The scientific basis for the use of augmentative and alternative communication in early childhood intervention

Prema Američkoj udruzi za govor, jezik i sluh (ASHA) potpomognuta komunikacija predstavlja različite načine komuniciranja koji mogu nadomjestili ili nadoknaditi narušene obrasce komunikacije u osoba s privremenim ili trajnim ograničenjima u ekspresivnoj komunikaciji (ASHA, 2021). Namijenjena je osobama sa složenim komunikacijskim potrebama s govornim i/ili jezičnim teškoćama uslijed razvojnih poremećaja. Nekada se smatralo kako djeca nisu dobri kandidati za implementaciju navedenih intervencija ukoliko nisu posjedovala određenu razinu kognitivnih sposobnosti (Wilkinson i Henning, 2007), a posebice se ograničavala implementacija u mlađe djece potaknuto pogrešnim vjerovanjem o negativnim učincima na govor (Romski i Sevcik, 2005). Zahvaljujući rastućem broju empirijskih istraživanja o učinkovitosti potpomognute komunikacije, ASHA odbacuje prethodno gledište pri čemu dolazi do novog razumijevanja iste kao kontinuuma u rasponu od jednostavne komunikacije poput izmjene uloga pa sve do profinjenije uporabe simbola (Wilkinson i Henning, 2007). Dolazi i do promjene u potencijalnim kandidatima za istu pa se navedene intervencije počinju sve više implementirati u radu s djecom s razvojnim poremećajima u djetinjstvu. Danas se naglašava važnost implementacije potpomognute komunikacije u ranoj intervenciji s obzirom na veliki potencijal za incidentalno učenje djece rane dobi kao i važnost djetetovih ranih iskustava s okolinom (Landa, 2018). Unatoč značajnim prednostima potpomognute komunikacije, često se podcjenjuje korist intervencija u radu s djecom sa razvojnim teškoćama, posebice uz pridružene intelektualne teškoće. Kliničari te ostali stručnjaci koji rade s djecom s razvojnim teškoćama obvezni su u svome kliničkome radu implementirati one intervencije za koje postoje znanstveni dokazi o njihovoj učinkovitosti. Zahvaljujući napornom radu stručnjaka u području potpomognute komunikacije, iste se smatraju znanstveno utemeljenima te kao takve primarne su u ranoj intervenciji. Unatoč svojoj učinkovitosti istraživanja govore o varijabilnostima u učincima među djecom sa složenim komunikacijskim potrebama. Cilj ovog diplomskog rada je dati pregled dosadašnjih spoznaja o mogućnosti implementacije potpomognute komunikacije u radu s djecom s razvojnim teškoćama u ranoj dobi (do pete godine) s naglaskom na znanstveno utemeljene intervencije. Navedene spoznaje mogu poslužiti kao smjernice stručnjacima za rad u kliničkoj praksi, ali i kao temelj za buduća istraživanja.According to the American Speech-Language-Hearing Association (ASHA), augmentative and alternative communication represents various modes of communication that can compensate for impaired patterns of communication in individuals with temporary or permanent limitations in expressive communication (ASHA, 2021). It is intended for people with complex communication needs with speech and / or language difficulties due to developmental disorders. It was once thought that children were not good candidates for implementing these interventions if they did not possess a certain level of cognitive ability (Wilkinson and Henning, 2007), and especially there has been limited implementation in younger children driven by a misconception about negative speech effects (Romski and Sevcik, 2005). Thanks to a growing body of empirical research on the effectiveness of assisted communication, ASHA rejects the previous view and comes to a new understanding of it as a continuum ranging from simple communication such as role change to more refined use of symbols (Wilkinson and Henning, 2007). There are also changes in potential candidates for the same, so these interventions are increasingly being implemented when working with children with developmental disorders in childhood. Today, the importance of implementing assisted communication in early intervention is emphasized given the great potential for incidental learning of young children as well as the importance of the child’s early experiences with the environment (Landa, 2018). Despite the significant benefits of assisted communication, the benefit of interventions in working with children with developmental disabilities is often underestimated, especially with associated intellectual disabilities. Clinicians and other professionals who work with children with developmental disabilities are obliged to implement in their clinical work those interventions for which there is scientific evidence of their effectiveness. Thanks to the hard work of experts in the field of assisted communication, they are considered scientifically based and as such are primary in early intervention. Despite their effectiveness, research speaks of variability in performance among children with complex communication needs. The aim of this thesis is to provide an overview of current knowledge on the possibility of implementing assisted communication in working with children with developmental disabilities at an early age (up to five years) with an emphasis on scientifically based interventions. These findings can serve as guidelines for professionals to work in clinical practice, but also as a basis for future research