Using AAC with storytelling boosts literacy skills in proof-of-concept study

Narrative language skills, or the ability to understand, tell and retell stories, are an important part of communication and literacy. From a young age, children are encouraged to talk about their personal experiences or retell their favorite bedtime story.  

Children who depend on augmentative alternative communication (AAC) to communicate, on the other hand, are not usually encouraged to tell stories. This includes 25 to 30% of autistic children who never develop functional spoken communication even with early intervention. 

Instead, 60 to 90% of AAC interventions focus on requests, such as what toy they want or what food they prefer. 

Trina Spencer, director of the Juniper Gardens Children’s Project at the KU Life Span Institute, and her doctoral student investigated the impact of an AAC narrative intervention on autistic children’s communication. They co-authored a paper published earlier this year in Augmentative and Alternative Communication.  

The authors noted that there is a lack of AAC intervention research targeting communicative functions other than requesting, despite the significant need to enhance children's communication across social and educational contexts. 

The proof-of-concept study explored Story Champs AAC with children between the age of 6 and 12 years over the course of several sessions. Story Champs AAC is an adaptation of the Story Champs intervention developed by Spencer, which aims to support oral language as the foundation to success in school. 

At the conclusion of the intervention, all participants had improved the number and variety of AAC symbols used. All participants successfully produced two to three-symbol utterances and generalized their use of symbols in new stories and maintained these improvements 3 weeks after the intervention. Interestingly, the child with the most proficient AAC use prior to the study was the slowest to catch on. 

Spencer, who developed Story Champs and adapted the intervention for children using AAC, was encouraged by the results. 

"It was really exciting to see how quickly the intervention produced generative communication," she said. “We also learned that proficient use of AAC was not a prerequisite. It worked even faster with children with lower communication skills." 

Parents also reported that their children started using their AAC more often and for many purposes at home. One mother reported that the intervention was “eye opening” because she never expected her child to use so many symbols or put multiple symbols together. One participant’s speech language pathologist reported that he spontaneously told her a story about riding the bus to go swimming using his AAC device.  

While results of the study were promising, researchers stated future studies on AAC narrative intervention would benefit from a larger sample size and longer treatment duration.