Effect of Practice Protocol on Caregiver Fluency With Augmentative and Alternative Communication Applications

Purpose: For children learning to use augmentative and alternative communication applications (AAC apps), a key success factor is caregiver competence with the app. This study aimed to evaluate the effectiveness of a self-guided, asynchronous practice protocol in increasing caregiver fluency with their child's AAC app. Method: A multiple baseline, single-subject design was used to measure competence with a target AAC app in three caregivers who were following the experimental practice protocol. Outcome measures included the number of total words (NTWs), number of different words (NDWs), and number of multiword utterances produced by caregivers on the app in interaction with their children. Results: NTWs and NDWs increased significantly for two of the three caregivers, and changes in the number of multiword phrases were not significant for any caregiver. Conclusions: The experimental practice protocol is a feasible and promising tool for supporting caregivers new to AAC. Potential mediating factors, such as the caregiver's baseline performance and type of activity assessed, are discussed. Clinical Implications: There is a shortage of AAC specialists available to support families who are new to AAC, contributing to AAC underuse and abandonment. When launched to appropriate families, this self-guided practice protocol may improve caregivers' fluency with AAC systems and therefore increase the possibility of successful AAC implementation, without increasing AAC specialist contact hours.