Page 214 - Handbook of Electronic Assistive Technology

202 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

highly than well-developed and conducted studies that are not RCTs (Gugiu, 2015). In
addition, other arguments suggest that group studies that show positive average group
differences following intervention may not be of benefit to some particular individuals,
and/or may not reflect variation in change over time (McDonald et al., 2017). Equally,
the heterogeneous characteristics of individuals using AAC can challenge the require-
ment of RCTs that the randomly selected treatment group matches an alternative
nontreatment group.
It has been suggested that other robust methods such as experimental single case stud-
ies (e.g., Soto and Clarke, 2017) may be more suitable for evaluating the types of behavioural
interventions used in the field of AAC, and such studies may be more easily integrated into
everyday clinical practice (McDonald et al., 2017).

Practice-Based Evidence
While the use of the best available research evidence available is an important part of clini-
cal practice, it is perhaps equally important that the clinical practice in AAC be conducted,
as far as possible, in a standardised and structured way to support consistency across ser-
vices, and to contribute to developing understanding in the field. It is known (Pennington
et al., 2007) that people involved in AAC research are not described in terms adequate to
allow replication of studies, and the barriers to more standardised clinical practice are
also widely acknowledged. For example, there are few standardised assessment tools or
profiles specific to AAC, and so assessment reports are often based on observations and
assessment batteries that may be specific to a single therapist or team, making collection
of data from multiple centres challenging for researchers.

AAC Service Delivery in the United Kingdom

Finally, it may be helpful to consider how AAC services are currently delivered in the United
Kingdom.
The delivery and funding of AAC services varies across the United Kingdom. This sec-
tion provides a summary of the way in which services are organised in England and Wales,
Scotland and the Republic of Ireland. Since provision models are subject change, the
4
reader is advised to consult the website of Communication Matters for the latest infor-
mation on service delivery and commissioning.
England

In England, a key document in the development of AAC services was The Bercow Report:
A Review of Services for Children and Young People (0–19) with Speech, Language and
Communication Needs (2008). This report set out 40 recommendations for the devel-
opment of services for children with speech, language and communication needs,

4 http://communicationmatters.org.uk.