Facilitators’ use of a communication device following children’s aided turns in everyday interaction


  • Maja Sigurd Pilesjö University of Southern Denmark
  • Niklas Norén Uppsala University




Augmentative and Alternative Communication, Speaking and Pointing Practice, candidate understandings, requests for confirmation, retro-sequences, repeat, reformulation, recasts, conversation analysis


This conversation analysis study investigates facilitators’ simultaneous use of speech and aided means in instructional interaction with children with complex communication needs (CCN), who use aided communication in an everyday setting. The participants were children with severe speech impairments and their everyday communication partners. The analysis focused on facilitators’ aided turns immediately following aided turns by the children, within so-called retro-sequences. Retro-sequences were found in interactions involving four out of nine children. The facilitators systematically combined a spoken turn with an aided turn, a speaking and pointing (SAP) practice. The pointing consisted of a single graphical word, mostly a noun. The multimodal practice generally highlighted, emphasized, or exposed graphical words that increased noticeability and understandability within the local context. Adult repeats were treated as requests for confirmation of a candidate understanding and were responded to by the child using vocal and embodied resources. Reformulations (recasts) were treated as profferings of candidate understandings and were responded to using the communication device. The findings indicate that the partner’s use of a spoken and aided follow-up action shaped the immediate context for device use. The findings are relevant for the design of naturalistic interventions and may be used to improve treatment descriptions in augmentative and alternative communication (AAC) interventions.

Author Biographies

Maja Sigurd Pilesjö, University of Southern Denmark

Maja Sigurd Pilesjö is a speech and language therapist and Associate Professor at the University of Southern Denmark. Maja Sigurd Pilesjö’s main research interests are multimodal interaction under atypical conditions such as severe speech/language impairment, the role of the communication partner in Augmentative and Alternative Communication (AAC) and intervention practices in AAC. She has mainly used conversation analysis and multimodal interaction analysis as a research method.

Niklas Norén, Uppsala University

Niklas Norén is Associate Professor in Education at Uppsala University. Using the practices and principles of ethnomethodological and multimodal interaction analysis, his research concerns the organisation of interaction involving children with complex communicative needs in everyday and institutional contexts, interactional aspects of reading and writing practices in school, and interdisciplinary aspects of oral language in childrens’ literacy development.


Acheson, M. (2006). The effect of natural aided language dtimulation on requesting desired objects or actions in children with autism spectrum disorder. Dissertation, Department of Special Education, University of Cincinnati.

Alant, E., Alshubrumi, A., and Sun, L. (2017). Use of an eight-step instructional model to train school staff in partner-augmented input shows potential. Evidence-Based Communication Assessment and Intervention, 11 (1–2), 9–13. https://doi.org/10.1080/17489539.2017.1317100

Allen, A., Schlosser, R., Brock, K., and Shane, H. (2017). The effectiveness of aided augmented input techniques for persons with developmental disabilities: A systematic review. Augmentative and Alternative Communication, 33(3): 149–159. https://doi.org/10.1080/07434618.2017.1338752

Biggs, E., Carter, E., and Gilson, C. (2018). Systematic review of interventions involving aided AAC modeling for children with complex communication needs. American Journal on Intellectual and Developmental Disabilities, 123(5), 443–473. https://doi.org/10.1352/1944-7558-123.5.443

Binger, C., and Light, J. (2007). The effect of aided AAC modeling on the expression of multi-symbol messages by pre-schoolers who use AAC. Augmentative and Alternative Communication, 23(1), 30–43. https://doi.org/10.1080/07434610600807470

Binger, C., Maguire-Marshall, M., and Kent-Walsh, J. (2011). Using aided AAC models, recasts, and contrastive targets to teach grammatical morphemes to children who use AAC. Journal of Speech, Language and Hearing Research, 54, 160–176. https://doi.org/10.1044/1092-4388(2010/09-0163)

Blackstone, S., and Hunt Berg, M. (2003). Social Networks: A Communication Inventory for Individuals with Complex Communication Needs and their Communication Partners. Monterey: Augmentative Communication.

Bloch, S., and Wilkinson, R. (2004). The understandability of AAC: A conversation analysis study of acquired dysarthria. Augmentative and Alternative Communication, 20(4), 272–282. https://doi.org/10.1080/07434610400005614

Blockberger, S., and Sutton, A. (2003). Toward linguistic competence. Language experiences and knowledge of children with extremely limited speech. In J. Light, D. Beukelman, and J. Reichle (Eds.), Communicative Competence for Individuals who use AAC 63–106. Baltimore: Paul Brookes.

