Views of young people using augmentative and alternative communication systems

Children with physical impairments who cannot use intelligible speech are o ften recommended augmentative and alternative communication (AAC) systems. In England and Wales, it is usually the job of speech and language therapis ts to support development in AAC skills. This paper reports findings from d iscussion with children and young people who use AAC systems concerning the ir attitudes and opinions towards the organization of speech and language t herapy, the role of the speech and language therapist in school and issues concerned with AAC systems themselves. Six young adults and 17 children fro m London education authorities were interviewed on a one-to-one basis and i n focus groups. Children were interviewed who had a communication aid incor porating at least 20 symbols and/or pictures and/or written words, language understanding at the two-word level and above, i.e. they demonstrated unde rstanding of adult requests with at least two information carrying words. F or children using communication aids, it is conceivable that their communic ation systems do not contain appropriate symbol vocabulary to express compl ex ideas, opinions and feelings. Consequently, a symbol-based interview too l was designed to allow children to express complex issues through visual m eans. Most children interviewed reported that their AAC system was useful t o them. Further analysis of opinions revealed that negative attitudes towar ds AAC systems were primarily associated with operational issues (technical skills required to operate an AAC system) and issues of self-image/identit y, and to some degree, with a lack of perceived benefit in interaction. In apparent contrast to therapists' preferred models of working, children and young people identified a preference for therapy organized on a one-to-one basis targeting Linguistic and operational skills. It is suggested that mor e acceptable and individualized design of AAC systems could have implicatio ns for their use in school and other contexts. The value of service users' views in service planning and evaluation are discussed.