Consensus on factors critical to Augmentative and Alternative communication (AAC) use in Canada from multiple stakeholder perspectives: a Delphi study

PURPOSE: Research evidence supports the benefits of AAC in enhancing social participation for people with communication disabilities, including in education and employment, however underutilisation and discontinued use of AAC systems remain unresolved issues. With this study, the research team aimed to gather consensus on factors important to AAC use and identify priorities based on the perspectives of key stakeholders in Canada. The perspectives considered included those of people who use AAC, family, caregivers, service providers, manufacturers, and technicians. MATERIALS AND METHODS: A two-round modified Delphi study design was used. The research team developed 123 survey items, based on previous focus group studies, to be rated on a 9-point numeric rating scale with an online two-round Delphi survey. RESULTS: The result was consensus on 52 statements rated as important by at least 75% of participants. The statements related to several environmental and technological factors including characteristics of AAC systems, social interaction with AAC, AAC services, school, physical environment, and societal attitudes. CONCLUSION: The range of priorities identified as important for AAC pertain to the person who uses AAC, AAC system design, acquiring AAC systems, formal and informal support, and social context, highlighting where support is needed. Consensus on areas of importance based on the perspectives of different expert groups will help to inform future directions and priorities for research and practice, including recommendations for AAC service delivery guidelines in Canada.