Speech-Language Pathology Department, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha.
Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park.
Am J Speech Lang Pathol. 2023 Mar 9;32(2):545-564. doi: 10.1044/2022_AJSLP-22-00200. Epub 2023 Feb 10.
Children with complex medical and communication needs often experience extensive or frequent hospital stays and rely on augmentative and alternative communication (AAC) strategies to communicate in this environment. Health care providers seldom receive training to effectively communicate with these children, which may lead to limited participation opportunities for the child during inpatient interactions.
A pretest-posttest experimental group design was completed to evaluate the effects of a brief mobile training designed to teach providers a procedure to support children with complex communication needs to communicate choices. Each provider participated in two pretest and two posttest interactions with children with complex communication needs during naturally occurring inpatient activities. Providers in the treatment group completed the video training, whereas providers in the control group did not.
Following the training, (a) more providers offered choices to the children during hospital routines, (b) providers implemented the trained procedure with increased accuracy, and (c) the children with complex communication needs consistently communicated their choices when given the opportunity to do so. The providers rated the training as easy to use, effective, and suited to the needs of the inpatient setting.
This is the first AAC training designed to promote child-provider interactions in inpatient settings that demonstrates results that are efficient, socially valid, and effective in a real-world context. Future work is needed to develop additional brief and focused AAC partner trainings to teach providers to support the participation of children with complex communication needs in health care interactions.
患有复杂的医学和沟通需求的儿童通常需要在医院中接受长时间或频繁的住院治疗,并依赖于辅助和替代性沟通(AAC)策略在这种环境下进行沟通。医疗保健提供者很少接受过有效与这些儿童进行沟通的培训,这可能导致儿童在住院期间的互动中参与机会有限。
采用了预测试-后测试实验组设计,以评估一项旨在教授提供者支持具有复杂沟通需求的儿童进行沟通选择的程序的简短移动培训的效果。每个提供者都在自然发生的住院活动期间与具有复杂沟通需求的儿童进行了两次预测试和两次后测试互动。治疗组的提供者完成了视频培训,而对照组的提供者则没有。
在培训后,(a)更多的提供者在医院常规活动中为儿童提供了选择,(b)提供者以更高的准确性实施了所训练的程序,并且(c)具有复杂沟通需求的儿童在有机会时始终能够传达他们的选择。提供者将培训评为易于使用、有效且适合住院环境的需求。
这是首个旨在促进住院环境中儿童与提供者互动的 AAC 培训,其结果具有高效、社会有效和在真实环境中有效的特点。未来需要进一步开发其他简短而集中的 AAC 伙伴培训,以教授提供者支持具有复杂沟通需求的儿童在医疗保健互动中的参与。