What makes an AAC system robust?: Pediatric speech-language pathologists’ opinions

Abstract

Speech-language pathologists (SLPs) who support individuals who use AAC generally agree that these individuals should have access to a robust system for them to communicate their ideas, wants, and needs (Beukelman & Mirenda, 2013). Robust is a term frequently used in clinical practice, on social media, by people who use AAC (Zimmerman, 2024), and in research literature (Bean, 2019; Binger, Magallanes, et al., 2024). While many sources have articulated different elements of what constitutes a robust AAC system, there is not one clear definition. The purpose of this study was to gain a better understanding of how practicing pediatric SLPs conceptualize and describe what makes an AAC system robust. The primary research question was: how do practicing pediatric SLPs define the features that make an AAC system robust?  Secondary questions included: what are features and examples of robust AAC systems? and why do speech therapists feel an AAC system is robust or not?

Fifteen practicing pediatric SLPs participated in semi-structured interviews. Part 1 of the interviews asked the participants to provide information about their education and training, their considerations when identifying an AAC system, and their descriptions of a system they had found to be robust in their work, as well as a description of a system that they felt was less robust. In Part 2 of the interviews, SLPs were presented with photos and brief descriptions of 11 different AAC systems and asked to share if they found each system to be robust or not, with an explanation of why. Their thoughts were analyzed using a constructivist grounded theory approach with thematic analysis to explore these questions. Some descriptive analysis was also completed related to work setting, AAC features identified, and which AAC systems were found to be robust or less robust.

The results suggest that participating SLPs valued features such as allowing for personalization, core vocabulary, large vocabulary, access to a keyboard, allowing people to communicate different communication functions, fringe vocabulary, and consistent location of symbols amongst other features. Additionally, two larger themes emerged: (a) robust AAC allows people to generate novel utterances, and (b) robust AAC supports all stages of using the system, encouraging learning, personalizing, and buying into a system that facilitates both early use and long-term growth. This study revealed consistencies in how practicing SLPs view robust AAC, and participants provided rich descriptions of how they and their students or clients use robust AAC. Future work should explore the opinions and experiences of people who cannot rely on speech to be heard and understood related to this topic of AAC. This paper has the potential to inform conversations about AAC design, teaching, and learning.

References

Bean, A., Cargill, L.P., & Lyle, S. (2019). Framework for selecting vocabulary for pre-literate children who use augmentative and alternative communication. American Journal of Speech Language Pathology, 28(3), 1000-1009. https://doi.org/10.1044/2019_AJSLP-18-0041

 Beukelman, D. & Mirenda, P. (2013). Augmentative and alternative communication: Supporting children and adults with complex communication needs. Paul H. Brookes Publishing.

 Binger, C., Magallanes, P., San Miguel, V., Harrington, N. & Hahs-Vaugh, D. (2024). How toddlers use core and fringe vocabulary: What’s in an utterance? American Journal of Speech Language Pathology, 33(4), 1718-1747. https://doi.org/10.1044/2024_AJSLP-23-00366