Aided Language Input Annotated Bibliography

Aided Language Input is a communication strategy that requires a communication partner to teach symbol meaning and model symbolic communication by pairing speech with graphic symbols or other forms of aided augmentative and alternative communication (AAC). Modeling shows where graphic symbols are located and how they can be used to communicate various messages are critical to aided language input. The approach also involves observing the individual with complex communication needs, attributing meaning to their behaviors, and modeling symbolic alternatives using speech paired with the graphic symbols. Aided Language Input helps students: (1) understand that their behaviors carry meaning; (2) learn how they can use symbols to communicate more conventionally; and (3) develop language by showing how to expand messages by adding additional symbols.

Download this annotated bibliography on Aided Language Input here (.pdf)


Sennot, S.C., Light, J.C., & McNaughton, D. (2016). AAC modeling intervention research review. Research and Practice for Persons with Severe Disabilities, 41, 101-115.

This systematic review sought to understand the impact of aided language input. For the purpose of this review, modeling was defined as communication partners (1) pointing to aided AAC as they speak and (2) implementing intervention in the context of natural communication interactions. Participants in the studies reviewed ranged in ages from 2:11 to 12:1 years and represented a variety of developmental disability diagnoses (e.g.: Autism, Prader-Willi, DiGeorge syndrome, Cerebral Palsy, Childhood Apraxia of Speech). The results from the 10 studies reviewed indicate that aided language input led to meaningful gains across language domains. Specifically, children took more communication turns, gained vocabulary knowledge, increased multi-symbol utterances, and demonstrated knowledge of early morphological markers. Overall, this study strengthens the argument for using aided language input as a foundation for AAC intervention.

Romski, M.A., & Sevcik, R.A. (1996). Breaking the Speech Barrier: Language Development Through Augmented Means. Baltimore, M.D.: Brookes Publishing.

This book describes the results of a multi-year study of thirteen adolescent students with intellectual developmental disabilities and complex communication needs as they used the System for Augmenting Language (SAL) at school and home. During all activities, parents and teachers pointed to symbols when speaking to the students. They did this while encouraging but did not require the students to use the voice output system to communicate in return. As a result, the students were successful using both the speech-generating device and nonverbal communication (e.g. vocalizations, gestures, and words) to gain attention, answer questions, request items, name objects, and respond to communication partners. Despite aided language input emphasis on symbol use, the students continued to use existing communication abilities. Existing skills were primarily used to initiate communication, whereas SAL promoted the continuation of conversation and addition of new information with adults and peers.

Barker, R.M., Akaba, S., Brady, N.C.,& Thieman-Bourque, K. (2013) Support for AAC use in preschool, and growth in language in young children with developmental disabilities. Augmentative and Alternative Communication, 29(4), 334-346.

This longitudinal study examined AAC use by 83 preschool children with significant developmental disabilities, including autism spectrum disorder, down syndrome, global developmental delays, cerebral palsy, and spina bifida. Surveys were used to collect information about how teachers and students used the students’ devices to communicate, while standard assessments were given to assess the student’s current language skills. Results showed that children whose peers and teachers used their devices to speak to them had better language growth than children whose teachers used prompting and questioning as their primary teaching methods. In fact, the more teachers prompted use of AAC systems, the worse children performed on language assessments. Most notably, increased prompting was related to reduced size and use of vocabulary. This study is important in demonstrating the relationship between aided language input and language growth for children with a variety of developmental disabilities who use AAC.

Goossens, C. (1985). Aided communication intervention before assessment: A case study of a child with cerebral palsy. Augmentative and Alternative Communication,5, 14-26. doi:10.1080/07434618912331274926

This case study describes augmentative alternative communication (AAC) intervention for a 6-year-old child with severe spastic-athetoid cerebral palsy. Through interactive aided language stimulation by parents and clinicians in naturalistic contexts, the child learned to rapidly demonstrate emergent use of eye gaze and head-switch access selection. The benefit of aided language stimulation was two-fold as the child not only received frequent contextually relevant models but it also encouraged the adults to select vocabulary that fostered increased communicative interactions across contexts. This was demonstrated by the evolution of the AAC system from category-based vocabulary, to activity-based boards, and ultimately to a system of core and fringe vocabulary. In this way, the study highlights the importance of adult’s ability to navigate a students’ system.  Goossens noted the importance of adult familiarity with children’s aided AAC system because adults who are unable to use a child’s device in an interactive manner, provide few opportunities for the child to learn.

