And Alternative Communication Research Articles

Preliminary Investigation of Context-Aware AAC with Automated Just-in-Time Cloze Phrase Response Options for Social Participation from Children on the Autism Spectrum.

Social participation for emerging symbolic communicators on the autism spectrum is often restricted. This is due in part to the time and effort required for both children and partners to use traditional augmentative and alternative communication (AAC) technologies during fast-paced social routines. Innovations in artificial intelligence provide the potential for context-aware AAC technology that can provide just-in-time (JIT) communication options based on linguistic input from partners to minimize the time and effort needed to use AAC technologies for social participation. This preliminary study used an alternating treatment design to compare the effects of a context-aware AAC prototype with automated cloze phrase response options to traditional AAC for supporting three young children who were emerging symbolic communicators on the autism spectrum in participating within a social routine. Visual analysis and effect size estimates suggest the context-aware AAC condition resulted in increases in linguistic participation, vocal approximations, and visual attention for all three children. While this study was only an initial exploration and results are preliminary, context-aware AAC technologies have the potential to enhance participation and communication outcomes for young emerging symbolic communicators on the autism spectrum and more research is needed.

Child, family and professional views on valued communication outcomes for non-verbal children with neurodisability: A qualitative meta-synthesis.

There are many children with neurodisability who are unable to rely on speech to communicate and so use a range of augmentative and alternative communication (AAC) methods and strategies to get their message across. Current instruments designed to measure the outcomes of speech and language therapy interventions lack specific attention to communication outcomes that are valued by non-verbal children with neurodisability, their families and support networks. This qualitative meta-synthesis was conducted to identify valued communication outcomes to inform the next stage of developing a novel outcome measure. To systematically identify and synthesise the qualitative evidence about which communication outcomes non-verbal children with neurodisability, their family members, healthcare professionals and educators think are important to achieve, specifically which communication outcomes are most valued by: (1) non-verbal children with neurodisability; (2) parents or other family members of non-verbal children with neurodisability; and (3) professionals who work with non-verbal children with neurodisability. A systematic search of bibliographic databases and the grey literature was undertaken to identify qualitative studies that included evidence of views expressed by children, family members, healthcare professionals and educators on outcomes in relation to the communication of non-verbal children with neurodisability. All papers meeting the inclusion criteria were quality appraised using the Critical Appraisal Skills Programme Qualitative checklist, although none were excluded on this basis. The data synthesis involved organising coded data into descriptive themes which were then synthesised into analytical themes. We found 47 papers containing qualitative data meeting the inclusion criteria from research situated in 14 countries. The views of 35 children, 183 parents, six other family members, 42 healthcare professionals and 18 educators are represented in the review. The included studies contained very few data reported by children themselves; most data were provided by adults, especially parents. Three main analytical themes were identified: Experiences of communication and expectations; adapting to and acceptance of AAC; and becoming an autonomous communicator. This meta-synthesis brings together the limited qualitative research findings about what parents, professionals and children consider are important communication outcomes for non-verbal children with neurodisability. The synthesis identifies key gaps in our knowledge about the perspectives of children and their siblings. This synthesis will inform primary research to understand valued communication outcomes in this group, and ultimately the development of a patient-reported outcome measure (PROM) that can be used to demonstrate the effect of interventions, at both clinical and service levels. What is already known on the subject Studies of children with cerebral palsy and autism spectrum disorder indicate that at least 25% of children with these conditions are non-verbal. Studies on the health outcomes of children with neurodisability have identified that communication is rated as important by parents and health professionals. There is an evidence gap about which communication outcomes are important to non-verbal children, their families and the people who work with them. What this paper adds to the existing knowledge This is the first synthesis of data that relates to communication outcomes for non-verbal children with neurodisability. This qualitative meta-synthesis identifies from previous research studies the communication outcomes valued by children who are non-verbal, their parents or other family members, and the professionals who work with them. The findings will be used to shape further primary research and the development of a novel patient-reported communication outcome measure for non-verbal children with neurodisability. It is anticipated that this will be used by clinicians to measure the effect of their interventions. What are the practical and clinical implications of this work? Clinicians should reflect on parents' experiences of communication with their child before discussing potential outcomes with them. Gaining insight into the lived experience of communication for non-verbal children and their families will help healthcare professionals to understand which goals are important to them and why. Few studies have specifically asked which communication outcomes are important for non-verbal children with neurodisability. Further exploration is needed to determine which communication outcomes non-verbal children and their families would like to see included in outcome measures used by clinicians.

