title: AAC intervention using a VOCA for deaf children with multiple disabilities who received cochlear implantation.
abstract: OBJECTIVE
  The aim of this study was to examine the efficacy of a new habilitation approach, augmentative and alternative communication (AAC) intervention using a voice output communication aid (VOCA), in improving speech perception, speech production, receptive vocabulary skills, and communicative behaviors in children with cochlear implants (CIs) who had multiple disabilities.
  
  
  METHODS
  Five children with mental retardation and/or cerebral palsy who had used CIs over two years were included in this study. Five children in the control group were matched to children who had AAC intervention on the basis of the type/severity of their additional disabilities and chronological age. They had limited oral communication skills after cochlear implantation because of their limited cognition and oromotor function. The children attended the AAC intervention with parents once a week for 6 months. We evaluated their performance using formal tests, including the monosyllabic word tests, the articulation test, and the receptive vocabulary test. We also assessed parent-child interactions. We analyzed the data using a one-group pretest and posttest design.
  
  
  RESULTS
  The mean scores of the formal tests performed in these children improved from 26% to 48% in the phoneme scores of the monosyllabic word tests, from 17% to 35% in the articulation test, and from 11 to 18.4 in the receptive vocabulary test after AAC intervention (all p < .05). Some children in the control group showed improvement in the speech perception, speech production, and receptive vocabulary tests for 6 months, but the differences did not achieve statistical significance (all p > .05). The frequency of spontaneous communicative behaviors (i.e., vocalization, gestures, and words) and imitative words significantly increased after AAC intervention (p < .05).
  
  
  CONCLUSIONS
  AAC intervention using a VOCA was very useful and effective on improving communicative skills in children with multiple disabilities who had very limited oral communication skills after cochlear implantation.
authors.affiliation: Department of Speech-Language Therapy & Aural Rehabilitation, Woosong University, Daejeon, Republic of Korea.
authors.forename: Youngmee
authors.initials: Y
authors.lastname: Lee
authors.forename: Sung-Wook
authors.initials: SW
authors.lastname: Jeong
authors.forename: Lee-Suk
authors.initials: LS
authors.lastname: Kim
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000628:therapy; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods / Q000534:rehabilitation*; D003054:Cochlear Implants; D003143:Communication Devices for People with Disabilities; D003638:Deafness / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019988:Children with Disabilities / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008607:Intellectual Disability / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D007804:Language Development; D008297:Male; D011788:Quality of Life; D012016:Reference Values; D018570:Risk Assessment; D013067:Speech Perception; D016896:Treatment Outcome
keywords: Augmentative and alternative communication; Children; Cochlear implants; Intervention; Multiple disabilities; Voice output communication aid