The Research Behind Model Communicator
The studies that shaped MoCo’s design, what each one found, and how we used it. We have tried to say only what the research says, including where it is still thin.
1. Modeling (Aided Language Input)
People learn AAC the way anyone learns a language: by seeing it used.
Modeling works, across ages and diagnoses
A meta-analysis of 28 studies found that interventions in which partners used the AAC system themselves while talking (aided AAC input) were highly effective for both understanding and expression, across ages, disabilities and language levels. Partners usually combined modeling with waiting, prompting and responding to what the person said.
How MoCo uses this: The app is named for it. Our modeling guide teaches families and school teams how to do it in everyday routines.
O’Neill, T., Light, J., & Pope, L. (2018). Effects of interventions that include aided augmentative and alternative communication input on the communication of individuals with complex communication needs: A meta-analysis. Journal of Speech, Language, and Hearing Research, 61(7), 1743–1765. doi.org/10.1044/2018_jslhr-l-17-0132Different ways to model all helped
A systematic review of 48 studies with 267 children and youth grouped aided modeling into three approaches: augmented input, models used as prompts, and models inside teaching demonstrations. Procedures varied, and the interventions were generally effective at improving expressive communication.
How MoCo uses this: On the iPad, modeling mode lets an adult model on the communicator’s own device without those taps changing the word suggestions the communicator sees.
Biggs, E. E., Carter, E. W., & Gilson, C. B. (2018). Systematic review of interventions involving aided AAC modeling for children with complex communication needs. American Journal on Intellectual and Developmental Disabilities, 123(5), 443–473. doi.org/10.1352/1944-7558-123.5.443An earlier review reached the same conclusion
Sennott, Light and McNaughton reviewed the AAC modeling intervention studies available in 2016 and reported gains for beginning communicators when partners modeled on the AAC system during natural interactions.
Sennott, S. C., Light, J. C., & McNaughton, D. (2016). AAC modeling intervention research review. Research and Practice for Persons with Severe Disabilities, 41(2), 101–115. doi.org/10.1177/15407969166388222. Core and Topic Vocabulary
A small set of flexible words does a lot of work. It is not enough by itself.
A small set of words is used everywhere
Banajee, DiCarlo and Stricklin recorded toddlers in preschool routines and found a small set of words used across activities. These core words were pronouns, verbs, prepositions and words like more, no and that. Nouns were not among them.
How MoCo uses this: Core words sit on the MoCo-60 border and stay in view on every page, so they are always one tap away.
Banajee, M., DiCarlo, C., & Stricklin, S. B. (2003). Core vocabulary determination for toddlers. Augmentative and Alternative Communication, 19(2), 67–73. doi.org/10.1080/0743461031000112034The same holds for school-aged children
Boenisch and Soto recorded typically developing school-aged children, some of whom spoke English as a second language, during school activities. The words used most often across samples form a core vocabulary inventory that can serve as a source list for AAC vocabulary selection.
Boenisch, J., & Soto, G. (2015). The oral core vocabulary of typically developing English-speaking school-aged children: Implications for AAC practice. Augmentative and Alternative Communication, 31(1), 77–84. doi.org/10.3109/07434618.2014.1001521Core word lists alone under-serve beginners
Laubscher and Light compared published core word lists with the first words of typically developing children. Core lists under-emphasize the kinds of words that dominate early vocabularies, so the authors caution against relying on them alone when designing systems for early symbolic communicators.
How MoCo uses this: This is why MoCo is organized around topics. Each topic page puts the specific words for a routine or activity next to the core words, so a beginner can talk about what is actually happening.
Laubscher, E., & Light, J. (2020). Core vocabulary lists for young children and considerations for early language development: A narrative review. Augmentative and Alternative Communication, 36(1), 43–53. doi.org/10.1080/07434618.2020.1737964Universal Core
Project Core, from the Center for Literacy and Disability Studies at the University of North Carolina at Chapel Hill, publishes a 36-word Universal Core vocabulary and free teaching resources for students with significant disabilities.
