Need for Augmentative and Alternative Communication (AAC) in Adult Day Services in Germany—A Nationwide Survey

The aim of this study was to survey the need for augmentative and alternative communication (AAC) of adults with disabilities and high support needs in adult day services in Germany. In addition to individual data, organizational information was collected. The managers, the group leaders, the AAC specialists and the staff of all adult day services in Germany were invited to participate in an online survey. 91 staff members from 50 institutions provided information on 719 individuals in their care. From these staff members perspective 75% of the 719 clients had a need for AAC and 45% were provided with AAC (coverage rate 60%). Non-symbolic communication approaches for beginning communicators (74%) and low-tech communication book, boards, and card (65%) were used significantly more often than high-tech AAC systems (45%). For about three quarters of the people served, the staff was satisfied with the provision of AAC, but for just under a quarter, they were not. The most frequently cited reasons for dissatisfaction were lack of time/personnel, material resources and skills. Also, of the 193 facility managers surveyed, only 45% consider the available resources to be sufficient. There is a need for more nationwide surveys at the levels of society, organization and individual, differentiated by age groups, types of disability and services.