Spurring Innovation in AAC Technology through Collaborative Dreaming and Needs Finding with Individuals with Developmental Disabilities Who Use AAC.

Millions of individuals who have limited or no functional speech use augmentative and alternative communication (AAC) technology to participate in daily life and exercise the human right to communication. While advances in AAC technology lag significantly behind those in other technology sectors, mainstream technology innovations such as artificial intelligence (AI) present potential for the future of AAC. However, a new future of AAC will only be as effective as it is responsive to the needs and dreams of the people who rely upon it every day. AAC innovation must reflect an iterative, collaborative process with AAC users. To do this, we worked collaboratively with AAC users to complete participatory qualitative research about AAC innovation through AI. We interviewed 13 AAC users regarding (1) their current AAC engagement; (2) the barriers they experience in using AAC; (3) their dreams regarding future AAC development; and (4) reflections on potential AAC innovations. To analyze these data, a rapid research evaluation and appraisal was used. Within this article, the themes that emerged during interviews and their implications for future AAC development will be discussed. Strengths, barriers, and considerations for participatory design will also be described.

Implications of Constraints on the Language of Emerging Aided Communicators and Intervention Decisions: A Tutorial

This tutorial offers speech-language pathologists (SLPs) an opportunity to consider the theoretical constructs of language acquisition theory and the multifactorial determinants that can impinge on the language acquisition process for children with complex communication needs. The system of constraints observed through the lens of optimality theory is discussed alongside intrinsic and extrinsic barriers associated with children who acquire their first language simultaneous to their introduction to aided augmentative and alternative communication (AAC) systems. This examination calls into question whether the language competence of emerging aided communicators may be masked by their ability to produce language that accurately represents their understanding of their native language. Specific to this question is whether vocabularies available to emerging aided communicators, opportunities to access aided language models, and intervention decisions made by SLPs may be implicated in the language acquisition and development process. Suggestions for clinical practice are offered as a means of mitigating adverse outcomes related to extrinsic constraints.

Exploring children's preferences for graphic symbols to represent pain‐related words

AbstractChildren who are hospitalized may sometimes not be able to communicate verbally to self‐report their pain or other symptoms due to medical conditions, medical interventions, or communication difficulties. As such, these children may need other means, such as augmentative and alternative communication (AAC) strategies, in this case, graphic symbols, to express their pain‐related experiences and receive applicable treatment. Choosing suitable graphic symbols to represent pain‐related words contributes to the effective use and implementation of visual support. This study explored the preferences of 6.0–9.11‐year‐old (years; months) children with typical development regarding graphic symbols to represent pain‐related words. These symbols were selected from two commonly used and widespread symbol resources: Picture Communication Symbols (PCS®) and Aragonese Portal of Augmentative and Alternative Communication (ARASAAC) symbols. A descriptive, quantitative study design was employed, including a total of 30 typically developed South African children. Data were collected by means of an electronic questionnaire and analyzed using descriptive and inferential statistics. Probability values were determined and predictions, as well as inferences, were implemented. The results showed that the children preferred ARASAAC symbols to represent most pain‐related words (p < 0.001). It is important to consider stakeholders' (in this case, children's) input on their preferences in designing communication support to enable participation during the clinical decision‐making process.

Sensory Enhanced Interactive Storytelling Technique (SEIS-T): Supporting Active Communication Through Short, Multimodal Narratives

ABSTRACT Creating meaningful interaction can be challenging for communication partners of persons with intellectual disabilities and hearing impairment (IDHI). To elicit moments of interaction and communication, the sensory-enhanced interactive storytelling technique (SEIS-T) has been developed within clinical and educational practice for people with IDHI and their communication partners. SEIS-T uses custom-made storybooks, referential objects and augmentative and alternative communication (AAC). Although many positive communicative moments with SEIS-T have been mentioned by practitioners, scientific research regarding this approach is limited. The present study aimed to alleviate this by examining changes in communication patterns and engagement of children with IDHI over the course of 10 repeated SEIS-T sessions and comparing the results to regular storytelling sessions. Six children participated in a multiple-baseline study. An event-sampling method was applied to analyse videos of the reading sessions, with respect to the children’s verbal and nonverbal communicative acts (role, form and complexity), and their attention to the storytelling. Non-overlap of all pairs (NAP)-analysis was used to test differences between the baseline and intervention phase for each participant. Promising improvements were seen in the frequency and variety of communicative acts by the children and in their focused attention during storytelling, when employing the SEIS-T.

