Measuring impact of augmentative and alternative communication interventions: adapting the family impact of assistive technology scale for augmentative and alternative communication (FIATS-AAC-No) for use in Norway

Figures & data

Table 1. Domains, Definition and Numbers of Items in the Full-form Version (FIATS-AAC), Original Short-form Version (FIATS-AAC38), and the Norwegian Version (FIATS-AAC-No)

Domains	Definition	FIATS-AAC	FIATS-AAC38	FIATS-AAC-No
Child-related domains
Behavior	Degree to which the child engages in appropriate behavior	6	5	5
Contentment	Degree to which the child is content during the day	7	Not included	Not included
Doing activities	Degree to which the child has control over his/her own actions	5	Not included	Not included
Education	Degree to which the child is succeeding in school	7	5	4
Face-to face communication	Degree to which the child converse with others	8	8	8
Self-reliance	Degree to which the child performs activities independently	7	5	5
Social versatility	Degree to which the child interacts with others	7	5	5
Parent and family-related domains
Caregiver relief	Degree to which parent manages caregiving responsibilities	9	Not included	Not included
Energy	Degree of energy needed to assist the child	7	Not included	Not included
Family roles	Degree to which family members are involved in caregiving activities	7	Not included	Not included
Finances	Degree to which the family is free from financial stress	5	Not included	Not included
Security	Degree to which parent is free from worry about the child´s safety	7	5	5
Supervision	Degree to which the child is free from attention from family members	7	5	5
Total number of items		89	38	37

Table 2 Structure of the Content Analysis of Transcripts of Parents and Clinicians’ Reported Experiences of Using FIATS-AAC-No

Category	Code	Condensed meaning	Excerpt from transcription
Complexity	Effect of AAC	Why do AAC interventions not have an effect?	“Yes, so there will always be an evaluation then, of why it does not work. Why does it not work? Because.. the child’s development is so slow that we cannot get much further? Or does it not work because… yes..” (PI 129–131)
Concept definitions	Need for concept definitions	What is communication?	“I think it should be specified what is meant by communication. I was unsure if communication includes body language, gestures and hand guiding” (PS 6–7)
Influence of AAC on the family	Considerations when using an outcome measure	The scale does not represent how hard it is to be a parent of a child needing AAC.	“In a way… it is important that the scale does not represent how hard it is. Because, if you are told that it is so hard every day, then it is very hard” (PI 434–436)

PI: parent interview; PS: parent survey.

Table 3. Characteristics of Children as Reported by Parents Responding to Online Survey (N = 47)

Characteristics	n (%)
Sex
Boys	25 (53)
Girls	22 (47)
Education
Kindergarten	3 (6)
Mandatory education, Grades 1–7	30 (64)
Mandatory education, Grades 8–10	6 (13)
High school	8 (17)
Diagnoses
Intellectual disability	18 (38)
Cerebral palsy	5 (11)
Cerebral palsy and intellectual disability	4 (9)
Cerebral palsy, intellectual disability, and autism spectrum disorder or sensory impairment	4 (9)
Autism spectrum disorder	4 (9)
Autism spectrum disorder and intellectual disability	11 (23)
Sensory impairment	1 (2)
AAC used
None	3 (6)
Manual signs	12 (26)
Low-tech devices	1 (2)
High-tech devices	13 (28)
Manual signs and low-tech devices	1 (2)
Manual signs and high-tech devices	15 (32)
Low-tech and high-tech devices	1 (2)
Manual signs, low-tech and high-tech devices	1 (2)
Places where AAC is used
Only at home	3 (6)
Only at Kindergarten/school^a	8 (17)
At home and at Kindergarten/school	16 (34)
At home, at Kindergarten/school and at respite facility	13 (28)
At home, at Kindergarten/school and at after-school activities	1 (2)
At home, at Kindergarten/school, at respite facilities and during after-school activities	6 (13)

^a School includes mandatory education (Grades 1–10) and high school.

Table 4. Factor Structure of the FIATS-AAC-No

Items from FIATS-AAC-No	Factors of FIATS-AAC-No
	Social competence/communication	Education	Behavior	Supervision
My child lets me know if something is wrong	.762
I find it easy to play with my child	.741
My child socializes with other at mealtime	.718
My child tells me what she/he wants	.714			.391
My child communicates with people with whom she/he is less familiar	.683
My child tells me when she/he feels sick	.673	.303
My child tells me about her/his day	.660		.380	.489
My child tells me when she/he is afraid	.629
My child plays with friends	.618	.423	.503
My child behaves well around me	.613		.377
My child converses well with friends	.569	.539		.331
Everyone in my family knows how to communicate with my child.	.313
My child is proud of her/his schoolwork		.773
My child is well behaved at school		.619
I am satisfied with my child`s achievement of personal goals at school		.595
My child is performing well at school	.423	.565
My child`s teacher is satisfied with my child`s performance in school		.564
My child can phone for help in an emergency		.510		.478
If my child got lost, she/he could ask someone for directions	.371	.505		.487
My child acts appropriately toward other family members			.787
I am concerned about the way my child behaves	.345		.729
My child knows how to take turns during conversations	.352		.686	.368
Being independent improves my child`s self-esteem			.664
My child communicates with family members		.391	.642
My child likes to be independent			.629
My child knows how to keep a conversation going	.457		.626	.401
My child disrupts their classmates			.499
My child participates in community activities	.340		.476
I must take my child with me when I go from one room to another				.769
I am concerned about my child`s safety when she/he is left alone	.304		.445	.609
My child needs help from others when communicating				.602
My child communicates with other people on the phone	.506		.437	.594
My child needs me nearby to do many activities				.565
My child`s independence is increasing			.385	.508
My child communicates her/his ideas			.458	.500
I have little time to get chores done around the house	.350			.447
My child wants to be with me when I leave the room				.351

Colors refers to factors in original English version of FIATS-AAC: behavior = yellow, education = blue, face-to-face communication = red, security = green, self-reliance = purple, social competence = orange, supervision = grey.

Table 5. Correlations Between Factors of FIATS-AAC-No and the BAC Communicative Functions.

Variable	BAC communicative functions
Factor 1 from FIATS-AAC-No: Social competence/communication	.75**
Factor 2 from FIATS-AAC-No: Education	.31*
Factor 3 from FIATS-AAC-No: Behavior	.34*
Factor 4 from FIATS-AAC-No: Supervision	.57**

*p < .05, **p <.01

Figure 1. The Relationship between Mean scores on FIATS-AAC-No and BAC Communicative Functions