FACILITATORS AND BARRIERS OF AUGMENTATIVE AND ALTERNATIVE COMMUNICATION FACED BY SPEECH AND LANGUAGE PATHOLOGISTS
Main Article Content
Keywords
Augmentative, Alternative, Communication barriers, Speech and Language Pathologists
Abstract
The research study was to find out potential barriers and facilitators in the implementation of AAC devices by SLPs. The study design for this study was cross-sectional survey. This study was carried out at Riphah international University Lahore –campus. Data was collected from different cities of Pakistan i.e. Gujrat, Islamabad, Karachi, Rahim Yar khan, Faisalabad, Lahore, Multan, Sheikhupura and some other cities through online Google form and through in face. The study duration was 6 months. The study population included SLPs having at least 6 months of experience with AAC. The sample size for this study was 242 calculated through online calculator. Tool “Confidence and Self-Perceived Competence regarding the utilization of AAC” was used with the permission of author for data collection. There were 29 survey questions.54% of SLPs responded as they have knowledge about AAC as they had studied AAC in their undergraduate and 52.8% had studied in their graduate curriculum but participants reported a number of barriers including caseload on SLPs (46.2%), funding and affordability (73.5%), lack of continuing education credit courses (75.2%), and lack of proper evaluation and assessments for recommending AAC at their job places (45.5%). The responses support the notion that SLPs are generally comfortable using an AAC device with their clients. The main obstacles occur with implementation of AAC assessments and therapy protocols within job places. The sample highlighted several impediments, including a lack of awareness among working SLPs, a heavy caseload, and a lack of CEU courses. Increased AAC continuing education courses would help SLPs learn more about AAC and optimise their use of it in therapy.
References
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13. Boesch MC, Wendt O, Subramanian A, Hsu N. Comparative efficacy of the Picture Exchange Communication System (PECS) versus a speech-generating device: Effects on requesting skills. Res Autism Spectr Disord [Internet]. 2013;7(3):480–93. Available from: http://dx.doi.org/10.1016/j.rasd.2012.12.002
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15. Chung YC, Stoner JB. A meta-synthesis of team members’ voices: what we need and what we do to support students who use AAC. AAC Augment Altern Commun. 2016;32(3):175–86.
16. Dietz A, Quach W, Lund SK, McKelvey M. AAC assessment and clinical-decision Making: The impact of experience. AAC Augment Altern Commun. 2012;28(3):148–59.
17. Barry MJ. Evidence-based practice in pediatric physical therapy [corrected] [published erratum appears in PT MAG PHYS THER 2001 Dec; 9(12); 42]. PT Mag Phys Ther. 2001;9(11):38–53.
18. Tsai MJ. Revisiting communicative competence in augmentative and alternative communication. Folia Phoniatr Logop. 2017;68(5):222–31.
19. Light J, Wilkinson KM, Thiessen A, Beukelman DR, Fager SK. Designing effective AAC displays for individuals with developmental or acquired disabilities: State of the science and future research directions. AAC Augment Altern Commun [Internet]. 2019;35(1):42–55. Available from: https://doi.org/10.1080/07434618.2018.1558283
20. Gilroy SP, Leader G, McCleery JP. A pilot community-based randomized comparison of speech generating devices and the picture exchange communication system for children diagnosed with autism spectrum disorder. Autism Res. 2018;11(12):1701–11.
21. Ganz JB, Parker R, Benson J. Impact of the picture exchange communication system: Effects on communication and collateral effects on maladaptive behaviors picture exchange communication and maladaptive behaviors. AAC Augment Altern Commun. 2009;25(4):250–61.
22. Meder AM, Wegner JR. IPads, mobile technologies, and communication applications: A survey of family wants, needs, and preferences. AAC Augment Altern Commun. 2015;31(1):27–36.
23. Flores M, Musgrove K, Renner S, Hinton V, Strozier S, Franklin S, et al. A comparison of communication using the apple ipad and a picture-based system. AAC Augment Altern Commun. 2012;28(2):74–84.
