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Cruz Leon M, Zorn I. Picture book videos incorporating key word signing for children who require AAC and their families: design and evaluation of a multimedia-enhanced setting. Augment Altern Commun 2024:1-13. [PMID: 38994784 DOI: 10.1080/07434618.2024.2370821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 06/16/2024] [Indexed: 07/13/2024] Open
Abstract
Key word signing (KWS) is an unaided form of augmentative and alternative communication (AAC) and is frequently used by children with cognitive impairments and their families. Successful implementation of KWS requires a family environment that provides aided language input by modeling the signs. However, families face challenges implementing the signs in their everyday lives. KWS requires effort and sustained parental commitment. Users may also struggle with finding good learning resources and stimulating and enjoyable shared contexts for communication. Signed videos of popular children's books may help to implement KWS and create a signing environment which exposes children and their families to KWS in meaningful ways. The aim of this study was to create videos of this type and investigate whether and how they might serve as an attractive medium of support for families' KWS experience. Three families tested the videos. A triangulated qualitative study incorporating interviews and participant observation explored the families' experience of using these videos as a context for shared communication. The findings suggest that picture book videos supplemented by KWS may be appropriate resources for the use of KWS in everyday family life. They serve as a child-centered activity involving KWS exposure, in which children and their families can participate joyfully and naturally.
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Affiliation(s)
- Meike Cruz Leon
- Faculty of Applied Social Sciences, Institute of Media Research and Media Education, TH Köln (University of Applied Science Cologne), Cologne, Germany
| | - Isabel Zorn
- Faculty of Applied Social Sciences, Institute of Media Research and Media Education, TH Köln (University of Applied Science Cologne), Cologne, Germany
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Yau SH, Choo K, Tan J, Monson O, Bovell S. Comparing and contrasting barriers in augmentative alternative communication use in nonspeaking autism and complex communication needs: multi-stakeholder perspectives. Front Psychiatry 2024; 15:1385947. [PMID: 38919639 PMCID: PMC11197385 DOI: 10.3389/fpsyt.2024.1385947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/16/2024] [Indexed: 06/27/2024] Open
Abstract
Augmentative alternative communication (AAC) devices or systems are often prescribed to minimally verbal or nonspeaking autistic individuals and other individuals with complex communication needs to facilitate communication or as an alternative to spoken language. AAC use can result in communication gains and improved quality of life for minimally verbal or nonspeaking individuals. Despite this, AAC abandonment is high, limiting societal participation of the individual on the autism spectrum with complex communication needs. Our study is a novel exploration of the barriers of AAC use from a multi-stakeholder perspective, and a qualitative analysis of similarities and differences between stakeholders. We conducted semi-structured interviews and focus groups with 30 parent-carers, educators and clinicians currently supporting AAC users in Western Australia and analysed the data using reflexive thematic analysis. Barriers from each stakeholder group were coded, resulting in 17 subthemes forming five main themes common to all stakeholders: Stakeholder Knowledge, Stakeholder Attitudes and Stigma, Resources, AAC User Engagement, and Device Fit. Contrasting perspectives included actual and perceived stigma associated with AAC use (parent-carers vs clinicians); different struggles with resources and knowledge (parent-carers vs clinicians and educators); and a lack of clinician communication in the processes that determined AAC-fit for school environments (educators only). Findings are discussed in the context of improving inter-stakeholder collaboration and capacity building in Australian health service and practice to better support minimally verbal or nonspeaking autistic individuals and individuals with complex communication needs. Suggestions are also offered for communication partner training.
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Affiliation(s)
- Shu H. Yau
- School of Psychology, Murdoch University, Perth, WA, Australia
- School of Education, University of Bristol, Bristol, United Kingdom
| | - Kaylynn Choo
- School of Psychology, Murdoch University, Perth, WA, Australia
| | - Jane Tan
- School of Psychology, Murdoch University, Perth, WA, Australia
| | - Olivia Monson
- School of Psychology, Murdoch University, Perth, WA, Australia
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Kim J, Soto G. A Comprehensive Scoping Review of Caregivers' Experiences With Augmentative and Alternative Communication and Their Collaboration With School Professionals. Lang Speech Hear Serv Sch 2024; 55:607-627. [PMID: 38324385 DOI: 10.1044/2024_lshss-23-00117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
PURPOSE Parent engagement and involvement is essential for the successful implementation of augmentative and alternative communication (AAC) systems in the home. The purpose of the current study is to gain a deeper understanding of caregivers' experiences with AAC systems and their collaboration with school professionals during the implementation of AAC, which may have led to subsequent abandonment. METHOD This review intentionally included qualitative studies that employed semistructured interviews, focus groups, and ethnographic investigations that documented the experiences and perceptions of families implementing AAC at home. Electronic database search, ancestral search, and forward search procedures resulted in a total of 27 peer-reviewed studies portraying the voices of 319 caregivers. RESULTS An inductive analysis was conducted to record recurring themes into codes. The codes were thematically synthesized into three main themes: (a) the family unit, (b) the service providers, and (c) the AAC system. CONCLUSIONS The results emphasized the need for participatory practices of family involvement in co-constructing a collaborative AAC service provision. Future research directions should implement this practice and explore the outcomes of this process to validate its efficacy.
