Six principles of AAC research and practice are offered for consideration and discussion within the AAC community. Principle 1 requires the active participation of individuals with complex communication needs (CCN) in all AAC activities. Principle 2 seeks to ensure that theoretical constructs underlying research and development in AAC are grounded, widely accepted, and clearly defined. Principle 3 underscores the need to use ergonomics in the design and development of AAC technologies and instructional strategies. Principle 4 highlights communication partners and the unique roles they play in AAC. Principle 5 accentuates the need to focus on societal roles, relationships, and opportunities made possible by AAC technologies and services. Finally, principle 6 draws attention to the importance of measuring a broad range of AAC outcomes, especially those most significant to primary AAC stakeholders.

Delivering quality health care requires effective communication between health care providers and their patients. In this article, we call on augmentative and alternative communication (AAC) practitioners to offer their knowledge and skills in support of a broader range of patients who confront communication challenges in health care settings. We also provide ideas and examples about ways to prepare people with complex communication needs for the inevitable medical encounters that they will face. We argue that AAC practitioners, educators, and researchers have a unique role to play, important expertise to share, and an extraordinary opportunity to advance the profession, while positively affecting patient outcomes across the health care continuum for a large number of people.

Purpose: This scoping study sought to establish a baseline for how well the needs of children with cortical visual impairment (CVI) who use augmentative and alternative communication (AAC) are currently aligned with the services available to them. CVI is the most common cause of visual impairment in children today, and AAC methods rely heavily on vision. Yet, the prevalence of CVI in children who use AAC methods is not yet known, and there is virtually no research concerning use of AAC with children with CVI. Our overarching goals were to identify barriers and suggest priorities for improving outcomes for these children.Method: Surveys were distributed anonymously online to professionals from multiple disciplines in different school-based settings and to parents of children with CVI who use AAC.Results: School-based professionals identified many barriers, including a lack of knowledge and skills about CVI and about AAC, limited access to training and experts, and concerns about services being delivered in isolated silos with limited time allotted for interprofessional collaboration and planning. Parent reported that their children (M_age= 11 years) continued to rely predominantly on body-based forms of communication and lacked access to symbolic language, which, in AAC, is primarily visually based.Conclusions: The barriers to services identified by school-based professionals indicate a need to develop and disseminate reliable information about CVI and AAC, both at a preservice and in-service level and, while doing so, to respect the diversity of stakeholders who need this information, including parents. Future research on what types of AAC approaches support the development of language and communication skills for children with CVI is essential.

Purpose: There is limited information about how to support children with cortical visual impairment (CVI) who require augmentative and alternative communication (AAC). An initial review designed to explore the available evidence was used to outline critical needs in moving research and intervention forward for children who use AAC and have CVI. Method: Previous systematic reviews, six databases, and theses and dissertations were systematically searched, along with reviews of the resulting works cited. An initial yield of 575 articles was narrowed to 10, which discussed AAC interventions that included children with CVI. Results: Three interventions were technology based, and seven were instructional based. The use of textured microswitches was the most frequent form of technology intervention, with the frequency of switch activations being the most frequently coded outcome. Overall, the studies represent explorations in the area rather than systematic lines of inquiry. Conclusions: While evidence shows at least some children with CVI have been included in AAC research to date, the inclusion is more incidental than deliberate. Issues such as clear descriptions of the vision capabilities and needs of participants may have impacted study results.

Purpose: This article highlights the contributions of three pillars of an evidence-based practice approach (service providers, researchers, and families/clients) in the development of a framework to offer a way forward for professionals, families, and technology companies to support optimal visual and communication outcomes of individuals with cortical visual impairment (CVI) who use augmentative and alternative communication (AAC). By providing available research findings as well as practical information and lived experiences, the article offers clinical considerations and design features that can lead to addressing the unique needs of these individuals. Method: This article reviews literature concerning what is known about CVI and describes in detail and from multiple viewpoints important features required in AAC systems to support individuals with CVI and enable them to communicate effectively. Results: Components necessary for teams, communication partners, and AAC designers to optimize AAC system design in CVI are presented using external research evidence as internal evidence from lived experience to support their importance. Conclusions: An AAC system design that is tailored to the unique visual processing characteristics in CVI is likely to promote positive communication outcomes. The presentation of the lived experience of an individual who has CVI themselves illustrates the need for individualized assessments and interventions that incorporate and reflect the research presented here. Supplemental Material: https://doi.org/10.23641/asha.23902239

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.