The Relationship Between the Use of Speech-Generating Devices and Verbal Requests in Children with Autism Spectrum Disorder and Intellectual Disabilities.

Objective: This study aimed to investigate the effects of removing synthetic speech output from speech-generating devices (SGDs) and incorporating delayed reinforcement on verbal requests in children with autism spectrum disorder (ASD) and intellectual disabilities. Additionally, we examined how participants' receptive and expressive language abilities influenced vocal requests by comparing items categorized as easier or more difficult to name based on pre-assessment results.

Methods: Three children with ASD and intellectual disabilities participated. An alternating treatment design was used to compare two conditions: (1) synthetic speech output with immediate reinforcement and (2) no synthetic speech output with delayed reinforcement. Preferred items were classified into two sets based on pre-assessed receptive and expressive language abilities. The dependent variable was the number of verbal and SGD-based requests.

Results: Results showed that verbal requests increased in the no synthetic speech output with delayed reinforcement condition across both item sets, while SGD-based requests remained high. Post-intervention language assessments indicated significant improvements in expressive language abilities.

Conclusions: These findings suggest that removing synthetic speech output and incorporating delayed reinforcement may effectively promote vocal requests in children with ASD and intellectual disabilities. This intervention provides a novel approach to facilitate speech communication while continuing the use of AAC tools.