High-tech augmentative and alternative communication (AAC) in Asia: a narrative review of barriers, facilitators, and...

The use of low-tech Augmentative and Alternative Communication (AAC) in low-middle-income countries (LMICs) is largely adopted among individuals with communication disorders, whereas the adoption of high-tech AAC remains limited compared to high-income countries. In order to elucidate the discrepancy, this review identifies and addresses the systemic facilitators and barriers to the implementation of high-tech AAC in Asia's diverse contexts from 2015 to 2025.

Following the PRISMA guidelines, 29 articles published in English from 11 Asian countries between 2015 and 2025 were systematically reviewed from six major databases. The quality of the articles was assessed using Mixed Methods Appraisal Tool.

The included studies reported facilitators, including enhanced interaction, academic participation and user empowerment driven by modern technology and training. Critical structural impediments were reported, particularly financial constraints, poor professional training and sociocultural attitudes across Asia. Limited implementation was further exacerbated by inadequate government support, educational deficits and concerns about the accessibility of technology.

The review highlights significant access gaps to high-tech AAC in diverse Asian contexts, emphasising context-specific interventions attuned to cultural, economic and infrastructural factors. It outlines practical measures, such as localised training, policy advocacy and affordable device integration, to advance AAC adoption, communication and quality of life for individuals with developmental disabilities. These promising strategies, though descriptive, call for empirical research to confirm real-world impacts.