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Affiliation(s)
- John Kim
- Joint Doctoral Program in Special Education, University of California-Berkeley and San Francisco State University
| | - Gloria Soto
- Department of Speech, Language and Hearing Sciences, San Francisco State University, CA
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Noyes AM, Wilkinson KM. A qualitative pilot study of adult AAC users' experiences related to accessing and receiving mental health services. Augment Altern Commun 2024:1-15. [PMID: 38169438 DOI: 10.1080/07434618.2023.2294734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 09/24/2023] [Indexed: 01/05/2024] Open
Abstract
There is currently limited research related to mental health supports for individuals who use AAC, particularly about the actual lived experiences of AAC users who receive mental health services. There may be alterations to mental health services for individuals who use AAC. The aim of this study was to gain the perspectives of AAC users on accessing and receiving mental health services. Three participants who used AAC and received mental health services shared their experiences related to receiving mental health services. Data were analyzed using an inductive approach in which themes were based on participants' experiences. Five major themes were generated: (a) Time, (b) Communication Partner Skills, (c) Advocacy, (d) Means of Expression, and (e) Diagnosis. Participants described factors that positively or negatively impacted their experiences. Participant experiences were examined in light of Bronfenbrenner's Ecological Systems model. The findings of this study provide insights into the perspectives of individuals who use AAC in accessing mental health services, uncovering various barriers and facilitators within the patient-psychotherapist microsystem. Factors such as time constraints, communication partner skills, advocacy, means of expression, and diagnosis-related challenges significantly influenced the quality of interaction between patients using AAC and their mental health provider. The study also reveals the broader impacts of AAC on interactions within the meso-, exo-, and macro-systems, suggesting the need for improved involvement of speech-language pathologists and policy changes to support effective communication and accessibility for individuals using AAC in mental health settings. Ultimately, future research should involve participants of varying ages, diagnoses, and backgrounds and should include a variety of stakeholders.
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Affiliation(s)
- Adrianna M Noyes
- Communication Sciences and Disorders Department, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Krista M Wilkinson
- Communication Sciences and Disorders Department, The Pennsylvania State University, University Park, Pennsylvania, USA
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Kamonsitichai W, Goldstein H. Speech-language pathologists' perceptions of augmentative and alternative communication in Thailand. Augment Altern Commun 2023; 39:230-240. [PMID: 37171190 DOI: 10.1080/07434618.2023.2208222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/29/2022] [Indexed: 05/13/2023] Open
Abstract
Augmentative and alternative communication (AAC) systems are not well-known and broadly used in Thailand. To begin introducing AAC systems and interventions to children with complex communication needs in Thailand, understanding speech-language pathologists' (SLPs) perceptions toward various AAC systems is an important first step. This study assessed SLPs' perceptions of three AAC modalities: gestural communication, communication boards, and iPad1-based speech-output technologies. A total of 78 SLPs watched three video vignettes of a child using each mode and rated their impressions of intelligibility, ease of learnability and use, effectiveness, and preference. Then they were asked to rate factors on visual analog scales that provided additional insights into their rationales and their preferences for AAC modalities for nonverbal clients and for themselves if they were nonverbal. The results indicated that most of the SLPs rated iPad-based speech-output technologies as being the more intelligible, effective, and preferred mode of communication. Gestural communication was rated as the easiest mode to learn and use for a child with complex communication needs. Despite infrequent use of iPad-based speech-output technologies in Thailand, SLPs' ratings indicated high social acceptance of this modality for promoting communication abilities of children with complex communication needs. Results also revealed some biases and lack of knowledge about AAC systems in Thailand.
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Affiliation(s)
- Wansiya Kamonsitichai
- Department of Communication Sciences and Disorders, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Lillehaug HA, Klevberg GL, Stadskleiv K. Provision of augmentative and alternative communication interventions to Norwegian preschool children with cerebral palsy: are the right children receiving interventions? Augment Altern Commun 2023; 39:219-229. [PMID: 37212772 DOI: 10.1080/07434618.2023.2212068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 03/06/2023] [Indexed: 05/23/2023] Open
Abstract
Preschool children with cerebral palsy (CP) with no or unintelligible speech need augmentative and alternative communication (AAC), but not all children needing AAC have access to it. This study describes the use and perceived benefit of AAC and explores factors associated with receiving AAC interventions. Using a cross-sectional design, we combined parent-reported data with data from the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP). Communication, speech and hand function was classified according to the Communication Function Classification System (CFCS), Viking Speech Scale (VSS), and Manual Ability Classification System (MACS), accordingly. The need for AAC was defined as Levels III-V on the CFCS, without simultaneous classification at VSS Level I, and/or Levels III-IV on VSS. Parents reported on child- and family-directed AAC interventions using the Habilitation Services Questionnaire. Of the 95 children (42 females) with CP (M = 39.4 months, SD = 10.3), 14 had communication aids. Of the 35 children (31.4%) defined as needing AAC, 11 had been provided with communication aids. Parents of children with a communication aid reported satisfaction with and frequent use of the aid. Children at MACS Level III-V (OR = 3.4, p = .02) or with epilepsy (OR = 8.9, p < .01) were most likely to have received an AAC intervention. The low proportion of children receiving communication aids indicates an unmet need for AAC interventions among preschool children with CP.
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Affiliation(s)
- Hilde Aven Lillehaug
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | | | - Kristine Stadskleiv
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
- Department of Special Needs Education, University of Oslo, Oslo, Norway
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Joginder Singh S, Loo ZL. The use of augmentative and alternative communication by children with developmental disability in the classroom: a case study. Disabil Rehabil Assist Technol 2023; 18:1281-1289. [PMID: 37017363 DOI: 10.1080/17483107.2023.2196305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 03/23/2023] [Indexed: 04/06/2023]
Abstract
PURPOSE Augmentative and alternative communication (AAC) systems are often introduced to children with disabilities who demonstrate complex communication needs. As attending school is an essential part of these children's lives, it is important that they use their AAC system to communicate in the classroom. This study aimed to describe the nature of the use of AAC by students with developmental disabilities in the classroom. MATERIALS AND METHOD This study was conducted in Malaysia. Six students were observed twice each in their classroom and their classroom interactions were video recorded. The video recordings were transcribed and coded for the presence of a communication event, the student's mode of communication and communication function, the communication partner involved, and access to the AAC system. RESULTS Contrary to past studies, most students in this study spontaneously initiated interaction almost as many times as they responded. They primarily communicated with gestures and verbalizations/vocalizations despite having been introduced to an AAC system. When students communicated using their AAC system, they mainly interacted with the teachers, and for the function of either behavioral regulation or joint attention. It was found that for 39% of communicative events, the student's aided AAC system was not within arm's reach. CONCLUSION The findings highlight the need for efforts to encourage students with complex communication needs to use AAC more frequently in their classroom to be able to communicate more effectively and for a wider range of communicative functions. Speech-language pathologists can work closely with teachers to provide the necessary support to these students.
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Affiliation(s)
| | - Zhu Li Loo
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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West P, Jensen EJ, Douglas SN, Wyatt G, Robbins L, Given C. Perceptions of families with adolescents utilizing augmentative and alternative communication technology: A qualitative approach. J Pediatr Nurs 2023:S0882-5963(23)00103-3. [PMID: 37127476 DOI: 10.1016/j.pedn.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE Although family involvement is critical to successful augmentative and alternative communication (AAC) device utilization, little is known about how families adapt to technology. The aim of this qualitative study was to explore parent-reported factors contributing to family adaptation among families with adolescents diagnosed with autism and/or Down syndrome (DS) utilizing AAC technology. This study describes families' experiences related to several interacting variables of the Resiliency Model, including demand, type, appraisal, resources, and problem-solving/coping, that helped shape the outcome of adaptation to AAC technology. Nurses are well-positioned in a variety of practice settings to assess vulnerable families and assist with identifying resources and navigating complex service systems. DESIGN AND METHODS Semi-structured interviews were conducted with eight parents of adolescents with autism and/or DS (aged 13-18) recruited through online research registries, support organizations, and a social networking site. Recorded interviews were transcribed, and two independent reviewers coded and analyzed the data. Comparisons across all families' thematic summaries were examined for patterns. RESULTS Five themes described aspects of family adaptation: Contextual Strains and Influences, Continuum of Person-First Approach, Opening Doors, Facilitators of Support, and Planning Is Key. CONCLUSIONS Findings highlighted the challenges and demands associated with raising an adolescent using an AAC device, as well as the attributes, resources, perceptions, and strategies that either contributed or hindered family adaptation. PRACTICE IMPLICATIONS AAC technology is readily available for adolescents with developmental disabilities. It is essential that nurses assess key adaptation components to support families in integrating and using the technology.
