Augmentative and alternative communication services during the COVID-19 pandemic: impact on children, their families and service providers

Use of eye-gaze technology feedback by assistive technology professionals: findings from a thematic analysis

Purpose: Eye-gaze technology offers professionals a range of feedback tools, but it is not well understood how these are used to support decision-making or how professionals understand their purpose and function. This paper explores how professionals use a variety of feedback tools and provides commentary on their current use and ideas for future tool development.Methods and Materials: The study adopted a focus group methodology with two groups of professional participants: those involved in the assessment and provision of eye-gaze technology (n = 6) and those who interact with individuals using eye-gaze technology on an ongoing basis (n = 5). Template analysis was used to provide qualitative insight into the research questions.Results: Professionals highlighted several issues with existing tools and gave suggestions on how these could be made better. It is generally felt that existing tools highlight the existence of problems but offer little in the way of solutions or suggestions. Some differences of opinion related to professional perspective were highlighted. Questions about automating certain processes were raised by both groups.Conclusions: Discussion highlighted the need for different levels of feedback for users and professionals. Professionals agreed that current tools are useful to identify problems but do not offer insight into potential solutions. Some tools are being used to draw inferences about vision and cognition which are not supported by existing literature. New tools may be needed to better meet the needs of professionals and an increased understanding of how existing tools function may support such development.

Examining the Family-Centeredness of Speech-Language Pathologists Working With Children Who Use Augmentative and Alternative Communication

PURPOSE

Family-professional partnerships are important for youth learning to use aided augmentative and alternative communication (AAC). This study examined the family-oriented beliefs and practices of speech-language pathologists (SLPs) working with preschool and school-aged children learning to use aided AAC (aged 3-21 years), specifically during the COVID-19 pandemic.

METHOD

Participants were 25 SLPs who participated in an individual semistructured interview. Qualitative analysis was used to identify and describe groups of SLPs based on commonalities and differences in their beliefs and practices working with families. The characteristics of SLPs in each group was also explored descriptively (e.g., race/ethnicity, work setting, caseload).

RESULTS

SLPs clustered into three groups based on their beliefs and practices: (a) professionally centered, (b) family-allied, and (c) family-focused. SLPs varied across these groups in how they planned services, offered training/coaching, communicated, shared resources, offered emotional support, and adapted to and with different families.

CONCLUSIONS

Findings indicate the need to support greater family-centeredness in AAC services by building on the strengths of SLPs in the field. Promoting strong family-professional partnerships could in turn improve outcomes for students who use AAC.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25044125.

Views of Parents on Supporting Language and Literacy for Their Children With Complex Communication Needs

PURPOSE

Understanding students' home literacy environments can help speech-language pathologists, teachers, and other educators partner with families to promote language and literacy learning. This study focused on gaining insight into the views of parents of elementary-age students with intellectual and developmental disabilities who had complex communication needs related to supporting children's language and literacy learning in the home.

METHOD

This qualitative study was conducted during the COVID-19 pandemic, when many schools were utilizing remote or hybrid learning arrangements. Participants were 37 parents of students with complex communication needs in kindergarten to fourth grade. Most children had either autism or Down syndrome, and they ranged from primarily communicating prelinguistically (e.g., gestures and nonword vocalizations) to using some two to three word phrases in different modes (e.g., speech, sign, and aided augmentative and alternative communication [AAC]). Each parent was interviewed three times over the 2020-2021 school year, and data were analyzed using an inductive qualitative approach.

RESULTS

Findings showed patterns of commonalities and differences in parents' experiences, including related to their (a) goals and values about communication, language, and literacy; (b) perceptions and experiences with roles supporting language and literacy; and (c) satisfaction with supports and progress in these areas.

CONCLUSION

This study provides important insight into the views of parents related to home literacy that can be used to improve the design and delivery of interventions for school-age students with complex communication needs and their families.

Augmentative and Alternative Communication Services During the COVID-19 Pandemic: Contextual Determinants of the Parent-Speech-Language Pathologist Partnership

PURPOSE

The COVID-19 pandemic caused significant changes for family-professional interactions. Many services shifted to telepractice, with new opportunities for parents and speech-language pathologists (SLPs) to partner for service delivery. Parent-coached models of augmentative and alternative communication (AAC) intervention provide positive outcomes for children; however, SLPs have reported difficulty building strong partnerships with families. The shift to telepractice during the COVID-19 pandemic provided a unique context to examine factors influencing parent-SLP partnerships, particularly for parents with children who use aided AAC.

METHOD

Twenty-five parents and 25 SLPs who engaged in services with children and youth from 3 to 21 years of age who used aided AAC during the initial stages of the COVID-19 pandemic in June 2020 participated. Semistructured interviews were conducted individually with parents and SLPs to understand perspectives on whether the change in service delivery facilitated or hindered family-oriented practice. Inductive qualitative analysis was used to analyze information about the factors impacting parent-SLP partnerships.

RESULTS

The parent-SLP partnership was influenced by setting and systemic determinants, and intrinsic determinants to the parent and the SLP that included their history and rapport, beliefs about partnering, and knowledge and skills. These determinants served as barriers or facilitators to their partnership.

CONCLUSIONS

It is essential to consider the relationship, expectations, and knowledge and skills that SLPs and parents bring to the partnership, along with extrinsic structural factors that can impact this partnership. Positive rapport, valued partnership, and an openness to sharing knowledge through teaming and collaboration provided for positive parent-SLP partnerships.