Functional impact of augmentative and alternative communication scale: development of an outcome measure for educators of students with complex communication needs

Abstract

Purpose

The study aim was to develop and assess the measurement properties of the Functional Impact of Augmentative and Alternative Communication – Educator (FIAAC-E) scale – an educator-reported measure designed to detect change in factors associated with communicative participation in students who use augmentative and alternative communication (AAC).

Methods

The study had three phases. In phase 1 (content validity), 22 content specialists independently rated the relevancy of 22 dimensions proposed for the new scale. In phase 2 (item generation, face validity), 8 educators independently completed a preliminary version of the FIAAC-E scale and flagged items that were unclear. Next, these educators adjusted the wording of unclear items during consensus-building sessions. In phase 3 (item reduction, reliability, convergent validity), 62 educators completed an online survey that included the revised FIAAC-E scale. Survey data were used to shorten the scale, estimate its reliability, and evaluate support for its convergent validity.

Results

In phase 1, the 11 dimensions ranked most highly by content specialists were selected for inclusion in the preliminary scale. In phase 2, educators reviewed 113 items and revised 33 to improve clarity. In phase 3, correlational statistics informed the selection of 77 items for the shortened scale. Subsequent data analyses indicated acceptable levels of internal consistency and test-retest reliability and support for convergent validity of the preliminary measure.

Conclusion

The study provides emerging evidence that supports the FIAAC-E scale as a reliable way to evaluate communicative participation in children and youth who use AAC systems at school.

Implications for rehabilitation

• Using a reliable means to measure the effectiveness of AAC for children and youth at school may reveal important factors that influence successful communicative, academic, and social participation in school.

• The FIAAC-E scale is a promising educator-reported questionnaire to inform the development of communication goals and monitor progress towards meeting these goals for students with complex communication needs.

Keywords:

• Augmentative and alternative communication
• communicative participation
• childhood disability
• surveys and questionnaires
• reliability
• school environment
• outcome measurement

Acknowledgements

The authors thank the content specialists, educators who participated in the survey and the school board-based professionals, other AAC clinicians, and professional associations who provided in-kind support for this development work. We gratefully acknowledge the following team members who contributed to the development of the FIAAC-E scale: Dianne Parr, Liisa Nilsen, Gail Ozols, Jim Donohoo, and Elizabeth Cambridge. This study was funded through knowledge translation grants from the Holland Bloorview Kids Rehabilitation Hospital Foundation through the Centre for Leadership.

Disclosure statement

The authors report no conflict of interest.