Speech pathologist perspectives on the acceptance versus rejection or abandonment of AAC systems for children with complex communication needs

Despite the benefits of augmentative and alternative communication (AAC) systems for children with complex communication needs, these systems are not consistently accepted by parents. This study aimed to explore factors that contribute to the acceptance, rejection, or abandonment of AAC systems. Semi-structured interviews were conducted with 16 speech-language pathologists (SLPs) who had introduced at least one AAC system that was rejected or abandoned by the parent of a young child, as well as one that had been accepted. Thematic analysis revealed six themes that describe influences on parent acceptance of AAC systems: (a) The Way Parents View their Child, (b) Parents' Views on AAC Intervention, (c) Support Networks Around Parents, (d) The Capacity of and Demands on Parents, (e) Services Provided by SLPs, and (f) Specific Features of AAC Systems. Themes were largely consistent with the existing literature; however, SLPs raised the novel concept of parent grief and loss as a potential contributor to AAC abandonment. To increase AAC acceptance, SLPs should consider not only the child with complex communication needs, but also the child's parents, the AAC systems available, and their own clinical limitations.