A qualitative evidence synthesis of the experiences and perspectives of communicating using augmentative and alternative communication (AAC).
Katherine Broomfield, Deborah Harrop, Georgina L Jones and 2 others
PMID 36026563WHAT IT FOUND
People who use AAC devices value them for more than just sending messages.
They see the tools as key to maintaining their identity and independence. However, frustration arises when synthetic voices lack personality, privacy is limited, or devices fail in noisy environments.
Key findings
01Users describe AAC as central to their sense of 'humanness', providing control, identity, and independence, but also a source of frustration when it fails to capture their personality.
02Outcomes extend beyond basic communication needs to include connecting with others, building relationships, and using devices for non-communication tasks like organization and work.
03Contextual factors heavily influence experience, with device design issues like battery life, portability, and synthetic voice quality often limiting use.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The review excluded people with autism spectrum conditions and social communication difficulties, so findings may not apply to this large AAC user group. Participants under 12 were excluded, limiting applicability to children. Included studies often lacked depth in analysis and failed to report on the researcher's role or reflexivity. The review focused on aided AAC devices; experiences of those using only unaided methods (signs, gestures) are not included. Confidence in evidence was moderate, with concerns about the coherence of findings and relevance of extracted data in some studies.
Declared interests
The authors declared no conflicts of interest. The review was supported by a Patient and Public Involvement group including people who use AAC.
The easy way to misread this
Do not assume these findings apply to all people who use AAC. The review specifically excluded children under 12, people with autism, and those using only unaided communication like sign language. The experiences described relate primarily to aided devices (electronic or paper-based) used by adolescents and adults with motor or acquired communication impairments.