24. Anderson K, Balandin S, Stancliffe R. Australian parents’ experiences of speech generating device (SGD) service delivery. Dev Neurorehabil. 2014;17(2):75–83.
25. Alamsaputra DM, Kohnert KJ, Munson B, Reichle J. Synthesized speech intelligibility among native speakers and non-native speakers of English. AAC Augment Altern Commun. 2006;22(4):258–68.
26. McNaughton D, Light J. The iPad and mobile technology revolution: Benefits and challenges for individuals who require augmentative and alternative communication. AAC Augment Altern Commun. 2013;29(2):107–16.
27. Fried-Oken M, Beukelman DR, Hux K. Current and future AAC research considerations for adults with acquired cognitive and communication impairments. Assist Technol. 2012;24(1):56–66.
28. Williams MB, Krezman C, McNaughton D. “Reach for the stars”: Five principles for the next 25 years of AAC. AAC Augment Altern Commun. 2008;24(3):194–206.
29. Article O. Knowledge of AAC Devices in Pakistani Speech Therapists. 2015;3(1):17–21.
30. Baxter S, Enderby P, Evans P, Judge S. Barriers and facilitators to the use of high-technology augmentative and alternative communication devices: A systematic review and qualitative synthesis. Int J Lang Commun Disord. 2012;47(2):115–29.
31. Radici E, Heboyan V, Mantovani F, De Leo G. Attitudes and Perceived Communicative Competence: The Impact of Different AAC Means of Communication among Italian Teenagers. Int J Disabil Dev Educ [Internet]. 2022;69(3):976–86. Available from: https://doi.org/10.1080/1034912X.2020.1740185
32. Lorah ER, Holyfield C, Miller J, Griffen B, Lindbloom C. A Systematic Review of Research Comparing Mobile Technology Speech-Generating Devices to Other AAC Modes with Individuals with Autism Spectrum Disorder. J Dev Phys Disabil [Internet]. 2022;34(2):187–210. Available from: https://doi.org/10.1007/s10882-021-09803-y
33. Syriopoulou-Delli CK, Eleni G. Effectiveness of Different Types of Augmentative and Alternative Communication (AAC) in Improving Communication Skills and in Enhancing the Vocabulary of Children with ASD: a Review. Rev J Autism Dev Disord. 2021;
34. Alsari NAM, Alshair AM, Almalik SA, Alsa’ad SS. A survey on the awareness, accessibility and funding for augmentative and alternative communication services and devices in Saudi Arabia. Disabil Rehabil Assist Technol [Internet]. 2021;16(7):789–95. Available from: https://doi.org/10.1080/17483107.2020.1736651
35. Aldabas R. Barriers and facilitators of using augmentative and alternative communication with students with multiple disabilities in inclusive education: special education teachers’ perspectives. Int J Incl Educ [Internet]. 2021;25(9):1010–26. Available from: https://doi.org/10.1080/13603116.2019.1597185
36. Brown MN, Grames LM, Skolnick GB. Augmentative and Alternative Communication (AAC) Use Among Patients Followed by a Multidisciplinary Cleft and Craniofacial Team. Cleft Palate-Craniofacial J. 2021;58(3):324–31.
37. Chua ECK, Gorgon EJR. Augmentative and alternative communication in the Philippines: a survey of speech-language pathologist competence, training, and practice. AAC Augment Altern Commun [Internet]. 2019;35(2):156–66. Available from: https://doi.org/10.1080/07434618.2019.1576223
38. Andzik NR, Chung YC, Doneski-Nicol J, Dollarhide CT. AAC services in schools: a special educator’s perspective. Int J Dev Disabil [Internet]. 2019;65(2):89–97. Available from: https://doi.org/10.1080/20473869.2017.1368909
39. Donato C, Spencer E, Arthur-Kelly M. A critical synthesis of barriers and facilitators to the use of AAC by children with autism spectrum disorder and their communication partners. AAC Augment Altern Commun [Internet]. 2018;34(3):242–53. Available from: https://doi.org/10.1080/07434618.2018.1493141
40. Kulkarni SS, Parmar J. Culturally and linguistically diverse student and family perspectives of AAC. AAC Augment Altern Commun. 2017;33(3):170–80.
