| Family involvement in augmentative and alternative communication (AAC) is important, especially with a toddler or preschooler. This study examined AAC family satisfaction within the framework of family paradigms, which states that families view their environments in paradigmatically different ways. The view from a paradigm, (i.e., closed, random, open, and synchronous), guides families in using resources of time, space, energy, and material in the pursuit of their goals of control, affect, meaning, and content.Closed paradigms involve strategies that follow traditions, conserve resources, and reinforce loyalty to one's family. Random paradigms involve strategies that seek innovation, expend resources with zest, and encourage individual freedom. Open paradigms involve strategies that create collaborative action, balance group and individual needs for resources, and communicate practicality. Synchronous paradigms involve strategies that ground family constancy, maintain resources, and connect with the timeless universals of life. More than one paradigm can be used by a family.In this study, participants were 54 primary caregivers from 27 different states. The 55 children, aged 15 to 75 months, had not yet started kindergarten, had used the then current AAC system for six to 24 months, and had a variety of developmental disorders resulting in a severe communication disorder. Most had multimodal AAC systems, which included both aided and unaided components although 11 had only the unaided AAC system of sign language. More than half of the AAC systems included a voice output component. Sign language was the most frequently used AAC within the child's home.The primary caregivers, all mothers, completed an 81-question case history and a 10-question instrument, the AAC Family-Paradigm Assessment Scale (AACF-PAS), which was adapted from earlier scales that identified family paradigms that guide family behavior. The AACF-PAS results from 42 families revealed that 33% frequently used a closed paradigm, 48% frequently used a random paradigm, 76% frequently used a open paradigm, and 10% frequently used a synchronous paradigm, with one half of the families frequently combining family paradigms.In contrast to those results, closed (36%), random (57%), and open (55%) paradigms were most frequently remembered when caregivers provided a retrospective judgment of their family functioning from the period of time before the child's diagnosis. However, after the child's diagnosis, closed and open paradigms were used by more families while random paradigm decreased. After AAC implementation, families reported increased reliance on random and open while decreasing closed strategies. This trend continued when families identified a hypothetical, ideal method of family functioning.The primary caregivers were generally satisfied with the child's AAC system. Families who started with random paradigms before the child was diagnosed and/or who ideally desired random paradigms were more likely to be satisfied with their AAC system. In contrast, families who more frequently used a closed paradigm at the time of the study were more likely to be dissatisfied with their AAC system. Additional demographics, future research directions, and clinical implications are also discussed. |
