Aided Communication With Individuals Who Have Multiple Disabilities That Include Visual Impairments: A Meta-Analysis

Purpose: Despite several decades of research focused on improving early symbolic communication for individuals with multiple disabilities, relatively limited focus has been placed on individuals who also have visual impairments. To establish what is currently known about aided language adaptations for this population, a meta-analysis was conducted to examine augmentative and alternative communication (AAC) intervention approaches for individuals with multiple disabilities that include visual impairments. Method: Six relevant databases were systematically searched. Seven hundred eighty-nine articles were narrowed to eight intervention studies that met the design standards set for this review. Results: Of the eight intervention studies that met design standards, five used modified versions of the Picture Exchange Communication System and three used a combination of approaches such as communication partner instruction plus environmental arrangement. Most studies used low-tech AAC such as tangible symbols, photo cues, and communication books, and most focused on improving independent requesting. Overall, the studies indicated positive findings for increasing pragmatic language skills such as requesting, turn-taking, and student-to-peer interactions. However, the total number of participants across studies was extremely limited (i.e., 19 participants total). Clearly, much additional research is required to devise adequate accommodations for individuals with multiple disabilities, including visual impairments, and to expand communicative functions beyond simple requests. Conclusions: The use of visual impairment accommodations appeared largely effective for the included aided AAC interventions, although consultation with visual impairment specialists was not consistently reported across the included studies. More rigorous research must occur within this population to better inform clinical practice and future studies.