The Results: Augmentative and Alternative Communication (AAC) Modeling Implementation Intention “Experiment”

Last month, for Better Hearing and Speech Month (#BHSM), we challenged you to participate in an “experiment.” We wanted to know if the body of research that exists for Implementation Intentions would work to increase AAC modeling/aided language input. **If you don’t need the background, skip to the Participants or Results section.**

We asked you to make room for AAC modeling within your week. Research shows that if you carve out a specific time and place for an important activity, you’re significantly more likely to do it! It’s true of exercise, doctor appointments, and writing. Inherently, we know this. We put reminders in our calendar to put Frontline on the dog, change the air filter in the heater, or get our teeth cleaned.

So, for the first two weeks of May, we asked you to make an appointment to model AAC for the important AAC learners in your life.

Many of you participated, and twenty-four of you generously took the time to answer our survey questions after the two weeks. This post will share the results of those survey questions (except for the irrelevant t-shirt-related questions of course:).

Background

Modeling for individuals learning to use AAC devices is critical. Immersing AAC learners in the language you are expecting them to speak is one area where AAC professionals are in agreement. Evidence based research also supports the use of aided language input as an intervention strategy. Actually, if you are working with an AAC professional or speech-language pathologist who does NOT include aided language input as part of their AAC  implementation plan with your child, you should probably seek a different professional. It’s that important: Speak AAC to teach AAC.

However, it’s not always easy. Life is busy, and children who have complex communication needs often have complex medical needs as well. Some days, it’s hard to find the time to add one more thing. So when I heard a podcast guest talking about implementation intentions (it’s number 52 on the list:Minisode Monday #43), I immediately thought it may be an effective way to plan to increase modeling for our students who are learning to use AAC. This post has the background about the implementation intentions research.

With this experiment, we were hoping to answer two questions:
1. Will scheduling time for aided language input at a specific time and location increase exposure of AAC for the students who use it?

2. Is scheduling implementation intentions for AAC modeling a helpful strategy for individuals who support AAC learning?

Methods

The methods for this “experiment” were not super scientific, but I’m sharing it in the format of a research article because, it could actually be replicated.

  1. Information about implementation intentions was shared in the form of a blog post and shared on social media. That post also contained an announcement that more details would follow and t-shirts would be given away for participating in the survey.
  2. A blog post detailing the “experiment” was published and shared on social media. The post invited anyone using AAC to participate regardless of the language program that was being used.
  3. Participants were given the following instructions/challenge:Give AAC modeling a place to live within your day. Carve out the time to show your child/student(s) that communication is a priority. Put it in your schedule. We’re asking you to plan to communicate and connect with your student(s)/child(ten) who are using AAC. If you’re already doing that, that’s wonderful!
    1. Commit to modeling for (at least) 15 minutes a day for the next two weeks.
    2. Decide on a time and place that *should* give you 15 minutes of modeling time with the AAC user(s) in your life.
    3. Decide on a contingency plan. Unexpected things happen all the time. Plan around them for success.
    4. Complete the form below. Write it on your dry erase board in your kitchen. Put it in your calendar. Put a sticky note near the place you plan to model. Whatever you decide,  publish your intention so that you will see it every day for the next two weeks.

    Modeling intention form to put your plan in writing.

We asked participants keep track for 2 weeks and complete a brief survey letting us know if it worked or not!

4. Each day for the two weeks, I published a “modeling motivation” on the Speak for Yourself Facebook page. Those modeling motivations were compiled in this blog post following the two week experiment.

5. At the end of the two weeks, a survey was published and shared in this post and participants were given five days to complete the survey. We gave t-shirts to participants for taking the time to complete the survey, regardless of their results.

**Participants

Participants self-selected for this experiment. It’s likely that many more people in the AAC community actually participated, but 24 followed through with completion of the survey. Survey response rates are traditionally low, but the most accessible means of data collection for a social media driven experiment by an inexperienced researcher. Participants included 14 parents of AAC users, 9 professionals whose caseload mostly consists of people using AAC and 1 (one) non-parent family member.

Here is the data for the participants:

What best describes your current relationship with AAC?

