{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T08:15:27Z","timestamp":1785658527968,"version":"3.56.0"},"reference-count":51,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Autism"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>From a critical disability rights lens, everyone has a right to communicate using any means available, which includes augmentative and alternative communication. The uptake of augmentative and alternative communication beyond the therapy room may be influenced by awareness, perceptions and acceptance of augmentative and alternative communication by caregivers, family members and the wider society. This study aimed to uncover parental perceptions of augmentative and alternative communication in a Global South context. Ten mothers and six fathers (16 participants) of children with complex communication needs were invited to be part of the study. A focus-group discussion and semi-structured interviews were undertaken using an interview guide. The participant data were analysed using Framework Analysis and through the lens of gender and critical disability theory. The key theme expressed was fear of augmentative and alternative communication deterring speech development. In addition, there was also concern that siblings might adopt the alternative communication method and stop talking. The participants questioned whether the visibility of a communication device could highlight their child\u2019s disability, thereby fearing societal stigma and negativity. Overall, parents\u2019 attitudes towards perspectives of and openness to use augmentative and alternative communication impact its uptake. The results suggest the need to consider the preparedness of parents prior to introducing augmentative and alternative communication and the need to offer on-going parental training.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Lay abstract<\/jats:title>\n                    <jats:p>Everybody has a right to communicate in any way they can, which includes augmentative and alternative communication. The uptake of augmentative and alternative communication in everyday life may be influenced by awareness, perceptions and acceptance of augmentative and alternative communication by caregivers, family members and the wider society. This study aimed to uncover what parents thought about augmentative and alternative communication in a Global South context. Eleven mothers and five fathers (16 participants) of children with complex communication needs were included. Data were collected using an interview guide from a focus-group discussion and semi-structured interviews. The data were analysed using Framework Analysis and from a gender and critical disability theory viewpoint. The key theme found was fear of augmentative and alternative communication stopping the child from learning to speak. The parents wondered if siblings might also use the alternative communication method and stop talking. They worried whether the communication device will negatively highlight their child in society. As parents\u2019 views on augmentative and alternative communication influence whether they use it with their child, informing and preparing parents before introducing augmentative and alternative communication to a child and on-going parent training should be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13623613241298061","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T02:38:48Z","timestamp":1732588728000},"page":"1157-1170","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Parental expectations and perceptions of augmentative and alternative communication: A Sri Lankan perspective"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6253-193X","authenticated-orcid":false,"given":"Shyamani","family":"Hettiarachchi","sequence":"first","affiliation":[{"name":"Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamra","family":"Nizar","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Lanka Foundation, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gopi","family":"Kitnasamy","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Lanka Foundation, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilani","family":"Gopi","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Lanka