Augmentative and Alternative Communication Assessment for Children on the Autism Spectrum: Protocol Development and Content Validation.

Previous research has shown that many speech-language pathologists (SLPs) lack confidence in conducting augmentative and alternative communication (AAC) evaluations. The AAC Clinical Assessment Project team developed a protocol to help guide SLPs to complete AAC assessments for children with autism spectrum disorder (ASD). This article describes the creation and content validation of the protocol. Two studies were conducted. The first study developed the content of the protocol using information from previous research, observation of two AAC clinical specialists, and interviews with these specialists. In the second study, five specialists in AAC and ASD provided content validation by rating the appropriateness of each item in the protocol. Advisory group meetings were held with the specialists to discuss how to edit the protocol based on the survey results. The final protocol contains a description of each area to be assessed, a rationale for assessing it, and suggested methods to conduct the assessment. The final version of the protocol has excellent content validity. Future research will evaluate the feasibility of using the protocol in clinical practice and whether using the protocol improves the clinical decision making of SLPs when planning AAC assessments. https://doi.org/10.23641/asha.27156207.

Socio-Communicative Behaviors Involving Minimally Speaking Autistic Preschoolers and Their Typically Developing Peers: Effects of an Augmentative and Alternative Communication Intervention Package.

The purpose of this study was to examine the effectiveness of an augmentative and alternative communication (AAC) intervention package consisting of systematic instruction and aided AAC modeling with speech-output technology on the acquisition, maintenance, and generalization of socio-communicative behaviors in four minimally speaking, preschool-aged, autistic children. A multiple-probe design across behaviors (i.e., initiating a request for a turn, answering questions, and commenting) replicated across participants was implemented to evaluate the effects of the intervention package on socio-communicative behaviors. Furthermore, a pretreatment and posttreatment multiple-generalization-probe design was used to assess generalization across typically developing peers who were not a part of the intervention. Maintenance data were collected 3 weeks post intervention. Visual analysis, corroborated by nonoverlapping of all pairs statistics, established a strong functional relationship between the AAC intervention package and all targeted socio-communicative outcomes for two participants. For the other two participants, inconsistent intervention effects were observed. In terms of generalization from interacting with the researcher to typically developing peers, a functional relationship between the intervention and generalization outcomes for all targeted behaviors was established for only one participant (i.e., Aiden). The outcomes of this study suggest that aided AAC modeling and systematic instruction using a speech-output technology may lead to gains in socio-communicative behaviors in some minimally speaking, preschool-aged, autistic children. https://doi.org/10.23641/asha.27091879.

Listen up! perspectives of people of color who use augmentative and alternative communication in the United States

Every individual has a fundamental right to communicate and access equal opportunities to fully participate in society. However, this right may not be fully manifested for individuals with communication access needs especially those from underrepresented groups. This project had two aims, to determine 1) the specific experiences, challenges, and aspirations related to the cultural identities of people of color (POC) who use augmentative and alternative communication (AAC) and 2) how AAC service providers and manufacturers can support POC AAC users in a culturally and linguistically responsive manner. We conducted an online, asynchronous focus group with seven participants over eight weeks. The participants’ responses were coded qualitatively. Seven major themes were identified: AAC is a Culture, AAC System Features, Self-Identity as a Person of Color who uses AAC, Experience with Service Providers, Improvements to the Field of AAC, Racial Inequities in AAC Support, and Future Research. Suggestions are provided regarding how service providers and manufacturers can serve as better allies to support POC who use AAC.

