Autism Therapy: voice-output communication aid (VOCA)

definition of voice-output communication aid (VOCA): A portable speech synthesizer that a child can use to create speech representing the pictures or words s/he selects from a visual display.

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Comparison of PECS and the Use of VOCA: A Replication
Education and Training in Developmental Disabilities, by Beck, AR, Stoner JB, Bock SJ, and Parton T., published in 2008, summarized Oct 3, 2008

Both picture exchange communication system (PECS) and voice output communication aids (VOCA) may have a role in helping nonverbal children to communicate.

This study was designed to compare PECS and VOCA with four preschool children with autism who were non-speaking. The children learned PECS quickly. VOCA was harder for the children to learn than PECS. One child was not able to learn to use the GoTalk VOCA system. Only one of the children showed signs of generalizing (in his case VOCA) to the home. The study showed that it is hard to know which system a child is most likely to learn and adopt.


The Effects of Enhanced Milieu Teaching and a Voice Output Communication Aid on the Requesting of Three Children with Autism
J Autism Dev Disord, by Olive, ML, de la Cruz B., Davis TN, Chan JM, Lang RB, OReilly MF, and Dickson SM, published in 2007, summarized Jun 17, 2008

Young children may be taught to use voice output communication aids (VOCA) to ask for things during playtime.

This study was designed to see if a type of speech therapy known as enhanced milieu teaching may help children with autism to speak using a VOCA. The children received therapy for five minutes a day for up to 19 therapy sessions. All three young (ages 4-5 years) children in the study learned to use the VOCA. The authors believe that they learned so quickly because the therapy followed the child's lead and took place during play sessions. The study did not look to see if the children used the VOCA in other settings (generalization).


The Effects of Enhanced Milieu Teaching and Voice Output Communication Aid on the Requesting of Three Children with Autism
J Autism Dev Disorder, by Olive, ML, de la Cruz B., Davis TN, Chan JM, Lang RB, OReilly MF, and Dickson SM, published in 2007, summarized Oct 22, 2007

Speaking tools can help children with autism play with other children.

This study was designed to see if children with autism play better if they have a voice output communication aid (VOCA). The three children in the study were aged 3-6 and received only 5 minutes of therapy a day in 19 therapy session over one month's time. The speaking tool was able to help all three children in the study to play with other children. The children learned to play in a normal classroom setting (milieu), but it was enhanced because they got support from their teacher to address their specific weaknesses (enhanced milieu teaching (EMT)). The study did not follow the children over time and across settings.


Comparing Two Types of Augmentative and Alternative Communication Systems for Children with Autism
Pediatric Rehabilitation, by Son, S. - H., Sigafoos J., OReilly M., and Lancioni GE, published in 2006, summarized Dec 18, 2006

Both picture exchange communication (PEC) and voice-output communication aide (VOCA) are effective for preschoolers with autism.

PEC and VOCA are two common forms of augmentative and acquired communication (AAC). The authors designed this study to see which of these two forms of AAC worked best for preschoolers. The study found that AAC was an effective way of teaching preschoolers with autism to correctly request things. Since both PEC and VOCA are equally effective, they recommend letting the child decide which system they want to work with. This has the added advantage of letting the child feel included in the therapy decisions.


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    • Synonyms for voice-output communication aid (VOCA) include: speech synthesizer, VOCA, VOCAs, voice output communication aid, voice-output communication aid
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