An Investigation of SLP Knowledge Related to Assessment and Management of AAC in Persons with Aphasia: A Survey Study
Introduction
Persons with aphasia (PWA) frequently face challenges in expressing themselves, limiting their participation in daily communication. Although various cognitive-linguistic therapies exist, their success often depends on the severity and location of brain lesions. Augmentative and Alternative Communication (AAC) provides a compensatory method for such individuals, helping them express basic needs, share information, and maintain social interaction through aided systems like communication boards or high-tech devices.
Evidence indicates that PWAs have a reduced quality of life, poorer health outcomes, and limited involvement in healthcare settings due to communication barriers. Studies (Gormley et al., 2018; Bartlett et al., 2008) show that AAC can address some of these challenges, especially for those not benefiting adequately from traditional speech-language therapy. While AAC has primarily been viewed as a compensatory rather than restorative tool (Jacobs, 2004; Kraat, 2021), emerging research suggests it may support language recovery in some individuals. However, there is limited consensus on its effectiveness in early recovery stages, and many SLPs report discomfort or lack of training in AAC assessment and management (Hurtig, 2013; Dietz et al., 2012).
Need for the Study
Despite AAC’s growing relevance, most speech-language pathologists (SLPs) lack adequate knowledge and training in its assessment and application, especially for PWAs. This study aimed to explore SLPs’ knowledge regarding AAC use for aphasia and to identify areas requiring further training and support.
Aim and Objectives
The primary aim was to investigate SLPs’ knowledge of AAC assessment and intervention in PWAs. Specific objectives included comparing SLPs’ basic understanding of AAC in assessment and intervention domains.
Method
A total of 115 experienced SLPs working across institutions, hospitals, and clinics participated in this survey-based study. The study was conducted in three phases. Phase I involved the development and validation of a questionnaire covering demographics, AAC basics, assessment, and intervention. The tool used Likert-scale and multiple-choice questions and was validated by five experts in aphasia. In Phase II, the questionnaire was distributed both online and in print. In Phase III, responses were analyzed both qualitatively and quantitatively.
Results and Discussion
Results revealed that while most SLPs agreed AAC is useful for PWAs with severe expressive impairments, only 30% felt confident in their knowledge of AAC techniques and outcomes. In the assessment domain, 60% emphasized evaluating motivation and willingness before recommending AAC, and 70% linked assessment parameters to aphasia type and severity. However, only 40% felt confident conducting AAC assessments. A significant number (90%) noted that cognitive-communication impairments complicate AAC assessment. In the intervention domain, all SLPs supported using both low-tech and high-tech AAC tools. Forty percent believed AAC benefits all aphasia types, particularly global aphasia, and could be used as early as 4–6 weeks post-stroke. Factors like caregiver support, training, and communication opportunities were seen as critical to success.
Statistical analysis showed a significant difference between basic knowledge and assessment scores (p<0.05), while no significant difference was found between assessment and intervention domains, suggesting surface-level understanding across both.
Conclusion
SLPs generally hold a positive attitude toward AAC use in PWAs but exhibit limited confidence and knowledge in assessment and outcome evaluation. The findings highlight the urgent need for targeted training programs to enhance AAC-related competencies among SLPs.
