Effects of Alternative and Augmentative Communication Systems on Problem Behavior Management and Vocal Speech Development in a 10-Year-Old Child with ASD

Objectives. The effectiveness of typing as an alternative and augmentative communication (AAC) tool for problem behavior management and the development of vocal request skill has been underexplored. This study compares the effects of two alternative communication systems—the Picture Exchange Communication System (PECS) and typing via a tablet application—on reducing problem behavior episodes and increasing vocal requests in a child with autism spectrum disorder (ASD).

Methods. From 2018 to 2020, a problem behavior intervention was implemented for a 10-year-old child with ASD who had difficulties using vocal speech. The primary method used was functional communication training (FCT) combined with an extinction procedure. Two AAC tools were applied sequentially: PECS with reinforcement of vocal requests; Typing requests in a tablet app, also with reinforcement of vocal requests..

Results. When using the AAC system based on typing, the average percentage of problem behavior relative to all responses (both functional communication and problem behavior) was 12%, compared to 25% when using PECS. The average number of vocal requests per school day was 25.9 when using typing in the app, compared to 8.8 with PECS.

Conclusions. The acquisition of phrase-typing skills for requests in a specialized app led to greater reductions in problem behavior and a higher frequency of vocal requests compared to PECS. Further research is needed to explore the effectiveness of typing in a tablet app as an AAC tool for problem behavior management and vocal request development in children with ASD and speech impairments. Additionally, a possible mediating relationship should be investigated, where a change in AAC format may lead to an increase in vocal requests, which in turn contributes to a reduction in problem behavior.

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