Examination of Factors Influencing Behavioural Intention of Communication Partners of People With Severe/Profound Intellectual Disabilities to Use Augmentative and Alternative Communication: Research Article

Access to Justice: An SLP’s Guide to Helping Persons with Complex Communication Needs Voice Their Case

What is augmentative and alternative communication?: Augmentative and alternative communication (AAC) describes the ways people communicate without, or in addition to, speech.What do we know about AAC for autistic adults who can speak?: Research on AAC and autism has focused on nonspeaking children. However, autistic adults who use AAC sometimes tell each other about AAC. This community knowledge includes reasons AAC is important, useful AAC strategies, and barriers to AAC use. This article talks about autistic community knowledge about AAC and then makes suggestions.Why is AAC important for autistic adults who can speak?: Autistic adults, including those who talk, may not always be able to meet all their communication needs with speech alone. Autistic people who use speech may experience intermittent, unreliable, and/or insufficient speech.What AAC strategies do speaking autistic adults use?: The three main ways that autistic adults report on using AAC include: (1)Free or low-cost tools that are not specific to AAC (e.g., online chat rooms, text messaging applications, or handwriting).(2)Mobile applications designed for communication support.(3)Signed languages such as American Sign Language.What are some common barriers to AAC use for speaking autistic adults?: Several barriers may prevent AAC use. These include the following: Knowledge of AAC optionsAttitudes about who AAC is useful forBeliefs that the use of AAC should be decreased if a person can speakCost of AAC devices and applications.What are our recommendations to autistic adults who might use AAC and their supporters?: Support autistics in defining their own communication needs, regardless of speech.Evaluate communication goals and match them with system features when making decisions about AAC.Prioritize all communication, not just speech.Explore a variety of options to support communication.Explore low- and no-cost options to support communication. What are some research questions that still need to be answered?: What communication strategies do autistic adults see as effective?What AAC strategies are being used, in what environments, and by whom?What prevents effective AAC use?How can AAC specialists and autistic adults best collaborate to promote and evaluate AAC use?How can communication supports be designed to better meet the needs of autistic adults?

Supporting Families of Children Who Use AAC

Background Augmentative and Alternative Communication (AAC) serves as a compensatory intervention approach for individuals with aphasia and is often introduced by speech-language pathologists (SLPs) after outcomes from restorative approaches plateau. Communication partners (i.e., caregivers) have a pivotal role in ensuring the successful use of AAC by adults with aphasia. Despite there being a large body of research on the use of AAC by adults with aphasia little is known about the experience of caregivers of individuals with aphasia who use AAC in supporting its use. Aims This study conducted in Malaysia was aimed to (a) explore the practices of Malaysian SLPs when introducing AAC to adults with acquired communication disorders (ACD) including aphasia and (b) describe the experience of caregivers regarding the use of AAC by adults with aphasia under their care. Method & Procedures This mixed-methods study had two phases. In Phase 1, a survey was distributed to 200 SLPs throughout Malaysia. Thirty-seven SLPs who met the inclusion criteria of having a caseload of more than 80% adults and at least 20% adults with aphasia responded to the survey and provided information about their use of AAC. For Phase 2, eight caregivers of adults with aphasia who had been introduced to AAC were interviewed to obtain information about their experience using AAC. Outcomes & Results Findings from Phase 1 indicated that Malaysian SLPs most often introduced unaided and low-tech AAC to adults with ACD (including aphasia). Most of them felt that they lacked knowledge and skills in the provision of AAC services to adults and hoped for more training. Three themes emerged from the qualitative content analysis conducted on interview transcripts from Phase 2: (a) the positive impact of the use of AAC, (b) challenges faced when using AAC, and (c) hopes for the future. The findings of this study suggest that both SLPs and caregivers recognize the importance of AAC for adults with ACD including aphasia and need to work together closely to promote inclusion of adults with aphasia who use AAC and acceptance of AAC as a form of aphasia rehabilitation.