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Affiliation(s)
- Patricia West
- College of Nursing, Michigan State University, 1355 Bogue Street, Life Science, East Lansing, MI 48824, United States.
| | - Emily J Jensen
- Human Development and Family Studies, Michigan State University, 552 West Circle Drive, Human Ecology, East Lansing, MI 48824, United States.
| | - Sarah N Douglas
- Human Development and Family Studies, Michigan State University, 552 West Circle Drive, Human Ecology, East Lansing, MI 48824, United States.
| | - Gwen Wyatt
- College of Nursing, Michigan State University, 1355 Bogue Street, Life Science, East Lansing, MI 48824, United States.
| | - Lorraine Robbins
- College of Nursing, Michigan State University, 1355 Bogue Street, Life Science, East Lansing, MI 48824, United States.
| | - Charles Given
- College of Nursing, Michigan State University, 1355 Bogue Street, Life Science, East Lansing, MI 48824, United States.
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Joginder Singh S, Mohd Ayob N, Hassan FH. Parents' perception on the use of augmentative and alternative communication by children with complex communication needs in Malaysia. Disabil Rehabil Assist Technol 2023; 18:118-126. [PMID: 36344474 DOI: 10.1080/17483107.2022.2140850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
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 rehabilitationSpeech-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.
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Affiliation(s)
| | | | - Fatimah Hani Hassan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Joginder Singh S, Suhumaran LV, Skulski K, Ahmad Rusli Y. Malaysian speech-language pathology students' reflections about their participation in an AAC training program. Augment Altern Commun 2022; 38:236-244. [PMID: 36573041 DOI: 10.1080/07434618.2022.2141135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Most speech-language pathologists (SLPs) in Malaysia practice with an undergraduate degree, which provides them with limited knowledge about and training in augmentative and alternative communication (AAC). This limited knowledge and training may affect their confidence and competence when introducing and using AAC with individuals for whom it is required. This study aimed to obtain feedback, via semi-structured interviews, from a group of 11 Malaysian university students who participated in an AAC training program about their experiences participating in and the effectiveness of the training program. Three themes were derived from qualitative content analysis of the interviews: (a)Time Demands, (b) Generalizing the use of AAC, and (c) Learning Required When Introducing AAC. The participants reported that they obtained better insights into the role of SLPs and communication partners with regards to AAC, as well as the struggles they faced. Students also reported increased confidence when working with individuals who use AAC after participating in the training program, thus supporting the need for similar training programs in the future.
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Affiliation(s)
| | | | | | - Yazmin Ahmad Rusli
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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King M, Ward H, Soto G, Barrett TS. Supporting Emergent Bilinguals Who Use Augmentative and Alternative Communication and Their Families: Lessons in Telepractice From the COVID-19 Pandemic. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2004-2021. [PMID: 35926088 DOI: 10.1044/2022_ajslp-22-00003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this project was to examine the effect of the COVID-19 pandemic on speech-language pathologist (SLP) service provision for emergent bilinguals who use augmentative and alternative communication (AAC). One prominent issue in AAC service delivery is the efficacy and feasibility of providing AAC services via telepractice. The COVID-19 pandemic intensified this issue as most providers, clients, and families adjusted to remote service delivery models. While emerging evidence supports telepractice in AAC, little is known about the potential benefits and challenges of telepractice for emergent bilinguals who use AAC and their families. METHOD Data were collected via a nationwide survey. Licensed SLPs (N = 160) completed an online questionnaire with Likert-type, multiple-choice, and open-ended questions, analyzed using mixed methods. RESULTS Findings illustrated a shift in service delivery from in-person to telepractice and hybrid (both telepractice and in-person) models. Overall, child intervention outcomes declined for emergent bilinguals who used AAC during the COVID-19 pandemic, regardless of service delivery format. However, collaboration increased for many providers and families. Qualitative analyses highlighted barriers to AAC service provision for emergent bilinguals who use AAC that were exacerbated by the COVID-19 pandemic, as well as factors that facilitated collaboration and family engagement. CONCLUSION These findings suggest that, despite challenges, telepractice or hybrid services may be a promising approach to provide more culturally responsive, family-centered care for emergent bilinguals who use AAC. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20405673.
