Reciprocal Innovation to Optimize Low-Tech Augmentative and Alternative Communication (AAC) for Individuals

Summary

Many people with autism and other developmental conditions have difficulty speaking or do not use speech and need other ways to communicate. Augmentative and alternative communication (AAC) includes tools such as picture boards, communication books, and gestures that support communication. In low-resource settings and underserved rural areas in the United States, high-tech AAC devices are often too expensive or difficult to access, and trained specialists are limited.

Low-tech AAC options are more affordable but are often not used successfully because tools may not match the individual's abilities or daily environment, caregivers and providers may lack training, and stigma or low awareness may discourage use. These challenges can lead to AAC abandonment and social isolation.

Rural Virginia and western Kenya face similar barriers, including limited AAC expertise, inconsistent assessment, and insufficient training for families, educators, and community providers. This project uses a shared learning approach that combines western Kenya's experience implementing low-tech AAC in new settings with rural Virginia's expertise in individualized assessment, training, and scalable service delivery. The goal is to better match individuals to appropriate low-tech AAC systems and support communication partners to use them effectively.

Conditions

• Autism
• Neurodevelopment

Interventions

BEHAVIORAL

Automated AAC Assessment and Low-Tech AAC Implementation Support

This intervention includes a computer-based assessment that identifies individual communication needs and generates personalized recommendations for low-tech augmentative and alternative communication (AAC) strategies. Recommended AAC materials, such as picture-based boards, object symbols, and communication routines, are culturally adapted for use in western Kenya and rural Virginia. Communication partners use these recommendations to support consistent and appropriate AAC use in daily activities.

BEHAVIORAL

Standard AAC Support

Communication partners receive standard of care, defined as usual AAC referral pathways and locally available AAC training and support resources.

Sponsors & Collaborators

• Moi Univeristy

  collaborator OTHER

• University of Virginia

  collaborator OTHER

• Indiana University

  lead OTHER

Principal Investigators

• Eren Oyungu, MBChB · Moi University

• Megan S. McHenry, MD · Indiana University

• Mandy Rispoli, PhD · University of Virginia

• Jim Solan, PhD · University of Virginia

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

SEQUENTIAL

Eligibility

Min Age

3 Years

Max Age

14 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2027-06-01

Primary Completion

2030-06-01

Completion

2032-06-01

Countries

• United States
• Kenya

Study Locations