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Non-electronic communication aids (summary)

Low
technology
communication

Background There are two main types of communication aids. High-tech, or electronic, communication aids include speech-generating devices with a variety of ways to generate messages. Low-tech, or non-electronic, communication aids do not have speech output functions and also lack other features that may assist the speedy generation of messages.

What was the aim of the study? This paper aimed to explore whether international policy on communication aids supports access to both electronic and non-electronic aids, to report evidence from a pilot project on non-electronic communication aids, to determine whether research literature provides evidence in support of non-electronic versus electronic communication aids and to comment on the challenges in providing outcome measures relevant to policy and evidence-based practice.

Why was the paper written? Both electronic and non-electronic communication aids can form successful AAC strategies for individuals with disabilities. However, there is some evidence that individuals who lack sufficient speech skills to meet their daily needs are more likely to access non-electronic than electronic communication aids. It is unclear whether current policy and the research literature adequately addresses both electronic and non-electronic forms of communication aids.

What did the authors do? The authors reported information from a variety of sources in order to address their aims. They reviewed the literature to identify papers relevant to their research, and they reported the results of surveys that had been carried out in many different places across the globe. They also reported some original findings that evaluated a trial programme in Victoria, Australia to provide non-electronic communication aids to adults with complex communication needs, the Non-Electronic Communication Aids Scheme (NECAS).

What did they find? Though both electronic and non-electronic communication aids can benefit those with communication needs, government funding often addresses only electronic communication aids, and discussion in the literature focuses on the purchase and supply of electronic aids. In developed countries, included Australia, Canada and the United States, available funding for communication aids often does not cover the whole cost of a device, leaving individuals who need a communication aid to fund a substantial portion of the total cost themselves. The multi-agency nature of work around the provision of communication aids makes it difficult for individuals to obtain appropriate assessment, training and support in using their communication aid.

The NECAS project in Australia received more requests for communication aids than it was able to meet, illustrating the very high demand for services in the area of AAC. Most communication aids provided under this scheme went to adults with developmental disabilities, and speech and language therapists were most often the source of the request. Other individuals who received aids from the NECAS project included adults with cerebral palsy, aphasia, traumatic brain injury and degenerative diseases. This demonstrates the wide range of individuals who could benefit from this type of communication aid service.

The authors identified 205 published studies that addressed electronic and non-electronic communication aids. The majority of research pertained to electronic communication aids, followed by research that addressed both types of communication aids. The least amount of research focussed exclusively on non-electronic communication aids. Most research also pertained to individuals with developmental disabilities, though information on adults with acquired disabilities, combined diagnoses and no disabilities was also available. This literature consisted mostly of case studies of individual participants. This is problematic because this type of research does not allow authors to make causal claims about the use of AAC; for example, even if positive outcomes are reported after an AAC intervention, the methodology does not allow the researcher to claim that they resulted from the use of AAC. There is also limited evidence available on individual diagnoses and how generalizable such findings are outside the very contrived research setting.

The most successful AAC intervention makes a positive impact on the everyday communication of an individual. However, it is difficult to find measures that represent this outcome. Several authors have suggested that a variety of people related to an AAC intervention be involved in determining its goals, methods and evaluation, including the client, communication partners, peers and family. There is only limited evidence that this suggestion has been taken up be those implementing and reporting on AAC interventions, and lack of doing so can lead to negative experiences with AAC.

Conclusions: Future research needs to address the extent to which non-electronic communication aids assist the functional communication and social participation of adults with disabilities. The policy and literature relating to communication aids is dominated by a focus on electronic aids, but this does not necessarily reflect demand from adults with disabilities, who may choose a non-electronic aid to best fit their personal circumstances. Future research should also include outcome measures relevant to funding bodies in order to support the continuation of services for those who need communication aids.


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Added to site January 2014


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