Using a Life Course Approach to Explore How the Use of AAC Impacts on Adult Sibling Relationships

"Filling in the gap": A qualitative case study about identity construction of siblings of youth with a neurodisability

INTRODUCTION

In families of children with a neurodisability, siblings have unique experiences that can shape their identity. There is limited information about the developmental process of how siblings form their identity. This study aims to understand the identity construction of young siblings who have a sibling with a neurodisability.

METHODS

As part of a patient-oriented research program, we engaged with our Sibling Youth Advisory Council in Canada. In this qualitative case study, data from semi-structured interviews augmented by photo elicitation and graphic elicitation of relational maps were analyzed using reflexive thematic analysis.

RESULTS

Nineteen sibling participants (median age = 19 years, range = 14-33 years) reflected on the uniqueness of their role during childhood. During adolescence and emerging adulthood, they became closer with their sibling with a neurodisability and increased communication with their parents about how to care for their sibling with a neurodisability. These experiences influenced how they explored and began to reconcile their sibling identity with their professional and social identities.

CONCLUSION

Siblings of youth with a neurodisability discover their unique identity and require support in this developmental process. Future interventions could evaluate how supports for siblings can have an impact on the positive development of their identity.

Telehealth experiences of providers and patients who use augmentative and alternative communication

OBJECTIVE

We explore the telehealth experiences of adults who use augmentative and alternative communication (AAC) and clinicians who work with people using AAC.

MATERIALS AND METHODS

We conducted semistructured, online interviews with 6 adults who use AAC and 8 clinicians who provide telehealth services to people who use AAC between July and September 2020. Participants were located in the United States and the United Kingdom. All participants had engaged in 2 or more telehealth visits in the past 6 months. We used an inductive, thematic approach to analyze the interview data.

RESULTS

Our findings reveal that (1) telehealth is an essential service, (2) technology causes barriers, (3) policies meant to protect actually inhibit, and (4) remote monitoring devices have the potential to mitigate risks.

DISCUSSION

Telehealth systems created for persons without disabilities do not provide equitable access to everyone. Telehealth should be flexible enough to allow patients to use the communication modality that best meets their needs. We suggest that healthcare systems think of the healthcare ecosystem as one which includes a variety of telehealth options in addition to traditional in-person clinical visits.

CONCLUSIONS

The benefits of telehealth for people who use AAC are substantial and should be an option for ongoing health care. However, the accessibility of telehealth technologies needs to be improved. Designers should view telehealth as part of a broad healthcare ecosystem, which includes in-person, telehealth, and remote health monitoring technologies. Designers should also include AAC users in the design and development process. Telehealth policies should encourage multimodality access to health care and address funding concerns.

The roles of adult siblings in the lives of people with severe intellectual and developmental disabilities

BACKGROUND

Siblings of people with intellectual and developmental disabilities (IDD) often assume key roles to support their brothers and sisters. For people with more significant support needs, siblings may undertake additional roles and responsibilities throughout their lives. The purpose of the present study was to identify and describe the roles of adult siblings who have a brother or sister with severe IDD.

METHOD

Seventy-nine adult siblings from 19 to 72 years of age completed an online survey with open-ended questions about the roles they play in their relationships with their brother or sister.

RESULTS

Thematic analysis resulted in identification of several roles including caregiver, friend (social partner), advocate, legal representative, sibling (teacher/role model), leisure planner and informal service coordinator.

CONCLUSION

Siblings assume key roles in the lives of people with IDD and need support from family and professionals to perform these roles.

Communication styles of persons with ALS as recounted by surviving partners

The purpose of this study was to describe the communication patterns of individuals with Amyotrophic Lateral Sclerosis (ALS) as reported from the surviving spouses' perspectives. Six surviving spouses of people with ALS participated in semi-structured interviews after the deaths of their partners. The interviews were transcribed and coded. Data analysis revealed four primary themes: communication styles, augmentative and alternative communication (AAC) use, decision-making, and lifestyle changes. Spouses described unique changes in communication styles as their partners began to use augmentative communication strategies and devices. AAC devices were described as essential for individuals with ALS with respect to decision making and maintaining social roles. Spouses stated the importance of adapting social activities in order to maintain involvement in the community as well as with family and friends.