Bilingualism, augmentative and alternative communication, and communication disability: a scoping review

Abstract

Background

Augmentative and alternative communication (AAC) options are often utilised by people with communication disability (PWCD). A limited range of bilingual AAC systems are currently available, and uptake of these options is impacted by misconceptions among speech-language pathologists and PWCD, and clinician knowledge and skill gaps.

Aim

To explore literature on AAC use in more than one language for bilingual PWCD.

Method

A systematic search of six databases and grey literature was conducted to identify research evidence on bilingualism, AAC, and PWCD. A descriptive synthesis was generated from charted data.

Results

A total of 16 articles met the eligibility criteria. This included four qualitative research studies, one participatory action research study, one quasi-experimental study, one case study, one case series, and eight expert opinion papers, primarily focused on the paediatric population and high-technology AAC. Linguistic, social, and ethical bases were identified for the development and use of bilingual AAC systems. Studies found bilingual AAC use was not detrimental to language development, promoted self-identity among users, and increased caregiver involvement in supporting AAC use. However, small sample sizes limit the generalisability of these findings, and considerable barriers exist to developing and implementing bilingual AAC.

Conclusion

This review highlights the need for developing AAC that is accessible to PWCD in each of their languages. Further research is needed to co-produce efficient and culturally responsive bilingual AAC systems with PWCD and/or their caregivers and identify effective strategies for supporting implementation.

Notes

1 ‘Communication disability’ is used with acknowledgement of and respect for personal preferences for describing individual language experiences.