“Finding Common Ground” – Impact of a Complex Intervention on Collaboration in Augmentative and Alternative Communication Care of People without Natural Speech

Figures & data

Figure 1 Intervention elements and involved active and passive stakeholders; METACOM Symbol © Annette Kitzinger.

Table 1 Sample Description of Focus Group Participants

Focus Group Participant Characteristics (Intervention Group)	n (%)
Total number of participants	31 (100)
Homogeneous focus groups (n=3)
Consultants at AAC consultation centers	11 (35.5)
Heterogeneous focus groups (n=4)
Informal caregivers (parents)	8 (25.8)
Therapists	2 (6.5)
Educators and institutional employees
Teachers	3 (9.7)
Employees of homes for persons with disabilities	2 (6.5)
Employees of sheltered workshops	1 (3.2)
Educators	3 (9.7)
Remedial teachers	1 (3.2)
Sex
Female	25 (80.7)
Male	6 (19.4)
Age groups
18–25 years	1 (3.2)
26–35 years	6 (19.4)
36–45 years	11 (35.5)
46–55 years	11 (35.5)
56–65 years	2 (6.5)

Note: Due to rounding, percentages might not add up to exactly 100%.

Table 2 Sample Description of Survey Participants

Survey Participant Characteristics (T0+T1+T2 Completed)	Intervention Group n (%)	Comparison Group n (%)
Total number of caregivers	184 (100)	97 (100)
Formal caregivers	83 (100)	40 (100)
Educators and institutional employees
Teachers	21 (25.3)	15 (37.5)
Educators	18 (21.7)	3 (7.5)
Employees of residential or social facilities (eg, homes for persons with disabilities, sheltered workshops)	17 (20.5)	5 (12.5)
Therapists	24 (28.9)	14 (35)
Other formal caregivers (eg, remedial teacher)	3 (3.6)	3 (7.5)
Informal caregivers	101 (100)	57 (100)
Spouse/Partner	2 (2)	1 (1.8)
Mother/Father	80 (79.2)	56 (98.2)
Other informal caregivers (eg, relatives)	19 (18.8)	0 (0)
Sex
Female	149 (81)	81 (83.5)
Male	35 (19)	16 (16.5)
Age groups
0–29 years	31 (16.8)	9 (9.3)
30–39 years	66 (35.9)	23 (23.7)
40–49 years	57 (31)	36 (37.1)
50–59 years	23 (12.5)	26 (26.8)
60–69 years	7 (3.8)	3 (3.1)

Figure 2 Flow charts of the intervention group and comparison group.

Table 3 Visualization of Perceived Improvements in the Collaboration with Stakeholders Within the Focus Group Interviews

Collaboration with Stakeholders	No Improvements in Collaboration	Improvements in Collaboration	Total Number of Stickers
Active stakeholders
Informal caregivers	3	21	24
AAC consultants	0	12	12
Educators and institutional employees	2	22	24
Therapists	4	21	25
Passive stakeholders
Medical care providers	7	2	9
Medical equipment suppliers	7	3	10
Health insurance companies	13	3	16
Total number of stickers	36	84	120

Notes: Within the focus group interviews, all participants received red and green stickers to visualize whether collaboration has improved, deteriorated or remained unchanged within the intervention.

Table 4 Assessment of Case Management

Time Point	Items	Intervention Group		Comparison Group
		n	Mdn	n	Mdn	Mann–Whitney U-Test			Effect size r
						U	z	p
	How much support did you receive from the AAC consultation center during AAC care...
T1	1. …in applying for the new AAC system?	141	3.00	70	3.00	4314.00	−1.590	0.112
	2. …in defining a common goal of AAC care?	165	3.00	74	2.00	4016.50	−4.417	<0.001*	0.286
T2	3. …in involving the AAC user’s environment (eg, family, kindergarten, sheltered workshop) in the use of the new AAC system?	159	3.00	69	1.00	2500.50	−6.758	<0.001*	0.448
	4. …in achieving the defined common goal of AAC care?	160	3.00	65	2.00	2471.00	−6.384	<0.001*	0.426

Notes: Significant results are marked with *p=significance level: *Statistically significant at 5% level. Abbreviations: Mdn, median.

Figure 3 Case management assessment: Unmet support needs in AAC care the intervention versus comparison group. Note: Chi-square test: significant results are marked with * (p<0.001; p<0.001; p=0.014; p<0.001).

Table 5 Evaluation of Collaboration with the Respective Active Stakeholders in the Intervention versus Comparison Group

Time Point	Items	Intervention Group		Comparison Group
		n	Mdn	n	Mdn	Mann–Whitney U-Test			Effect size r
						U	z	p
	Use of the new AAC system eg, talker, communication board, gestures: How do you rate collaboration in the last 4 weeks with...
T2	…the crèche/the day center/the kindergarten?	67	3.00	34	3.00	892.50	−1.859	0.063
	…the school?	66	3.00	38	3.00	946.50	−2.225	0.026*	0.218
	…the residential or social facilities (eg, assisted living, sheltered workshop)?	50	3.00	15	2.00	216.00	−2.585	0.010*	0.321
	…with therapists (eg, speech and language pathologists, physiotherapists)?	117	3.00	51	3.00	2621.00	−1.334	0.182

Notes: Significant results are marked with *p=significance level: *Statistically significant at 5% level. Abbreviations: Mdn, median.

Table 6 Assessment of Collaboration with the Respective Passive Stakeholders by the Intervention and Comparison Group

Time Point	Items	Intervention Group		Comparison Group
		n	Mdn	n	Mdn	Mann–Whitney U-Test
						U		z		p
	The path to the new ACC system: your experiences How do you rate the collaboration with...
T2	…the medical equipment supplier?	100	3.00	60	3.00	2972.50		−0.108		0.914
	…the health insurance company?	95	3.00	53	3.00	2360.50		−0.673		0.501
	…the physician?	86	3.00	44	3.00	1777.50		−0.620		0.535

Abbreviation: Mdn, median.