In dialogue with the body: a phenomenological exploration of the interrelationship between people who use AAC and their AAC devices

This paper explores the intricate relationship between people who use Augmentative and Alternative Communication (AAC) and their AAC devices. Drawing upon insights from phenomenology, I conducted a modified systematic review to explore the enduring phenomenon of low AAC device adoption and as a means to unravel the moments of embodiment and disembodiment experienced by people who use AAC with their devices. The discussion begins with an introduction to phenomenology as a philosophical inquiry and the guiding principles I employed to explore the phenomenon, namely, parte extra parte and object embodiment. Subsequently, I analyze the hegemony of a device-centric approach within the AAC landscape and delve into the first-person experiences of people who use AAC in living with their devices. Lastly, I discuss the embodiment and disembodiment of people who use AAC with their devices, conceptualize the interrelationship between them, and provide future directions for a more holistic and participatory AAC development and investigation that centers on the lived experiences of people who use AAC.

Frequency of Hebrew word usage by children with intellectual and developmental disabilities: implications for AAC core vocabulary

Appropriate vocabulary selection for augmentative and alternative communication (AAC) intervention is crucial to support communication and language development in children with intellectual and developmental disabilities (IDD). Core vocabulary lists are commonly used to guide this process, and there is a need for language-specific consideration. This paper aimed to develop a wordlist for selecting the core vocabulary for AAC intervention for young Hebrew-speaking children with IDD. Five children (age 3;5–8;4) were audio-recorded in naturalistic interactions with an interviewer and family members. Using Levy’s clinical corpus in the Child Language Data Exchange System (CHILDES) and Child Phonology Analyzer (CPA) tools and preestablished codes, wordlists with usage frequencies were extracted and coded for lexeme, lexical categories and functions or content. The percentages of the 20, 50, 100, and 200 most frequent lexemes were calculated for each child and for the five children combined. The top 200 most frequently used lexemes constituted 85% of the composite lexicon. A comparison was made between this study list and a previous list derived from language samples of typically developing (TD). Lexemes representing function words dominated, albeit with a slight preference for content words in children with IDD. Among the content words, children with IDD used more adverbs, while children with TD used more verbs. Implications for AAC core vocabulary are discussed.

Validated patient reported outcome measures in speech-language pathology: A scoping review of adult practice

Purpose Patient reported outcome measures (PROMs) are increasingly used to inform value-based healthcare. Within speech-language pathology (SLP), there is no synthesis of validated PROMs to guide professional practice. This scoping review systematically identifies and evaluates condition-specific PROMs across adult SLP practice. Method A literature search was performed to identify studies published until 18th February 2022 from MEDLINE, Embase, CINAHL, PsycInfo, Scopus, Cochrane Collaboration, and Web of Science. s and full texts were screened in Covidence. Relevant studies that validated PROMs in English were extracted and assessed using the “Checklist to operationalise measurement characteristics of PROMs” by two independent reviewers. Result Ninety-seven articles provided validation data for 71 PROMS across seven SLP practice areas. These included voice (n = 18), swallowing (n = 14), language (n = 11), fluency (n = 8), speech (n = 4), laryngectomy (n = 3), and cognitive-communication (n = 2). No PROMs were identified for augmentative and alternative communication (AAC) (n = 0). Quality ratings were variable on the Francis et al. checklist. Conclusion A range of validated PROMs were identified to guide SLP practice in measuring patient perceptions across a range of practice areas in adults. Opportunities for further development in SLP practice areas with limited PROMs, such as speech, cognitive-communication, and AAC are also highlighted.

Together We Can Do Great Things! AAC Teams From the Perspective of Special Education Teachers

Collaborative teams are vital in the service provision for students with complex communication needs. Professional competencies in augmentative and alternative communication (AAC) practices are an essential consideration in the distribution of roles and responsibilities each team member will hold within teams. However, it is unclear to what extent special education teachers consider themselves having a key role within teams that provide AAC services. To better understand their perspectives, an anonymous, web-based survey was disseminated across the United States to gather special education teachers’ views on AAC collaborative teams. A total of 888 special education teachers shared their views on their practices, roles, and responsibilities within AAC teams. Findings indicated that special education teachers agreed they should be part of the AAC team and have specific roles and responsibilities within the team. Practical implications, recommendations, and future research directions are discussed.

Communication Partners' Perceptions of Their Roles and Responsibilities in the Design, Planning and Use of Augmentative and Alternative Communication With Individuals With Severe or Profound Intellectual Disability: A Qualitative Descriptive Study

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.

