Acquisition and functional use of voice output communication by persons with profound multiple disabilities

The acquisition and subsequent functional use of communication skills by persons with profound mental and physical impairment using a voice output communication aid (VOCA) was evaluated. Initially, a graduated guidance and time delay procedure was used to teach three individuals to use a VOCA in response to a trainer's specific request. Results indicated that all participants increased their correct VOCA activations in response to specific requests following training. Probes also indicated that participants effectively used the VOCA after training to request preferred items in a variety of settings. The functional utility of VOCA skills was supported by a survey of individuals unfamiliar with the participants. This survey indicated that those surveyed could better understand the participants when they used a VOCA. Results are discussed as to potential advantages of VOCAs relative to other augmentative communication options for persons with multiple disabilities. Future research directions are discussed, focusing on strategies for promoting a broader set of communicative interactions using VOCAs.