Parent and speech pathologists’ expectations and experiences in implementing augmentative and alternative communication (AAC) in Ghana

Abstract

This study explored the perspectives of Ghanaian speech pathologists (SPs) and communication partners following participation in an AAC implementation project.  The project was a partnership between an Australian based not-for-profit organisation and the University of Ghana and aimed to support AAC implementation in Ghana. The project included online training for SLPs, mentoring, and donation of mid-tech and high-tech AAC systems to families.

This presentation describes outcomes from the qualitative evaluation, which explored barriers, facilitators, and perceived impacts of the implementation of high-technology AAC in Ghana. Ten SLPs and thirteen communication partners participated in semi-structured interviews conducted by a Ghanaian research assistant at two time points: (1) prior to receiving the AAC system and (ii) six months post-delivery. Thematic analysis was used to analyse data. Interviews were inductively coded by two researchers, using NVivo. Codes were organised into themes using Miro.com boards and collaboratively reviewed by three authors.

The results reflected a complex interplay between contextual, cultural, and systemic factors. Barriers included technological limitations (e.g., electricity, internet), financial constraints, and stigma surrounding disability and AAC. Facilitators included motivated clients, supportive families and schools, and personalised device features including language options. Participants described the impact of AAC on everyday communication, literacy, and participation of the AAC user in community activities. Communication partners played a pivotal role in device use. SLPs described a shift in their own practice, highlighting the importance of ongoing mentoring and training that can be adapted to a Majority World context.

Findings offer insight into the dynamic nature of AAC implementation with specific consideration of needs when introducing high-tech AAC in Majority World contexts. They underscore the need for culturally responsive training, ongoing support, and collaborative approaches to AAC service delivery. This work contributes to a growing evidence base for sustainable AAC implementation in under-resourced settings.