The AAC Connect Project was designed to address significant challenges in Alternative and Augmentative Communication (AAC) for children with special needs. Focused on fostering community engagement, the program aimed to bridge the gap between AAC device use in schools and at home. With a particular emphasis on empowering families, the Project sought to enhance caregiver’s skills, facilitate networking among carers and parents, and provide solutions to common challenges in communication. The Project involved three main stages, each contributing to the overarching goal of improving communication support for children with AAC needs. The AAC Connect Program was facilitated by Allied Health Partnerships.
The Project was developed between October 2020 to February 2024 with 3 main stages.
The Stage 1 Pilot Study ran from February to April 2021 at a School for Specific Purposes (SSP). Stage 2 was initiated in 2022, however was not put into effect until April 2023 due to an initial lack of uptake from parents and the restrictions of COVID-19 lockdown. A secondary phase was run again in April to October 2023.
Finally, Stage 3 of the project aimed to consolidate previous goals and obtain valuable feedback from parents was completed in January and February 2024.
The contents of this report include:
- Methodology
- Findings
- Implications and Recommendations
- Conclusion
Methodology
The AAC Connect Program was designed to run in 10-week cycles and included the following:
- A 1-hour presentation to discuss practical skills that can be used in the home to help parents and carers utilise their child’s AAC device.
- A 1-hour face-to-face small group parent and carer peer session to problem solve and engage in conversation based on their specific AAC device.
- 2x 1-hour individual coaching sessions provided to each parent/caregiver to help increase their knowledge around their child’s specific AAC device.
- Access to a private Facebook page allowing parents to engage with one another on wins and challenges encountered at home when communicating with their children using the AAC device. Families were provided the opportunity to be able to ask questions to one another, help each other problem solve and post up any concerns/queries they wish the Allied Health Partnerships clinician to answer.
- Pre and post interviews/questionnaires for data collection.
During 2023, adjustments were made based on feedback from the previously run programs. Notably, it included practical skills education in the initial webinar and 2x additional 1-hour sessions with parents. These adjustments were made to ensure that the needs of both children and families using AAC devices were effectively met, and to enhance their familiarity and usage of these devices.
A significant change was implemented in July 2023, due to a lack of parent availability for joining the program. The Initial group presentation was recorded and uploaded to YouTube. This link was then shared among all schools currently serviced by Allied Health Partnerships and to all private clients seen at One Stop Allied Health. This totalled 13,695 families. The YouTube clip directed viewers to sign up for the program after viewing, which resulted in more participants joining the program in September 2023.
During Stage 3, the AAC Connect Program was finalised through:
- A 1-hour face-to-face parent-learning session with clinical application tailored to the child’s needs.
- A 1-hour morning tea dedicated to fostering a social environment for parents and carers to interact and connect.
- A one and a half-hour Speech Pathology and Occupational Therapy group session for children utilising AAC devices focusing on enhancing their communication skills and overall development.
- A Christmas Party where families were invited to connect with each other and celebrate the end of the year together. 30 families attended the afternoon tea and games.
- All Schools for Special Purposes (SSPs) in NSW were contacted and invited to join in an information session about AAC. Schools were offered a live information session, a link to a live online session or a link to a pre-recorded session via YouTube.
- Collection of feedback on Stage 3 and overall AAC Connect Program.
Findings
The AAC Connect Program was implemented three times across Stage 1 and 2 with a total of 40 families actively participating in some capacity and 18 families completing the full program. Another 165 views have been registered through the YouTube webinar, which has allowed many more families to access the information and empower them to advocate for their child who is using AAC. Through formal and informal data collection, the project identified the following:
Confidence Building and Community Connection:
Participants successfully overcame initial reservations, gaining confidence in sharing their experiences and concerns. Families established connections, contributing to a supportive community atmosphere, particularly noteworthy in the post-COVID-19 context. Parents were most interactive in face-to-face contexts. Consistently, there was noticeable resistance, and at times, apprehension, in connecting with others in the community. However, this changed to a sense of pleasure and relief once the connection was facilitated.
AAC Usage- Understanding and Skill-Building
Participants enhanced their understanding and skills related to AAC usage and were provided evidence-based research supporting AAC use in children of varying age and capability levels. Families acknowledged the significance of improving language skills in children utilising AAC devices alongside verbal communication. Additionally, participants gained insight and confidence in expanding vocabulary on AAC devices.
Shifted Perception
There was a perceptual shift among families who initially questioned the efficacy of utilising AAC devices at home, preferring familiar gestures. However, families later recognized the long-term benefits of consistent AAC usage and acknowledged the evidence supporting it’s connection with verbal communication or ability to participate successfully in academic, social and community contexts. Additionally, families came to understand the potential of AAC devices for bidirectional communication beyond child-to-parent interactions.
