Tact Training with Augmentative Gestural Support for Language Disorder and Challenging Behaviors: A Case Study in an...

Gestures or manual signing are valid options for augmentative and alternative communication. However, the data in the literature are limited to a few neurodevelopmental disorders, and less is known about its application in the community setting.

This case report explores the feasibility and preliminary efficacy of tact training with augmentative gestural support intervention for a child affected by a language disorder with challenging behaviors in a community setting.

Baseline assessments were conducted using the Verbal Behavior Milestone Assessment and Placement Program (VB-MAPP) and Griffiths Mental Developmental Scale-III (GMDS-III). The patient received six months of standard treatment, consisting of neuropsychomotor and speech therapy each twice a week, with improved cooperation in proposed activities, but no improvement in language. Afterward, a total of 24 sessions of tact training with augmentative gestural support interventions were performed. Data were collected by two independent observers and analyzed to measure language and behavioral outcomes.

VB-MAPP scores increased form minimal communication and social interaction at T0 (baseline) to improved compliance but unchanged language skills at T1 (after standard therapy). After tack training with augmentative gestural support (T2), VB-MAPP scores showed significant improvements, with notable increases in verbal operants, independence in communication, and intersubjectivity skills. GMDS-III scores at T2 also demonstrated growth in social, communicative, and cognitive skills. Additionally, challenging behaviors were reduced by more than 70% and nearly resolved by the end of the intervention.

Personalized approaches appear to be essential for interventions tailored to developmental age. Further research is needed to determine the effectiveness of these approaches for other neurodevelopmental disorders, identify patient characteristics that may be predictors of outcomes to tailor the intervention, and explore the generalization of the results obtained with these strategies.