And Alternative Communication Implementation Research Articles

Designing Cultural Adaptations of Caregiver-Implemented Interventions for Latinx Caregivers of Children Who Use Augmentative and Alternative Communication: Key Considerations.

Caregivers play a critical role in their children's development and serve as their primary communication partners. Family interactions provide the most naturally occurring opportunities for children with complex communication needs to learn language in the context of family routines. A growing body of research suggests that caregivers can effectively support their children's use of augmentative and alternative communication (AAC) systems when provided with appropriate training and coaching through caregiver-implemented interventions (CIIs). However, the efficacy of these interventions remains untested among culturally and linguistically diverse caregivers. Given the increasing diversity in the United States, there is a pressing need to develop CIIs that align with the cultural and linguistic preferences of diverse families. Using the Ecological Validity Framework and the Checklist for Cultural Adaptations, this tutorial explores considerations for culturally adapting caregiver-implemented AAC interventions for Latinx caregivers of children with AAC needs. The aim is to ensure that interventions are relevant, meaningful, and respectful of cultural and linguistic practices. Through carefully crafted cultural adaptations, interventions can achieve greater acceptance by caregivers. This tutorial suggests a series of cultural adaptations to ensure accessibility, sustainability, and success of caregiver-implemented AAC interventions for Latinx caregivers of children with AAC needs. By incorporating cultural and linguistic considerations into the intervention design, we can enhance its acceptability among Latinx caregivers. This, in turn, can lead to improved outcomes in AAC implementation within the home environment.

Knowledge and readiness of teachers in implementing augmentative and alternative communication

This qualitative study critically examines the knowledge and readiness of teachers in South African classrooms in utilising Augmentative and Alternative Communication (AAC) for learners facing communication challenges. The study addresses the concerns expressed by teachers regarding their lack of knowledge and skills in utilizing AAC, highlighting the crucial role of teacher readiness in successfully implementing this approach. The findings demonstrate that many teachers in South Africa feel ill-equipped to work with learners who rely on AAC due to limited resources and inadequate training. To ensure the effective use of AAC in classrooms and extend access to communication aids for all students, efforts are needed to enhance teacher training and support.This study also explores the challenges involved in implementing AAC exclusively within the school environment, emphasizing the importance of extending AAC usage to learners' homes for skill sharing and relevance in daily life. Additionally, the impact of staff turnover on AAC implementation in schools is examined, underscoring the necessity of addressing turnover rates and providing sufficient training to ensure successful integration of AAC. Overall, this study emphasizes the significance of incorporating AAC in the classroom and the need to equip teachers with the necessary resources and training to effectively support AAC learners both in the classroom and beyond. The research adopts a single-case study design, focusing on a Primary School in Johannesburg East, South Africa.

Teacher Training’s Content and Delivery Method Related to Augmentative and Alternative Communication (AAC): A Systematic Literature Review (SLR)

Augmentative and Alternative Communication (AAC) is one of the methods used to assist students with communication problems, particularly those in special education who suffer from speech delay and total loss of speech, for example, those with processed autism, cerebral palsy, or intellectual disabilities. The implementation of AAC in Malaysia’s schools falls primarily on the shoulders of special education teachers. However, past research has demonstrated that most special education teachers do not undergo enough teacher training to equip themselves with skills and knowledge in the field of AAC. There is scant literature about teacher training related to AAC as there has been a lack of guidelines in terms of AAC training for educators. Therefore, a Systematic Literature Review (SLR) was carried out to identify teacher training in AAC in terms of content and delivery method so that it can be used as a reference for an upcoming teacher training course. By using PRISMA, as a guideline, the Google Scholar and Scopus databases yielded a total of 18 articles. Findings reveal that previous teacher preparation programmes did not go into detail about delivery methods, particularly when it comes to how theory and practical experience are combined to maximise learning for collaborative skills and AAC-related information that was becoming more technologically advanced and online-based. Future studies should examine how each delivery modality impacts teacher learning in AAC and how to enhance in-field training to reduce the gap between theory and practice concerns in teacher preparation.

