Maingi Bhavya, Akkunje Preetie Shetty, Karuppali Sudhin
Department of Audiology and Speech Language Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, 90 Wellesley Street West, Toronto, ON, M5S 1C5, Canada.
J Autism Dev Disord. 2025 Sep 15. doi: 10.1007/s10803-025-06990-x.
The implementation of Augmentative and Alternative Communication (AAC) systems for individuals with nonverbal Autism Spectrum Disorder (nvASD) remains highly debated, especially in a multilingual and multicultural country like India. Existing AAC guidelines are largely Western-based and may not be fully applicable in the Indian context. This study explored the perspectives of Indian Speech-Language Pathologists (SLPs) on AAC implementation in individuals with nvASD. A cross-sectional study was conducted in two phases. Phase 1 involved developing and validating a questionnaire assessing SLP's practices and attitudes towards AAC. In phase 2, the validated questionnaire was administered online to 93 Indian SLPs (29.23 years of mean age, 71% female) represented diverse clinical, educational, and academic settings. The survey explored key parameters, including AAC candidacy, cultural and linguistic adaptation, AAC selection and customization, interdisciplinary collaboration and caregiver involvement, outcome based evaluation practices, speech-AAC integration, and barriers to AAC implementation. Most SLPs emphasized working on communication prerequisites before introducing AAC. Vocabulary selection was prioritized over partner training. AAC was primarily used for both intervention and communication, employing goal-oriented approaches alongside other speech and language strategies. Challenges included lack of resources, inadequate training, and limited interdisciplinary collaboration. Parental involvement and caregiver feedback were identified as critical to success. SLPs in India broadly recognize AAC as a valuable tool for individuals with nvASD but report facing multiple systemic and practical challenges to its implementation. The findings underscore the need for culturally and contextually relevant AAC guidelines, targeted clinician training, and supportive policy measures to improve access and long-term communication outcomes in Indian settings.
为非言语型自闭症谱系障碍（nvASD）患者实施辅助和替代沟通（AAC）系统仍存在很大争议，尤其是在像印度这样的多语言和多元文化国家。现有的AAC指南主要基于西方，可能不完全适用于印度的情况。本研究探讨了印度言语语言病理学家（SLP）对nvASD患者实施AAC的看法。进行了一个分两个阶段的横断面研究。第一阶段包括开发和验证一份评估SLP对AAC的实践和态度的问卷。在第二阶段，将经过验证的问卷在线发放给93名印度SLP（平均年龄29.23岁，71%为女性），他们来自不同的临床、教育和学术环境。该调查探讨了关键参数，包括AAC的适用性、文化和语言适应性、AAC的选择和定制、跨学科合作和照顾者参与、基于结果的评估实践、言语与AAC的整合以及AAC实施的障碍。大多数SLP强调在引入AAC之前先处理沟通的先决条件。词汇选择比伙伴培训更受重视。AAC主要用于干预和沟通，采用目标导向方法以及其他言语和语言策略。挑战包括资源短缺、培训不足和跨学科合作有限。家长参与和照顾者反馈被认为是成功的关键。印度的SLP普遍认为AAC是nvASD患者的一种有价值的工具，但报告称在实施过程中面临多种系统和实际挑战。研究结果强调需要制定与文化和背景相关的AAC指南、有针对性的临床医生培训以及支持性政策措施，以改善印度环境中的获取机会和长期沟通结果。
