Revisiting Communicative Competence in Augmentative and Alternative Communication

Development of ICF core set to profile communicative competence in dyadic communication among adults who use communication devices in Taiwan

PURPOSE

This study aimed to develop an ICF core set to profile communicative competence in dyadic communication among adults who use communication devices in Taiwan.

MATERIALS AND METHODS

The study was conducted following the release of a manual by the World Health Organisation (WHO) on how to develop the International Classification of Functioning, Disability and Health (ICF) core set in three phases: Preparatory Phase, Phase I, and Phase II. The Preparatory Phase helped collect and sort second-level ICF codes into a candidate list based on different perspectives, including the Systematic Literature Review Phase (i.e., researchers' perspectives), Empirical Multi-Center Study Phase (i.e., clinical perspectives), Qualitative Study Phase (i.e., perspectives of individuals with a health condition), and Expert Survey Phase (i.e., health professionals' perspectives). An ICF core set was developed from the candidate list in Phase I through the Delphi technique, and the content validity of this core set was assessed in Phase II.

RESULTS

Altogether, 94 s-level ICF codes in the candidate list from the Preparatory Phase were included in the three rounds of the Delphi technique for Phase I. Finally, these 94 s-level ICF codes were validated and included in the core set for Phase II, including 28 in Body Functions (b), 0 in Body Structures (s), 42 in Activities and Participation (d), and 24 in Environmental Factors (e).

CONCLUSIONS

The developed ICF core set provides an evaluation tool to profile communicative competence in dyadic communication among adults using communication devices. This core set identifies the gap and future opportunities for further examining the care providers' roles, together with exploring the environmental facilitators and barriers. The implications concerning rehabilitation, limitations, and the way forward are discussed.Implications to RehabilitationThis core set was first developed in the context of Taiwan from the perspectives of adults and professionals who used communication devices to profile communicative competence in dyadic communication.This core set, which can be utilised across health care disciplines, can serve as the foundation for more holistic evaluation, profiling levels of communicative competence in daily dyadic communication among adults who use communication devices.Rehabilitation providers may decide, based on this core set, if communication devices should be proposed for adults again in order to minimise the abandonment of subsidised communication devices.Levels of communicative competence in daily dyadic communication among adults who use communication devices can be profiled through this ICF core set.

Using the ICF Framework to Assess Communicative Competence in Dyadic Communication among Children and Adolescents Who Use Augmentative and Alternative Communication Devices in Taiwan

Augmentative and alternative communication (AAC) devices enable children and adolescents (CAD) with communication disorders to communicate competently and develop friendships through communicative competence (CC). Existing assessment tools are unable to indicate whether CAD aged 0 to 18 years would competently use the subsidized AAC devices provided by the Ministry of Health and Welfare in Taiwan. This study, thus, aimed to develop an assessment tool by using the International Classification of Functioning, Disability and Health (ICF) to measure CC in dyadic communication among CAD using AAC devices. Five speech-language pathologists (SLPs), five special education teachers, and four AAC experts (14 in total) selected codes relevant to the four domains of CC via the Delphi method. Next, they categorized the selected codes into one of the four domains of CC through a face-to-face expert panel. A total of 112 codes were listed in the tool and fully classified into the four domains of CC. Among these, seven codes were concurrently placed under two domains of CC. Consequently, this study developed an assessment tool by employing the ICF for children and youth core set using universal qualifiers to measure the relative levels of CC in dyadic communication among CAD who use AAC devices in their daily life.