Preservice Training in Augmentative and Alternative Communication for Speech-Language Pathologists and Special Education Teachers: Prevalence and Preferences

Purpose: Preservice training is an important step to provide augmentative and alternative communication (AAC) professionals with the skills needed to facilitate inclusion and AAC success. However, existing research has largely focused on evaluating the perspectives of speech-language pathology faculty regarding preservice AAC course design. Thus, identifying important teaching topics and pedagogical teaching strategies for AAC from the perspectives of practicing professionals may provide an avenue for bolstering effective AAC implementation. Method: A total of 67 speech-language pathologists (SLPs) and 330 special education teachers (SETs) in the state of Nebraska completed an online survey investigating the prevalence of preservice training in AAC, preferred teaching topics and strategies, and self-perceived levels of competency immediately following their preservice training in AAC. Results: The majority of SLPs (76.1%) and the minority of SETs (23.5%) indicated receiving a dedicated course in AAC. Participants reported a preference for active learning activities, or a mix of active and passive learning, although specific preferences slightly differed between SLPs and SETs. Participants also indicated a desire for the incorporation of individuals from different disciplines in their preservice coursework. However, strategies for facilitating interactive learning between disciplines require further study. Conclusion: Study findings corroborate and extend existing research and methods for preservice AAC delivery. Supplemental Material: https://doi.org/10.23641/asha.24316996

Turkish speech-language therapists' perceptions and experiences of augmentative and alternative communication

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.

Reflections on Building a Multi-Country AAC Implementation Guide.

Augmentative and Alternative Communication (AAC) implementation at any level is a multifaceted process that requires selection of relevant and appropriate systems to suit individual users who may have complex communication needs and other co-occurring difficulties. Careful and systematic action may be required to develop skills and abilities in the use of chosen technologies with suitable ongoing support within a wide range of settings. The wider milieu in which services are provided must also be considered in order to provide a firm foundation for capacity building alongside considerations for multilingual and multicultural factors. UNICEF with the Global Symbols team supported by local professionals working with AAC users, their families and carers set out to collaboratively provide an implementation guide based on their experiences in several Eastern European countries. The aim of the guide was to illustrate work already being undertaken in the area and to ensure the sharing of knowledge and resources where gaps were discovered. The result became a series of linked webpages in an online framework that covered practical aspects for the development of policies and procedures to support early intervention for those with severe speech, language and communication needs across countries of differing cultures and languages. The actual AAC implementation required ingenuity on all sides with translations for pictographic symbol and software adaptations with Cyrillic and Latin alphabets, new synthetic voices alongside deployment and capacity development. Considerable local support was forthcoming and captured with interviews by those working with AAC users as technology was introduced and outcomes measured. As the guide was completed several videos were shared publicly by carers with examples of AAC and assistive technology use. Policies and procedures were also shared in the form of tables, charts, symbol sets, communication boards and software that illustrated not only the occurrence of knowledge transfer and the use of open licenses, but also differences in strategies and the way they were adapted to suit the range of settings in the various countries.

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

Augmentative and alternative communication (AAC) encompasses all forms of unaided and aided modes of communication, but typically excludes codified language such as spoken words or American Sign Language (ASL). In pediatric patients with a documented additional disability (population of interest), deficits in communication may pose a barrier to language development. While forms of AAC are frequently mentioned in the literature, recent innovations have permitted the use of high-tech AAC in the rehabilitation process. Our objective was to review the implementation of AAC in pediatric cochlear implant recipients with a documented additional disability. A scoping review of existing literature examining the use of AAC in pediatric CI recipients was conducted in the PubMed/MEDLINE and Embase databases. Studies with pediatric cochlear implant recipients with a concomitant diagnosis requiring additional therapeutic intervention outside the scope of standard post-CI follow-up care and rehabilitation from 1985 to 2021 met inclusion criteria (population of interest). Studies limited to spoken or formal sign language (e.g., American Sign Language, ASL) as communication modalities were excluded. Four hundred twenty studies were screened of which 29 were included. 13 were prospective, 10 were retrospective, 1 was cross-sectional, and 5 were case reports. Of these 29 studies, 378 patients met the inclusion criteria (age <18, CI user, additional disability, utilized AAC). Fewer studies (n=7) utilized AAC as the primary intervention for investigation. Autism spectrum disorder, learning disorder, and cognitive delay were frequently mentioned as additional disabilities in conjunction with AAC. Unaided forms of AAC included gesture/behavior, informal sign, and signed exact English, while aided AAC included a Picture Exchange Communication System (PECS), Voice Output Communication Aids (VOCA), and touchscreen programs such as TouchChat® HD. Various audiometric and language development outcome measures were mentioned, most commonly the Peabody Picture Vocabulary Test (PPVT) (n=4) and the Preschool Language Scale, Fourth Edition (PLS-4) (n=4). There is a gap in the literature regarding the use of aided and high-tech AAC in pediatric CI users with a documented additional disability. Given the use of multiple different outcome measures, additional exploration of the intervention of AAC is warranted.

