Research Design and Methodology
The I-ASC project has taken a mixed methods approach to the study. This means both qualitative and quantitative methodologies were used.
This was achieved through focus groups and interviews with children and adults who use AAC, as well as family members, clinicians and other professionals. The work looked at what they think are the important decisions when assessing for an electronic communication aid. The attributes or characteristics identified in this work were used in the quantitative work and to design the decision making tools to enhance communication aid recommendations in the future
Word Package 1: Systematic Review
There are three linked systematic reviews relating to current evidence of:
- b) The language and communication characteristics of the communication aids considered in decision making
- c) Clinical decision making associated with aided communication in allied health professions
The reviews informed work packages 2,3 and 4 plus the decision-making tool.
Work Package 2: Focus groups with Clinicians reviewing current assessment processes
The aim of this work package was to understand the factors clinicians consider when making symbol communication aid recommendations. This generated data for work package 4 and contributed to one strand of the “expert clinical opinion” for the decision making tool.
Work Package 3: Interviews with children, young adults and adults who use AAC and the team around them regarding assessment experiences
Work package 3 provided a detailed understanding of the perspectives of all key stakeholders by exploring specific decisions for specific people. Child and family involvement was crucial to unpick long-term impact of decisions made on people who use symbol communication aids and their support networks. This contributed to the service users view and values (with the results of WP1, WP2 and WP4) to the decision-making tool.
Work Package 4: Quantitative Discrete Choice Modelling Study and surveys
The DCE, specifically using Choice Modelling, identified which attributes of the child and symbol communication aid were used by clinicians during recommendation of symbol communications aids and their relative importance in clinical decision making. These findings informed WP5 in terms of determining hierarchies explicit to these attributes and how they act as facilitators or barriers to the long term successful take up of symbol communication aid systems.
Work Package 5: Development of a heuristic (decision making resource) including focus groups to review findings
To influence practice, this phase combined all work packages, resulting in the development of a prototype decision support resource and decision making heuristic with guidance to ensure the best match between a symbol communication system and a child.
Through a purposive recruitment process, health and educational professions involved in current symbol communication aid decision making, along with PPI representative groups were invited to test the guidelines and heuristic.
Work Package 6: Dissemination
The final stage translated the findings into practice through targeted dissemination of the guidance/resources. However, it was recognized that dissemination was key throughout the project to engage participants in the study, as those people who dissemination was aimed at, were likely to be those to initiate change.
The PPI co-researchers took the lead on all dissemination through the life of the project.