Teaching Parents Read, Ask, Answer, Prompt Strategies via Telepractice: Effects on Parent Strategy Use and Child Communication

Purpose: This study aimed to explore the feasibility of a telepractice communication partner intervention for children who use augmentative and alternative communication (AAC) and their parents. Method: Five children (aged 3;4-12;9 [years;months]) with severe expressive communication impairments who use AAC and their parents enrolled in a randomized, multiple-probe design across participants. A speech-language pathologist taught parents to use a least-to-most prompting procedure, Read, Ask, Answer, Prompt (RAAP), during book reading with their children. Parent instruction was provided through telepractice during an initial 60-min workshop and five advanced practice sessions (M = 28.41 min). The primary outcome was parents' correct use of RAAP, measured by the percentage of turns parents applied the strategies correctly. Child communication turns were a secondary, exploratory outcome. Results: There was a functional relation (intervention effect) between the RAAP instruction and parents' correct use of RAAP. All parents showed a large, immediate increase in the level of RAAP use with a stable, accelerating (therapeutic) trend to criterion after the intervention was applied. Increases in child communication turns were inconsistent. One child increased his communication turns. Four children demonstrated noneffects; their intervention responses overlapped with their baseline performance. Conclusions: Telepractice RAAP strategy instruction is a promising service delivery for communication partner training and AAC interventions. Future research should examine alternate observation and data collection and ways to limit communication partner instruction barriers.