A long-standing partnership between UNM’s Speech & Hearing Sciences Professor Cathy Binger and University of Central Florida (UCF)’s Assistive Technology Center Founder and Professor Jennifer Kent-Walsh is proving that there’s hope for families of all backgrounds to give their child the help they need to communicate properly.   

The pair has just received a $3 million National Institutes of Health (NIH) grant for their joint Augmentative and Alternative Communication (AAC) Labs and related research. AAC encompasses the methods and tools used to supplement or replace speech and writing for those with spoken or written impairments.  

“We’ve been building this program of research from the inception of our research careers, and this current project is the next logical step in improving language outcomes for children who cannot use their speech to communicate effectively,” Binger said.  

“Communication is a basic human right which can, and must, be supported for all. We have been able to learn and accomplish as much as we have to this point through true team science,” Kent-Walsh said. 

The money will go towards furthering the establishment of official interventions in the AAC field. These interventions include not only a focus on communication technologies but also a focus on building language skills.  This combined focus on vocabulary, grammar and language displays through AAC is still in the early stages in the speech-language pathology field. 

“The current project uses both new and existing data to develop a range of new measures to monitor aided language progress. There are many ways to validly measure language progress for children who rely on spoken communication, but no one has validated measures for the type of ‘aided communication’ we work with,” Binger said.   

Binger explains their approach with the use of the iconic children’s book Clifford the Big Red Dog. Utilizing apps on tablets or mobile devices, clinicians can establish communication patterns with children through symbols that refer to the vocabulary in book, such as symbols representing the words walk, big, red and dog.  

“Children who are preliterate and who have functional vision typically use picture symbols to help them communicate. These kinds of displays allow the child to see the vocabulary they need to talk about the story while simultaneously working to develop their sentence-building skills,” Binger said. 

Once those symbols are supported by the clinician by using techniques such as modeling and wait time, the child learns over time to move from very simple one- or two-word productions to eventually producing complete sentences. 

“For example, if I point to a picture in a book and say, ‘look at what Clifford is doing here,’ and the child produces CLIFFORD WALK on the AAC device, I could follow up by saying, “yes, Clifford is walking with his friend’ and then produce CLIFFORD WALK WITH FRIEND on the device,” Binger explained. 

This benefits a whole range of children, including those with cerebral palsy, Down syndrome, autism spectrum disorder and childhood apraxia of speech, as well other syndromes such as the lesser known velocardiofacial syndrome and Prader-Willi syndrome. AAC could also help in early intervention stages.  

“Children with a host of different diagnoses can have highly unintelligible speech that results in the need for AAC,” Binger said. “We work with children at such young ages – typically preschoolers – and many children come to us with no reliable diagnoses. They may be diagnosed as part of our work with them, or we may refer to other medical professionals such as pediatric neurologists for additional assessment.”  

Binger and Kent-Walsh are coming off a previous round of successful large-scale intervention studies, which did show the success of their intervention approach; now, it’s about using those past lessons and data to officially establish that range of measures for monitoring language progress. 

“Some of our new measures appear to be quite promising, and if we’re successful, this will open up practical ways for both researchers and clinicians to track language progress for children who use picture symbols to communicate,” Binger said.  

If the future trials continue to progress positively, this NIH grant will, at last, establish practical ways for both researchers and clinicians to track language progress for children who use images to communicate.   

“Both the scientific findings and, more importantly, the feedback from the families of children using AAC and their service-providers, have shown us the incredible power assistive technology can hold for children with significant speech impairments when combined with customized language therapy,” Kent-Walsh said. 

It may seem daunting to operate a study so integral over 1,700 miles away, but Binger and Kent-Walsh have gotten the hang of long-distance research in the two decades they have developed this procedure. 

“During our PhD programs at Penn State, we became fast friends and quickly realized how much our research interests overlapped,” Binger said. “We were both interested in researching how to improve language outcomes for children with limited speech by using various assistive technologies. Our very specific areas of interest were highly complementary, and we knew long before we graduated that we planned to continue working together for years to come.” 

This partnership has also created a domino effect for future speech-language pathologists, inviting dozens of students to study previous clinical trials, learn assessment techniques and learn how to work with the children themselves. 

“Dozens and dozens of students have attained valuable clinical and research experiences in our labs over the years,” Binger said. “Our students regularly report that they find these experiences to be invaluable: they are better prepared for their clinically-focused classes, they learn how to work as a team, and they learn critical clinical skills that they will carry forward into their own clinical practice.” 

“When we involve students and our community at large, the network of advocates expands to ensure that any child can gain access to assistive technology services. They know, and NIH knows, that there is a growing body of findings indicating that the use of AAC technologies, combined with tailored language intervention, is where the magic happens,” Kent-Walsh said.  

While this grant and the clinical trials are huge steps forward, there is still a drastic need for AAC to become commonplace for helping these children.  

“For the children we work with, the biggest challenge is ensuring that all children who could benefit from AAC get access to effective AAC assessments and interventions. We’ve made great strides forward in the past few decades, but countless children still lack appropriate clinical services,” Binger said. “When we can show that their language skills are growing, funders such as insurance companies are more likely to pay for services – which, in turn, allows more children to gain access to those services.” 

“Jennifer and I along with a host of other research team members are so thankful for this award,” Binger said. 

In particular, Binger and Kent-Walsh are grateful to fellow team members UCF Project Manager Nancy Harrington, UCF Community Innovation and Education Professor Debbie Hahs-Vaughn, and University of Wisconsin-Milwaukee Professor John Heilmann.

“We could not complete this work without the contributions of these irreplaceable colleagues,” Binger continued. 

The additional universities involved emphasize the importance of this topic, but Binger’s relentless commitment to improving the lives of children also is a testament to UNM Speech & Hearing Sciences.  

“UNM’s Speech & Hearing Department is a hidden gem at UNM,” she said. “This project is just one of many examples of the amazing projects we conduct and services provided  by faculty in the Department of Speech & Hearing Sciences.”