Exploring Communication Needs and Challenges in the Intensive Care Unit: A Survey Study From Providers' and Patients' Perspectives.

Effective communication between nonspeaking patients and providers is critical for the quality of care in intensive care units (ICUs). This study aims to evaluate perspectives of health care providers and nonspeaking patients on effective communication and communication barriers in the ICU. Qualitative and quantitative survey methodologies were employed to evaluate providers' and patients' perspectives on effective communication. Rating scales were utilized to measure patients' frustration levels and communication effectiveness. Open-ended questions were employed to reflect on barriers to communication in the ICU, instances of ineffective communication, and recommendations for enhancing effective communication. The results of the study suggest that nonspeaking patients experienced high levels of frustration due to ineffective communication. However, the data reveal that access to appropriate augmentative and alternative communication (AAC) strategies and materials could help mitigate patients' frustration. Providers mainly communicated via asking yes/no questions, which largely limited the information patients conveyed, leading to frequent communication breakdowns. Providers expressed a desire to participate in training programs to utilize appropriate AAC strategies and promote effective communication. This study provides preliminary survey results on perspectives of patients and providers on effective communication in the ICU. Both providers and patients reported experiencing challenges and frustration during their communication, due to barriers such as providers' insufficient training experience and lack of access to AAC materials. Skill training is warranted to promote effective patient-provider communication in intensive care settings. https://doi.org/10.23641/asha.26339623.

Augmentative and Alternative Communication Interventions in Critical and Acute Care With Mechanically Ventilated and Tracheostomy Patients: A Scoping Review.

Communication with nonspeaking patients is a critical challenge of person-centered care. This scoping review aimed to map the literature on augmentative and alternative communication (AAC) interventions for nonspeaking mechanically ventilated and tracheostomy patients in critical and acute care settings. Electronic database, ancestry, and forward citation searches were conducted using eligibility criteria established a priori. Data were extracted, synthesized, and summarized according to scoping review methodology. Studies were categorized by type of intervention and summarized in terms of purpose, participants, design, quality appraisal (including validity and reliability of selected efficacy measures), and efficacy. Small-to-large treatment effect sizes indicated demonstrable impact on patient health and communication efficacy with high-tech and no-tech visual interface-based interventions and systematic nurse training interventions. Treatment effects primarily pertained to dependent variables of patient anxiety, communication satisfaction, comfort, symptom self-reporting, and nursing practice changes. There is a paucity of high-quality AAC intervention research for mechanically ventilated and tracheostomy patients in critical and acute care settings. Emergent evidence suggests that select visual interface and nurse training interventions can impact efficacy of patient-provider communication and patients' overall health. https://doi.org/10.23641/asha.26506102.

Latent class analysis of communication methods and devices among Japanese patients with amyotrophic lateral sclerosis: a cross-sectional survey

ABSTRACT Augmentative and alternative communication (AAC) is used to support individuals with communication impairments, such as those with amyotrophic lateral sclerosis (ALS). The selection of AAC for patients with ALS involves a variety of factors, sometimes leading to the utilization of multiple AAC methods. This study aimed to survey patients with ALS in Japan, focusing on objectives: to describe the actual state of AAC usage among these patients and to investigate potential classifications in their choice of communication methods, along with identifying influential latent factors. Data from 102 patients with ALS were analysed using descriptive statistics and latent class analysis. A latent class analysis revealed four distinct classifications: class I, replacing unaid communication with AAC (n = 46, 45.1%); class II, with minimal AAC use (n = 24, 23.5%); class III, centred around no-tech/low-tech AAC (n = 17, 16.7%); and class IV combining unaid communication with various AACs (n = 15, 14.7%). These classifications were influenced by age at diagnosis, TPPV use, gastrostomy use, and the Revised ALS Functional Rating Scale. The characteristics of each class revealed a correlation between increased medical needs, such as bulbar palsy, motor and respiratory function decline, and the necessity for AAC. Notably, patients diagnosed at an older age and those with severe bulbar palsy, like those seen in bulbar-onset ALS, require early communication support due to early onset of communication impairments. Additionally, introducing AAC in the early stages of ALS suggests that learning diverse communication methods can contribute to the maintenance of communication.