Foundation, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"Ambikile J. S. Outwater A. (2012). Challenges of caring for children with mental disorders: Experiences and views of caregivers attending the outpatient clinic at Muhimbili National Hospital Dar es Salam Tanzania. Child Adolescent Psychiatry Mental Health 6 Article 16. https:\/\/doi.org\/10.1753-2000-6-16","DOI":"10.1186\/1753-2000-6-16"},{"key":"e_1_3_2_3_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5\u2122 (5th ed.). American Psychiatric Publishing Inc. https:\/\/doi.org\/10.1176\/appi.books.9780890425596","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_3_2_4_1","unstructured":"American Speech-Language-Hearing Association. (2004). Augmentative and alternative communication (AAC). https:\/\/www.asha.org\/practice-portal\/professional-issues\/augmentative-and-alternative-communication\/"},{"key":"e_1_3_2_5_1","doi-asserted-by":"crossref","unstructured":"Bailey R. L. Parette H. P. Stoner J. B. Angell M. E. Carroll K. (2006). Family members\u2019 perceptions of augmentative and alternative communication device use. Language Speech and Hearing Services in Schools 37 50\u201360. https:\/\/doi.org\/10.1044\/0161-1461(2006\/006)","DOI":"10.1044\/0161-1461(2006\/006)"},{"key":"e_1_3_2_6_1","doi-asserted-by":"crossref","unstructured":"Binger C. Kent-Walsh J. Berens J. de Campo S. Rivera D. (2008). Teaching Latino parents to support the multi-symbol message productions of their children who require AAC. Augmentative and Alternative Communication 24 323\u2013328. https:\/\/doi.org\/10.1080\/07434610802130978","DOI":"10.1080\/07434610802130978"},{"key":"e_1_3_2_7_1","doi-asserted-by":"crossref","unstructured":"Branson D. Demchak M. (2009). The use of augmentative and alternative communication methods with infants and toddlers with disabilities: A research review. Augmentative and Alternative Communication 25 274\u2013286. https:\/\/doi.org\/10.3109\/07434610903384529","DOI":"10.3109\/07434610903384529"},{"key":"e_1_3_2_8_1","doi-asserted-by":"crossref","unstructured":"Bunning K. Gona J. K. Newton C. R. Hartley S. (2014). Caregiver perceptions of children who have complex communication needs following a home-base intervention using augmentative and alternative communication in rural Kenya: An intervention note. Augmentative and Alternative Communication 30 344\u2013356. https:\/\/doi.org\/10.3109\/07434618.2014.970294","DOI":"10.3109\/07434618.2014.970294"},{"key":"e_1_3_2_9_1","unstructured":"Central Bank of Sri Lanka. (2022). Sri Lanka socio economic data 2022. Central Bank of Sri Lanka Statistics Department. https:\/\/www.cbsl.gov.lk\/sites\/default\/files\/cbslweb_documents\/publications\/otherpub\/publication_sri_lanka_socio_economic_data_folder_2022_e.pdf"},{"key":"e_1_3_2_10_1","doi-asserted-by":"crossref","unstructured":"Cress C. J. Marvin C. A. (2003). Common questions about AAC services in early intervention. Augmentative and Alternative Communication 19 254\u2013272. https:\/\/doi.org\/10.1080\/07434610310001598242","DOI":"10.1080\/07434610310001598242"},{"key":"e_1_3_2_11_1","unstructured":"Department of Official Languages. (2024). Official languages policy. Ministry of Public Administration Home Affairs Provincial Councils and Local Government. https:\/\/www.languagesdept.gov.lk\/web\/index.php?option=com_content&view=article&id=38&Itemid=163&lang=en"},{"key":"e_1_3_2_12_1","unstructured":"Global Centre for Pluralism. (2023). Global pluralism monitor: Sri Lanka. https:\/\/monitor.pluralism.ca\/wp-content\/uploads\/2023\/07\/GPM-Report-Sri-Lanka-EN-WEB-1.pdf"},{"key":"e_1_3_2_13_1","doi-asserted-by":"crossref","unstructured":"Gona J. K. Newton C. R. Hartley S. Bunning K. (2014). A home-based intervention using augmentative and alternative communication (AAC) techniques in rural Kenya: What are the caregivers; experiences? Child: Care Health and Development 40 29\u201341. https:\/\/doi.org\/10.1111\/cch.12031","DOI":"10.1111\/cch.12031"},{"key":"e_1_3_2_14_1","doi-asserted-by":"crossref","unstructured":"Goode S. (2006). Assistive technology and diversity. Topics in Early Childhood Special Education 26 51\u201354. https:\/\/doi.org\/10.1177\/02711214060260010","DOI":"10.1177\/02711214060260010501"},{"key":"e_1_3_2_15_1","author":"Goodley