Managing expectations of AAC
Augmentative and alternative communication (AAC) is an important clinical intervention for many people with motor neurone disease (MND).
This information is for health and social care professionals working with people with MND. It provides suggestions for best practice in AAC provision, and where to find more information.
As part of the process of assessing for AAC, it is important to establish what expectations people have of AAC. If they have very high expectations, there is a risk that no intervention will ever meet their needs.
Expectations of AAC are commonly based on a belief in, and hope for, technological solutions to communication problems. Such hopes are particularly prevalent in emerging and new technologies, such as eye gaze systems and brain-computer interface control, as well as the availability and relative affordability of tablets, smart phones and associated apps.
It is important to be realistic about how AAC really works on a day-to-day basis, and that problems can occur with the technology and how it is used. It is essential to have a low-tech AAC system available as a back-up.
Expectations can be explored through the use of basic questions such as:
- What do you know about AAC?
- What have you already been told about AAC?
- What do you feel an AAC system will do for you?
- How do you think an AAC system will help your communication?
It is important to understand and manage the expectations of:
- people with MND, their families and friends
- other professionals, and those who refer people for AAC advice.
This can be done by providing honest, direct and clear information and clinical opinion about any differences between what is desired and what is feasible for the individual’s needs. In some cases, this may mean explaining that a range of low-tech options are more appropriate than high-tech.
Any concerns about managing high expectations may be discussed with a more experienced colleague. It may be helpful to rehearse ways to deal with expectations that, however understandable, cannot be met.
In some cases, a person may already have been promised an AAC system from another agency (eg directly from a company that manufactures and/or supplies AAC systems). Professionals should be honest with their own professional opinion and judgement, but work collaboratively with other people to ensure the person’s needs are at forefront of the decision-making process.