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Affiliation(s)
- Marika King
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | - Hannah Ward
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | - Gloria Soto
- Department of Speech, Language and Hearing Sciences and Department of Special Education, San Francisco State University, CA
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Muttiah N, Seneviratne A, Drager KDR, Panterliyon NA. Parent perspectives on augmentative and alternative communication in Sri Lanka. Augment Altern Commun 2022; 38:173-183. [PMID: 36285713 DOI: 10.1080/07434618.2022.2121940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Parental support is an important part of introducing an augmentative and alternative communication (AAC) system to a child. Professionals providing AAC services to children with complex communication needs should practice family-centered service provision. The aim of this study was to explore Sri Lankan parents' perspectives on AAC and their lived experiences. Semi-structured interviews were conducted with 10 parents of children with complex communication needs. Thematic analysis was used to analyze the findings, with the following themes identified: (a) External Systems, (b) Impact on the Family, (c) Impact on the Child, and (d) Communication (including AAC). Findings from this study provide important information for speech-language therapists providing services to families from low- and middle-income countries. In particular, parents reported several positive aspects of AAC. However, parents also reported challenges, including speech-language therapist's lack of knowledge of and training in AAC.
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Affiliation(s)
- Nimisha Muttiah
- Department of Disability Studies, The University of Kelaniya, Kelaniya, Sri Lanka.,Communication Disorders and Sciences Department, State University of New York College at Cortland, Cortland, NY, USA
| | - Ayendree Seneviratne
- Department of Disability Studies, The University of Kelaniya, Kelaniya, Sri Lanka
| | - Kathryn D R Drager
- Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA, USA
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Berenguer C, Martínez ER, De Stasio S, Baixauli I. Parents’ Perceptions and Experiences with Their Children’s Use of Augmentative/Alternative Communication: A Systematic Review and Qualitative Meta-Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138091. [PMID: 35805750 PMCID: PMC9266194 DOI: 10.3390/ijerph19138091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/23/2022]
Abstract
Augmentative and alternative communication (AAC) consists of any method of communicating that supplements or completely substitutes oral and/or written language when it is impaired. Therefore, it enables children with complex communication needs to develop their full communicative potential. However, despite the many benefits of AAC and its widespread use, several review studies have underscored the problems faced by parents and children who use AAC in their daily lives. The general objective of this systematic review and qualitative meta-synthesis is to provide a complete overview of parents’ experiences and perceptions with their children’s use of AAC. Specifically, it aimed to identify common themes and subthemes of interest and to analyze the research quality of the selected studies. An exhaustive literature search was carried out using different electronic databases. Nineteen studies were included, involving 297 parents. A thematic synthesis was undertaken. Three main themes and nine subthemes were identified: service support (accessibility, providers and coordination); characteristics of AAC systems (usability and acceptability, features, cost and funding); and integration of AAC in daily life (family, school, social and community). Findings raise a need for more services that support children with complex communication deficits in different contexts, more functional use of AAC systems at school and in real-world situations, as well as service assistance over an extended time period.
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Affiliation(s)
- Carmen Berenguer
- Department of Developmental and Educational Psychology and ERI-Lectura, University of Valencia, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain
- Correspondence:
| | - Eva Rosa Martínez
- Department of Basic Psychology and ERI-Lectura, University of Valencia, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain;
| | - Simona De Stasio
- Department of Human Studies, LUMSA University, 00193 Rome, Italy;
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Muttiah N, Gormley J, Drager KDR. A scoping review of Augmentative and Alternative Communication (AAC) interventions in Low-and Middle-Income Countries (LMICs). Augment Altern Commun 2022; 38:123-134. [PMID: 35289193 DOI: 10.1080/07434618.2022.2046854] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Currently, a small number of studies discuss augmentative and alternative (AAC) interventions in low- and middle-income countries (LMICs). The primary purpose of this scoping review was to summarize the current evidence base on communication-based interventions and partner training in LMICs, to explore and identify gaps in the AAC evidence base and guide future research. A total of 18 studies were identified. The results revealed many positive outcomes arising from AAC interventions, including increased communication, improved participation, increased knowledge about communication, and increased use of partner communication strategies, thus adding to the evidence base that AAC can be successfully implemented in LMICs. However, these studies did not broadly represent most LMICs and there were only a handful of indirect intervention studies training communication partners. To this end, there is an urgent need to expand the level of AAC intervention research conducted in LMICs in order to better serve individuals with complex communication needs living in these countries.