41. Alzrayer N, Banda DR, Koul RK. Use of iPad/iPods with Individuals with Autism and other Developmental Disabilities: A Meta-analysis of Communication Interventions. Rev J Autism Dev Disord. 2014;1(3):179–91.
42. Davis L, Copeland K. Computer Use in the Management of Aphasia: A Survey of Practice Patterns and Opinions. Contemp Issues Commun Sci Disord. 2006;33(Fall):138–46.
2. Biggs EE, Carter EW, Gilson CB. Systematic review of interventions involving aided AAC modeling for children with complex communication needs. Am J Intellect Dev Disabil. 2018;123(5):443–73.
3. Sigafoos J, Didden R, O’Reilly M. Effects of speech output on maintenance of requesting and frequency of vocalizations in three children with developmental disabilities. AAC Augment Altern Commun. 2003;19(1):37–47.
4. Broomfield K, Harrop D, Judge S, Jones G, Sage K. Appraising the quality of tools used to record patient-reported outcomes in users of augmentative and alternative communication (AAC): a systematic review. Qual Life Res [Internet]. 2019;28(10):2669–83. Available from: https://doi.org/10.1007/s11136-019-02228-3
5. Drager KDR, Light J, Currall J, Muttiah N, Smith V, Kreis D, et al. AAC technologies with visual scene displays and “just in time” programming and symbolic communication turns expressed by students with severe disability. J Intellect Dev Disabil [Internet]. 2019;44(3):321–36. Available from: https://doi.org/10.3109/13668250.2017.1326585
6. Khan SG, Butt AK, Noreen H, Iftikhar N, Khan M, Azmat R. Perception of speech and language pathologists towards augmentative and alternative communication in Pakistan. J Pak Med Assoc. 2019;69(2):164–7.
7. Moorcroft A, Scarinci N, Meyer C. A systematic review of the barriers and facilitators to the provision and use of low-tech and unaided AAC systems for people with complex communication needs and their families. Disabil Rehabil Assist Technol [Internet]. 2019;14(7):710–31. Available from: https://doi.org/10.1080/17483107.2018.1499135
8. Iacono T, Lyon K, Johnson H, West D. Experiences of adults with complex communication needs receiving and using low tech AAC: An Australian context. Disabil Rehabil Assist Technol. 2013;8(5):392–401.
9. Light J, McNaughton D, Caron J. New and emerging AAC technology supports for children with complex communication needs and their communication partners: State of the science and future research directions. AAC Augment Altern Commun [Internet]. 2019;35(1):26–41. Available from: https://doi.org/10.1080/07434618.2018.1557251
10. Klein C. Communication and Developing Relationships for People Who Use Augmentative and Alternative Communication. Assist Technol Outcomes Benefits [Internet]. 2017;11(1):58–65. Available from: https://manchester.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/communication-developing-relationships-people-who/docview/2067204137/se-2?accountid=12253%0Ahttp://man-fe.hosted.exlibrisgroup.com/openurl/44MAN/44MAN_services_page?genr
11. Light J, Drager K. AAC technologies for young children with complex communication needs: State of the science and future research directions. AAC Augment Altern Commun. 2007;23(3):204–16.
12. Huffman LE. Effects of Augmentative and Alternative Communication on Language Acquisition and Expression In Young Children. Res Pap [Internet]. 2011;(Paper 69):24. Available from: http://opensiuc.lib.siu.edu/gs_rp%5Cnhttp://opensiuc.lib.siu.edu/gs_rp/69
13. Boesch MC, Wendt O, Subramanian A, Hsu N. Comparative efficacy of the Picture Exchange Communication System (PECS) versus a speech-generating device: Effects on requesting skills. Res Autism Spectr Disord [Internet]. 2013;7(3):480–93. Available from: http://dx.doi.org/10.1016/j.rasd.2012.12.002
14. Education S, Disabilities D, June N, Bailey RL, Stoner JB, Parette HP, et al. Division on Autism and Developmental Disabilities AAC Team Perceptions : Augmentative and Alternative Communication Device Use Author ( s ): Rita L . Bailey , Julie B . Stoner , Howard P . Parette , Jr . and Maureen E . Angell Published by : Division on A. 2016;41(2):139–54.
