A scoping review of Augmentative and Alternative Communication (AAC) interventions in Low-and Middle-Income Countries (LMICs)

Efficacy of a novel augmentative and alternative communication system in promoting requesting skills in young children with Autism Spectrum Disorder in India: A pilot study

“…The Jellow AAC system is one of the first of its kind developed to cater to the unique socio-cultural sensibilities of the Indian diaspora. A majority of the commercially available AAC systems have been developed from an Anglo-European perspective (Muttiah et al, 2022; Nigam, 2006; Srinivasan et al, 2011). It is paramount that AAC systems be designed bearing in mind the local socio-cultural, linguistic, and geographic context (Blake Huer, 2000; Huer & Saenz, 2002; Nigam, 2006; Parette & Huer, 2002; Soto & Yu, 2014).…”

“…Although we did not conduct an individualized preference assessment for low-tech versus high-tech AAC modalities, in a developing country like India, we think that in addition to culturally-sensitive high-tech AAC apps, it is equally important to provide families access to low-tech aids that are more affordable and that families may regard as being “easier to use” given their existing comfort level with technology (Muttiah et al, 2022). This is also beneficial from the perspective of clinicians who may be initially more comfortable facilitating mastery of low-tech aids using well-established instructional protocols (Gilroy et al, 2017).…”

“…For example, from a cultural standpoint, certain festivals/holidays are highly region-specific, with origins rooted in local cultural, historical, and mythological traditions. From a sociological perspective, for instance, certain societies that are collectivistic may have different linguistic terms to contrast members of extended families from maternal and paternal sides (Morelli et al, 2018;Muttiah et al, 2022). From a linguistic perspective, AAC systems should be available in children's native languages to improve integration into the child's daily routines (An et al, 2017;Genc-Tosun & Kurt, 2017;Mngomezulu et al, 2019;Tönsing & Soto, 2020;Wepener et al, 2021).…”

“…This framework is in line with contemporary practices of speech therapists in India. This approach is frequently chosen in low-to-middle income developing countries since low-tech aids are accessible and affordable to a wide variety of people from varying socio-economic backgrounds (Bhatnagar & Silverman, 1999; Muttiah et al, 2022). Moreover, it is easier to educate families with a wide range of literacy levels on the use of low-tech aids as a starting point for the introduction of AAC into their child's life (Dada et al, 2017; Gormley, 2017).…”

“…To ensure effective adoption of an AAC system, it should be (a) accessible, with an easy-to-learn, intuitive interface, and (b) affordable, thereby facilitating integration into the child's daily routines (beyond speech therapy sessions) and social interactions (Basson & Alant, 2005; Mandak et al, 2017; Rackensperger, 2012; Sevcik & Romski, 2007). In a developing country like India, the cost of the system is a crucial consideration impacting system adoption (Blake Huer, 2000; Muttiah et al, 2022; Nigam, 2006; Srinivasan et al, 2011). Therefore, we developed an open source, cost-effective, child-friendly, and easy-to-use AAC system available in multiple formats to suit the diverse needs of children with communication difficulties.…”