Bruno, J., and Trembath, D. (2006). Use of aided language stimulation to improve syntactic performance during a weeklong intervention program. Augmentative and Alternative Communication, 22(4), 300–313. https://doi.org/10.1080/07434610600768318

Clarke, M., and Bloch, S. (2013). AAC practices in everyday interaction. Augmentative and Alternative Communication, 29(1), 1–2. https://doi.org/10.3109/07434618.2013.767487

Clarke, M., and Wilkinson, R. (2007). Interaction between children with cerebral palsy and their peers 1: Organizing and understanding VOCA use. Augmentative and Alternative Communication, 23(4), 336–348. https://doi.org/10.1080/07434610701390350

Clarke, M., and Wilkinson, R. (2008). Interaction between children with cerebral palsy and their peers 2: Understanding initiated VOCA-mediated turns. Augmentative and Alternative Communication, 24(1), 3–15. https://doi.org/10.1080/07434610701390400

Clarke, M., and Wilkinson, R. (2010). Communication aid use in children’s conversation – Time, timing and speaker transfer. In H. Gardner and M. Forrester (Eds.), Analysing Interactions in Childhood. Insights from Conversation Analysis 249–266. Chichester: Wiley-Blackwell.

Clarke, M., Soto, G., and Nelson, K. (2017). Language learning, recasts, and interaction involving AAC: Background and potential for intervention. Augmentative and Alternative Communication, 33(1), 42–50. https://doi.org/10.1080/07434618.2016.1278130

Drager, K., Postal, V., Carrolus, L., Castellano, M., Gagliano, C., and Glynn, J. (2006). The effect of aided language modeling on symbol comprehension and production in 2 pre-schooler’s with autism. American Journal of Speech-Language Pathology, 15(2), 112–125. https://doi.org/10.1044/1058-0360(2006/012)

Friedland, D., and Miller, N. (1999). Language mixing in bilingual speakers with Alzheimer’s dementia: A conversation analysis approach. Aphasiology, 13(4–5), 427–444. https://doi.org/10.1080/026870399402163

Gardner, H. (2006). Training others in the interactional art of therapy for specific needs. Child Language Teaching and Therapy, 27(1), 27–56. https://doi.org/10.1191/0265659006ct296oa

Goldstein, H. (2002). Communication intervention for children with autism: A review of treatment efficacy. Journal of Autism and Developmental Disorders, 32(5), 373–396. https://doi.org/10.1016/B978-012373606-2.50012-7

Goosens, C. (1989). Aided communication intervention before assessment: A case study of a child with cerebral palsy. Augmentative and Alternative Communication, 5(1), 14–26. https://doi.org/10.1080/07434618912331274926

Harris, M. D., and Reichle, J. (2004). The impact of aided language stimulation on symbol comprehension and production in children with moderate cognitive disabilities. American Journal of Speech-Language Pathology, 13(2), 155–167. https://doi.org/10.1044/1058-0360(2004/016)

Hepting, N., and Goldstein, H. (1996). What’s natural about naturalistic language intervention? Journal of Early Intervention, 20(3), 249–265. https://doi.org/10.1177/105381519602000308

Jonsson, A., Kristoffersson, L., Ferm, U., and Thunberg, G. (2011). The ComAlong communication boards: Parents’ use and experiences of aided language stimulation. Augmentative and Alternative Communication, 27(2), 103–116. https://doi.org/10.3109/07434618.2011.580780

Kaiser, A., and Roberts, M. (2011). Advances in early communication and language intervention. Journal of Early Intervention, 33(4), 298–309. https://doi.org/10.1177/

Kent-Walsh, J., Binger, C., and Hasham, Z. (2010). Effects of parent instruction on the symbolic communication of children using augmentative and alternative communication during storybook reading. American Journal of Speech-Language Pathology, 19(2), 97–107. https://doi.org/10.1044/1058-0360(2010/09-0014)

Kitzinger, C. (2014). Repair. In J. Sidnell & T. Stivers (Eds.), The Handbook of Conversation Analysis 229–256. Chichester: Wiley Blackwell. https://doi.org/10.1002/9781118325001.ch12

Lesser, R., and Milroy, L. (1993). Linguistics and Aphasia. London: Longman.

Lund, S. K.. and Light, J. (2003). The effectiveness of grammar instruction for individuals who use augmentative and alternative communication systems: A preliminary study. Journal of Speech, Language and Hearing Research, 46(5), 1110–1123. https://doi.org/10.1044/1092-4388(2003/087)

McNaughton, S. (Ed.) (1985). Communicating with Blissymbols. Toronto: Blissymbolics Communication Institute.

Norén, N., Samuelsson, C., and Plejert, C. (2013). Dialogical perspectives on aided communication. In N. Norén, C. Samuelsson, and C. Plejert (Eds.), Aided Communication in Everyday Interaction 1–22. Guildford: J & R Press.

Norén, N., Svensson, E., and Telford, J. (2013). Participants’ dynamic orientation to folder navigation when using a VOCA with a touch screen in talk-in-interaction. Augmentative and Alternative Communication, 29(1), 20–36. https://doi.org/10.3109/07434618.2013.767555

Ochs, E., Schegloff, E., and Thompson, S. (1996). Interaction and Grammar. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511620874

Romski, M., and Sevcik, R. (2003). Augmented input: Enhancing communication development. In J. Light, D. Beukelman, and J. Reichle (Eds.), Communicative Competence for Individuals Who Use AAC 147–162. Baltimore: Brookes.

