Abstract
The Communication Bill of Rights states, “All people with a disability of any extent or severity have a basic right to affect, through communication, the conditions of their existence” (Brady et al., 2016, p. 123). Meaningful and functional communication are important for all individuals regardless of their age, cultural background, abilities, or needs. Therefore, caregivers, practitioners, and researchers need reliable information about research-based interventions and strategies that may promote and enhance communication of individuals with disabilities, across the lifespan. Interventions for Individuals with Autism Spectrum Disorder and Complex Communication Needs, an edited book that is part of the Augmentative and Alternative Communication Series produced by Brookes Publishing, provides a comprehensive review of assessments and interventions designed specifically for individuals with autism spectrum disorder (ASD) who have complex communication needs (CCN). As researchers who conduct research with individuals with ASD and other developmental disabilities who have CCN, and as educators who prepare and train both in-service and pre-service special education teachers and other professionals to serve these individuals, we were excited to find a book that specifically focuses on this population.
Deficits in or challenges related to communication and social interaction are one of the primary characteristics of individuals with ASD. It is estimated that about 30% of individuals with ASD will never develop functional speech (Tager-Flusberg & Kasari, 2013). In addition, researchers report an increasing prevalence of ASD over the years. According to the Centers for Disease Control and Prevention (CDC; Baio et al., 2018), approximately one in 59 children has been diagnosed with ASD in the United States and it is estimated that one in 160 children has ASD globally (Elsabbagh et al., 2012). The authors of the book’s chapters provide clear definitions for important terms used throughout the book (e.g., augmentative and alternative communication [AAC] and CCN) and explain the different functions of communication (e.g., wants and needs, information sharing, social closeness, social etiquette) and methods for communication (e.g., unaided AAC, aided AAC, low-tech and high-tech AAC). Researchers, practitioners, and students will find the book to include a collection of informative and useful information.
The book is unique in multiple ways: (a) the authors of the different chapters represent experts in diverse areas such as ASD, applied behavior analysis, and AAC; (b) chapters include both general information on topics such as the characteristics of ASD and assessment tools, and detailed information on specific interventions or strategies such as functional communication training and parent-mediated interventions; (c) the book aims to address the gap between research and practice and includes information for both researchers and practitioners; and (d) evidence-based strategies to address communication of young children, school-age children, and adolescents and adults are described. Including authors from multiple disciplines, focusing on both research and practical information and implications, and providing information to address the needs of individuals with ASD who have CCN across a range of ages and abilities make this book a valuable resource. This book could be used as a “starting point” for learning about effective and evidence-based interventions and strategies to promote communication of individuals with ASD who have CCN.
The book is organized into four sections. The first section (Chapters 1 and 2) provides a general overview of ASD with focus on communication abilities, needs, and assessments used to diagnose and develop programming for individuals with autism. Although the information is general, it is needed to provide the context for other chapters in the book. The second section (Chapters 3–7) focuses on different types of interventions and strategies addressing communication skills. Chapter 3 includes an overview of evidence-based practices for individuals with ASD broken down by age, level of functioning, and outcome domain. Chapter 4 describes, in general, different unaided and aided AAC strategies, whereas Chapters 5 and 6 explain in depth specific low-tech and high-tech AAC strategies. In addition, Chapters 5 and 6 include practical considerations, step-by-step instructions, and case examples to illustrate the planning and implementation of low-tech and high-tech AAC strategies. The combination of both “basic” information about AAC and specific practical guidelines for implementation could be very helpful for teachers, service providers, and specialists who work with a variety of individuals with disabilities who have CCN and not just those with ASD. The last chapter in this section focuses on functional communication training. The chapter includes a literature review of articles on functional communication training published between 2007 and 2016 and a series of case studies illustrating approaches to program effective and generalized functional communication training. The chapter is detailed and informative but may be difficult for novice readers to follow.
The third section of the book (Chapters 8–10) focuses on interventions based on age group including young children (Chapter 8), school age children (Chapter 9), and adolescents and adults (Chapter 10). Chapter 8 highlights a few instructional strategies that are commonly used with young children such as enhanced milieu, least to most prompting, and embedded explicit instruction. A major focus of the chapter is promoting communication of young children with disabilities who have CCN in the natural environment. Chapter 9 identifies strategies that are both scientifically supported (e.g., published in peer-reviewed journals) and practitioner friendly (i.e., include clinical judgment of the learnability, efficiency, and effectiveness of the strategy by the intervention agents). We especially appreciate the discussion related to the social validity of an intervention or strategy. An intervention could be effective in increasing communication skills, but if it is not being perceived as feasible or important by parents and teachers, it might not be maintained and generalized (Wolf, 1978). We also agree with the authors of the chapter who conclude that structured intervention may only be practitioner friendly with careful planning. In Chapter 10, the authors emphasize the need to provide communication opportunities for adolescents and adults with ASD and CCN and to train communication partners such as peers, co-workers, and community members to facilitate communication. These opportunities and trainings are essential, considering the different types of relationships that adolescents and adults have, and in many cases, the decreased focus on communicative competence of adolescents and adults with ASD and CCN. Although the principles of and approaches for interventions and strategies across the ages are similar in these chapters, each chapter in this section provides a unique perspective specific to the target age group.
The fourth section of the book (Chapters 11–14) provides chapters that focus on evidence-based practices implemented in natural contexts. The section begins with a review of the literature on naturalistic development of behavioral interventions (Chapter 11), followed by a review of the literature on parent and peer-mediated interventions (Chapter 12), and strategies to develop and implement visual and environment supports (Chapter 13). We appreciate the focus on natural contexts for the development and implementation of interventions for individuals with ASD and CCN. Researchers report that natural environments, natural routines, and natural change agents (e.g., peers, parents, teachers) are integral for a successful and effective intervention that could be generalized and maintained. The final concluding chapter (Chapter 14) includes a summary of the main themes across all chapters. The chapter describes future challenges and research themes and initiates a call to improve preparation of personnel who work with individuals with ASD and CCN; a call that is very much needed in our field.
Overall, Interventions for Individuals with Autism Spectrum Disorder and Complex Communication Needs includes a collection of useful information for a diverse group of readers. A few of the chapters provide a general overview of the topic while other chapters include in-depth discussion of one topic or intervention. In addition, a few of the chapters are written specifically for practitioners and include case studies, examples, and steps for implementation, whereas other chapters present systematic reviews of the published literature on specific topics or interventions. In this book, professionals will find strategies they can implement with individuals with ASD and CCN, and graduate students and researchers will find up-to-date information and ideas for future research to advance the field. The book highlights the need to continue studying evidence-based practices for individuals with ASD and CCN and to train professionals to implement these practices to support children, youth, and adults with ASD and CCN.