15. Chung YC, Stoner JB. A meta-synthesis of team members’ voices: what we need and what we do to support students who use AAC. AAC Augment Altern Commun. 2016;32(3):175–86.
16. Dietz A, Quach W, Lund SK, McKelvey M. AAC assessment and clinical-decision Making: The impact of experience. AAC Augment Altern Commun. 2012;28(3):148–59.
17. Barry MJ. Evidence-based practice in pediatric physical therapy [corrected] [published erratum appears in PT MAG PHYS THER 2001 Dec; 9(12); 42]. PT Mag Phys Ther. 2001;9(11):38–53.
18. Tsai MJ. Revisiting communicative competence in augmentative and alternative communication. Folia Phoniatr Logop. 2017;68(5):222–31.
19. Light J, Wilkinson KM, Thiessen A, Beukelman DR, Fager SK. Designing effective AAC displays for individuals with developmental or acquired disabilities: State of the science and future research directions. AAC Augment Altern Commun [Internet]. 2019;35(1):42–55. Available from: https://doi.org/10.1080/07434618.2018.1558283
20. Gilroy SP, Leader G, McCleery JP. A pilot community-based randomized comparison of speech generating devices and the picture exchange communication system for children diagnosed with autism spectrum disorder. Autism Res. 2018;11(12):1701–11.
21. Ganz JB, Parker R, Benson J. Impact of the picture exchange communication system: Effects on communication and collateral effects on maladaptive behaviors picture exchange communication and maladaptive behaviors. AAC Augment Altern Commun. 2009;25(4):250–61.
22. Meder AM, Wegner JR. IPads, mobile technologies, and communication applications: A survey of family wants, needs, and preferences. AAC Augment Altern Commun. 2015;31(1):27–36.
23. Flores M, Musgrove K, Renner S, Hinton V, Strozier S, Franklin S, et al. A comparison of communication using the apple ipad and a picture-based system. AAC Augment Altern Commun. 2012;28(2):74–84.
24. Anderson K, Balandin S, Stancliffe R. Australian parents’ experiences of speech generating device (SGD) service delivery. Dev Neurorehabil. 2014;17(2):75–83.
25. Alamsaputra DM, Kohnert KJ, Munson B, Reichle J. Synthesized speech intelligibility among native speakers and non-native speakers of English. AAC Augment Altern Commun. 2006;22(4):258–68.
26. McNaughton D, Light J. The iPad and mobile technology revolution: Benefits and challenges for individuals who require augmentative and alternative communication. AAC Augment Altern Commun. 2013;29(2):107–16.
27. Fried-Oken M, Beukelman DR, Hux K. Current and future AAC research considerations for adults with acquired cognitive and communication impairments. Assist Technol. 2012;24(1):56–66.
28. Williams MB, Krezman C, McNaughton D. “Reach for the stars”: Five principles for the next 25 years of AAC. AAC Augment Altern Commun. 2008;24(3):194–206.
29. Article O. Knowledge of AAC Devices in Pakistani Speech Therapists. 2015;3(1):17–21.
30. Baxter S, Enderby P, Evans P, Judge S. Barriers and facilitators to the use of high-technology augmentative and alternative communication devices: A systematic review and qualitative synthesis. Int J Lang Commun Disord. 2012;47(2):115–29.
