The aim of this study was to describe how professionals from multiple disciplines (e.g., speech-language pathologists, teachers, occupational therapists) in the United States reported challenges they face in delivering services to children with cortical visual impairment (CVI) who use augmentative and alternative communication (AAC). Three surveys were utilized to identify barriers to and priorities for improving educational and clinical services and in-service and preservice education from the perspectives of professionals in school, community, and university settings. Results suggest that current service delivery models may not be meeting the needs of either children with CVI who use AAC or the professionals whose job it is to provide them with services. Professionals in community-based settings appeared to encounter more barriers. Findings help to support a discussion about approaching AAC interventions for children with CVI who use AAC by adopting interprofessional collaborative practice (IPCP) and interprofessional education (IPE) models, which reflect long-standing best practice guidelines for AAC service delivery and are encouraged by multiple professional organizations.

Purpose: Cortical visual impairment (CVI) is the most common cause of visual impairment in children today and can impact the outcomes of children who rely on augmentative and alternative communication (AAC). This study provides baseline data of 13 children with CVI who used AAC during their first year of participation in an integrated CVI program. One purpose was to describe similarities and differences in the student's demographic, functional vision, communication, and educational profiles. A second purpose was to examine differences in students described with different communicator profiles. Method: Archived student records were de-identified and reviewed using a systematic coding scheme. Two researchers independently reviewed and coded all student records. Reliability was established. Measures included CVI Range scores; supports for positioning, mobility, vision, and writing; AAC systems, including modes, access methods, and language representation; communicative competence; self-determination; literacy; and mathematics. Results: The study yielded a rich description of similarities and differences among students at baseline and led to careful consideration of differences among the participants with emergent communicator and context-dependent communicator profiles. Conclusions: Currently, limited evidence exists that informs practice regarding AAC assessment and intervention for children with CVI. This article describes a small sample of children with CVI who use AAC. Results underscore the need for educators and practitioners to ensure that vision functioning in students with CVI is evaluated carefully and regularly when conducting AAC assessment and intervention and formulating communication or education goals. Supplemental Material: https://doi.org/10.23641/asha.21357684

Purpose: This longitudinal, retrospective study addresses the extent to which changes in functional vision, as measured by the CVI Range, are associated with changes in other developmental areas, specifically communicative competencies and the use of augmentative and alternative communication (AAC) modes and access methods. Method: Twelve students with cortical/cerebral visual impairment (CVI) and severe speech and motor impairments who rely on AAC strategies, tools, and technologies to communicate participated in the study. All participants were enrolled at The Bridge School in Hillsborough, CA, between the school years 2012–2013 and 2018–2019. The school's interprofessional collaborative team delivered an integrated, individualized educational program for students that included specific accommodations for CVI and the use of AAC. In this study, archived student records were reviewed using a systematic coding scheme. Results: Results showed that at the end of the study, all children's CVI Range scores improved. In addition, the measured areas related to communicative competence (i.e., social, linguistic, operational, strategic) also improved. The results for AAC modes and access methods varied, reflecting each student's uniqueness. Conclusions: Results support the need for speech-language pathologists, educators, and other service providers to offer these children opportunities to improve their use of vision. The results suggest that improvement in functional vision is strongly correlated with improvement across other areas of development, specifically related to communication competence. Students whose functional vision scores were lowest at baseline showed the greatest improvement, highlighting the importance of early identification and intervention for CVI. Clinical implications were discussed. Supplemental Material: https://doi.org/10.23641/asha.29716511

Development in children is sometimes described as a series of isolated milestones, e.g., first smile, first word, sitting, crawling, first step, and so on, even though that is not actually how human development unfolds. Rather, many of the skills that emerge during childhood are better understood using neuroplasticity, dynamic systems theory, and embodied cognition. Based on these findings and theories, we explore the potential impact that upright, hands-free, self-initiated mobility can have on children with severe physical and communication disabilities who use augmentative and alternative communication, specifically focusing on their growth in communicative competence. We discuss research that demonstrates the benefits to children with different physical abilities when they engage in upright, hands-free, self-initiated mobility. This article reflects the World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth by considering the importance of identifying functional communication needs and goals, taking into account participation barriers, communication limitations, and personal and environmental factors. We advocate for adopting family-centered, interprofessional collaborative service delivery models that more directly align with current theories of human development. Finally, we call for the adoption of implementation science to help bridge the existing gaps between theory and evidence-based practices.

Background/Objectives: Children with severe physical and communication disabilities face many challenges. They have very limited opportunities for upright, hands-free, self-initiated mobility. Current findings in neuroscience and theories on child development suggest that self-initiated mobility can have positive cascading effects on various developmental areas, including language and communication. This study was conducted to examine the current use of hands-free support walkers with children who have severe physical and communication disabilities and use augmentative and alternative communication and to identify the benefits and problems perceived by their parents and professionals from different disciplines. Methods: Online surveys were utilized to collect information from 127 participants, including 31 parents and 96 professionals or paraprofessionals. Results: The participants reported that these children could perform various motor activities in the hands-free support walkers to achieve different goals. Benefits identified by both parents and professionals included providing a way to exercise and stay active, improving motor control, enhancing independence, and bringing enjoyment. Professionals also observed positive impacts on communication, vocalization, use of eye contact, and problem solving. Conclusions: Results suggest that children with severe physical and communication disabilities can benefit from the upright, hands-free, self-initiated mobility provided by hands-free support walkers. Clinical implications and needs for future research are discussed.