D.","year":"2016","unstructured":"Goodley D. (2016). Disability studies: An interdisciplinary introduction. SAGE.","journal-title":"Disability studies: An interdisciplinary introduction"},{"key":"e_1_3_2_16_1","doi-asserted-by":"crossref","unstructured":"Grech S. (2015). Decolonising Eurocentric disability studies: Why colonialism matters in the disability and global South debate. Social Identities 211(1) 6\u201321. https:\/\/doi.org\/10.1080\/13504630.2014.995347","DOI":"10.1080\/13504630.2014.995347"},{"key":"e_1_3_2_17_1","doi-asserted-by":"crossref","unstructured":"Grech S. (2016). Disability and development: Critical connections gaps and contradictions. In Grech S. Soldatic K. (Eds.) Disability in the global South: The critical handbook (1st ed. pp. 3\u201319). Springer. https:\/\/doi.org\/10.1007\/978-3-319-42488-0","DOI":"10.1007\/978-3-319-42488-0_1"},{"key":"e_1_3_2_18_1","unstructured":"Gunawardena N. (2010). Subverted heroes: Narrative experiences of disabled veterans in post-war Sri Lanka [Unpublished master\u2019s thesis]. https:\/\/www.academia.edu\/3586407\/Subverted_Heroes_Narrative_Experiences_of_Disabled_Veterans_in_Post_War_Sri_Lanka"},{"key":"e_1_3_2_19_1","author":"Gunesekera M.","year":"2005","unstructured":"Gunesekera M. (2005). The postcolonial identity of Sri Lankan English. Vijitha Yapa.","journal-title":"The postcolonial identity of Sri Lankan English"},{"key":"e_1_3_2_20_1","doi-asserted-by":"crossref","unstructured":"Hamzat T. K. Mordi E. I. (2007). Impact of caring for children with cerebral palsy on the general health of their caregivers in the African community. International Journal of Rehabilitation Research 30 191\u2013194. https:\/\/doi.org\/10.1097\/mrr.0b013e3281e5af46","DOI":"10.1097\/MRR.0b013e3281e5af46"},{"key":"e_1_3_2_21_1","doi-asserted-by":"crossref","unstructured":"Hettiarachchi S. Kitnasamy G. Gopi D. (2020). \u2018Now I am a techie too\u2019: Parental perceptions of using mobile technology for communication by children with complex communication needs in the global South. Disability and Rehabilitation: Assistive Technology 15(2) 183\u2013194. https:\/\/doi.org\/10.1080\/17483107.2018.1554713","DOI":"10.1080\/17483107.2018.1554713"},{"key":"e_1_3_2_22_1","doi-asserted-by":"crossref","unstructured":"Hetzroni O. (2002). Augmentative and alternative communication in Israel: Results from a family survey. Augmentative and Alternative Communication 18 255\u2013123. https:\/\/doi.org\/10.1080\/07434610212331281341","DOI":"10.1080\/07434610212331281341"},{"key":"e_1_3_2_23_1","doi-asserted-by":"crossref","unstructured":"Huer M. Parette H. Saenz T. (2001). Conversations with Mexican Americans regarding children with disabilities and AAC. Communication Disorders Quarterly 22(4) 197\u2013206. https:\/\/doi.org\/10.1177\/152574010102200405","DOI":"10.1177\/152574010102200405"},{"key":"e_1_3_2_24_1","doi-asserted-by":"crossref","unstructured":"Islam M. R. (2015). Rights of the people with disabilities and social exclusion in Malaysia. International Journal of Social Science and Humanity 5 171\u2013175. https:\/\/doi.org\/10.7763\/IJSSH.2015.V5.447","DOI":"10.7763\/IJSSH.2015.V5.447"},{"key":"e_1_3_2_25_1","doi-asserted-by":"crossref","unstructured":"Joginder Singh S. Hussein N. H. Kamal R. M. Hassan F. H. (2017). Reflections of Malaysian parents of children with developmental disabilities on their experiences with AAC. Augmentative and Alternative Communication 33(2) 110\u2013120. https:\/\/doi.org\/10.1080\/07434618.2017.1309457","DOI":"10.1080\/07434618.2017.1309457"},{"key":"e_1_3_2_26_1","doi-asserted-by":"crossref","unstructured":"Johnson J. M. Inglebret E. Jones C. Ray J. (2006). Perspectives of speech language pathologists regarding success versus abandonment of AAC. Augmentative and Alternative Communication 22(2) 85\u201399. https:\/\/doi.org\/10.1080\/07434610500483588","DOI":"10.1080\/07434610500483588"},{"key":"e_1_3_2_27_1","doi-asserted-by":"crossref","unstructured":"King A. M. Hengst J. A. DeThorne L. S. (2013). Severe speech sound disorders: An integrated multimodal intervention. Language Speech and Hearing Services in Schools 44(2) 