Bridging the gap from values to actions: a family systems framework for family-centered AAC services (summary)



The importance of family-centred interventions that recognise and acknowledge the differences between families and the roles all family members have to play in the success of input for people with additional needs have been increasingly recognised as important in the delivery of augmentative and alternative communication (AAC) services.

Family structures are increasingly diverse and studies have found that AAC intervention practices often lack family-centredness often being more professionally centred.

Professionals often intend to offer family-centred AAC services but face various and numerous challenges in delivering them. Challenges include lack of knowledge, skills and tools to deliver family-centred services effectively, particularly not understanding that this is more than simply having contact with families, but involves recognising the ‘centrality of the family’ and supporting and strengthening family ‘capacity to enhance the child’s communication’.

As a gap exists between the recognition of the need for family-centred practice and actual AAC service delivery professionals need support to establish collaborative family-professional relationships.

This paper had three aims:

  • to propose a theoretical framework to guide AAC services
  • to use research into family views to show the relevance of the framework for AAC services
  • to discuss clinical implications and offer suggestions for family-centred practice in AAC

The paper focusses on a small number of the elements of family systems and ecological systems theory that are most relevant to AAC service delivery. Alongside the theoretical framework some clinical tools are suggested to support professionals implementing family-centred interventions. It also stresses that the unique characteristics of each family must be considered.


What did they do?

The authors produced a theoretical framework showing how family systems theory applies to children who have complex communication needs (CCN); viewing the family as an interconnected system, interlinked and interdependent. Different family members; parents, siblings, grandparents etc. form ‘subsystems’ that vary depending on who are the important people in the child’s life,

The family must be viewed as a whole rather than individual members (wholism). The framework assumes that the family system is all affected by the environment and events in it and adjusts to maintain balance (homeostasis).

In addition families exist and interact and change in other contexts such as local communities, schools etc. People in these different ‘systems’ around the child can be significant influences on the child and family, for example a child’s ‘microsystem’ might include carers, siblings, extended family plus neighbours, friends etc.

The paper looks at and defines various components (subsystems) and processes that can influence families, discusses the implications of these for children who use AAC and offers suggestions for professionals to support the delivery of family-centred services.



Family involvement in AAC service delivery can be challenging, but not involving the family can have negative effects. The authors suggest that their theoretical framework can be used to improve understanding of a child’s family systems and so the environment in which they develop and communicate.

The framework suggested tools/assessments that can lead to improvements in the implementation of family-centred services based on established principles. This should lead to better professional support for children who rely on AAC and their families.

Things you may want to look into:

‘‘It’s got to be more than that’’. Parents and speech-language pathologists discuss training content for families with a new speech generating device

Alternative service delivery models for families with a new speech generating device: Perspectives of parents and therapists

Added to site April 17