Experiences of Augmentative and Alternative Communication use in School: A Qualitative Evidence Synthesis Protocol.

BACKGROUND: Augmentative and Alternative Communication (AAC) refers to a range of communication methods used by children or adults to enhance or replace oral communication. Studies show many children with communication needs who require AAC do not have access to appropriate supports, and that embedding AAC interventions in the classroom is challenging. This means many children who use AAC face barriers to meaningful participation, engagement, and independence. Understanding the experiences and perspectives of AAC users and those who support the use of AAC in the classroom can provide actionable knowledge to guide service improvement such that AAC users can be empowered to achieve and participate in school.

METHODS: A comprehensive literature search of the following electronic databases will be completed: PubMed, CINAHL Complete, EMBASE, EBSCO and Scopus. A manual search of the grey literature will also be carried out. Qualitative studies and mixed-methods designs that include qualitative data on the perspectives and experiences of AAC users, their families, and educators and healthcare professionals who support AAC users in school settings for children 3-18 years will be analysed. Methodological quality of included papers will be appraised using the Critical Appraisal Skills Programme (CASP) checklist for qualitative research by two independent reviewers. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) - Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach will be employed to assess how much confidence to place in the findings of the qualitative evidence synthesis. Qualitative content analysis will be undertaken using constructs from Normalisation Process Theory.

CONCLUSION: This qualitative evidence synthesis will summarise findings from the empirical international literature to provide a deeper understanding of the experiences of AAC use from a range of stakeholder perspectives. Findings will inform the development of pathways to support implementation of AAC for children with communication needs within schools. Prospero Registration No. CRD420251229480.