A Family Systems Approach to Augmentative and Alternative Communication Service Delivery in the Inpatient Setting: Recommendations for Speech-Language Pathologists.

PURPOSE: Family-centered care is necessary to deliver high-quality health care services. It is especially critical that family members are included in augmentative and alternative communication (AAC) service provision in the inpatient setting. AAC can be overwhelming to families and requires accommodations for it to effectively integrate into daily communicative interactions. Currently, there is minimal guidance for family-centered care by speech-language pathologists (SLPs) working with children with limited functional speech in the inpatient pediatric setting. The purpose of this clinical focus article is to apply principles from family systems theory to the inpatient pediatric setting to guide effective family-centered clinical practice and improve outcomes.

METHOD: This clinical focus article describes a family systems framework to guide the development and use of supports to families during the extended hospitalization of a child with limited speech who may benefit from AAC in the inpatient rehabilitation setting. Two case studies are used to illustrate the application of a family systems approach in the pediatric inpatient setting.

RESULTS: Recommendations are provided for the inclusion of primary caregivers in service delivery by SLPs in the inpatient hospital context. Clinical implications and future directions are discussed.

CONCLUSIONS: The hospitalization of a child who uses AAC can be a stressful experience for the entire family system. By using a family systems framework, SLPs may improve AAC service delivery outcomes by working collaboratively with family members and offering supports for both AAC implementation and general well-being. SLPs may also benefit from this approach to AAC service delivery as families may be more actively engaged in sessions, leading to increased uptake of intervention strategies and AAC.