by Marci Revelli, MS, SLP (speech-language pathologist); NWACS Board Member
reading time: 6 minutes
This is a plain-language summary of a journal article. The article is one of 21 articles in a special issue of the AAC journal (Volume 41, Issue 3, 2025). All the articles are written or co-written by AAC users. The articles are free to read. Plain-language summaries of research are important for accessibility. Providing summaries in plain language helps make complex information easier to read. This helps to better understand and put the research into practice.
Summary of: Dismantling societal barriers that limit people who need or use AAC: lived experiences, key research findings, and future directions by Light et al. (2025)
Barriers to Successful Communication
This article starts with a powerful statement. AAC research clearly shows the benefits of using AAC. AAC allows people who cannot rely on speech alone to communicate. Communication is key to participating in all aspects of daily life. This article focuses on the barriers to successful communication. And there are many. AAC users are at risk for
crime,
maltreatment,
neglect,
medical errors,
and social isolation.
The associated stress and trauma of these events can be lifelong. Having access to AAC is not enough. There also needs to be meaningful opportunities to communicate.
Beukelman and Light (2020) have long described barriers to AAC access. This article discusses each barrier and then tries to offer ideas for overcoming each barrier. This article is different from previous discussions on this topic. It includes AAC users as co-authors. The barriers discussed include:
policy and practice barriers
technology barriers
attitude barriers
knowledge and skill barriers
Policy and practice barriers and ideas to overcome this barrier:
A policy barrier results from laws and regulations or lack thereof. It is systemic, meaning it effects whole groups of people or societies. A practice barrier is a common procedure or way of thinking. This restricts the communication and participation of people who use AAC. But is not an official policy. Here are some examples:
The Americans with Disabilities Act (ADA) offers general protections but not specifically for AAC.
The Convention on the Rights of Persons with Disabilities (CRPD, United Nations, 2006) specifically acknowledges the right to communicate via AAC. It also states the need for reasonable accommodations to support participation. However, the CRPD is not enforceable. It is guidelines only with no legal repercussions.
Marginalized populations who need AAC may not get access to AAC. There are many reasons for this. Some include race, gender, socioeconomic class, geographic isolation, and other factors.
In the US, about 75% of speech-language pathologists report not feeling adequately prepared to provide AAC services. There are a myriad of professional training opportunities. These do not always fit the exact needs of the SLP. Searching through and finding the exact type of training takes time, knowledge, and resources. This is a practice barrier.
There is little data to track the effects of policies and practices. So, it is difficult to evaluate the impact of attempts at systemic change. One AAC user stated,
“In our society, it is the loudest voices that get the resources. Yet, when communication or speech is the disability, advocacy is difficult. There is a desperate need to increase our volume so that our voices are heard.”
In my own practice, two very specific examples come to mind for policy and practice barriers.
A university has a policy that only allows some of their graduate students to apply for AAC-focused internships. Rather than restricting it, all graduate students should be able to apply. Especially graduate students who have a specific interest.
Graduate students who desire AAC internships may sometimes have to look out of state. This can create a barrier when the placement and higher education institution cannot come to an agreement to support an out of state placement. In this case, it was due to issues of liability.
Policies can be changed. Practices can be changed. It takes advocacy and time but is well worth the effort.
Technology barriers and techniques to reduce these barriers:
Increases in technology can be helpful and harmful. One AAC user writes,
“Technology is never neutral. It can liberate or isolate and exclude.”
Consider the following:
In recent years, access to technologies has increased and become more available. Some examples of this are screen readers, live captioning, and eye control.
Artificial Intelligence (AI) has the potential to be supportive. However, current AI large language models come from databases that reflect a biased culture.
User interfaces have become more complex and exclusive rather than inclusive. Consider the number of motor actions required to operate a phone. This is not a barrier for only those with disabilities. How many of you support older family members to learn how to double click, click and hold, swipe left or right, scroll up or down, or pinch? A light press or a hard press can be difficult for many.
AAC manufacturers have made gains in the wide development of AAC tools. These still have big learning demands. There is a need to improve access for people who have vision, hearing and/or motor challenges. The design needs to reduce the learning demands.
There is an overemphasis on technology as a solution. There is a failure to recognize, respect, and support the diversity of communication strategies used by the people who need AAC. AAC systems need to better support the expression of identity across diverse languages and cultures. One AAC user writes,
“The technology should not be the focus. The focus should be on social inclusion and equity.”
Attitude barriers and techniques to reduce these barriers:
An attitude barrier occurs happens when people are predisposed inclined to act in ways that limit the communication and participation of people who use AAC.
One AAC user writes, “There is still a belief in our society that someone who does not speak must have limited understanding, little to say and little to give.”
There is research to say that these attitudes exist. There is little to no research to know what actions are needed to overcome negative attitudes.
One of the most promising techniques for changing attitudes appears to be providing meaningful opportunities for people to interact with those who have disabilities. Simply placing students who use AAC in general education classrooms is not enough. Inclusion must target meaning and connectedness to reduce isolation and support belonging.
Knowledge and skill barriers and techniques to reduce these barriers.
Knowledge and skill barriers refer to limitations that arise when communication partners lack information about AAC and use interaction strategies that limit the communication of people who use AAC.
The lack of knowledge and skills for communication partners can have negative consequences.
This can restrict access to AAC, limit practice opportunities, and limit overall participation.
There are specific and well researched tools to help communication partners. See the full article for these examples.
Communication partner training has been supported by telehealth. Telehealth allows training and support to people who may otherwise not have access to in-person resources.
I think this article falls short when considering the knowledge and skills of communication partners. In my own practice, it rarely comes down to knowledge and skill alone. Many families report not having the time to support communication using AAC. Taking care of a child who has a disability presents many challenges. Families are tasked with keeping their child healthy and safe, nourished, housed, clothed, and well rested. Moments of true connectedness and communication are often using gaze or gesture. As SLPs, we need to celebrate the joy of connectedness. We can help families create AAC moments easily embedded into everyday routines.
Mentoring and future research:
The last part of the article focuses on the areas of mentoring and future research:
Mentoring of AAC users by AAC users. Mentoring has been shown to help
ease transitions following injury/illness,
solving problems,
and building confidence.
Research has ignored the greatest problem. This is the pervasive societal barriers that limit access to AAC and to meaningful opportunities to communicate and participate in society.
Including AAC users in future research is imperative.
There are a lot of priorities for future research, too many to summarize here. I encourage you to read the full article to explore these ideas. However, the messaging is clear. AAC users must be involved as equitable partners. Future research must focus on dismantling societal barriers that limit the lives of people who need or use AAC.
Citation:
Janice Light, Susan K. Fager, Jessica Gormley, Glenda Watson Hyatt & Erik Jakobs (2025) Dismantling societal barriers that limit people who need or use AAC: lived experiences, key research findings, and future directions, Augmentative and Alternative Communication, 41:3, 230-244, DOI: 10.1080/07434618.2025.2508490
Access full article: https://doi.org/10.1080/07434618.2025.2508490