Canadian manufacturer and technician perspectives on the design and use of augmentative and alternative communication technology

Purpose Device manufacturers and technicians (MaTs) of augmentative and alternative communication (AAC) systems play key roles in the design and successful uptake of communication devices. This study aims to investigate MaT perspectives on AAC device design and effective use. Materials and Methods To investigate their perspectives, a focus group of MaTs within Canada was conducted. Reflexive thematic analysis was used to analyze data. Findings Three major themes resulted from analysis, which reflect MaT’s views: AAC hardware and software flexibility, AAC knowledge and implementation, and social good versus financial resources. Conclusions This study provides insights into the complexities faced by MaTs in balancing technical support of system end-users and the financial resources necessary for that support. These insights indicate a need for increased financial resources and the expansion of individuals who qualify for AAC system candidacy. MaTs suggest that an increase in resources and candidacy could lead to more successful AAC implementation and a greater understanding of AAC for all stakeholders.

Reduction in Behavior Problems with Increase in Communication Skills Through Augmentative and Alternative Communication among Special Needs Children

Cerebral Palsy is one of the most prevalent physical handicaps in children. Sensory-motor problems such as communication and cognitive impairment are major symptoms of cerebral palsy. In Pakistan, lack of interventions for cerebral palsy children exists due to low health budget. Consequently, CP children are facing difficulty in having the treatment. The present study aims to implement an augmentative and alternative communication (AAC) approach among nonverbal children with cerebral palsy living in Pakistan. Past research evidence has revealed the co-morbidity of communication problems with behavioral issues among cerebral palsy children. Keeping in view, the present study also aims to examine the behavioral issues of nonverbal children with cerebral palsy. For the said purpose, a pilot study employed the interventional research design (pre and post assessment) which was conducted in Pakistan. 10 nonverbal cerebral palsy children were selected from three different special needs centers by using non-probability sampling technique. Repeated measures, pre and post assessment t-test analysis was conducted to assess the impact of augmentative and alternative communication (AAC) intervention on the communication skills and behavioral problems of the participants. The results showed that AAC intervention has significantly improved the communication skills (t = -11.09, P < .001) and reduced the behavioral problems (t = 2.55, P <.005) of the participants which were nonverbal children with cerebral palsy. Thematic analysis on the open-ended questions from Pragmatic profile reported that participants have started to enjoy indoor and outdoor activities. After the intervention, significant improvement in communication has been observed in participants when they present needs/desire. Thus, this study recommends that implementation of AAC on cerebral palsy population would be effective in improving communication skills and reducing their behavioral problems.

Augmentative and alternative communication with children with severe/profound intellectual and multiple disabilities: speech language pathologists’ clinical practices and reasoning