People with severe/profound intellectual disability experience challenges in communicating and require their communication partners to adapt to their means of communication. Augmentative and Alternative Communication (AAC) is recognised as a potential means to meet their communication needs. Interventions need to be aimed at both the individual and their communication partners. We conducted a mixed methods systematic review of the literature to synthesise evidence on communication partners experience of communicating with adults with severe/profound intellectual disability through AAC. Eight publications met the inclusion criteria, they underwent thematic synthesis where four themes emerged. A shared commitment to communication partnership is fundamental for the effective and efficient use of AAC. However, there was a disconnect between communication partners perceptions of their roles and responsibilities. This review prompts further research to explore communication partners perceptions of their roles and responsibilities in the use of AAC with people with severe/profound intellectual disabilities.

BackgroundIn Germany, clear care pathways for people without natural speech who require augmentative and alternative communication (AAC) are currently lacking. Therefore, AAC is often not sustainably implemented in everyday life. For this reason, a complex intervention was developed that supplements existing AAC consultation with additional AAC training, AAC therapy, and case management. This article presents the results of the process evaluation of the complex intervention. It examines (1) how caregivers and AAC consultants rate the intervention (2), which contextual factors influence its implementation, and (3) the acceptance, use competence, and use of the new AAC system.MethodsThe process evaluation used a mixed methods design. Quantitative data were collected with a longitudinal survey of caregivers of AAC users in the intervention and comparison groups at three time points (T0: after AAC consultation; T1: 4 weeks after AAC system receipt; T2: 4 months after AAC system receipt). Semi-structured focus group interviews were conducted with caregivers of AAC users and with AAC consultants. The quantitative data were analysed descriptively and with nonparametric mean value comparisons. The qualitative results were analysed using structured qualitative content analysis.ResultsThe evaluation and presentation of results were based on the Medical Research Council process evaluation guidance by Moore et al. The intervention elements were rated positively. AAC training and therapy enabled the participants to use the AAC system effectively in different contexts. Case management provided support, particularly in the event of problems in the care process. However, the results also show the heterogeneity of the intervention, as it depended on various contextual factors. Overall, acceptance, use competence, and use of the AAC system were rated higher in the intervention group than in the comparison group.ConclusionsThe process evaluation illustrates various contextual factors that can influence the implementation of the AAC intervention. The results highlight the potential of the intervention to improve AAC care and establish a sustainable use of AAC systems in everyday life. In addition, the process evaluation provides indications of how AAC interventions can be adapted for successful implementation.Trial registrationGrant number 01NVF17019.

Communication changes following acquired brain injury (ABI) may necessitate use of augmentative and alternative communication (AAC). Speech pathologists regularly assist people with ABI and their families with AAC assessment and recommendations, as well as education and training on AAC use. To date, there has been no Australian research investigating the perspectives of speech pathologists working in the field of ABI and AAC. This research aimed to 1) Explore speech pathologists' insights regarding enablers and barriers to considerations and uptake, and ongoing use, of AAC by people with ABI and 2) Understand their perspectives on AAC acceptance, abandonment and rejection. A qualitative research design, with semi-structured interviews, was used with seven speech pathologists working across three Australian states. Interviews were transcribed verbatim, and thematically analysed. To triangulate results, the lived experience reflections of one co-author, who has an ABI and uses AAC, were drawn on. Seven themes were identified, relating to four of the five domains of the World Health Organization's assistive technology model. These included that AAC should be person-centred, with consideration of both products and personnel required, and with effective policy aiding AAC trial, uptake and use. This research has highlighted considerations for AAC use by people with ABI, from the perspective of speech pathologists and aided by lived experience reflections. Speech pathologists need to understand the breadth of products, and good practice service steps, to ensure successful AAC use and skill development. Listening to the perspectives of people with ABI is central to that understanding.

