Experiences and Contextual Factors Impacting AAC Use at Home: A Qualitative Interview Study

We investigated caregivers' experiences with early augmentative and alternative communication (AAC) services and explored the contextual factors shaping AAC use in family routines. We conducted thematic analysis of semi-structured online interviews with 20 caregivers of children aged 24-60 months with intellectual and developmental disabilities. Caregivers reported three service delivery challenges in early intervention (EI): limited AAC instruction, systemic barriers to access, and provider resistance to high-tech AAC. Seven contextual factors also shaped AAC use at home, including early "growing pains," societal perceptions, device cost, time and fatigue, design gaps for young children, evolving caregiver beliefs, and reliance on non-symbolic communication. These findings highlight the need for greater provider support to help families use AAC effectively at home. Future research should test strategies to address these common barriers to AAC implementation.