Perspectives of people with cerebral palsy and communication partners about eye-gaze control technology opportunities and service provision in Australia: a qualitative study

Eye-gaze control technology (EGT) can facilitate communication and participation for people with physical disabilities or those who use augmentative and alternative communication (AAC). Clinical guidelines for EGT in cerebral palsy (CP) were published in 2021, but users' perspectives on service provision and outcomes remain underexplored. This study aimed to investigate these perspectives in the Australian context. Using a qualitative descriptive approach, semi-structured videoconference or email interviews were conducted with three adults with CP who use EGT and four communication partners. Data were analyzed using reflexive thematic analysis. Two themes were derived: 'EGT Has Opened the Doors for Us' and 'Navigating the EGT Journey', with subthemes 'The Integral Role of Support Systems' and 'Building Skills and Confidence'. Participants described how EGT enabled previously inaccessible forms of communication and participation, fostering autonomy and social connection. They also reported inconsistencies in assessments, trials, and support. Implementing EGT was characterized as a long and complex journey, involving challenges such as navigating funding systems, managing technical issues, and building skills and confidence. Findings revealed that access to EGT alone was insufficient; outcomes were shaped by the consistency of support, clinician expertise, and opportunities for users to build confidence over time. This study highlights the need for consistent application of EGT clinical guidelines to ensure equitable access, while allowing flexibility in how and when ongoing support is provided, reflecting user priorities and the complexity of EGT implementation in practice.