VSDs and NDBIs (Pope et al., 2025)
Purpose: Naturalistic developmental behavioral interventions (NDBIs) are a promising approach for supporting early language and communication development for young children on the autism spectrum.1 However, the children with the greatest need of language supports—those with minimal speech—have limited means to participate within these interventions and are therefore the least likely to benefit from traditional NDBIs that focus primarily on speech production.
Method: Using a single-case, multiple-probe across participants design, the current study investigated whether adding visual scene display (VSD) augmentative and alternative communication (AAC) supports with just-in-time programming and aided AAC input to NDBI procedures within an interactive storybook reading context resulted in (a) an increase in the number of symbolic communicative turns or (b) an increase in the rate of the number of different unique concepts expressed by young children on the autism spectrum with minimal speech.
Results: All participants tended to take more symbolic communicative turns each session and add new expressive vocabulary more rapidly with the addition of VSD AAC supports as compared to NDBI procedures alone, although with notable variation across participants.
Conclusions: The results of this study indicate that including VSD-based aided AAC systems and strategies designed to support beginning communicators within the framework of an NDBI can increase both the communication frequency and expressive vocabulary of children on the autism spectrum with minimal speech, beyond the effects of NDBI procedures alone.
Supplemental Material S1. Participant book sets.
Supplemental Material S2. Example storybook pages in baseline and intervention.
Supplemental Material S3. Book-related signs/gestures.
Supplemental Material S4. Baseline procedural sequence.
Supplemental Material S5. Intervention procedural sequence.
Supplemental Material S6. Baseline procedural fidelity checklist.
Supplemental Material S7. Intervention procedural fidelity checklist.
Supplemental Material S8. Results of caregiver social validity questionnaire.
Pope, L., Light, J., & Exton, K. (2025). Incorporating visual scene display augmentative and alternative communication supports into naturalistic developmental behavioral interventions. American Journal of Speech-Language Pathology, 34(4), 2260–2279. https://doi.org/10.1044/2025_AJSLP-24-00450
Funding
This research was completed in partial fulfillment of the requirements for the first author’s doctoral program. It was supported in part by funding received from the U.S. Department of Education (The Penn State AAC Doctoral Leadership Grant #H325D170024) and from the American Speech-Language-Hearing Foundation (Student Research Grant in Early Childhood Language). The contents do not necessarily represent the policy of the funding agencies, and you should not assume endorsement by the Federal government.
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