Center for Literacy and Disability Studies. Project Core. University of North Carolina at Chapel Hill. www.project-core.com/3. Consistent Word Locations
When a word stays in one place, finding it gets faster with practice.
Consistent locations get faster with practice
Preschoolers without disabilities searched for symbols over five sessions. There was no difference in the first session. By the fifth, children whose symbols stayed in the same place were significantly faster than children whose symbols moved. The authors note that replication with children who use AAC is critical.
How MoCo uses this: Words on a MoCo board do not move. The border is the same on every page.
Thistle, J. J., Holmes, S. A., Horn, M. M., & Reum, A. M. (2018). Consistent symbol location affects motor learning in preschoolers without disabilities: Implications for designing augmentative and alternative communication displays. American Journal of Speech-Language Pathology, 27(3), 1010–1017. doi.org/10.1044/2018_ajslp-17-0129Teach words in their final location
Adults without disabilities learned six words either as large icons filling the screen, or as small icons in their final positions on a 40-location grid with the other icons hidden. On the full grid, those trained in the final locations found the words faster and more accurately.
How MoCo uses this: Instead of starting on a smaller board, keep the full MoCo-60 layout and hide the words you are not teaching yet. When a word is revealed it is already where it will always be.
Dukhovny, E., & Zhou, Y. (2016). Effects of icon size and location on speed and accuracy of SGD access. Augmentative and Alternative Communication, 32(4), 241–248. doi.org/10.1080/07434618.2016.12368354. Color and Arrangement
How symbols are grouped matters at least as much as how they are colored.
Grouping by word type speeds up message building
Fifty-two young children without disabilities built multi-symbol messages on a 4 × 4 array. They were significantly faster when symbols were arranged by word class. Most were also faster on white backgrounds than colored ones, though that difference was not statistically significant, and the authors advise caution with background color for young children.
How MoCo uses this: The MoCo border groups words by type, in the order a sentence is built.
Thistle, J. J., & Wilkinson, K. (2017). Effects of background color and symbol arrangement cues on construction of multi-symbol messages by young children without disabilities: Implications for aided AAC design. Augmentative and Alternative Communication, 33(3), 160–169. doi.org/10.1080/07434618.2017.1336571Spacing and grouping reduce visual crowding
Using eye tracking with ten adolescents and adults with Down syndrome, Wilkinson, Gilmore and Qian found that layouts which reduced crowding and used position to signal grammatical category led to fewer looks at irrelevant symbols. Background color helped participants find the target sooner.
How MoCo uses this: MoCo tiles are color coded by word type using a version of the Fitzgerald Key, and a high contrast setting is available. See what the tile colors mean.
Wilkinson, K. M., Gilmore, R., & Qian, Y. (2022). Judicious arrangement of symbols on a simulated augmentative and alternative communication display optimizes visual attention by individuals with Down syndrome. Journal of Speech, Language, and Hearing Research, 65(2), 710–726. doi.org/10.1044/2021_jslhr-21-00278Display design: the state of the science
This review summarizes what is known about how display variables affect visual attention and performance for children with developmental disabilities and adults with acquired conditions, for both visual scene displays and grids, and sets out what still needs to be studied.
Light, J., Wilkinson, K. M., Thiessen, A., Beukelman, D. R., & Fager, S. K. (2019). Designing effective AAC displays for individuals with developmental or acquired disabilities: State of the science and future research directions. Augmentative and Alternative Communication, 35(1), 42–55. doi.org/10.1080/07434618.2018.1558283What the Research Does Not Tell Us
Several of the display studies above were done with children or adults without disabilities, and their authors say the findings need to be repeated with people who use AAC. The evidence on background color is mixed. No study has tested MoCo itself. MoCo-60 is in its pilot, and we are learning from the families, teachers and speech-language pathologists who use it.
If we have described a study badly, or there is one we should read, please tell us.