Thirteen observational studies were included in the review. Sample types and sizes varied (for example, from six to 165 individuals and from four to 114 families). Methodological quality was limited and common problems were: small sample size; low response rate; unrepresentative population (such as predominantly white middle class); selective outcomes reporting; and lack of rigour in statistical analysis.
Family interaction (seven studies): Some studies reported that AAC had a positive impact on aspects that related to relationships with nuclear and extended family, and on family communication styles and preferences. However, a need was identified for extended family members to be included in the process of planning for AAC and for the affected family’s preferred communication style to be taken into account, especially among ethnic minorities.
Parenting (eight studies): Two studies reported that AAC devices helped ease some aspects of parenting tasks; other studies indicated an increased parenting workload, especially for mothers, that required time, energy and advocacy. They perceived a need for more information and training, especially on integrating AAC into family and community life (such as accessing support groups).
Physical/material well being (six studies): Introduction of AAC had a substantial financial impact on families, who expressed a need for information about funding mechanisms, vendor support and warranties available on devices.
Disability-related support (seven studies): Families requested partnership with professionals in AAC use and for attention to be given to their specific family needs. AACs needed to fit in to a child’s social and community life and be adaptable to changing communication requirements over time. Parents needed to be made aware of their child’s educational and social rights to permit informed parental choices.
Emotional well being (seven studies): AAC devices had both positive and negative impact in this domain. Professional insensitivity to family concerns during AAC implementation was identified as a source of frustration, but professionals were also identified as a primary source of social support.