Further References

Articles showing that aided language input builds receptive understanding and expressive use of graphic symbols

Brady, N. C., Thiemann-Bourque, K., Fleming, K., & Mathews, K. (2013). Predicting language outcomes for children learning augmentative and alternative communication: Child and environmental factors. Journal of Speech, Language, and Hearing Research, 56, 1595-1612. doi: 10.1044/1092-4388.

Romski, M.A., Sevcik, R.A., & Pate, J.L. (1988). Establishment of symbolic communication in persons with severe retardation. Journal of Speech and Hearing Disorders, 53, 94-107.

Sevcik, R. (2006). Comprehension: An overlooked component in augmented language development. Disability and Rehabilitation. 28, 159-167. doi:10.1080/09638280500077804

Articles showing that teachers and classroom staff can learn to implement aided language input

Cafiero, J.  (2001). The Effect of an Augmentative Communication Intervention on the communication, behavior, and academic program of an adolescent with autism. Focus on Autism and Other Developmental Disabilities, 16, 179-183. doi:10.1177/108835760101600306

Clendon, S. A., & Anderson, K. (2016). Syntax and morphology in aided language development. In M. Smith, & J. Murray (Eds.) The silent partner? Language, interaction, and aided communication (pp. 119-140). Surrey, UK: J & R Press

Douglas, S., Light, J., & McNaughton, D. (2012). Teaching paraeducators to support the communication of young children with complex communication needs. Topics in Early Childhood Education, 33, 91-101. doi: 10.1177/0271121712467074

Kent-Walsh, J., Murza, K., Malani, M., & Binger, C. (2015). Effects of communication partner instruction on the communication of individuals using AAC. A meta-analysis. Augmentative and Alternative Communication, 31, 271-284. doi: 10.3109/07434618.2015.1052153

Sonnenmeier, R., McSheehan, M., & Jorgensen, C.M. (2005). A case study of team supports for a student with autism’s communication and engagement within the general education curriculum: Preliminary report of the Beyond Access model. Augmentative and Alternative Communication, 21, 101-115. doi: 10.1080/07434610500103608

Articles showing that aided language input leads to gains for beginning communicators

Binger, C., Kent-Walsh, J., Ewing, C., & Taylor, S. (2010). Teaching educational assistants to facilitate the multisymbol message productions of young students who require augmentative and alternative communication. American Journal of Speech-Language Pathology, 19, 108–120. doi: 10.1044/1058-0360(2009/09-0015)

Binger, C. & Light, J. (2007). The effect of aided AAC modeling on the expression of multi-symbol messages by preschoolers who use AAC. Augmentative and Alternative Communication, 23, 30-43. doi:10.1080/07434610600807470

Drager, K., Postal, V., Carrolus, L., Castellano, M., Gagliano, C., & Glynn, J., (2006). The effect of aided language modeling on symbol comprehension and production in two preschoolers with autism. American Journal of Speech-language Pathology, 15, 112-125.  doi: 10.1044/1058-0360(2006/012)

Romski, M. A., Sevcik, R. A., Adamson, L. B., Cheslock, M., Smith, A., Barker, R. M., & Bakeman, R. (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech, Language, and Hearing Research, 53, 350-364. doi: 10.1044/1092-4388(2009/08-0156)

Articles showing increased communicative turn-taking in response to aided language input

Binger, C., Kent-Walsh, J., Berens, J., Del Campo, S., & Rivera, D. (2008). Teaching latino parents to support the multi-symbol message productions of their children who require AAC. AAC: Augmentative and Alternative Communication, 24(4), 323–338.

Romski, M.A., Sevcik, R.A., Robinson, B., & Bakeman, R. (1994) Adult-directed communications of youth with mental retardation using the system for augmenting language. Journal of Speech and Hearing Research, 37, 617-628. doi: 10.10.1044/jshr.3703.617

Rosa-Lugo, L.I. & Kent-Walsh, J. (2008). Effects of parent instruction on communication turns of latino children using augmentative and alternative communication during storybook reading. Communication Disorders Quarterly, 30, 49-61. doi: 10.1177/1525740108320353