Purpose Children with developmental disabilities who have complex communication needs (CCN) frequently need to use augmentative and alternative communication (AAC) to communicate effectively and efficiently. Speech–language pathologists (SLPs) often work closely with parents and other professionals when deciding on the best AAC system to introduce to these children. This study aimed to describe the use of AAC by children with CCN in Malaysia as reported by their parents. Materials and method An online survey distributed for this study was completed by 235 parents. Results Most of the parents of children with CCN who participated in this study reported that their children used low-tech AAC systems. A majority of respondents were satisfied with their child’s AAC system. Parental satisfaction was positively associated with the frequency of use and whether the use of AAC helped parents understand the child better. Challenges reported by parents when using AAC and the reason some families abandoned the use of AAC were similar. Examples of challenges include parents having limited time and the child lacking the motivation to use the AAC system. Conclusion The findings of this study suggest the importance of SLPs actively involving parents in the selection of their children’s AAC system so they are agreeable with the system introduced and continuously supporting children and their families to encourage and sustain the use of AAC. Implications for rehabilitation Speech–language pathologists (SLPs) can create communication opportunities for the child to use augmentative and alternative communication (AAC) and experience success, teach parents how to incorporate AAC into the family’s daily routine and activities, and reduce the demands on parents by preparing the AAC materials and programming the AAC system where possible. SLPs can provide ongoing support to school teachers to equip them with the necessary knowledge and skills to support the use of AAC in the classroom.

Literacy in Ireland

Evidence-Based Practice in AAC

Training and Intervention in South Africa

ABSTRACTBackgroundThis study explores communication partners' perceptions of their roles and responsibilities in the design, planning and use of augmentative and alternative communication (AAC) with individuals with severe/profound intellectual disability.MethodsA qualitative descriptive approach was used. Purposive sampling, data collection and qualitative content analysis were undertaken simultaneously. Data were collected from nine participants, four parents and five professionals over 4 months through audio or video‐recorded, semi‐structured, open‐ended interviews.FindingsAn overarching theme ‘Maximising Communication through AAC’ emerged, capturing participants' unanimous agreement that their shared goal was to optimise individuals' communication through AAC. This was influenced by three themes: ‘Developing a Communicative Environment’, ‘The Act of Communicating; Attempting to Realise the Individuals' Ability’ and ‘Living with Uncertainty’.ConclusionsThese findings contribute to enhancing understanding of AAC use with individuals with severe/profound intellectual disability and their communication partners.

Are We Ready for Growing AAC Needs in Group Homes?

Augmentative and alternative communication (AAC) in pediatric cochlear implant recipients with complex needs: A scoping review.

Objectives: In this study, it is aimed to reveal what extent speech and language therapists (SLT) working in Turkey used augmentative and alternative communication (AAC) systems in their working area. For this purpose, it was investigated how they perceive AAC in terms of its scope and role; ACC applications within the scope of interventions for communication, language and speech disorders; best practice insights on AAC; what factors are seen as facilitating or limiting the implementation of AAC within the scope of intervention and suggestions for providing the best practice for AAC. Methods: Phenomenology, one of the qualitative research methods, was used in the study. The subject of the study is the opinions of SLTs working in Turkey on their clinical practices and thoughts on the use of AAC. The study group consists of 15 SLTs from Turkey and determined by using maximum diversity sampling method. The semi-structured interview forms were used in which SLTs’ views, suggestions and expectations about AAC applications in the service delivery as a data collection tool. The obstacles and difficulties in these applications were discussed. Content analysis was used and also carried out using the qualitative data analysis program MAXQDA 2018. In order to ensure the consistency of the data analysis, the data were analyzed by another field expert and the 92% consensus was tried to be reached by using the consistency formula. Results: Participant opinions consist of benefiting status from AAC, opinions on the importance of AAC, preferred case groups and reasons for AAC implementation, opinions on current best practice understanding on communication and language intervention/use of AAC, opinions on current working conditions on AAC practices, opinions on the limitations of the use of AAC in communication and language intervention and recommendations for ensuring effective use of AAC themes. Conclusions: The results of the study show that supporting individuals who can benefit from AAC in the context of intervention services for communication disorders requires great effort. In addition, SLTs stated that they strongly believed in AAC and its potential value for individuals with communication disorders, but did not have sufficient self-confidence about their current or developing skills in this area. It is also seen that clinicians need training and support from employers, professional or government agencies that set policies and standards to achieve their AAC related goals.