Purpose Augmentative and alternative communication (AAC) is recommended to be included in communication interventions directed at children/youth with severe/profound intellectual and multiple disabilities (S/PIMD). Even so, the evidence base for AAC practices with children with S/PIMD is limited. Also, little is known about how frequently AAC is implemented with this target group, which AAC tools and methods are applied, and the related clinical reasoning of speech-language pathologists (SLPs). This study aimed to explore SLPs’ beliefs, clinical reasoning and practices in relation to AAC implementation with children/youth with S/PIMD. Materials and methods In this sequential, mixed-methods study, 90 SLPs working with children with disabilities within habilitation services in Sweden participated in an online survey. The survey answers were statistically analysed. Subsequently, focus group data were collected from seven SLPs and analysed using thematic analysis. Results and conclusions Despite AAC being highly prioritized, SLPs found it challenging and complex to implement with this target group. A wide variety of AAC methods and tools were considered and implemented. Clinical decision-making was a balancing act between competing considerations and was mainly guided by the SLPs’ individual, clinical experiences. The resources, engagement and wishes of the social network surrounding the child were considered crucial for clinical decision-making on AAC. Implications for research and practice are discussed. Implications for rehabilitation Speech-language pathologists (SLPs) seemingly find a wide variety of Augmentative and Alternative Communication (AAC), ranging from unaided methods to assistive technology of various complexity, to be potentially suitable for children/youth with severe/profound intellectual and multiple disabilities (S/PIMD). The motivation and preferences of the social network surrounding the child with S/PIMD seem to influence SLPs’ clinical decision-making on AAC to a high degree. Sometimes this may be considered an even more important factor than the abilities of the child. SLPs’ clinical decision-making on AAC for children/youth is guided by their individual, clinical experience to a high degree. An increase in family oriented AAC intervention research targeting individuals with S/PIMD could potentially strengthen the association between research and the current, experience-based clinical practice.

Participant characteristics predicting communication outcomes in AAC implementation for individuals with ASD and IDD: a systematic review and meta-analysis

This meta-analysis examined communication outcomes in single-case design studies of augmentative and alternative communication (AAC) interventions and their relationship to participant characteristics. Variables addressed included chronological age, pre-intervention communication mode, productive repertoire, and pre-intervention imitation skills. Investigators identified 114 single-case design studies that implemented AAC interventions with school-aged individuals with autism spectrum disorder and/or intellectual disability. Two complementary effect size indices, Tau(AB) and the log response ratio, were applied to synthesize findings. Both indices showed positive effects on average, but also exhibited a high degree of heterogeneity. Moderator analyses detected few differences in effectiveness when comparing across diagnoses, age, the number and type of communication modes, participant’s productive repertoires, and imitation skills to intervention. A PRISMA-compliant abstract is available: https://bit.ly/30BzbLv.

Clinical Practice Patterns in Childhood Apraxia of Speech and Augmentative and Alternative Communication: Implications for Speech-Language Pathology Education

Purpose: The purpose of this study was to describe speech-language pathologists' (SLPs') clinical practice patterns related to childhood apraxia of speech (CAS) and augmentative and alternative communication (AAC). Method: A survey study was conducted with a total of 52 SLPs. Survey questions were related to SLPs' education, clinical experiences, and perceptions of CAS and AAC and implementation of AAC. Results: Most SLPs reported having had a dedicated AAC class during graduate school and are regularly pursuing continuing education in both CAS and AAC. SLPs reported varied clinical experiences, perceptions, and implementation of AAC in clients with CAS, with 86.54% reporting recommending AAC at some point to a client with CAS. The percentage of clients with CAS who were recommended AAC was significantly less for clinicians who pursued less continuing education in CAS ( p = .023). SLPs were significantly more likely to report comfort with AAC if they pursued continuing education in AAC ( p = .025) or had an AAC class in graduate school ( p = .007). Conclusions: SLPs' educational and clinical experience influence their clinical practice patterns related to clients with CAS and implementation of AAC. Based on the needs and skills of clients with CAS, graduate clinical education and continuing education courses regarding treatment of CAS should include information on AAC, particularly in the context of supporting receptive and expressive language skills, alongside speech development.

Augmentative and Alternative Communication in the Classroom: Teacher Practices and Experiences.

This study explored the practices and experiences of teachers who teach students using augmentative and alternative communication (AAC), more specifically, speech-generating devices (SGDs). Nine teachers (one general education, eight special education) from four countries participated in semistructured interviews. A generic qualitative approach was taken to inductively code interview transcripts and establish descriptive themes. Three themes emerged from the data. The teaching experience theme captured teachers' feelings, role, collaboration with others, knowledge and learning around AAC, and challenges teaching students who use SGDs. The teaching practices theme included curricula that teachers use, instructional planning, materials and adaptations, instructional strategies, and methods for student evaluation and progress monitoring. Finally, the overarching views and practices theme captured teachers' beliefs and interpretation of the educational system for students using SGDs, as well as teachers' overarching views on communication and approach to AAC implementation. In sharing their perspectives and practices, teachers highlighted a number of constructs that speech-language pathologists could consider when responding to and supporting teacher and student needs. The findings of this study have implications for facilitating collaborative relationships and supporting the use of AAC in schools. Discussion on how educational placement can influence teacher experiences and student outcomes is also integrated into the context of this study.