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Affiliation(s)
- Nimisha Muttiah
- Department of Disability Studies, The University of Kelaniya, Kelaniya, Sri Lanka
| | - Jessica Gormley
- Department of Speech-Language Pathology, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kathryn D R Drager
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA, USA
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Avagyan A, Mkrtchyan H, Shafa FA, Mathew JA, Petrosyan T. Effectiveness and Determinant Variables of Augmentative and Alternative Communication Interventions in Cerebral Palsy Patients with Communication Deficit: a Systematic Review. Codas 2021; 33:e20200244. [PMID: 34378726 DOI: 10.1590/2317-1782/20202020244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/20/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Assess the effectiveness of augmentative and alternative communication (AAC) interventions in patients with CP and to reveal determinant variables of main intervention outcomes: receptive and expressive language. RESEARCH STRATEGIES The search was performed in following databases: MEDLINE (Ovid); PubMed (NLM); Embase (Ovid); Cochrane Database of Systematic Reviews; Cumulative Index to Nursing and Allied Health Literature; Database of Abstracts of Reviews of Effects; Cochrane Central Register of Controlled Trials; Health Technology Assessment database and PEDro. SELECTION CRITERIA Full-text and peer-reviewed studies in English studying the effectiveness of AAC in patients with cerebral palsy were included. Studies with patients (<18 years) diagnosed with CP were included. DATA ANALYSIS A narrative analysis was conducted to evaluate the efficacy of AAC methods. A random-effects model meta-analysis was used to assess determinants of AAC intervention outcomes. RESULTS The online database and manual reference search revealed 445 records. Nine studies investigating a total of 294 subjects with CP met predefined eligibility criteria: 4 studies with single subject, multiple baseline research designs, 3 longitudinal cohort studies, 1 case control study and 1 case series. Results revealed moderate-quality evidence that AAC interventions improve the receptive and expressive communication skills in patients with CP. The random-effects model meta-analysis revealed the power of identified determinant variables affecting the AAC intervention outcomes. CONCLUSION Diversity of CP patients requires proper analysis of determinant variables to ensure the efficacy of AAC assessment and intervention. More studies of high methodological and practical quality assessing the efficacy of AAC interventions are needed to clarify the evidence.
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Affiliation(s)
| | - Hasmik Mkrtchyan
- Department of Speech and Rehabilitation Therapy, Armenian State Pedagogical University after Khachatur Abovyan - ASPU - Yerevan, Armenia
| | - Fatemeh Alsadat Shafa
- Technologies for Management of Health Ltd - Yerevan, Armenia.,School of Medicine, Yerevan Haybusak University - Yerevan, Armenia
| | - Joan Alexandra Mathew
- Technologies for Management of Health Ltd - Yerevan, Armenia.,School of Public Health, American University of Armenia - Yerevan, Armenia
| | - Tigran Petrosyan
- Department of Speech and Rehabilitation Therapy, Armenian State Pedagogical University after Khachatur Abovyan - ASPU - Yerevan, Armenia.,Technologies for Management of Health Ltd - Yerevan, Armenia
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Joginder Singh S, Diong ZZ, Mustaffa Kamal R. Malaysian teachers' experience using augmentative and alternative communication with students. Augment Altern Commun 2020; 36:107-117. [PMID: 32706287 DOI: 10.1080/07434618.2020.1785547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Teachers play an important role in the successful implementation of augmentative and alternative communication (AAC) for students with complex communication needs. The goal of this two-phase, mixed-methods study was to explore Malaysian teachers' use of, experience with, and perceptions about AAC. Phase 1 involved 252 teachers who completed a questionnaire that was aimed at collecting nationwide data about their use and overall perceptions of AAC. Phase 2 involved semi-structured interviews with 13 teachers who had experience supporting students who used AAC. Approximately half of the participants who completed the questionnaire knew about AAC and had used AAC with their students. Almost all of the participants had positive views of AAC though some misconceptions were reported. Most participants had limited knowledge about AAC that led them to experience difficulties supporting their students. Teachers were motivated to receive AAC-related training to enable them to use AAC more successfully with their students given the small number of SLPs in the country.
