The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review.

PURPOSE This article presents the results of a meta-analysis to determine the effect of augmentative and alternative communication (AAC) on the speech production of individuals with developmental disabilities. METHOD A comprehensive search of the literature published between 1975 and 2003, which included data on speech production before, during, and after AAC intervention, was conducted using a combination of electronic and hand searches. RESULTS The review identified 23 studies, involving 67 individuals. Seventeen of these studies did not establish experimental control, thereby limiting the certainty of evidence about speech outcomes. The remaining 6 studies, involving 27 cases, had sufficient methodological rigor for the "best evidence analysis" (cf. >R. E. Slavin, 1986). Most of the participants (aged 2-60 years) had mental retardation or autism; the AAC interventions involved instruction in manual signs or nonelectronic aided systems. None of the 27 cases demonstrated decreases in speech production as a result of AAC intervention, 11% showed no change, and the majority (89%) demonstrated gains in speech. For the most part, the gains observed were modest, but these data may underestimate the effect of AAC intervention on speech production because there were ceiling effects. CONCLUSIONS Future research is needed to better delineate the relationship between AAC intervention and speech production across a wider range of participants and AAC interventions.