Daisy Clay takes a candid look at why abandonment of electronic communication aids is so common, and what can we do about it.
For children, young people, and adults who experience difficulty with speech, electronic communication aids can be life-changing. Some people use these tools to support their speech, while others may use them to fully replace speech. Communication aids, also known as speech generating devices, are part of a broader set of tools known as augmentative and alternative communication (AAC). AAC includes everything from paper-based symbol boards to electronic devices and apps that support or replace someone’s natural speech.
Despite professionals and educators frequently identifying the need for AAC tools in both classroom and home settings, research tells us that many people who are provided with AAC will ultimately stop using it. This can happen even though their need for communication support has not gone away—sometimes only months after beginning to use it. Because living with a disability is a deeply individual experience, the reasons for device abandonment differ between people and context. Our extensive research into AAC abandonment has enabled us to organise our findings into themes that families and professionals can recognise and act on.
Form and function
An AAC solution must be suitable for the individual user’s physical and cognitive needs, but in practice this doesn’t always happen. Factors such as the physical skills needed to access the device, cognitive abilities such as attention and understanding, and even the suitability of the voices available on devices can all affect how a person can use their device. This is commonly referred to as feature matching—matching the features of the AAC system to the individual user. It is a critical part of the AAC decision-making process and requires expertise from professionals with AAC knowledge, alongside the insights of those who know the individual best: their family, the person themselves, and other key professionals. When the technology is not well matched to a person’s specific capabilities and needs, this can quickly lead to frustration and abandonment.
Uptake
For AAC to be accepted, it must not only fit into someone’s everyday life—it must be perceived by the user as genuinely useful. As a minimum, AAC must be reliable, portable, easy to use and fast enough for communication. If it’s too hard or too slow, or it’s likely to break down, it’s no surprise when it’s put aside. For someone to truly embrace an AAC device, it needs to enhance their ability to communicate and support greater independence. Personalisation is essential. The AAC user must have access to vocabulary for the things they want to talk about, and be able to express themselves in ways that feel authentic. When this happens, communication becomes more natural, and interactions with others become more meaningful.
Different features of a communication aid may be more or less important to an individual user. For example, it may be important for them to use their device on social media, to send messages, or to make a phone call. So much communication now happens beyond face-to-face conversations, and AAC provision needs to reflect this.
Parents and caregivers can feel intimidated by the learning curve involved in using electronic AAC, and this can be a barrier to using the device consistently at home. Families who connect with others on a similar AAC journey are far more likely to embrace the technology in the long term. Having a support network like this can help to manage expectations, build confidence, share practical ideas, and reduce feelings of isolation.
Context
External influences also play a major role in the success of AAC. Fundamentally, there must be access to funding for a device to be provided. However, this funding also needs to cover ongoing training and support. In fact, training and support were the most frequently reported factors throughout our research. It is not enough to simply gain access to an AAC device—the AAC user, their families and the professionals around them must all be trained and supported in how to use that device.
Crucially, this training and support must be ongoing. It should support the continued development of the AAC user’s communication skills and be available at times of transition, when the risk of abandonment increases—for example, when moving classes, changing schools, or transferring from child to adult services. The attitudes of those around the user—teachers, therapists, peers, and family members—are equally important. Without a positive approach to AAC, regular modelling and encouragement to use the device, an individual’s engagement and confidence can quickly decline.
In school, consistently including AAC across the classroom, the playground and wider activities helps to normalise its use. However, competing priorities and limited training can make this challenging for educators. Similarly, at home, parents often feel unsure about using new technology. Building familiarity through practical guidance, repetition, and reassurance from professionals can make a significant difference to confidence and long-term AAC success.
The personal factor
Personal motivation, mental and physical health, and the feedback users receive from those around them can all shape how consistently they use their AAC device. Positive reinforcement, enjoyment, and encouragement are vital for maintaining engagement over time. Small successes, noticed and celebrated by the people around the AAC user, can make a big difference. People with disabilities are at higher risk of mental health difficulties, and this risk is even higher for those with communication difficulties. Yet AAC has the potential to positively influence mental health by improving independence, relationships, self-esteem and self-advocacy.