Data_Q1_role (to view above as a PDF)

We also asked for the age of the AAC users that the parents, professionals, and family members are supporting. Here is that data:

How old is/are the AAC user(s) in your life?

Data_Q2_AACuserage (to view above as a PDF)

**Results

The two questions we were trying to answer were essentially an attempt to increase AAC language immersion for students who use AAC.  We wanted to know if the broad body of research on implementation intentions has beneficial applications for AAC modeling. It is also my general impression that a commitment to modeling increases familiarity with the language system, and that comfort level increases modeling. We all like to feel successful.

For that reason, one of our survey questions was: My knowledge of the app/device has improved over the past two weeks. Respondents could choose strongly agree, agree, I don’t know, disagree, or strongly disagree. Of the respondents, 19 of them (79%) chose strongly agree or agree, indicating that their knowledge had improved.

My knowledge of the app/device has improved over the past two weeks.

Data_Q7_deviceknowledge (to view as a PDF)

One of the survey questions asked about daily goal modeling times. Fifty (50%) percent of respondents set a goal to model 15 minutes a day. That was the amount of time I suggested in my post. Now I’m wondering if it would have made a difference if I suggested a longer amount of time. It may just be that 15 minutes seems like a manageable amount of time to make a daily commitment. Guess we’ll never know. Anyway, here are the results:

What was your daily time target for AAC modeling for the past two weeks?

Data_Q3_targettime (to view as PDF)

Then we asked if it worked. Did you stick to your plan and/or use your backup plan? Of the 24 respondents, 100% said they modeled more than they usually do. Pretty exciting, right? Of those, 54% said that they stuck to their plan or used their back up plan, but that they modeled the amount of time they planned.

Which statement best describes your AAC modeling over the past two weeks?

Data_Q4_diditwork (to view as a PDF)

We also asked about weekly time spent modeling prior to using an implementation intention approach. Eighty-eight (87.5%) of respondents said that they spent less than one hour modeling in a typical week prior to this challenge. Here are those results:

In a TYPICAL week, prior to using this AAC implementation intention strategy, how many total minutes did you spend modeling/using AAC in front of your AAC user(s)?

Data_Q5_PREminutesofmodeling (to view as a PDF)

Then we asked: How many total minutes were spent modeling during the two week experiment using implementation intentions? For comparison purposes, I changed those numbers into weekly totals. Here are the raw responses from the survey:

How many total minutes did you spend modeling or using AAC in front of you AAC user(s) over the past two weeks?

The system was not able to graph the open-ended question. I did it manually. Here are those results:

Weekly AAC modeling time with Implementation Intentions

Modeling with Implementation Intentions (to view as a PDF)

Discussion

When participants used implementation intentions to schedule their AAC modeling time, 87.5% said that they modeled more than an hour per week. Prior to using implementation intentions, only 12.5% of the participants said they modeled more than an hour per week.

Prior to scheduling time to model, no one said they modeled more than two hours per week. However, after using implementation intentions, 45.83% of participants said they modeled more than two hours per week.

Conclusion

So, what does all of this mean? Scientifically, there probably are not enough participants to come to an actual conclusion about the impact of implementation intentions on aided language input. And that’s fine. My purpose was not to create evidence-based research.

The purpose was to see if scheduling time to model AAC helps those of you who support children who use AAC. For the people who participated and answered the survey, it did. Maybe it will for you too.

The purpose was to see if carving out a time and place to focus on using aided language input increased the children’s exposure to AAC.  For the people who participated and answered the survey, it did. Maybe it will for the children in your life too.

More than 24 children benefited from the increased AAC modeling for those first two weeks of May. Professionals shared the challenge with other professionals so that clients experienced increased modeling throughout their days. Entire families participated and “argued” over preferred AAC modeling times.

Regardless of the efficacy or validity of this “experiment,” there is a large body of evidence-based research for implementation intentions that sounds an awful lot like common sense: If something is important, schedule the time and place to do it. Aided language input is an evidence-based, valuable strategy for AAC learners.        

AAC modeling is important. Give it a place to live in your routine.

(Survey Monkey was used to create the survey and graphs.)

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