Supporting Communication Access of People With Communication Disabilities and Communication Differences in UNCRPD-Ratified Countries: An Integrative Review.
Áine Kearns, Caroline Jagoe, Rachael Stockdale and 7 others
PMID 40742753WHAT IT FOUND
Communication access lacks a shared definition across 11 projects, which stalls implementation.
Training and exposure to Deaf or disabled groups build staff confidence more than policy alone. Pen and paper are insufficient adjustments for Deaf people. Clear records of patient communication needs are essential.
Key findings
01Only four of the eleven included projects attempted to define communication access, and their definitions varied significantly, creating a barrier to widespread implementation.
02Healthcare professionals' direct exposure to groups with communication disabilities, such as the Deaf community or adults with intellectual disabilities, was identified as a more powerful driver for changing attitudes and building confidence than training and education alone.
03Pen and paper communication was explicitly rejected as a sufficient 'reasonable adjustment' for Deaf people, with arguments that an ineffective adjustment cannot be considered reasonable.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review only included English-speaking countries, excluding data from other regions that might offer different models of accessibility. Only 11 papers were included, and many were commentaries or grey literature rather than robust empirical studies. No quality appraisal tool was used because the literature types were too heterogeneous, so the strength of evidence for each included study is unknown. The search was limited to publications from 2007 to 2023. Most included projects did not report community engagement, limiting the understanding of how patient perspectives shape these initiatives.
Declared interests
The authors declare no conflicts of interest. The review was part of the ENSPIRED project, which aims to explore social participation for people with communication disabilities in Ireland.
The easy way to misread this
Do not interpret the lack of consensus on 'communication access' as a sign that current practice is flexible and adaptable. The review suggests this ambiguity is a barrier to implementation. Furthermore, do not assume that providing written information is an adequate adjustment for all patients; for Deaf individuals, this was specifically deemed insufficient.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →