Development and evaluation of an augmentative and alternative communication training for caregivers of young children in a low-income rural context of South Africa

Abstract

This study employed an exploratory sequential mixed method design to develop and evaluate a programme aimed at training Vhavenda caregivers of children living in low-income contexts to implement augmentative and alternative communication strategies with their children aged 2-6 years living with complex communication needs. In the exploratory phase, a scoping review of the literature as well as interviews with cultural stakeholders generated data that informed program design undertaken during the development phase. The development phase also comprised an expert review and pilot study to further refine the programme. The evaluation phase entailed testing the effects of the programme on three caregiver and two child variables by means of a single case multiple probe design across three caregiver-child dyads. The social validity of the programme was also evaluated. Medium to strong effects of the intervention on the five variables were established but were not maintained three weeks post intervention. Social validity of the programme was found to be high. The caregivers were able to implement the strategies taught during the guided practice phase, attesting to the effectiveness of the intervention. The fact that skills were not maintained post intervention may point to a need for a longer period of support in order to firmly establish the behaviours