Abundant evidence supports the use of the Rapid Prompting Method (RPM), Spelling 2 Communicate (S2C), facilitated communication training (FC), supported typing, and similar methodologies that teach individuals with complex communication support needs to communicate effectively by typing or pointing to letters on a letterboard.
See the compiled peer-reviewed research that supports the use of these AAC teaching methodologies here (PDF) (v7).
- Some of this research used eye-tracking and accelerometer technologies to provide evidence that non-speaking individuals are authoring their own messages, even when they are assisted in some way by another person.
- Some of this research provides evidence that non-speaking individuals cannot be assumed to lack language or the desire to communicate socially, and therefore should be presumed capable of expressing complex thought and engaging with others. This evidence shows that most assessments of intelligence are not reliable for autistics and others who cannot speak or control their bodies reliably.
- Some of the research provides evidence that autism is primarily a neuro-motor condition rather than a social or behavioral one.
- Some of this research provides evidence of the need for and role of well-trained communication partners in both teaching and supporting the use of augmentative and alternative communication (AAC), especially in users with motor disabilities.
- Some of the research stresses the importance of communication choice, of the existence of individual idiosyncrasies in communication, and of the need to tailor training and AAC methods and devices to individual differences.
- And some of the research demonstrates that no single AAC training methodology or AAC method or device that allows an individual to communicate in an open-ended manner has been demonstrated in randomized controlled trial studies to be efficacious for non-speaking or unreliably-speaking autistics. Indeed, the research demonstrates that both our understanding of that segment of the autism population and of AAC are in their infancy.
A few of these publications are highlighted below:
Eye-tracking Reveals Agency in
Assisted Autistic Communication
Jaswal, V.K., Wayne, A., & Golino, H. (2020)
Nature: Scientific Reports, 10, 7882
Using eye-tracking technology, this study measured the speed with which nine minimally and non-speaking autistic people pointed to letters on a letterboard held by a trained assistant. Their speed, accuracy, timing, and visual fixation patterns suggest that participants pointed to letters they selected
themselves, not letters they were directed to by the assistant. The blanket dismissal of assisted autistic communication is therefore unwarranted debunks the conventional wisdom that nonspeaking autistic individuals are incapable of communicating their own thoughts when using assisted communication.
Courchesne, V., Meilleur, A.-A.S., Poulin-Lord, M.-P., Dawson, M., & Soulières, I. (2015)
Molecular Autism, 6:12
Establishes that conventional measures of intelligence are inappropriate for non-speaking autistics, and may lead to them being underestimated. This study tested 27 non-speaking autistic children enrolled in special schools and characterized as having “the highest level of impairment,” and 27 non-autistic children using conventional intelligence tests (Wechsler-IV; Leiter-R) and strength-informed assessments (Raven’s Colored Progressive Matrices; Children’s Embedded Figures Test), finding that the non-speaking autistics were generally unable to complete the former set of tests, but sometimes outperformed the typical children in the latter set of assessments.
What We Write about When We Write About AAC: The Past 30 Years of Research and Future Directions
McNaughton, D., & Light, J. (2015)
Augmentative and Alternative Communication, 31:4, 261-270
Reviews 30 years of AAC research and finds that there is very little published research (a) on AAC interventions that allow the user to communicate more than just simple requests, (b) conducted in the natural environment, (c) using natural communication partners rather than researchers themselves, (d) conducted over more than a six-week intervention period, and (e) on adults with complex communication needs.
How Valid Is the Checklist for Autism Spectrum Disorder When a Child Has Apraxia of Speech?
Tierney, C., Mayes, S., Lohs, S.R., Black, A., Gisin, E., Veglia, M. (2015)
J. Dev. Behav. Pediatrics, 36:8, 569-74
Finds that autism and apraxia are highly co-morbid: 64% of children initially diagnosed with autism also had apraxia.
Autism: The Movement Perspective (2013-2015)
Torres, E.B., & Donnellan, A.M., eds. (2013-2015)
Frontiers in Integrative Neuroscience
Compiles 38 peer-reviewed articles published by 91 authors between 2013 and 2015 that support the idea that movement and sensory differences are core features of autism.
The Maturing of Facilitated Communication: A Means Toward Independent Communication
Cardinal, D., & Falvey, M. (2014)
Research and Practice for Persons with Severe Disabilities, 39:3, 189-194
Reviews the research history of facilitated communication (FC) and articulates how studies over the last two decades have validated the effectiveness of the method.
Tager-Flusberg, H., & Kasari, C. (2013)
Autism Research: Official Journal of the International Society for Autism Research, 6:6
Finds that even though about 30% of children with autism spectrum disorder are minimally verbal, even after receiving years of interventions and a range of educational opportunities, almost all autism research focuses on verbal children, and thus most autism research cannot be assumed to be relevant to the minimally verbal. Observes that the non-verbal and minimally-verbal autistic population is itself highly heterogeneous, and the causes of and solutions for their inability to speak cannot be generalized. Finds there is almost no evidence for effective AAC or language interventions in the minimally verbal ASD population; and no data exists to support PECS or iPad-based AAC applications improving communicative functions beyond requesting. Provides suggestions for how researchers can improve our understanding of and develop more effective interventions for minimally verbal children with autism.
Communication Partner Instruction in AAC: Present Practices and Future Directions
Kent-Walsh, J., & McNaughton, D. (2005)
Augmentative and Alternative Communication, 21:3, 195-204
Discusses the importance of skilled and well-trained communication partners in interactions between individuals with complex communication needs who use AAC and others. Notes that little attention has been paid to communication partner instruction and proposes avenues for more research and focus in this important aspect of AAC.
Grammar and lexicon in individuals with autism: A Quantitative analysis of a large Italian corpus
Tuzzi, A. (2009)
Intellectual and Developmental Disabilities, 47:5, 373-385
Establishes that the grammatical and lexical patterns of language produced by autistic individuals using FC are quantitatively different from language produced by their non-autistic facilitators.
The Level and Nature of Autistic Intelligence
Dawson, M., Soulières, I., Gernsbacher, M.A., & Mottron, L. (2007)
Psychological Science, 18:8, 657–662
Empirically tested assumptions about autistic intelligence using both the Wechsler scales of intelligence and Raven’s Progressive Matrices, concluding that “intelligence has been underestimated in autistics.” Study found that on average, autistics tested 30 percentile points, and in some cases more than 70 percentile points, higher on the Raven’s than on the Wechsler. Nonautistic controls showed no such discrepancy. No autistic subjects in the study scored in the “high intelligence” range on the Wechsler, while one-third of the autistic children scored at or above the 90th percentile on the Raven’s, and the mean adult autistic score was in the 83rd percentile on the Raven’s but in the 50th percentile on the Wechsler. One-third of the autistic children tested in the intellectually-disabled range on the Wechsler, but only 5% did on the Raven’s.