Speech-language pathologists' practices in augmentative and alternative communication during early intervention.
Emily Lorang, Nell Maltman, Courtney Venker and 2 others
PMID 35422176WHAT IT FOUND
SLPs are most likely to recommend AAC for children with no spoken words, favoring sign language and photos over devices.
They cite caregiver resistance and poor carryover as the biggest barriers, not child ability.
Key findings
01SLPs were significantly more likely to recommend all types of AAC for children not yet using words compared to those producing single or two-word utterances.
02Expressive and receptive language abilities were rated as the most important child factors influencing AAC decisions, significantly more so than diagnosis or chronological age.
03The primary barriers to AAC intervention identified by SLPs were lack of caregiver buy-in and poor carryover across providers.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was recruited via social media and word-of-mouth, which may not represent all early intervention SLPs. The study relied on self-reported practices and perspectives; actual clinical behavior was not observed. Survey terminology for AAC tools was inconsistent, and tablets were accidentally omitted from the 'app or device' option, which may have influenced responses. A significant number of participants skipped the open-ended questions, potentially biasing the reported barriers and factors.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not interpret these findings as evidence that sign language and photos are more effective than speech-generating devices. This study reports what SLPs recommend and why they face barriers, not which interventions produce better outcomes for children.