# Early Augmentative and Alternative Communication (AAC) Intervention Delivered via Hybrid Telehealth

> **NIH NIH R21** · OREGON HEALTH & SCIENCE UNIVERSITY · 2022 · $206,000

## Abstract

PROJECT SUMMARY
Augmentative and Alternative Communication (AAC) intervention can increase language, literacy, social, and
adaptive skills for children with severe communication impairments. However, AAC is underutilized in speech-
language therapy for toddlers with intellectual and developmental disabilities (IDD). Hybrid telehealth models
can transform the delivery of early AAC interventions by expanding access to speech-language pathologists
(SLPs) with AAC expertise and reducing geographic and transportation barriers in underserved communities.
The purpose of this proposal is to develop and pilot test a hybrid telehealth AAC intervention for toddlers
with IDD and their families. We employ an implementation science approach, using systematic qualitative
methods to identify caregiver and SLP preferences and single-case experimental design methods to assess
the feasibility of the AAC intervention. The central hypothesis is that the intervention will improve caregivers’
use of AAC strategies, which will lead to increases in children’s expressive communication skills. Three
specific aims are proposed. Aim 1: Determine stakeholders’ preferences and needs for two key AAC
intervention components: (a) service delivery and (b) strategies to enhance treatment adherence. We
will conduct interviews with caregivers and SLPs to assess their needs and preferences regarding the
intervention. Interview findings will inform initial modifications to the service delivery model and treatment
adherence strategies investigated in Aims 2 and 3. Aim 2: Develop an AAC intervention through iterative
testing cycles. We will conduct six multiple baseline designs across behaviors to refine the AAC intervention
and demonstrate preliminary efficacy using an in-person service delivery. Findings from this study will inform
adaptations for a hybrid telehealth delivery of the AAC intervention, involving both in-person and telehealth
sessions evaluated in Aim 3. Aim 3: Conduct a pilot test of a hybrid telehealth AAC intervention. We will
pilot test the hybrid telehealth AAC intervention using a combination multiple-probe design across participants
and behaviors. Nine parent-child dyads will receive 24 intervention sessions, eight sessions provided to
families in-person, and 16 provided via telehealth. The primary outcome is caregivers’ use of AAC intervention
strategies, and the secondary outcome is child communication acts. This proposal is innovative because it
uses implementation science methods to develop a novel hybrid telehealth AAC intervention that is
feasible, acceptable, and appropriate for its end-users, increasing the likelihood of widescale adoption in
routine clinical practice. The project is significant because it addresses a critical need for early AAC
language interventions designed for home use. Our expected outcomes are to have developed the AAC
intervention and implementation strategies in preparation for an R01 application to conduct a large-scale
clinical tr...

## Key facts

- **NIH application ID:** 10437264
- **Project number:** 1R21DC019464-01A1
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Emily Dayle Quinn
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $206,000
- **Award type:** 1
- **Project period:** 2022-04-04 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10437264

## Citation

> US National Institutes of Health, RePORTER application 10437264, Early Augmentative and Alternative Communication (AAC) Intervention Delivered via Hybrid Telehealth (1R21DC019464-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10437264. Licensed CC0.

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