Harnessing Collective Efficacy: Strategies for Augmentative…

“Speech Language Pathologists (SLPs) identified caregiver buy-in and carryover across providers as the most significant barriers to AAC implementation,” (Lorang, Emily, et al.). During interviews with a variety of stakeholders, Yau. S.H., et al. found all stakeholders, including parents-carers, educators, and clinicians ranked a lack of AAC knowledge as a barrier. The interviews “also noted that 88% of parent-carers, 80% of educators, and all clinicians mentioned experiencing negative attitudes towards AAC use and uptake. Lastly, all stakeholder groups experienced communication partners withholding the device, due to a fear the device would ‘break on their watch’.” These studies reinforce what many experience when implementing AAC systems and supporting multiple team members. At Kansas Infinitec, our mission is to advance independence and promote inclusive opportunities for all learners through technology. We achieve this by partnering with Kansas school districts and our work with the Technical Assistance System Network (TASN) High Quality Instruction within Inclusive Learning Environments (HQIILE), a project of the Kansas State Department of Education (KSDE). Through our work with Kansas Infinitec and as Speech-Language Pathologists, we have discovered the importance of harnessing collective efficacy to build a shared vision for AAC implementation. This approach leads to powerful and exciting outcomes for students and their families. AAC IMPLEMENTATION The AmericanSpeech-Language-Hearing Association (ASHA) practice portal on AAC notes that “Beukelman and Light (2020) estimated approximately 5 million Americans and 97 million people in the world may benefit from AAC.” However, according to the United States Society for Augmentative and Alternative Communication (USSAAC, n.d.), there are over 2 million children and adults in the United States who use Augmentative Alternative Communication (AAC). If there are approximately 5 million Americans who may benefit from AAC, but only 2 million are using it, why is AAC not being used, and specifically, when it is introduced why is it being abandoned or not used? Team members can often feel intimidated by the technology, or that they have a lack of knowledge about the use and integration of the AAC systems. The following scenario is inspired by the authors' experiences but does not depict any specific school, team members, or student. Any names used are fictional and not intended to represent real individuals. At Rock Elementary School, a dedicated school team is working with Jose who has been provided with an AAC system. The team includes paraeducators, teachers, therapists, and parents, all committed to supporting the student's communication needs. The Speech-Language Pathologist (SLP) introduces the AAC system and provides training, demonstrating how to model its use with the student. The SLP effectively uses the device during

sessions, but some team members still feel unsure about how to integrate it into daily routines. Maria is a team member who works closely with Jose, understanding his needs and wants without the device has become second nature. After the initial training, Maria begins incorporating the AAC device into activities. However, over time, she forgets to bring the device along to different settings or it goes uncharged, and Maria feels Jose doesn't appear to miss it. Gradually, the device is used less and less, often remaining on a shelf. When the SLP visits the classroom, she gets the device out, models its use with Jose, and encourages the team to continue using it. The SLP checks with Maria, since she is with Jose the most during the day, to see if she has any questions, but none are voiced because she is skeptical about whether the device is helping. After all, Jose has had it for three months and still doesn’t seem to use it except with the SLP. Renee is the SLP on the team. She completed an AAC evaluation with the team members who were participating and collecting data, at the IEP meeting the team reviewed this information and determined that Jose needed the device. During the evaluation, Jose engaged in activities in ways he had not done before, demonstrating exciting communication possibilities. Staff and family were trained in using the device with Jose, short videos were created for reference, and links to the company’s “how-to” videos were shared. Data sheets were designed to track the student's use of the device throughout the day, and reminders were placed around the classroom. Everyone seemed to be on board. However, a few weeks later, while walking by the library, Renee sees that Jose does not have his device. More time passes, and when Renee goes into the classroom for therapy, the device has to be retrieved from a shelf. The team is reminded of the importance of modeling and asked if there are any questions, but they say they have none. Renee wonders how she can get the team to see the importance of using the AAC system with Jose across his day. She has tried everything she can think of. She shares her concerns with her supervisor who talks to her about Collective Efficacy and how it could be used to build a sense of team and build trust and collaboration. This scenario presents a common challenge in AAC implementation: initial excitement followed by a decline in usage. While this example focuses on a high-tech communication device, this same lack of use of a system can happen if the student is using low-tech, or mid-tech. When a new system is started with a student, or the student transitions to a new school or classroom, there can be unmet expectations. These expectations will be different depending on the role of the person on the team and can impact one’s perception of the AAC system’s effectiveness. For the SLP or person who has had a lead role in recommending a system, that expectation is that people will use the tool as they have been trained to do, they will ask questions if they are unsure of something, and they will

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