Saxton, M. (2005). ‘Recast’ in a new light: Insights for practice from typical language studies. Child Language Teaching and Therapy, 21(1), 23–38. https://doi.org/10.1191/0265659005ct279oa

Schegloff, E. (1996). Turn organization: One intersection of grammar and interaction. In E. Ochs, E. Schegloff, and S. Thompson (Eds.), Interaction and Grammar 52–133. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511620874.002

Schegloff, E. (2007). Sequence Organization in Interaction: A Primer in Conversation Analysis, Volume 1. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511791208

Schegloff, E. A., Jefferson, G., and Sacks, H. (1977). The preference for self-correction in the organization of repair in conversation. Language, 53(2), 361–382. https://doi.org/10.2307/413107

Sennott, S., Light, J., and McNaughton, D. (2016). AAC modeling intervention research review. Research and Practice for Persons with Severe Disabilities, 41(2), 101–115. https://doi.org/10.1177/1540796916638822

Sidnell, J. (2014) Basic conversation analytic methods. In J. Sidnell and T. Stivers (Eds.), The Handbook of Conversation Analysis 77–100. Chichester: Wiley Blackwell.

Sidnell, J., and Stivers, T. (2014). The Handbook of Conversation Analysis. Chichester: Wiley Blackwell. https://doi.org/10.1002/9781118325001.ch5

Sigurd Pilesjö, M. (2013) On the use of bodily action and vocalizations as resources and methods when claiming and completing turns in aided interaction. In N. Norén, C. Samuelsson, and C. Plejert (Eds.) Aided Communication in Everyday Interaction 59–94. Guildford: J&R Press.

Sigurd Pilesjö, M. (2014). Creating meaning through the coordination of gaze direction and arm/hand movement. Journal of Interactional Research in Communication Disorders, 5, 63–96. https://doi.org/10.1558/jircd.v5i1.63

Sigurd Pilesjö, M., and Norén, N. (2017). Teaching communication aid use in everyday conversation. Child Language Teaching and Therapy, 33(3), 241–253. https://doi.org/10.1177/

Sigurd Pilesjö, M., and Rasmussen, G. (2011). Exploring interaction between a non-speaking boy using aided augmentative and alternative communication and his every-day communication partners: features of turn organization and turn design. Journal of Interactional Research in Communication Disorders, 2(2), 183–213. https://doi.org/10.1558/jircd.v2i2.183

Simmons-Mackie, N., and Damico, J. (2008). Exposed and embedded corrections in aphasia therapy: Issues of voice and identity. International Journal of Language and Communication Disorders, 43(S1), 5–17. https://doi.org/10.1080/13682820701697889

Snell, M., Chen, L.-Y., and Hoover, K. (2006). Teaching alternative and alternative communication to students with severe disabilities: A review of intervention research 1997–2003. Research and Practice for Persons with Severe Disabilities, 31(3), 203–214. https://doi.org/10.1177/154079690603100301

Snell, M., Brady, N., McLean, L., Ogletree, B., Siegel, E., Sylvester, L., Mineo, B., Paul, D., Romski, M., and Sevcik, R. (2010). Twenty years of communication intervention research with individuals who have severe intellectual and developmental disabilities. American Journal of Intellectual and Developmental Disabilities, 115(5), 364–380. https://doi.org/10.1352/1944-7558-115-5.364

Soto, G., Clarke, M., Nelson, K., Starowicz, R., and Savaldi-Harussi, G. (2019). Recast type, repair, and acquisition in AAC mediated interaction. Journal of Child Language, 47, 250–264. https://doi.org/10.1017/S0305000919000436

Tomasello, M. (2003). Constructing a Language: A Usage-Based Theory of Language Acquisition. Cambridge: Harvard University Press.

Von Tetzchner, S., and Basil, C. (2011) Terminology and notation in written representations of conversations with augmentative and alternative communication. Augmentative and Alternative Communication, 27(3), 141–149. https://doi.org/10.3109/07434618.2011.610356

Widgit symbols. https://www.widgit.com

Wilkinson, R., Bloch, S., and Clarke, M. (2011). On the use of graphic resources in interaction by people with communication disorders. In J. Streeck, C. Goodwin, and C. LeBaron (Eds.), Embodied Interaction: Language and Body in the Material World 152–168. Cambridge: Cambridge University Press.




How to Cite

Pilesjö, M. S., & Norén, N. (2021). Facilitators’ use of a communication device following children’s aided turns in everyday interaction. Journal of Interactional Research in Communication Disorders, 10(1), 67–98. https://doi.org/10.1558/jircd.19318