The effectiveness of of the introduction augmentative and alternative communication in a child with congenital brain malformations

Abstract

The clinical population of children with congenital brain malformations is very heterogeneous, being defined by the location and severity of the damaged part of the brain. Developmental profiles range from severe intellectual difficulties and inability to express through speech to milder clinical presentation that imply difficulties in the development of communication, language and speech. Children with congenital brain malformations often rely on augmentative and alternative communication (AAC) methods which enable them to express themselves or better understand language.
    The aim of this study is to describe the characteristics of communication, language and speech in a boy with congenital brain malformations and primary microcephaly and to determine the effectiveness of the introduction of augmentative and alternative communication on his communication, language and speech development. The speech therapy intervention was organized for 5 months. A low-tech tool (a communication book) and a high-tech communication tool (a nonspecialized tablet) were used to achieve the set goals of the intervention. Communication development was recorded using video analysis, and comprehension and word production data were collected using the MacArthur—Bates Communicative Development Inventory (CDI). During the five months of intervention, positive changes were observed in the boys': a) patterns of communication functions, i.e., the frequency with which he communicate for specific functions, b) language production: increase in vocabulary size and language complexity, and c) use of speech as a primary mean of communication. The changes in communication tool use pattern, particularly the significant gains in the use of speech after the introduction of augmentative and alternative communication, are consistent with previous research on the importance of augmentative and alternative communication as an evidence-based intervention.