Barriers and Facilitators to Success Using High-Tech Augmentative and Alternative Communication (AAC) Devices with Children with Autism Spectrum Disorder (ASD): An Interview Study Examining Stakeholder Perspectives

Background: Children with a diagnosis of ASD and limited speech often use high-tech AAC devices or applications as their primary mode of communication. A wide range of factors is associated with successful implementation of AAC across the home, school and community environments. In particular, stakeholders such as family and a range of supporting professionals play an integral role in the successful selection, training and implementation of AAC technology for children with ASD. Among the key players in the process are parents, AAC specialists, teachers, speech and language pathologists and behaviour analysts. These stakeholders approach AAC interventions with different aims, priorities and methods. This qualitative interview study employs a social constructivist perspective to examine the experiences and key factors associated with AAC success and failures among a unique range of stakeholders involved in supporting children with ASD.

Objectives: The objective of this study was the exploration of experiences, barriers, and facilitators to success across a range of supporting stakeholders involved in supporting children with ASD to use high-tech AAC devices.

Methods: Eleven parents and practitioners with extensive experience supporting children with ASD using high-tech AAC devices and applications participated in this study. Individual semi-structured interviews were carried out in order to access rich descriptions of barriers, and, facilitators to using high-tech AAC with this population. The interviews were recorded, transcribed verbatim and analysed thematically as per Braun and Clarke (2006). Double coding of the interviews was used to ensure rigour.

Results: Analysis revealed nine prominent themes providing insight into important features of AAC devices for this population, barriers to successful communication outcomes, and stakeholder perspectives on features of effective AAC training and implementation. Participants shared many common concerns, but the data also revealed some diversity of views. Themes and sub-themes are described with illustrative and representative quotes.

Conclusions: Findings illustrate the multitude and complexity of factors and perspectives involved in successful support and implementation of AAC device use for children with ASD. The participants in this study approach AAC interventions differently, however, they share many of the same aims, goals, and experiences. Awareness of these shared insights may be useful to focus family and practitioners when planning and implementing AAC interventions. This research lead to the development of a questionnaire used in a Delphi study identifying factors associated with successful AAC device and intervention selection and implementation for children with ASD