Peer-reviewed article

Play-Based Naturalistic Augmentative and Alternative Communication (AAC) Intervention: Educator Fidelity and Effects on Communication and Peer Interactions.

Biggs E, Turner E, Lee S · 27 Jul 2026

Abstract

This study utilized an experimental single-case design to evaluate a professional development package to support educators' implementation of an augmentative and alternative communication (AAC)-supported, play-based naturalistic developmental behavioral intervention (NDBI), which we called naturalistic AAC intervention (N-AAC). Participants were three minimally speaking students with autism (4-8 years of age), each paired with one of their educators (i.e., speech-language pathologist, pre-service special education teacher, early childhood assistant teacher). The primary aim was to examine the effects of professional development on educator implementation of N-AAC. We also descriptively examined changes in students' communication and language use during educator-child play and generalization to peer interactions. The findings showed that professional development was effective at teaching educators to implement N-AAC with fidelity. Student communication outcomes showed descriptive improvements following educator training and coaching and N-AAC implementation. However, as expected, gains did not generalize to peer interactions. The findings suggest that professional development improves educator implementation of AAC-supported NDBI strategies during play and that their increased implementation fidelity is accompanied by promising descriptive changes in student communication. Future research is needed to further examine the impact on student communication, promote generalization to peer interactions, and evaluate the potential for larger-scale implementation.