This mixed methods survey study aims to investigate school staff's perspectives on using augmentative and alternative communication (AAC) with students with the most severe disabilities in Swedish school settings. The study employed a convergent mixed methods design, where both quantitative and qualitative data were collected and analysed in parallel and then integrated and compared in the discussion and conclusion section of the paper. The study's respondents consisted of school staff who worked with students with severe or profound intellectual and multiple disabilities (S/PIMD) in Swedish schools. Results showed that almost all staff reported using AAC with students at least half of the time. The frequency of AAC use did not seem to differ between staff with different educational backgrounds, apart from teachers/special educators appearing slightly more inclined to use AAC in planned classroom activities when compared to staff with other educational backgrounds. The results also corroborate previous research stating that collaboration between stakeholders (such as school, family and the habilitation services) is fundamental to successful AAC implementation but that there are challenges when establishing efficient collaborations between stakeholders.

Communication is essential for social closeness, educational success, and quality of life. For students with intellectual disability (ID), communication is often challenging due to limitations in intellectual functioning and adaptive behavior. This thesis explores turn-taking and the use of augmentative and alternative communication (AAC) in schools for students with ID. It also examines a communication partner intervention, the AKKtiv ComPal. 

The participants included 33 students with ID and 30 school staff members from seven schools. Data were collected through video observations of structured (circle time) and unstructured (leisure time) group activities at three time points: pre-intervention, post-intervention, and follow-up. Data were also collected to assess students’ communicative skills and limitations. 

A cross-sectional design was used to examine classroom communication, and multiple case studies examined intervention applications and changes over time. Turn-taking and communication modes of students and staff were analyzed using a coding scheme developed for this thesis. Teachers’ use of responsive strategies was analyzed using the Responsive Augmentative and Alternative Communication Style (RAACS) scale. The frequency of their augmented input and the number of communication boards were also measured. Non-parametric statistical tests, descriptive statistics, and visual representations were used to analyze and present the findings. 

Pre-intervention, staff dominated the classroom interactions, and AAC was used less during unstructured activities than in structured and pre-planned activities. Students used AAC more frequently when school staff also did so. Following the intervention, teachers (N = 4) used responsive strategies and augmented input more extensively. Students (N = 10) increased both their number of turns and their use of picture-based communication. 

Consistent use of communication partner strategies by school staff is critical for enhancing student communication. Regular staff training and support may be necessary to address high turnover rates among support staff and to ensure these strategies are applied consistently over time. Improved access to personalized communication systems and better integration of AAC into daily activities are recommended to support students with ID effectively.

Background and aims: Teachers serve as critical communication partners for students with intellectual disability (ID) who face communication difficulties. However, teachers may lack sufficient training in using communication partner strategies and augmentative and alternative communication (AAC) in the classroom. This study aimed to explore teacher application of a communication partner intervention (AKKtiv ComPal) in schools for students with ID.

Methods: Video observations were conducted at four schools during a teacher-led group activity at pre- and postintervention, with follow-up 7 months later, focusing on communication partner strategies and AAC use applied as a universal approach in the classroom. Differences and similarities in intervention application and contextual factors that may influence teacher application were investigated using a multiple case study approach, in which the four teachers and their contexts served as the four examined cases.

Results: All cases increased the access to communication boards in the classroom and used more augmented input and responsive strategies following intervention. Follow-up measures revealed variability in augmented input and sustained or more use of responsive strategies. Despite increased strategy use, access to communication boards remained inconsistent, and augmented input was used with variability across observation minutes. Influencing factors to teacher application seemed to be classroom setups (such as having a table), previous AAC skills, student characteristics, and postintervention efforts such as repeating the intervention or participating in follow-up sessions.

Conclusions: This study demonstrates that classroom teachers for students with ID can use augmented input and responsive strategies as a universal design approach in the classroom following the AKKtiv ComPal intervention. However, teachers may utilize the strategies somewhat differently, partly influenced by their contextual factors.

Implications: The findings suggest that while teachers for students with ID can successfully use communication partner strategies in the classroom, their use of augmented input should be nurtured over time to ensure sustained use and possibly improve consistency. Additionally, adapting to the physical environment of the classroom is crucial to optimize the application of these strategies.

Most students with intellectual and communicative disability who rely on augmentative and alternative communication (AAC) attend non-inclusive school settings. Little is known about turn-taking and the use of various communication modes in groups of students and staff in this context. Previous studies on single students with intellectual disability in various school settings have found that staff tend to dominate interactions and augmented communication modes are used more during structured than unstructured activities. The present study explored turn-taking contributions and communication modes in whole groups of students and staff in non-inclusive school settings in Sweden. Video observations of 33 students and 30 school staff were conducted in seven classrooms during one structured activity (circle time) and one unstructured activity (leisure time). Turn-taking contributions and communication modes were examined when comparing students and staff and when comparing the two activities. Findings revealed that staff dominated the interactions and augmented communication modes were used less during leisure time than circle time. Notably, aided augmented communication modes, particularly speech-output technologies, were used sparsely. Findings of this study highlight the importance of supporting staff members in applying partner strategies and incorporating augmented input, especially aided augmented input, across various group activities at school.