'They Absolutely Love It, or They're Terrified of It'. The Self-Perceived Competence of Australian Speech-Language Pathologists in Augmentative and Alternative Communication.

Abstract

Background: Augmentative and alternative communication (AAC) requires speech-language pathologists (SLPs) to have unique skills that may not be easily transferred from other practice areas. The introduction of the National Disability Insurance Scheme (NDIS) also created a distinctive work context for Australian SLPs within the disability sector.

Aim: Therefore, this study aimed to investigate the self-perceived competence of Australian SLPs in AAC.

Method and procedures: This study followed a sequential explanatory mixed methods approach. First, 203 SLPs completed a quantitative online survey. Next, 16 SLPs of those surveyed, participated in a one-on-one, semi-structured interview over Zoom.

Outcome and results: Competency ratings were higher for those SLPs who received pre-professional training in AAC, worked in a metropolitan area, had spent more time in the workforce and had a higher proportion of AAC users on their caseload. Competency ratings also differed by service delivery task; delivering therapy received the highest rating, while conducting assessments received the lowest. When asked about barriers and facilitators to clinical competence in AAC, four themes were identified (1) access to training and information, (2) AAC is a quickly evolving and changing field, (3) the impact of workplace context and (4) the attitudes of key stakeholders regarding AAC.

Conclusions and implications: SLPs in Australia report mixed levels of competence in AAC and experience many barriers to further developing their competence. Considerations should be made for how to reduce these barriers at a national level to ensure AAC users are accessing high quality supports.

What this paper adds: What is already known on the subject Previous literature has highlighted that speech-language pathologists (SLPs) internationally have varied levels of self-perceived competence in augmentative and alternative communication (AAC). Most of this research has been conducted in the United States and has been quantitative. What this paper adds to the existing knowledge This mixed methods study highlights that the self-perceived competence of Australian SLPs is impacted by university training, geographical location, time in the workforce, caseload and service delivery task. SLPs also feel that workplace context, attitudes of key stakeholders, technological advances and access to post-professional training impacts their ability to further develop competence in AAC. What are the potential or actual clinical implications of this work? This study highlights the critical role of key stakeholders such as university staff, funding bodies and employers in the development of clinical competence in AAC for SLPs.