The field of augmentative and alter

The field of augmentative and alternative communication (AAC) has evolved since the 1970s, consequently there now exists a group of adults with cerebral palsy (CP), in the UK, who are life-time users of AAC prescribed as an intervention for their complex communication impairments.

Ten adults, aged between 20-55 years, participated in conversations about their unique life experiences and aspirations, using AAC, including voice output communication aids (VOCAs). The ability and opportunity to interact and communicate personal accounts has significance for conceptualizing outcomes of intervention. Clinical practice informed this research project. A qualitative research design was employed to explore questions about the extent to which adult aided communicators talk about their lives, aspirations and opinions; the past life experiences participants talk about and finally how they talk about their quality of life. Conversational-styled, semi-structured interviewing using literature-guided questions yielded rich interactional data. A discourse analytical approach to the 34 interviews was taken.

Findings identified a number of ordinary interactional features and discourses. Aided communicators used multimodal communication to interact and converse, positioning through their contributions as assertive speakers and engaged recipients. Interactional turns were managed with participants using unaided communication signals as conversational continuers. Participants demonstrated how to manage others who speak on their behalf. Examples of interactional repair were noted when participants pre-empted breakdown. Managing novel utterances was a feature with unexpected responses challenging the listener’s position.
Participants constructed VOCA-mediated utterances to share long-term memories, worries, satisfaction with life, and aspirations. Aspirations included community ambitions and creating fulfilling daily lives. Some participants expressed frustration but balanced this against a position of contentment. Some participants also demonstrated personal responsibility and positioned themselves through their talk as contributors to communities.

Recommendations for clinical practice are suggested that include the provision of adult clinical services and interaction focused intervention for adult aided communicators with cerebral palsy