Parents’ perceptions of barriers and facilitators to the implementation of Augmentative and Alternative Communication : a scoping review

Abstract

Background: Parents’ involvement is essential for their children’s successful use of augmentative and alternative communication (AAC) devices. When implementing AAC in their daily lives, children with complex communication needs (CCN) and their parents face multiple barriers, which may impact their use of AAC. Parents also report facilitators of AAC implementation which may increase the use of AAC. The aim of this qualitative meta-synthesis was to describe parents’ perceptions of barriers and facilitators in the implementation of aided and unaided AAC for children with CCN who use AAC. Methodology: A qualitative meta-synthesis approach was used summarize the literature. A systematic approach was used to identify studies that met the inclusion criteria. The 14 studies that met these criteria were critically evaluated using the JBI Critical Appraisal Checklist. Barriers and facilitators as reported in the studies were mapped onto the Participation Model. The Participation Model is a systematic approach used to implement AAC through assessment and intervention. The approach emphasizes the necessity for professionals to identify barriers and facilitators to participation for children who use AAC. Results: Results indicate that the majority of studies included the perspectives of both parents (i.e., mothers and fathers). Aligned with the Participation Model, most barriers and facilitators reported by parents were opportunity related, specifically practice barriers and/or facilitators. Access barriers were only mentioned in four studies. The most significant barriers to AAC implementation as reported by parents were (a) professionals’ lack of knowledge of AAC; (b) professionals’ lack of skills regarding the use of AAC devices; (c) time constraints that hampered parents’ effective implementation of AAC; (d) the financial cost of AAC devices; and (e) parents’ acceptance of AAC devices.

Conclusions: By identifying the barriers to and facilitators of the use of AAC as experienced by children with CCN and their parents, professionals can be better equipped to provide the necessary support for the successful implementation of AAC devices. Suggestions are provided for future research directions.