Caregiver Perceptions of Children who have Complex Communication Needs Following a Home-based Intervention Using Augmentative and Alternative Communication in Rural Kenya: An Intervention Note

Abstract

A high level of unmet communication need exists amongst children with developmental disabilities in sub-Saharan Africa. This study investigated preliminary evidence of the impact associated with a home-based, caregiver-implemented intervention employing AAC methods, with nine children in rural Kenya who have complex communication needs. The intervention used mainly locally-sourced low-tech materials, and was designed to make use of the child's strengths and the caregiver's natural expertise. A pretest-posttest design was used in the study. Data were gathered using an adapted version of the Communication Profile, which was based on the International Classification of Functioning, Disability, and Health (ICF) framework. The non-parametric Wilcoxon signed-rank test was applied to data from the first two sections of the Communication Profile-Adapted. Qualitative analysis was conducted on the final section. The data provided evidence of statistically significant positive changes in caregiver perceptions of communication at the levels of Body Structure and Function, and Activities for Communication. Also, analysis of the Participation for Communication section revealed some expansion to the children's social activities. The potential impact of the home-based intervention would benefit from investigation on a larger scale. Limitations of the study are discussed.

Keywords::

• Low-income country
• Developmental condition
• Home-based intervention
• Augmentative and alternative communication

Acknowledgements

We would like to thank the Director of Kenya Medical Research Institute for permission to publish the data. We would also like to thank the Educational Assessment and Resource team in Kilifi. Most importantly we would like to express our appreciation for the involvement of the mothers, their children and other family members who participated in this study.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of this paper.

This work was supported by the C.P. Trust (UK) and the KEMRI/Wellcome Trust research programme. Charles R. Newton is supported by Wellcome Trust, UK.