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Affiliation(s)
| | - Zhi Zhi Diong
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rahayu Mustaffa Kamal
- Kulliyyah of Allied Health Sciences, Universiti Islam Antarabangsa, Kuantan, Malaysia
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West P, Van Riper M, Wyatt G, Lehto R, Douglas SN, Robbins L. Adaptation to Technology Use in Families of Children With Complex Communication Needs: An Integrative Review and Family Theory Application. JOURNAL OF FAMILY NURSING 2020; 26:153-178. [PMID: 32389060 DOI: 10.1177/1074840720915536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Families with children who have developmental disabilities and complex communication needs (CCNs) face challenging demands affecting family adaptation. Many children with CCNs use augmentative and alternative communication (AAC) devices to support communication, yet little is known about family adaptation to such technology. To fill this gap, an integrative review, guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation was conducted to assess conceptual foundations and the state of the science of family adaptation among children utilizing AAC. Web-based searches were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the Mixed Methods Appraisal Tool. Thirty-three studies met eligibility. Findings demonstrated that to enhance the science underpinning family adaptation to AAC use, future research should be grounded conceptually and address important components of the Resiliency Model. Work in this emerging area will identify and facilitate nursing efforts to assist families as they adapt to communication technology.
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Affiliation(s)
| | | | - Gwen Wyatt
- Michigan State University, East Lansing, USA
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18
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Hettiarachchi S, Kitnasamy G, Gopi D. "Now I am a techie too" - parental perceptions of using mobile technology for communication by children with complex communication needs in the Global South. Disabil Rehabil Assist Technol 2020; 15:183-194. [PMID: 30735067 DOI: 10.1080/17483107.2018.1554713] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Parental perceptions are key to the uptake of augmentative and alternative communication (AAC) devices for their children with complex communication needs. This study aimed to explore the perceptions of parents in a resource poor Global South country on the use of mobile technology as AAC devices.Materials and methods: Sixteen participants (11 female; 5 male) were included in the study. Focus group discussions, face-to-face interviews and telephone interviews were conducted with the aid of an interview guide. The interview data were analysed using the key principles of Framework analysis and through the lens of critical disability studies.Results: Six broad themes emerged. Most participants indicated a penchant for mobile technology, though its current use with their children was mainly as a teaching tool rather than a communication device. Concerns were raised about the cost of mobile technology, which if used within communication, was only as a temporary stop-gap measure with limited knowledge. The power of mainstream technology to challenge prevalent notions of disability was also highlighted by the participants.Conclusions: There is an openness to using mainstream mobile technology by parents with their children with complex communication needs. This use is currently reserved mainly for educational purposes while its power to challenge disability-related stereotypes is acknowledged. More parent training is required to encourage the use of mobile technology as AAC devices for communication.Implications for rehabilitationCurrent parent perspectives on mobile technology as AAC devices must be explored, given its potential impact on the uptake of these devices to support communication in their children with complex communication needs.Mainstream mobile technology could challenge perceptions of disability and therefore, be more acceptable to parents for their children with complex communication needs.Parental training is required to increase knowledge on the use of mobile technology as AAC devices for communication to enable informed choice-making.
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Affiliation(s)
- Shyamani Hettiarachchi
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.,School of Social Work and Social Policy, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | | | - Dilani Gopi
- Cerebral Palsy Lanka Foundation, Colombo, Sri Lanka
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Glacken M, Healy D, Gilrane U, Gowan SHM, Dolan S, Walsh-Gallagher D, Jennings C. Key word signing: Parents' experiences of an unaided form of augmentative and alternative communication (Lámh). JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2019; 23:327-343. [PMID: 30122092 DOI: 10.1177/1744629518790825] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Parents' experiences of using Lámh, a key word signing approach used in Ireland, were captured through in-depth face-to-face interviews with parents of children with a range of intellectual disabilities. It emerged that Lámh provides child users with one of the rudiments of inclusion, that is, a means of engaging with others. A number of factors can potentially influence the engagement achieved, namely ongoing family commitment to the sustainment of Lámh, available communication partners, accessibility, appropriate Lámh training, speech and language therapy support and the existence of a Lámh signing environment external to the home. The child's family, education and community need to commit to Lámh in order to support a child user become an active member of their community.
