Autism & Developmental

Using a speech-generating device to enhance communicative abilities for an adult with moderate intellectual disability.

Cheslock et al. (2008) · Intellectual and developmental disabilities 2008
★ The Verdict

Adults with moderate ID and limited speech can still gain independence through AAC—age or partial speech is not a barrier.

✓ Read this if BCBAs serving adults with developmental disabilities in day programs, group homes, or vocational sites.
✗ Skip if Clinicians who only work with fully verbal clients or early-childhood cases.

01Research in Context

01

What this study did

One adult with moderate intellectual disability and limited speech got a speech-generating device.

Staff taught him to press picture buttons that spoke his wants.

The team watched if he used the device to ask, choose, and take charge of daily life.

02

What they found

The man started to use the device every day.

He asked for food, picked clothes, and told staff when he needed a break.

His independence and self-direction grew along with his talking.

03

How this fits with other research

Leaf et al. (2012) pooled 24 single-case studies and found big gains when adults or kids with ID used speech-generating devices.

Johnson et al. (2021) looked at 28 studies and saw AAC boost speech in children with autism, but speech never passed AAC use.

Brennan et al. (2024) later showed a low-tech eye-gaze board also worked for a young adult with Sanfilippo Syndrome.

Together the papers say AAC helps both kids and adults, high-tech or low-tech, across many labels.

04

Why it matters

Do not skip AAC just because your client is an adult or already says a few words.

Try a speech tablet or simple eye-gaze board and teach one clear function first, like "I want."

Track if the client uses it more each week and let the device do the talking so the person can do more living.

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→ Action — try this Monday

Program one screen with three large buttons that speak common requests and prompt the client to hit one during the next snack break.

02At a glance

Intervention
augmentative alternative communication
Design
case study
Sample size
1
Population
intellectual disability
Finding
positive

03Original abstract

For adults with disabilities who are unable to speak, the literature recommends that intervention include augmentative and alternative communication (AAC) to improve communication and interactions with others. Some adults with moderate intellectual disabilities who exhibit limited functional speech are often overlooked as candidates for AAC interventions because they have some speech abilities. The perception is that they are too old to improve their language and communication skills. This article presents a case report of a 30-year-old woman with a moderate intellectual disability and a severe expressive language disorder who uses a speech-generating device as a compensatory strategy to facilitate her communicative abilities, independence, and self-determination.

Intellectual and developmental disabilities, 2008 · doi:10.1352/2008.46:376-386