195\u2013210. https:\/\/doi.org\/10.1044\/0161-1461(2012\/12-0023)","DOI":"10.1044\/0161-1461(2012\/12-0023)"},{"key":"e_1_3_2_28_1","doi-asserted-by":"crossref","unstructured":"Kulkarni S. S. Parmar J. (2017). Culturally and linguistically diverse student and family perspectives of AAC. Augmentative and Alternative Communication 33(3) 170\u2013180. https:\/\/doi.org\/10.1080\/07434618.2017.1346706","DOI":"10.1080\/07434618.2017.1346706"},{"key":"e_1_3_2_29_1","doi-asserted-by":"crossref","unstructured":"Light J. McNaughton D. (2012). Supporting the communication language and literacy development of children with complex communication needs: State of the science and future research priorities. Assistive Technology 24(1) 34\u201344. https:\/\/doi.org\/10.1080\/10400435.2011.648717","DOI":"10.1080\/10400435.2011.648717"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/07434619612331277688"},{"key":"e_1_3_2_31_1","doi-asserted-by":"crossref","unstructured":"McCord M. S. Soto G. (2004). Perceptions of AAC: An ethnographic investigation of Mexican American families. Augmentative and Alternative Communication 20 209\u2013227. https:\/\/doi.org\/10.1080\/07434610400005648","DOI":"10.1080\/07434610400005648"},{"key":"e_1_3_2_32_1","doi-asserted-by":"crossref","unstructured":"Mik-Meyer N. (2016). Othering ableism and disability: A discursive analysis of co-workers\u2019 construction of colleagues with visible impairments. Human Relations 69(6) 1341\u20131363. https:\/\/doi.org\/10.1177\/0018726715618454","DOI":"10.1177\/0018726715618454"},{"key":"e_1_3_2_33_1","doi-asserted-by":"crossref","unstructured":"Millar D. C. Light J. C. Schlosser R. W. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review. Journal of Speech Language and Hearing Research 49 248\u2013264. https:\/\/doi.org\/10.1044\/1092-4388(2006\/021)","DOI":"10.1044\/1092-4388(2006\/021)"},{"key":"e_1_3_2_34_1","volume-title":"Disabling \u2018the disabled\u2019: A study of Malaysian perceptions of disability \u2013 Theoretical and practical orientations in language and literature studies","author":"Norazit L. K.","year":"2007","unstructured":"Norazit L. K., Awab S. (2007). Disabling \u2018the disabled\u2019: A study of Malaysian perceptions of disability \u2013 Theoretical and practical orientations in language and literature studies. Pearson."},{"key":"e_1_3_2_35_1","doi-asserted-by":"crossref","unstructured":"Pape T. L. B. Kim J. Weiner B. (2002). The shaping of individual meanings assigned to assistive technology: A review of personal factors. Disability and Rehabilitation 24(1\/2\/3) 5\u201320.","DOI":"10.1080\/09638280110066235"},{"key":"e_1_3_2_36_1","unstructured":"Parette H. P. Brotherson M. J. Huer M. B. (2000). Giving families a voice in augmentative and alternative communication decision-making. Education and Training in Mental Retardation and Developmental Disabilities 35(2) 177\u2013190. http:\/\/www.jstor.org\/stable\/23879942"},{"key":"e_1_3_2_37_1","doi-asserted-by":"crossref","unstructured":"Parette H. P. Huer M. B. (2002). Working with Asian American families whose children have augmentative and alternative communication needs. Journal of Special Education Technology 17 5\u201313. https:\/\/doi.org\/10.1177\/016264340201700401","DOI":"10.1177\/016264340201700401"},{"key":"e_1_3_2_38_1","doi-asserted-by":"crossref","unstructured":"Pennington L. Noble E. (2010). Acceptability and usefulness of the group interaction training programme: It takes two to talk to parents of pre-school children with motor disorders. Child: Care Health and Development 36 285\u2013296. https:\/\/doi.org\/10.1111\/j.1365-2214.2009.01054.x","DOI":"10.1111\/j.1365-2214.2009.01054.x"},{"key":"e_1_3_2_39_1","doi-asserted-by":"crossref","unstructured":"Pickl G. (2011). Communication intervention in children with severe disabilities and multilingual backgrounds: Perceptions of pedagogues and parents. Augmentative and Alternative Communication 27 229\u2013244. https:\/\/doi.org\/10.3109\/07434618.2011.630021","DOI":"10.3109\/07434618.2011.630021"},{"key":"e_1_3_2_40_1","doi-asserted-by":"crossref","unstructured":"Raina P. O\u2019Donnell M. Rosenbaum P. Brehaut J. King G. Walter S. D. Wood E. (2005). The health and well-being of caregivers of children with cerebral palsy. Paediatrics 