Paraeducator Implementation of a Communication Intervention for Individuals with Significant Autism

Initiating requests is a crucial communication skill for individuals who use augmentative and alternative communication (AAC) systems. Yet individuals with significant autism (i.e., Level 3) often face barriers in developing this skill. Previous researchers have shown that training paraeducators to support AAC use is effective, but their primary focus has been with individuals without Level 3 autism. We aimed to extend these findings by evaluating the effects of a paraeducator training package designed to teach initiation skills to students with Level 3 autism spectrum disorder. Using a multiple-probe design, the authors trained paraeducators to implement a communication intervention that included opportunities to initiate and least-to-most prompting across naturalistic settings. Three participant dyads, consisting of one paraeducator and one student with autism, aged 9–19, were observed across baseline and intervention phases. Researchers measured the rate at which paraeducators provided opportunities for participants to initiate with their devices and recorded their initiations (prompted and independent). Results indicated that paraeducators offered more opportunities, which increased AAC initiation for all student participants, although response rates varied. We demonstrated that paraeducators can successfully teach initiation skills to students with Level 3 autism, though we identified challenges, including staff turnover and unfamiliarity with devices. These challenges underscore the need for comprehensive, team-based approaches and for refining training methods to enhance the consistency and effectiveness of AAC interventions in therapeutic school settings.