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Tönsing KM, van Niekerk K, Schlünz G, Wilken I. Multilingualism and augmentative and alternative communication in South Africa - Exploring the views of persons with complex communication needs. Afr J Disabil 2019; 8:507. [PMID: 31061819 PMCID: PMC6494916 DOI: 10.4102/ajod.v8i0.507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 09/27/2018] [Indexed: 12/05/2022] Open
Abstract
Background Augmentative and alternative communication (AAC) can assist persons with complex communication needs to communicate competently with a variety of communication partners in a variety of contexts. However, AAC systems and intervention often do not take multilingual aspects into consideration. Objective This small-scale exploratory study had three aims, namely: (1) to describe the self-reported language skills of multilingual South African adults using AAC, (2) to describe the languages and communication modalities they used in interaction and (3) to obtain their views regarding access to various languages. Methods Twenty-seven adults using AAC were recruited via an empowerment programme, as well as an email list for persons interested in AAC, and provided responses to a questionnaire. To compensate for access and written language challenges, the questionnaire was administered with help and/or as a face-to-face interview where needed. Responses were analysed using mostly descriptive statistics. Results Participants generally could not express themselves in all the languages they understood and were regularly exposed to. Speech-generating devices specifically gave access almost exclusively to English. Participants expressed a desire to increase their expressive language repertoire, and mentioned both limitations of communication technology as well as their own literacy skills as barriers to overcome in this regard. Conclusion In order for multilingual South African adults using AAC to express themselves in multiple languages, appropriate AAC systems and interventions as well as literacy learning opportunities need to be developed and provided. Keywords adult, augmentative and alternative communication; multilingualism; complex communication needs, language and communication skills; self-report, views.
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Affiliation(s)
- Kerstin M Tönsing
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Karin van Niekerk
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Georg Schlünz
- Human Language Technology Research Group, Meraka Institute, Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Ilana Wilken
- Human Language Technology Research Group, Meraka Institute, Council for Scientific and Industrial Research, Pretoria, South Africa
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21
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Smith M. Innovations for Supporting Communication: Opportunities and Challenges for People with Complex Communication Needs. Folia Phoniatr Logop 2019; 71:156-167. [DOI: 10.1159/000496729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 01/07/2019] [Indexed: 11/19/2022] Open
Abstract
Individuals with complex communication needs have benefited greatly from technological innovations over the past two decades, as well as from social movements that have shifted focus from disability to functioning and participation in society. Three strands of technological innovation are reviewed in this paper: (1) innovations in the tools that have become available, specifically tablet technologies; (2) innovations in access methods (eye gaze technologies and brain-computer interfaces); and (3) innovations in output, specifically speech technologies. The opportunities these innovations offer are explored, as are some of the challenges that they imply, not only for individuals with complex communication needs, but also for families, professionals, and researchers.
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Smith M, Hemsley B. Reflections on a special issue: motivations to encourage intervention designs. Augment Altern Commun 2018; 34:255-257. [PMID: 30369256 DOI: 10.1080/07434618.2018.1525764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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von Tetzchner S, Launonen K, Batorowicz B, Nunes LRDDP, Walter CCDF, Oxley J, Massaro M, Stadskleiv K, Yang CK, Deliberato D. Communication aid provision and use among children and adolescents developing aided communication: an international survey. Augment Altern Commun 2018; 34:79-91. [DOI: 10.1080/07434618.2017.1422019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
| | - Kaisa Launonen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Beata Batorowicz
- Faculty of Heath Sciences, School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | | | | | - Judith Oxley
- Department of Communicative Disorders, University of Louisiana at Lafayette, Lafayette, LA, USA
| | - Munique Massaro
- Department of Special Education, Rio Claro Municipality, Rio Claro, Brazil
| | | | - Chih-Kang Yang
- Department of Special Education, National Dong Hwa University Hua-Shih College of Education, Hualian, Taiwan
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Kulkarni SS, Parmar J. Culturally and linguistically diverse student and family perspectives of AAC. Augment Altern Commun 2017; 33:170-180. [DOI: 10.1080/07434618.2017.1346706] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Saili S. Kulkarni
- Department of Special Education, California State University Dominguez Hills, Carson, CA, USA
| | - Jessica Parmar
- Department of Special Education, California State University Dominguez Hills, Carson, CA, USA
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