly compared.
What they found
All four kids learned to mand with every tool.
Learning speed was about the same no matter which tool the EFL had picked.
Each child ended up liking a different tool; the EFL guess did not match the favorite for every child.
How this fits with other research
O’Brien et al. (2024) looked at 27 studies and saw that most people with IDD pick high-tech AAC when given the choice.
That trend did not show up here; one child liked signs, another liked pictures, another liked the high-tech voice device.
Leaf et al. (2012) showed PECS works well for preschoolers with autism; this study adds that picture cards are just one of several tools that can work equally fast.
EScior et al. (2023) ran a similar rotation with kids who have Rett syndrome and also found idiosyncratic winners, showing the pattern holds across diagnoses.
Why it matters
Do not rely on a single assessment to pick a child’s AAC. Run a brief trial of two or three options, track acquisition, then ask the child which one feels best. This quick rotation saves weeks of slow progress and gives the child a voice in the decision.
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02At a glance
03Original abstract
Approximately 25% to 35% of individuals diagnosed with an autism spectrum disorder (ASD) do not acquire vocal speech and may require an augmentative and alternative communication (AAC) modality to express their wants and needs. There are various modes of AAC that individuals with limited vocal speech may use (e.g., manual signs, picture cards). However, the process used to identify the most appropriate communication modality for an individual is not always systematic. Thus, the acquisition of the specified AAC modality may be slow if the communication modality prescribed is inappropriate. To date, there are a few methods that may be used to select an AAC modality. However, these methods consider different variables. For example, McGreevy et al. (2014) included a communication assessment within the Essential for Living (EFL) manual that identifies and ranks appropriate AAC modalities for individuals. Nevertheless, to date, there is no research demonstrating that individuals will acquire the communication modality recommended by the EFL or comparing acquisition of this AAC modality to other frequently used AACs. Thus, this study aimed to compare acquisition of mands across three AACs, evaluate whether mands taught using the AAC modality recommended by the EFL were acquired in fewer sessions, and determine whether participants preferred the AAC modality acquired in fewer sessions. Four children diagnosed with ASD and limited vocal repertoires participated in this study. All participants acquired mands using the AAC modality recommended by the EFL. However, for all participants, rate of acquisition was similar across all three modalities of AAC and preference of AAC was idiosyncratic.
Behavior Analysis in Practice, 2023 · doi:10.1007/s40617-022-00764-y