What Parents Say About AAC: South African Parents’ Perceptions of AAC Interventions

Abstract

Parents play a central role in augmentative and alternative communication (AAC) implementation (Moorcroft et al., 2019; O’Neill & Wilkinson, 2020); however, their perspectives remain largely under‑represented in research from Lower‑ and Middle‑Income Countries (LMICs) (Singh et al., 2023) In a multilingual and culturally diverse context, such as South Africa, AAC interventions are influenced by complex systems, socioeconomic, and contextual factors (Abrahams et al., 2019; Dada et al., 2017). This study aimed to explore South African parents’ perspectives on their child’s AAC intervention, including their experiences, perceived barriers and facilitators, and recommendations for improving AAC services.

A qualitative, exploratory design was employed for this study (Leedy & Ormrod, 2020; McMillan & Schumacher, 2014). Purposive, convenience sampling was used to recruit participants (McMillan & Schumacher, 2014) with direct experience with AAC intervention. Eight parents of children who use AAC and attend special needs schools in the Western Cape province of South Africa participated in semi‑structured interviews. Interviews were audio‑recorded, transcribed verbatim, and analysed thematically.

Using thematic analysis (Hseih & Shannon, 2005; Dada et al., 2022) several themes around parents’ experiences with their child’s AAC intervention were identified. Parents described varied and often complex pathways to AAC intervention, influenced by delays in obtaining a diagnosis, fragmented intervention systems, and challenges with accessing early intervention. Parents described themselves as taking a central role in AAC implementation for their children and holding primary responsibility for learning about and sustaining AAC use at home. They reported both emotional strain and a strong commitment as they navigated their child’s communication needs, intervention systems and learning about AAC.

Parents also described meaningful changes associated with AAC use for their children, including improved expressive communication, reduced frustration, and increased participation in daily routines and social contexts. However, they identified multiple challenges that constrained AAC implementation. These included limited access to consistent intervention services, financial barriers, insufficient training and guidance on AAC use, and difficulties accessing and maintaining AAC systems across environments. Some parents highlighted challenges related to the cultural and linguistic relevance of the AAC systems, particularly when systems did not adequately reflect home languages or local contexts.

Alongside these challenges, parents identified factors that supported successful AAC use. These included consistent routines, visual learning strategies, supportive professionals or organisations, and children’s own motivation and problem‑solving abilities. Parents also offered clear suggestions for improving AAC interventions, such as earlier introduction of AAC, more regular and individualised intervention, improved communication between schools and families, and the need for improved access to affordable AAC resources.

The findings highlight the resourcefulness of South African parents and the important role they play in ensuring AAC use across environments. The results also indicate gaps in AAC intervention systems that could contribute to limiting communication opportunities for children who need AAC. The findings of this study highlight the importance of fostering quality parent-professional partnerships and improving access to training and ongoing support for parents. Furthermore, the importance of ensuring that AAC systems are culturally and linguistically appropriate to support effective AAC interventions in diverse LMIC contexts, like South Africa, was highlighted. This study contributes to the limited body of AAC research in South Africa and offers insights to improve AAC intervention.

References

Abrahams, K., Peters, L., Pillay, M., & Kathard, H. (2024). Engaging with injustices: progressively re-orienting our practices in speech-language pathology toward community development. Journal of Clinical Practice in Speech-Language Pathology, 26(3), 267–278. https://doi.org/10.1080/22000259.2024.2412982

Dada, S., ö, K., & Goldbart, J. (2022). Friendship experiences of young adults who use augmentative and alternative communication. International Journal of Disability, Development and Education, 69(3), 951-975

Leedy, P. D., & Ormrod, J. E. (2020). Practical Research: Planning and Design,

Global Edition. Pearson Education, Limited.

McMillan, J., & Schumacher, S. (2014). Research in Education Evidence-Based Inquiry. Pearson.

Moorcroft, A., Scarinci, N., & Meyer, C. (2019). A systematic review of the barriers and facilitators to the provision and use of low-tech and unaided AAC systems for people with complex communication needs and their families. Disability and rehabilitation. Assistive technology, 14(7), 710–731. https://doi.org/10.1080/17483107.2018.1499135

O’Neill, T., & Wilkinson, K. M. (2020). Preliminary investigation of the perspectives of parents of children with cerebral palsy on the supports, challenges, and realities of integrating augmentative and alternative communication into everyday life. American journal of speech-language pathology, 29(1), 238-254. https://doi.org/10.1044/2019_AJSLP-19-00103

Singh, S. J., Mohd Ayob, N., & Hassan, F. H. (2023). Parents’ perception on the use of augmentative and alternative communication by children with complex communication needs in Malaysia. Disability and Rehabilitation: Assistive Technology, 1–9. https://doi.org/10.1080/17483107.2022.2140850