Improving Augmentative and Alternative Communication Use Between Mothers, Siblings, and Children with Communication Disabilities

Siblings are essential communication partners within the family support system with longest-lasting relationships within a family structure (Howe et al., 2015). However, there is limited research about the inter-relationships between mothers, siblings and children with intellectual and developmental disabilities (IDD) who benefit from augmentative and alternative communication (AAC). This thesis explores the communicative interactions between mothers, siblings and children with IDD who use AAC to support their comprehensive and expression of spoken language (Ganz et al., 2014). Thus, a systematic review of the literature of family-led interventions was conducted. A total of 21 studies, including 6 groups studies and 15 single-case experimental designs, were included in the coding and analysis stage. A range of interventions, including parent and sibling training programmes storybooks and speech generated devices, were reported. The need for more research in mother-sibling-focal child interactions where a child has a communication disability was highlighted. Therefore, the first study consisted of a Pilot study involving three families of children with communication disabilities. Two independent small-scale studies involved six families of typically developing children (study 2a) and six families of children with communication disabilities (study 2b). The researcher aimed to understand behaviour patterns in mother-sibling-focal child interactions for typically and atypically developing children. A mixed-methods study design involving both qualitative and quantitative methods wsa used. Mothers and siblings presented with a range of behaviours that were in synchrony with the mothers' and children's responsivity and their emotional capacity to respond to each other. Despite the benefits of using AAC in the home, it was evident that no consistent and functional use was observed. In view of this, a final study was conducted to evaluate the effects of sibling-mediated interventions using existing modes of communication within the home environment. A pre/post-test research design of three phases was chosen: baseline, instructional, and post-instructional. Observational data were collected on reciprocal sibling-focal child interactions, use of prompts directed towards the sibling of focal child, and levels of proximity. Results suggested an increase in sibling-focal child initiations and responses while parental prompts decreased following the intervention. These results confirm that siblings may be excellent co-interventionists in the intervention process, and wit hthe right level of support, the use of a communication system may be successfully implemented within the home environmental. Finally, implications and recommendations for further research were discussed for improving the social interactions of siblings and the focal child within the home environment.