The role of the body in SGD-mediated interactions

Most research about augmentative and alternative communication (AAC) has focused on improving use of and access to speech generating devices (SGDs). However, many adults with significant physical and developmental disabilities express a preference for unaided, embodied forms of communication. This study used conversation analysis (CA) techniques to analyze the forms and functions of embodied communication that occurred during interactions between a young man who used unaided, embodied communication and an SGD to communicate with a familiar communication partner. Close analysis revealed that embodied resources were required for both unaided and aided forms of communication. Furthermore, both participants used their bodies to establish interactional spaces with different focal points during interaction, which placed different demands on the aided speaker. Unfortunately, when the SGD was the focal point, problematic demands were placed on the aided speaker, which in turn resulted in increased embodied effort on his part. The forms and functions of the body, differences in the participants’ interactions when communication did and did not involve the SGD, and implications for research and practice are all reported and discussed.

A-Speak: Augmentative and alternative communication application for Thai individuals with complex communication needs

Background: Augmentative and alternative communication (AAC) is the approach that enhances communication competence in individuals with complex communication needs. With the advancement of technology, there are varieties of AAC applications with colored-graphic symbols and speech output, improving communication’s intelligibility compared to low-tech AAC systems. However, those AAC applications had some features that were not entirely suitable for Thai users, such as symbol appearance, speech intonation, etc. Objective: This study aimed to develop the first version of the Thai AAC application, A-Speak, based on Thai culture, lexicon, and intonation and remove other constraints that other AAC applications had, such as variation in voice-output age and gender. The proficiency of A-Speak regarding communication functions was also examined. Materials and methods: The participants comprised 15 individuals with cerebral palsy and complex communication needs. The participants were trained to use the A-Speak application, installed on a tablet, to communicate. The training procedures consisted of 3 phases: Phase 1: Train to select icons; Phase 2: Shift to different categories; and Phase 3: Use A-Speak to communicate. The researchers trained the participants to achieve adequate operational skills (i.e., Phases 1 and 2) before beginning Phase 3. In Phases 1 and 2, switches were employed to facilitate participants with limited mobility to operate A-Speak by finger. The researchers also taught the participants’ caregivers to continue training them at home. The researchers collected the participants’ communication abilities regarding communication functions in the recorded form. The data was reported into code numbers according to communication proficiency. Results: After receiving A-Speak training, all participants showed improvement in their communication abilities across a variety of communication functions. Participants showed significant progress in 10 out of 12 communication functions. The communication function in which participants exhibited the most improvement was explaining skills, whereas the communication function that showed the least development was storytelling skills. Conclusion: A-Speak AAC application reduced the constraints that possibly influenced communication intelligibility in the Thai language. Nevertheless, A-Speak still had a few drawbacks that required to be corrected to increase the productivity of this program. The findings indicated that participants gained communication skills through A-Speak as a means of communication. Keywords: A-Speak, augmentative and alternative communication, application, High-tech AAC

Augmentative and alternative communication training: The effect on perceptions of special school teachers

Augmentative and alternative communication (AAC) strategies benefit learners with complex communication needs (CCN) by allowing them to participate, interact and learn. AAC is realised in the South African Education policy; however, research indicates that many teachers still have limited AAC knowledge. With this study we aimed to describe the effect of a newly developed evidence-based AAC training programme on special school teachers’ perceptions of their own abilities related to teaching learners with CCN as well as their perceptions of the general academic, communication, and classroom interaction skills of learners with CCN and finally the teachers’ perceptions of the inclusion of learners with CCN. A quasi-experimental pre-test-post-test group design with a non-randomised control group was used, employing a standardised measuring instrument, with 5 subscales, namely the modified teachers attitude scale (MTAS). The sample size included 58 teachers who participated: 6 in the pilot, 34 in the experimental and 18 in the control group. The brief AAC training session of 4 hours had a positive, statistically significant effect on several items on the subscales measuring teachers’ perceptions of their abilities related to teaching learners with CCN, as well as their perceptions of the communication of learners with CCN, classroom interaction skills, and teachers’ perceptions on the inclusion of learners with CCN. AAC training is recommended for special school teachers to enhance their own knowledge and to enhance the academic and social skills of learners with CCN. Furthermore, future studies are recommended to determine the prevalence of learners with CCN to influence the planning of services for this population in this context.