31. Radici E, Heboyan V, Mantovani F, De Leo G. Attitudes and Perceived Communicative Competence: The Impact of Different AAC Means of Communication among Italian Teenagers. Int J Disabil Dev Educ [Internet]. 2022;69(3):976–86. Available from: https://doi.org/10.1080/1034912X.2020.1740185
32. Lorah ER, Holyfield C, Miller J, Griffen B, Lindbloom C. A Systematic Review of Research Comparing Mobile Technology Speech-Generating Devices to Other AAC Modes with Individuals with Autism Spectrum Disorder. J Dev Phys Disabil [Internet]. 2022;34(2):187–210. Available from: https://doi.org/10.1007/s10882-021-09803-y
33. Syriopoulou-Delli CK, Eleni G. Effectiveness of Different Types of Augmentative and Alternative Communication (AAC) in Improving Communication Skills and in Enhancing the Vocabulary of Children with ASD: a Review. Rev J Autism Dev Disord. 2021;
34. Alsari NAM, Alshair AM, Almalik SA, Alsa’ad SS. A survey on the awareness, accessibility and funding for augmentative and alternative communication services and devices in Saudi Arabia. Disabil Rehabil Assist Technol [Internet]. 2021;16(7):789–95. Available from: https://doi.org/10.1080/17483107.2020.1736651
35. Aldabas R. Barriers and facilitators of using augmentative and alternative communication with students with multiple disabilities in inclusive education: special education teachers’ perspectives. Int J Incl Educ [Internet]. 2021;25(9):1010–26. Available from: https://doi.org/10.1080/13603116.2019.1597185
36. Brown MN, Grames LM, Skolnick GB. Augmentative and Alternative Communication (AAC) Use Among Patients Followed by a Multidisciplinary Cleft and Craniofacial Team. Cleft Palate-Craniofacial J. 2021;58(3):324–31.
37. Chua ECK, Gorgon EJR. Augmentative and alternative communication in the Philippines: a survey of speech-language pathologist competence, training, and practice. AAC Augment Altern Commun [Internet]. 2019;35(2):156–66. Available from: https://doi.org/10.1080/07434618.2019.1576223
38. Andzik NR, Chung YC, Doneski-Nicol J, Dollarhide CT. AAC services in schools: a special educator’s perspective. Int J Dev Disabil [Internet]. 2019;65(2):89–97. Available from: https://doi.org/10.1080/20473869.2017.1368909
39. Donato C, Spencer E, Arthur-Kelly M. A critical synthesis of barriers and facilitators to the use of AAC by children with autism spectrum disorder and their communication partners. AAC Augment Altern Commun [Internet]. 2018;34(3):242–53. Available from: https://doi.org/10.1080/07434618.2018.1493141
40. Kulkarni SS, Parmar J. Culturally and linguistically diverse student and family perspectives of AAC. AAC Augment Altern Commun. 2017;33(3):170–80.
41. Alzrayer N, Banda DR, Koul RK. Use of iPad/iPods with Individuals with Autism and other Developmental Disabilities: A Meta-analysis of Communication Interventions. Rev J Autism Dev Disord. 2014;1(3):179–91.
42. Davis L, Copeland K. Computer Use in the Management of Aphasia: A Survey of Practice Patterns and Opinions. Contemp Issues Commun Sci Disord. 2006;33(Fall):138–46.
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Sep 5, 2024
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FACILITATORS AND BARRIERS OF AUGMENTATIVE AND ALTERNATIVE COMMUNICATION FACED BY SPEECH AND LANGUAGE PATHOLOGISTS. (2024). Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 195-217. https://doi.org/10.53555/v1j40857
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Author Biographies
Ayesha Fayyaz
Speech language pathologist, Govt special education centre RahimRar Khan
Maryam Nazeer
Speech language pathologist, Govt special education centre Jahania
Beenish Naseer
Speech therapist, Special education center Bhakkar
Hafiza Aqsa Shahzadi
Senior Speech therapist, Sehat Medical Complex- Hanjarwal, University of Lahore
Faryal Ikram
Speech and language pathologist in CMH Multan, CEO of Rehman Rehabilation Center
Madiha Manzoor
Speech and language pathologist at Dear Life Rehabilitation center for specially-abled children and youngsters Lahore
Muzammil Nasir
Speech and language pathologist at Dear Life Rehabilitation center for specially-abled children and youngsters Lahore.
How to Cite
FACILITATORS AND BARRIERS OF AUGMENTATIVE AND ALTERNATIVE COMMUNICATION FACED BY SPEECH AND LANGUAGE PATHOLOGISTS. (2024). Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 195-217. https://doi.org/10.53555/v1j40857