Abstract：
Both naturalistic developmental behavioral interventions (NDBIs) and augmentative and alternative communication (AAC) have been shown to support the language development of children with a diagnosis of autism spectrum disorder and minimal speech. However, little research has addressed the impact of incorporating AAC systems within NDBIs. This systematic review was conducted to assess the relative impact of NDBI procedures with and without AAC on the language development of children on the autism spectrum with minimal speech. Relevant studies were located through systematic database searching, targeted review of relevant journals, and ancestral search of references from identified and associated papers. Relevant study characteristics were coded for all included studies, as well as determining certainty of evidence and calculating effect sizes for language variables. All procedures followed the systematic review guidelines set by the Cochrane Collaboration. A total of 29 relevant studies were included within this review, covering both single-case and group design research. Three studies were identified that directly compared NDBI and AAC interventions. NDBIs had a strong impact on language across study types (i.e., with and without AAC), though both aggregate and comparative effect sizes were notably larger when AAC was included within NDBI procedures, as compared to NDBIs without AAC. Results suggest that combining AAC with NDBI procedures may lead to better language outcomes than NDBIs alone for children on the autism spectrum with minimal speech.
摘要：
已经证明，自然发展行为干预（NDBIs）和增强和替代交流（AAC）都可以支持诊断为自闭症谱系障碍和言语很少的儿童的语言发展。然而,很少有研究解决将AAC系统纳入NDBIs的影响。进行了这项系统评价，以评估有和没有AAC的NDBI程序对自闭症儿童语言发展的相对影响。通过系统的数据库搜索找到了相关研究，有针对性地审查相关期刊，以及从已识别和相关论文中搜索参考文献的祖先。对所有纳入研究的相关研究特征进行编码，以及确定证据的确定性和计算语言变量的效果大小。所有程序均遵循Cochrane协作组制定的系统审查指南。本综述共纳入29项相关研究，涵盖单案例和群体设计研究。确定了三项直接比较NDBI和AAC干预的研究。NDBIs对跨研究类型的语言有很大的影响(即，有和没有AAC)，尽管当将AAC纳入NDBI程序时，总体效应和比较效应的大小都明显更大，与没有AAC的NDBIs相比。结果表明，对于自闭症谱系中言语最少的儿童，将AAC与NDBI程序相结合可能比单独的NDBIs产生更好的语言结果。