Speech-language pathologists’ practices in augmentative and alternative communication during early intervention

This survey study examined augmentative and alternative communication (AAC) practices reported by early intervention speech-language pathologists (SLPs) across the United States (N = 376). The study examined (a) types of AAC that SLPs reported using (i.e., sign language, photographs, pictures, symbols, talking switches, and iPad apps or dedicated speech-generating devices); (b) SLPs’ perspectives on the influence of child spoken language ability on AAC recommendations; (c) factors that influenced AAC decision-making within early intervention; and (d) perceived barriers associated with AAC implementation. SLPs reported that they were significantly more likely to introduce all types of AAC to children without spoken language abilities compared to children in later stages of language development. On average, they were most likely to report using or recommending sign language and photographs, and least likely to report using or recommending talking switches or speech-generating devices. Of the options provided, child expressive and receptive language abilities were rated as the most important factors to consider when determining AAC use, followed by cognitive ability, diagnosis, and chronological age. SLPs identified caregiver buy-in and carryover across providers as the most significant barriers to AAC implementation. Recommendations for future research and current AAC practices within early intervention are discussed.

Augmentative and Alternative Communication in an Elementary School Setting: A Case Study.

Although there is a strong evidence base supporting the use of augmentative and alternative communication (AAC) in school settings, the research-to-practice gap in this area remains a concern. Few studies have examined how AAC systems are implemented in school settings and whether these systems adequately promote communicative competence for students with complex communication needs. The aim of this case study was to better understand the ways in which elementary-age students with complex communication needs used AAC throughout daily routines. Observations of five students, four receiving services under the category of autism and one under intellectual disability, in school settings were conducted to document the communication function, type of AAC systems used, and the times and activities during which AAC systems were accessible. In addition, supplemental interviews were conducted to understand the rationale for AAC implementation from the perspective of the special education teacher and speech-language pathologist. Overall, findings from the observations and interviews indicated that a variety of AAC modes were utilized. Interactions represented a range of communicative functions, with the exception of social closeness, and were primarily observed during academic activities. However, there were some discrepancies between observations and interview data. Although these findings provide insight into how students with complex communication needs may use AAC in elementary school settings, more research is needed to explore AAC use across a range of students, classrooms, and schools. We present specific future research directions, along with implications and recommendations for AAC teams and researchers.

A Preliminary Study of the Relation of Visual Attention to Stimulus Complexity and Functional Vision in Individuals With Cortical Visual Impairment: Implications for Augmentative and Alternative Communication

Purpose: Individuals with cortical visual impairment (CVI) can have difficulties with visual processing due to physical damage or atypical structures of visual pathways or visual processing centers in the brain. Many individuals with CVI have concomitant disabilities, including significant communication support needs; these individuals can benefit from augmentative and alternative communication (AAC). Because much AAC involves a visual channel, implementation of AAC must consider the unique visual processing skills and challenges in CVI. However, little is known empirically about how to best design AAC for individuals with CVI. This study examined processing of visual stimuli in four young adolescents with CVI. Method: This study used a within-subjects experimental design that sought to provide an in-depth description of the visual engagement of individuals with CVI when viewing stimuli of various levels of complexity, either with or without a social cue. Results: Participants engaged most with the simplest stimuli (relative to the size of those stimuli) and engaged more when a social cue was provided during the task. The level of engagement with more complex stimuli was related to participants' score on the CVI Range, a clinical assessment tool that characterizes level of visual functioning. Conclusions: Implications for AAC include considerations for the internal complexity of AAC symbols and the complexity of the arrays created for individuals with CVI. Clinicians working with children with CVI who use AAC should consider the unique features of their visual processing.

