Alternative and augmentative communication technologies to support adults with mild intellectual disabilities during clinical consultations: a scoping review

Ryan Colin Gibson, Matt-Mouley Bouamrane, Mark D. Dunlop

Research output: Contribution to journalArticlepeer-review

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Abstract

Background: People with intellectual disabilities (ID) face significant communication barriers when accessing healthcare services. They find it difficult to identify and describe conditions in a clear enough manner to support practitioners in making an accurate diagnosis. In addition, medical professionals generally have little knowledge and understanding of the needs of people with ID, which may result in the employment of consultation techniques that do not cater to their patients’ skills.

Objective: To identify and synthesize the literature on Augmentative and Alternative Communication (AAC) technologies used to support adults with mild ID during the exchange of information with medical practitioners.

Methods: A scoping review of studies published in English, describing the technologies used to promote communication with patients with mild ID during medical consultations. The databases searched were PubMed; ACM Digital Library; and Google Scholar. A qualitative framework-based approach was used to synthesize the data and discern key recurring themes across the identified literature.

Results: Of the n=1557 articles screened, n=15 met our search inclusion criteria. The bulk of the communication aids employed focused on low-tech solutions, including: patient passports; notes based prompts; Talking Mats™; health diaries; and Easy Read information sheets. Their influence on current practice ranged from advancing medical professionals’ knowledge of the health and communication needs of people with ID, to increasing interagency collaboration, patient advocacy skills and health promotion activities. Major barriers to the implementation of low-tech aids centered on a lack of portability and increased efforts in maintenance. Just three studies explored the use of mobile applications to promote communication. Their findings indicated that high-tech solutions offer greater customization regarding the accessibility and healthcare needs of people with ID.

Conclusions: AAC technologies have the potential to increase the quality of care being provided to patients with mild ID, yet little work has been carried out in this area. Greater emphasis must be placed on (high-tech) two-way communication aids that empower patients to become involved in decisions regarding their care. Quantitative evaluation methods should be used to discern the true benefits of such aids, with researchers describing their study protocols in depth to promote replication and generalizability.

Original languageEnglish
Number of pages35
JournalJMIR Rehabilitation and Assistive Technologies
Publication statusAccepted/In press - 2 Apr 2021

Keywords

  • intellectual disabilities
  • health care
  • communication
  • augmentative and alternative communication
  • communication modalities
  • mobile applications
  • patient passports
  • Talking Mats
  • health assessment booklets

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