Enhancing Mealtime Communication for Adults with Disabilities Using Visual Supports
Communication is a key part of quality of life—but many adults with intellectual and developmental disabilities (IDD) or autism spectrum disorder (ASD) struggle to connect with others during everyday routines. This often leads to isolation and missed opportunities for building relationships. Fortunately, new research offers a simple and effective strategy for supporting social interactions, especially during mealtimes.
A recent study by Bateman et al. (2023) tested a visual communication intervention called Snack Talk. This approach used low-tech, personalized cards to prompt conversation among adults with disabilities during lunch. The results suggest that small supports can lead to big improvements in connection and engagement.
Why Focus on Adults with Disabilities?
Despite decades of investment in early intervention, many adults with ASD or IDD continue to face serious barriers later in life:
- Fewer opportunities to form new friendships
- Difficulty finding jobs or staying connected to communities
- Limited resources compared to services for children
Even in fields like Applied Behavior Analysis (ABA), most social skills research focuses on children. This leaves a major gap for supporting adult learning in natural, everyday settings like lunchtime.
So, What Is Snack Talk?
Snack Talk is a simple, yet thoughtful intervention designed to encourage more conversation during meals. The core tool is a set of laminated cards that include:
- Pictures and words tied to the participant’s interests
- Open-ended questions or conversation starters
- Prompts to model or support initiating and responding during conversations
Pairing visuals with topics people care about makes it easier, more comfortable, and more fun to talk to peers—even for those with limited expressive or receptive language.
Lunch was the chosen setting because it’s:
- A familiar, naturally social time of day
- A break from more structured learning or vocational work
- A realistic opportunity to practice communication skills in context
Study Details: Who, What, and How
Led by a team of behavior analysts, the study included five adults between the ages of 23 and 40. All had documented challenges with communication. Each person had a unique profile, including behaviors like scripted speech and limited conversation initiations.
The researchers used a single-case withdrawal design to test the effects of the cards:
- Baseline (no support)
- Intervention with Snack Talk
- Return to baseline (to assess changes)
- Second round of intervention
- Maintenance probes (to track lasting effects)
Snack Talk was delivered in a small group lunch setting inside an adult day services academy. Sessions were video recorded for accuracy.
What Improved, and by How Much?
All five participants increased conversation engagement during the intervention. Researchers tracked both verbal and non-verbal communication, including initiations and responses.
Here’s how participants responded:
- Brandon’s engagement grew from 0–10% (baseline) to 15–35% of observed intervals (with Snack Talk), and he maintained gains in follow-up.
- Mason showed steady growth, going from 8.3% to 33.9%.
- Tim peaked at 52% engagement during the intervention.
- Felicity’s data was more variable, but her average engagement nearly doubled.
- Alexander showed moderate gains with a 50% non-overlap in baseline vs. intervention data.
The intervention was implemented with 100% fidelity, and interobserver agreement ranged from 85% to 100%, adding strength to the data.
Social Meaning and Staff Views
Participant feedback was overwhelmingly positive:
- 100% said they liked using the Snack Talk cards.
- 100% said they used them to talk to friends.
- 100% said they wanted to keep using them.
Staff were more reserved. Though they praised the increased communication, they expressed:
- Concerns about implementing the strategy consistently
- Uncertainty about long-term impact on deeper friendships or inclusion
This feedback highlights the need for additional staff training and tool adaptability in real-world environments.
10 Ways to Apply Snack Talk in Practice
Behavior analysts can bring the spirit of Snack Talk into a variety of contexts. Here are 10 ideas:
- Personalize conversation cards around clients' hobbies or routines.
- Use similar visuals in AAC devices or notebooks.
- Change topics weekly to match seasons, holidays, or trending interests.
- Expand use beyond meals (e.g., while waiting for transport or during hobby groups).
- Train group home or day program staff to model prompts.
- Pair clients as “conversation buddies” for peer modeling.
- Use checklists to teach self-monitoring of conversational skills.
- Add a group reinforcement system like a social Bingo game.
- Embed visuals into community events or classes (e.g., culinary sessions).
- Use video modeling or self-review between sessions.
Why This Matters for ABA with Adults
This study proves something important: adults with ASD or IDD can still learn—and are still interested in—building social skills. It pushes ABA professionals to:
- Adapt evidence-based practices like prompting and reinforcement for adult settings
- Use naturally occurring environments like lunch to teach
- Prioritize visual supports that are low-cost and person-centered
It also reaffirms that ABA isn’t just for kids—it’s a lifelong approach.
What’s Next? Future Directions
While promising, the study had some limitations:
- It didn’t test generalization to new partners or places.
- Only researchers (not staff) delivered the intervention.
- It didn't isolate the effect of visuals vs. prompts and reinforcement.
Future work should:
- Involve adults in co-designing their own support tools.
- Examine how visual supports hold up across settings and time.
- Test staff-led delivery to boost sustainability.
Final Thoughts
Snack Talk demonstrates that meaningful communication growth can happen with simple, consistent, person-centered tools. As the adult population of people with disabilities continues to grow, now is the time to invest in scalable social supports—and continue pushing the boundaries of ABA research for adults.
Call to Action
If you're a behavior analyst, speech therapist, direct care staff, or family member—this study shows that visual supports like Snack Talk can make a difference in the lives of adults with communication barriers.
Start small:
- Add conversation visuals to your lunch tables.
- Train staff to model and reinforce social bids.
- Share this paper with your team and discuss how to adapt it locally.
And let’s advocate for more research and service funding focused specifically on adults.
🔗 Reference:
Bateman, K. J., Wilson, S. E., Ingvarsson, E., Doucette, J., Therrien, W., Nevill, R., & Mazurek, M. (2023). Snack Talk: Effects of a Naturalistic Visual Communication Support on Increasing Conversation Engagement for Adults With Disabilities. Behavior Analysis in Practice, 16, 1085–1099. https://doi.org/10.1007/s40617-023-00775-3
Let’s make conversation accessible—for life.
