Aim and Objectives: This gap analysis examined the intersection of innovation, inclusion, and advocacy by exploring facilitators and barriers to Augmentative and Alternative Communication (AAC) adoption across India’s north, east, west, central, and south regions. Perspectives from stakeholders like speech-language pathologists (SLPs), special educators, parents of children with diverse developmental conditions (e.g., Autism Spectrum Disorder [ASD], Cerebral Palsy [CP], Intellectual Disability [ID]), and AAC users. The objectives were to: (a) identify facilitators and barriers to AAC implementation; (b) examine gaps in AAC training content and delivery; and (c) analyze stakeholder suggestions for developing and upgrading AAC devices.
Method: The study followed a mixed-method design with quantitative survey followed by qualitative in-depth interviews. Validated questionnaires (16-item for professionals; 26-item for parents) were administered in English, both in person and online (Google Forms). The sample included 100 SLPs, 50 Special Educators, 50 parents of children aged 6-14 years, and 5 AAC users (aged 12–25), selected via purposive sampling across India. Selected 30 stakeholders participated in the in-depth interviews based on the unique responses in the gap analysis survey. Survey was subjected to descriptive statistical analysis. The responses from the interviews were subjected to thematic analysis based on Human Activity Assistive Technology (HAAT) framework (UNICEF, 2021) to explore sociotechnical barriers and inclusive solutions.
Results: 90% of participants identified facilitators supporting AAC implementation, while 71.5% (n = 143) lacked formal AAC training. Systemic barriers were reported by 78.5% of participants, including high device costs, poor device quality, and limited school accessibility. Twenty professionals were unaware of existing indigenous AAC devices. The result revealed a range of factors influencing AAC usage and preferences among professionals. Chi-square tests revealed a significant association between professional designation and the use of battery-operated AAC devices (p<0.001). An independent t-test demonstrated that professionals who attended training programs used AAC sessions more often (p<0.001) compared to those who did not. Thematic analysis revealed financial, cultural, and awareness-related barriers to AAC adoption, despite the existing awareness especially by users and families.
Discussion:
Findings highlight the need for affordable, culturally and linguistically appropriate AAC solutions; integration of AI and machine learning; community-based supports; and systemic advocacy to address structural barriers. Further, providing consistent support in using, updating and upgrading AAC devices is much needed for sustained usage (Beukelman, & Mirenda, 2013). Specific technology related suggestions from the stakeholders will be useful for the developers.
References:
1. Beukelman, D. R., & Mirenda, P. (2013). Augmentative and alternative communication: Supporting children & adults with complex communication needs (4th ed.). Paul H. Brookes.
2. UNICEF. (2021). Framework for building capacity for assistive technology: A comprehensive approach to strengthening access to assistive technology in Europe and Central Asia.
