Teaching requesting and rejecting sequences to four children with developmental disabilities using augmentative and alternative communication.

Choi et al. (2010) worked with four preschoolers who had developmental delays. None could speak clearly.

The team taught one AAC sequence: first ask for the missing piece, then push away the wrong piece. Kids touched picture cards on a board.

They used a multiple-baseline design. Each child started the lessons at a different time.

All four children learned the full ask-and-reject routine. Three kids still used the skill four weeks later with new toys and new adults.

Generalization and maintenance passed for three out of four. The fourth kept the asking part but forgot the reject part.

Alfuraih et al. (2024) ran a similar study with PECS. They also saw strong requesting gains in three non-verbal children. Both papers show AAC picture systems work, but Hayoung added the reject step.

Gilroy et al. (2023) compared high-tech tablets with low-tech cards in older autistic pupils. Both tools worked the same, backing Hayoung’s low-tech board choice.

Emerson et al. (2007) reviewed 37 older AAC studies. Most taught only requesting. Hayoung updates that list by showing you can safely bolt on a reject response without confusing the child.

If you run AAC lessons, pack the reject step into the same teaching loop. You get twice the communicative power for almost the same therapy minutes. Start with two clear pictures: one for “I want that” and one for “not this.” Use a multiple-baseline rollout if you need strong single-case proof for your notes.