115 626\u2013636. https:\/\/doi.org\/10.1542\/peds.2004-1689","DOI":"10.1542\/peds.2004-1689"},{"key":"e_1_3_2_41_1","doi-asserted-by":"crossref","unstructured":"Ripat J. Woodgate R. (2011). The intersection of culture disability and assistive technology. Disability and Rehabilitation: Assistive Technology 6(2) 87\u201396. https:\/\/doi.org\/10.3109\/17483107.2010.507859","DOI":"10.3109\/17483107.2010.507859"},{"key":"e_1_3_2_42_1","doi-asserted-by":"crossref","unstructured":"Ritchie J. Spencer L. (1994). Qualitative data analysis for applied policy research. In Bryman A. Burgess R. G. (Eds.) Analyzing qualitative data (pp.173\u2013194). Routledge. https:\/\/doi.org\/10.4324\/9780203413081_chapter_9","DOI":"10.4324\/9780203413081_chapter_9"},{"key":"e_1_3_2_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001163-200507000-00002"},{"key":"e_1_3_2_44_1","doi-asserted-by":"crossref","unstructured":"Romski M. A. Sevcik R. A. Adamson L. B. Cheslock M. Smith A. Barker R. M. Bakeman R. (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech Language and Hearing Research 53 350\u2013364. https:\/\/doi.org\/10.1044\/1092-4388(2009\/08-0156)","DOI":"10.1044\/1092-4388(2009\/08-0156)"},{"key":"e_1_3_2_45_1","doi-asserted-by":"crossref","unstructured":"Ryan S. Runswick-Cole K. (2008). Repositioning mothers: Mothers disabled children and disability studies. Disability & Society 23(3) 199\u2013210. https:\/\/doi.org\/10.1080\/09687590801953937","DOI":"10.1080\/09687590801953937"},{"key":"e_1_3_2_46_1","doi-asserted-by":"publisher","DOI":"10.2511\/rpsd.32.1.50"},{"key":"e_1_3_2_47_1","doi-asserted-by":"crossref","unstructured":"Schlosser R. W. Wendt O. (2008). Effects of augmentative and alternative communication intervention on speech production in children with autism: A systematic review. American Journal of Speech-Language Pathology 17 212\u2013230. https:\/\/doi.org\/10.1044\/1058-0360(2008\/021)","DOI":"10.1044\/1058-0360(2008\/021)"},{"key":"e_1_3_2_48_1","doi-asserted-by":"crossref","unstructured":"Soto G. (2012). Training partners in AAC in culturally diverse families. Perspectives on Augmentative and Alternative Communication 21(4) 144\u2013150. https:\/\/doi.org\/10.1044\/aac21.4.144","DOI":"10.1044\/aac21.4.144"},{"key":"e_1_3_2_49_1","doi-asserted-by":"crossref","unstructured":"Stuart S. Parette H. P. (2002). Native Americans and augmentative and alternative communication issues. Multiple Voices 5(1) 38\u201353. https:\/\/doi.org\/10.56829\/muvo.5.1.p8006861217m5414","DOI":"10.56829\/muvo.5.1.p8006861217m5414"},{"key":"e_1_3_2_50_1","unstructured":"United Nations Development Programme. (2004 December 4). Forging a global South: United Nations Day for South-South Cooperation. https:\/\/www.undp.org\/sites\/g\/files\/zskgke326\/files\/migration\/cn\/UNDP-CH-PR-Publications-UNDay-for-South-South-Cooperation.pdf"},{"key":"e_1_3_2_51_1","doi-asserted-by":"crossref","unstructured":"Walisundara D. C. Hettiarachchi S. (2015). English language policy and planning in Sri Lanka: A recent overview. In Kirkpatrick R. (Ed.) English language education policy in Asia (Language policy) (Vol. 13 pp. 301\u2013332). Springer. https:\/\/doi.org\/10.1007\/978-3-319-22464-0","DOI":"10.1007\/978-3-319-22464-0_14"},{"key":"e_1_3_2_52_1","unstructured":"World Health Organization (2001). The International Classification of Functioning Disability and Health (ICF). WHO. http:\/\/www.who.int\/classifications\/icf\/en\/"}],"container-title":["Autism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13623613241298061","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13623613241298061","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13623613241298061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:50:20Z","timestamp":1777380620000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13623613241298061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,25]]},"references-count":51,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1177\/13623613241298061"],"URL":"https:\/\/doi.org\/10.1177\/13623613241298061","relation":{},"ISSN":["1362-3613","1461-7005"],"issn-type":[{"value":"1362-3613","type":"print"},{"value":"1461-7005","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,25]]}}}