Centering the family in their system: a framework to promote family-centered AAC services

Families are the most significant communication partners for an individual with complex communication needs. Even though family-centered approaches are recommended to support augmentative and alternative communication (AAC) services for an individual, it is difficult to establish a successful plan that fits each individual’s family. A framework for practitioners is proposed to effectively obtain and understand information about a family’s unique dynamics as part of service delivery to positively impact AAC device uptake and long-term use. The goal of using this model is to minimize the disruption to the family while maximizing the integration of the AAC system. This paper proposes and illustrates a framework to enrich AAC services through the integration of several theoretical models of family systems theory, family paradigms, and a procedure called the self-created genogram. This paper begins by reviewing ecological family systems theory and family systems to guide and provide a framework to support effective AAC implementation. The process of self-creating genograms is then introduced as a means to obtain a rich perspective on family characteristics and dynamics that is informed by the individual who uses AAC. All of this information allows professionals to provide relevant information and tailor options for the family. As a result, the family is able to make informed decisions about AAC intervention in a manner most consistent with how they typically operate. Finally, we apply this framework to a hypothetical case of a child with autism and complex communication needs across three timepoints (preschool, late elementary/early middle school, and high school/post-secondary transition) to demonstrate how this framework can be used in clinical practice.

Rethinking family (dis)engagement with augmentative &amp; alternative communication

AbstractAugmentative and Alternative Communication (AAC) is a core component of special education for many children with learning disabilities and/or autism who have minimal or no speech. Much literature focuses on implementation of AAC in the classroom or therapy setting, but less is known about how AAC is used in the family home. Few studies are authored by an AAC parent/researcher with reflection on positionality, power and the advantages conferred by ‘insider’ status. This paper addresses this gap by exploring the perspectives of five families of minimally verbal children on the place of AAC in their child’s home communication. Semi‐structured family interviews were transcribed and subjected to Thematic Analysis. Formal AAC practices such as Picture Exchange Communication System (PECS) and Makaton were found to play a limited role in the children’s home communication. Findings indicate three possible explanations: the emotional and relationship‐building dimensions of family communication; the competing priorities of family life with a disabled child; and the child’s existing multimodal communication strategies including the use of household objects. These findings offer a preliminary starting point for understanding the emic perspectives of AAC families and reasons for their convergence/divergence with professional attitudes to AAC, and warrant further investigation in larger‐scale studies.

Collaboration between stakeholders involved in augmentative and alternative communication (AAC) care of people without natural speech

ABSTRACT Collaboration among health care providers is intended to dissolve boundaries between the sectors of health care systems. The implementation of adequate augmentative and alternative communication (AAC) care of people without natural speech depends highly on collaboration among multiple stakeholders such as speech and language pathologists, teachers, or physicians. This paper examines existing barriers to and facilitators of collaboration from a stakeholder perspective. Five heterogeneous focus group interviews were conducted with N= 32 stakeholders including speech and language pathologists, AAC consultants, teachers, employees of sheltered workshops, parents, and relatives of AAC users, and other educational professionals (e.g., employees of homes for persons with disabilities) at three AAC counseling centers in Germany. Interview data were analyzed by structured qualitative content analysis. The results show very different experiences of collaboration in AAC care. Factors were identified that can have both positive and negative effects on the collaboration between all stakeholders (e.g., openness toward AAC, knowledge about AAC, communication between stakeholders). In addition, stakeholder-specific influencing factors, such as working conditions or commitment to AAC implementation, were identified. The results also reveal that these factors may have an impact on the quality of AAC care. Overall, the results indicate that good collaboration can contribute to better AAC care and that adequate conditions such as personnel, and time-related resources, or financial conditions need to be established to facilitate collaboration.

Needs Analysis of Augmentative and Alternative Communication Knowledge and Skills among Special Education Teachers for Malaysian Primary Schools

Augmentative and alternative communication (AAC), also referred to as supplementary and replacement communication is critical to provide a communication channel for autistic students who find communicating via learning and facilitating the process in a class challenge. The communication competence of educators can promote and improve positive learning behaviours among students who have autism during the learning process. The objective of this research is to determine the augmentative and alternative communication skills possessed by special education teachers for autistic students in a classroom setting. The respondents of this study comprised of 73 Malaysian special education teachers. The pandemic has prompted the needs analysis questionnaire to be administered online to identify the knowledge and skills among the teachers. The findings reported the knowledge and skills among the respondents by percentage in the realization of AAC in a classroom setting. Findings based on the responses discovered an average level of the knowledge and skills among the teachers in the implementation of AAC which emphasizes the need for teachers to receive more extensive guidance.