The Relationship Between the Use of Speech-Generating Devices and Verbal Requests in Children with Autism Spectrum Disorder and Intellectual Disabilities.
Turn off SGD voice output and delay reinforcement to spark spoken requests in minimally verbal kids with ASD/ID while they keep using the device.
01Research in Context
What this study did
Three minimally verbal kids with autism and intellectual disability used speech-generating devices (SGDs) every day.
The team turned off the device’s voice output and waited five seconds before giving the requested item.
They compared this quiet-delay condition to normal SGD use with instant reinforcement.
Sessions alternated daily so each child served as their own control.
What they found
When the device stayed silent and reinforcement was delayed, all three children started asking out loud more often.
Their expressive-language test scores also went up, yet they still pressed the SGD symbols just as much.
In other words, the kids kept the tech and gained their own voice.
How this fits with other research
Bishop et al. (2020) got similar speech gains by adding echoic prompts through the SGD speaker.
Moeka’s team got the same result by removing the speaker sound and waiting to deliver the item.
Both studies show the device can be a bridge, not a crutch.
Muharib et al. (2021) also boosted spoken requests with echoic prompts plus bigger candy, but they kept instant reinforcement.
The new twist here is the five-second wait; that tiny delay seems to nudge the child to fill the silence with words.
Why it matters
If you run an SGD program, try turning off the voice output during requesting trials and pause before handing over the reinforcer.
You keep the picture system intact while giving the child a reason to speak.
One setting change, one timing rule—zero extra cost.
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02At a glance
03Original abstract
PURPOSE: This study aimed to investigate the effects of removing synthetic speech output from speech-generating devices (SGDs) and incorporating delayed reinforcement on verbal requests in children with autism spectrum disorder (ASD) and intellectual disabilities. Additionally, we examined how participants' receptive and expressive language abilities influenced vocal requests by comparing items categorized as easier or more difficult to name based on pre-assessment results. METHODS: Three children with ASD and intellectual disabilities participated. An alternating treatment design was used to compare two conditions: (1) synthetic speech output with immediate reinforcement and (2) no synthetic speech output with delayed reinforcement. Preferred items were classified into two sets based on pre-assessed receptive and expressive language abilities. The dependent variable was the number of verbal and SGD-based requests. RESULTS: Results showed that verbal requests increased in the no synthetic speech output with delayed reinforcement condition across both item sets, while SGD-based requests remained high. Post-intervention language assessments indicated significant improvements in expressive language abilities. CONCLUSION: These findings suggest that removing synthetic speech output and incorporating delayed reinforcement may effectively promote vocal requests in children with ASD and intellectual disabilities. This intervention provides a novel approach to facilitate speech communication while continuing the use of AAC tools.
Journal of autism and developmental disorders, 2025 · doi:10.1016/j.rasd.2012.04.005