Program Perceived as Beneficial:
The program was widely perceived as beneficial, even in the face of logistical challenges. Despite initial limited understanding, participants tended to agree with clinician-recommended AAC devices or changes, even if this caused frustration or confusion for the parent. The increased knowledge and skills of parents has empowered parents to advocate more confidently for their child in sessions or at school.
Identified Limitations and Barriers to AAC Usage
The following barriers to AAC usage were consistently found or reported during the program:
- AAC Usage in School Contexts/ Teacher Participation
Overarching barriers emerged concerning the implementation of AAC devices in school settings, particularly when teachers lacked familiarity with specific devices. Strategies and coaching were sought to actively involve teachers in facilitating device usage at school. - Variability in Speech Pathologists in the Community
Prolonged waiting times for Speech Pathology services further impeded the continuity of support. Families encountered challenges associated with inconsistent clinician messages and diverse clinician approaches. - Device Use at Home
Families encountered difficulties in incorporating AAC devices into their well-established home routines, perceiving the effort as challenging and seemingly inconsequential. Verbal or gestural communication was often more functional for busy households.
Limitations and Barriers of the Project:
The project faced challenges in terms of its limited reach. Although advertised throughout schools in Sydney and Rural NSW, parent interaction with mediums sent through school platforms was low, resulting in minimal uptake. A significant dropout of parents from the program also occurred, attributed to lack of family’s availability or issues with their children, such as prolonged illness leading to extended school absences.
Understanding the needs of parents revealed a crucial factor: many parents utilise the time their child spends at school for personal activities or work. This dynamic must be considered, as some parents may be unwilling to sacrifice this time, highlighting the importance of recognising their overall situation and needs at any given time. However, conflicting appointments and social engagements outside of school hours pose further barriers to attendance.
These logistical challenges resulted in the non-completion of certain program components, including final parent meetings and/or post-program questionnaires.
Privacy concerns emerged as a deterrent to participation in online forums, limiting opportunities for extended support and interaction among parents.
Understanding these achievements and limitations emphasises the need for targeted interventions and ongoing support to address specific challenges encountered by families using AAC devices.
Implications and Recommendations:
The results of the project provide valuable insight into the areas in which parents and caregivers of AAC users need support and the common challenges that arise for families.
A central theme identified was the emotional challenges associated with AAC use. Frustration arose from a lack of understanding about the device, including issues related to adding words, device functionalities, and challenges with classroom implementation. Confusion was a common sentiment, with participants feeling uncertain about incorporating new vocabulary and using the device for longer sentences. Additionally, sadness and concern were expressed about a child’s inability to master the AAC device due to school-related limitations. Some families conveyed distress over extended waitlists and difficulties accessing direct support. These emotional complexities underscore the varied obstacles participants face and emphasize the necessity for personalized interventions and robust support structures.
While some barriers to effective AAC usage are inevitable, it is clear that best practice can and should involve a high level of parent and caregiver support. Parent/caregiver’s education and training had a significant shift in the confidence, comfort and use of AAC for families participating in the program.
It was clear that a lack of knowledge and skills into the purpose and use of AAC relieved some of these heavy emotions or empowered parents for advocacy and decision-making.
It is recommended that parents and carers are provided with further resources, including further training of their device, knowledge of where they can go to for advice and information and access to face-to-face groups so they can meet up and discuss questions and concerns if they do not feel comfortable posting online.
More device-specific parent and caregiver training should include:
- How to add new vocabulary, placement of the vocabulary and selecting words or phrases that would be most appropriate for their child
- How to teach their child new vocabulary
- Adding pages and linking it to current words on the device
- How to generate reports to gather data of mostly searched and used terms
- How they can use the device when communicating with their child
- How to encourage teachers to use the device
- Using the device in different settings
Alongside parent and caregiver training, teacher training is a crucial aspect of holistic and efficacious care for children using AAC devices. Teachers must be supported in understanding different AAC devices, using communication devices in the classroom and implementing communication goals set by parents in conjunction with their clinician.
Conclusion
In conclusion, the AAC Connect Program has revealed vital insights into the challenges faced by parents and carers in facilitating effective communication for their children using AAC devices. The identified limitations and barriers underscore the need for continuous refinement and adaptation of the program. The recommendations outlined aim to address these challenges, ensuring ongoing support, increased engagement, and improved communication strategies for families in future iterations of the AAC Connect Program. The project serves as a foundational step toward fostering a supportive community and enhancing communication outcomes for children with AAC needs.
Allied Health Partnerships is actively integrating AAC Education and Parent Connection into our standard practices and policies, aiming to enhance our service delivery model and provide optimal support for parents of AAC users and holistic care.