Listening to Practitioners: A Critical Reflection on AAC Use in Supporting Children and Young Adults with Autism

Sehar Jaggi, University of Warwick

Introduction

Research involving communication and disability requires careful consideration of how experiences are understood and represented. Research questions, interview prompts and analytical decisions can influence which perspectives become visible and how findings are interpreted. These considerations were particularly relevant to my Undergraduate Research Support Scheme (URSS) project, which explored practitioners’ experiences of using Augmentative and Alternative Communication (AAC) to support children and young adults with autism at the Autism Centre for Excellence (ACE), New Delhi.

AAC encompasses communication tools and strategies, including manual signs, picture-based systems and speech-generating applications. Although these systems can provide alternative ways to communicate, their practical use involves more than technology itself. Communication occurs within institutions, relationships and everyday environments, suggesting that support and accessibility can influence how AAC is experienced (National Autistic Society, 2023).

This reflection examines my research experience through three dimensions: methodological learning, the representation of autistic people through practitioner accounts and my development as a researcher. I argue that the project’s most significant contribution to my learning was recognising that qualitative research involves not only collecting experiences but also making interpretive decisions about whose experiences are heard and how they are represented.

Background

This research project originated during my internship at the ACE, New Delhi, India, where I gained insight into how AAC was used to support autistic children and young adults. Observing practitioners incorporate AAC into their work sparked my curiosity about the role these systems played in facilitating communication. I became particularly interested in understanding practitioners’ experiences of using AAC, the benefits they perceived for the children they supported and the challenges they encountered in its implementation. This practical exposure prompted me to develop this interest into a formal undergraduate research project through the University of Warwick’s URSS.

The project aimed to explore practitioners’ experiences of using AAC to support communication among autistic children and young adults. I conducted five semi-structured online interviews, each lasting approximately 30 minutes, with practitioners who had experience of using AAC in their work. The interviews explored perceived benefits, practical challenges, caregiver involvement and opportunities to improve implementation.

I analysed the interview transcripts using Braun and Clarke’s (2006) approach to thematic analysis by identifying patterns across participants’ accounts. Four themes informed the final presentation: AAC as a route to communication, agency and participation; the relationship between personalisation and usability; the importance of support across settings; and the influence of beliefs, resources and cultural fit.

The project enabled me to build on my practical exposure to AAC by examining practitioners’ experiences more systematically. However, moving from observing AAC in practice to interpreting interview accounts also raised questions about how research questions are shaped by personal interests, how participants experiences are represented and what conclusions can reasonably be drawn from a small qualitative study.

Interpretation

Methodological learning

One of my key learning experiences was recognising the difference between identifying recurring themes and developing an interpretation of what those themes mean. Thematic analysis provided a structured approach to identifying patterns across interviews, but the resulting themes were not simply waiting to be discovered in the transcripts. They were developed through decisions about which extracts were significant, how themes related to one another and how individual accounts could be brought together into a coherent interpretation.

Braun and Clarke (2006) describe thematic analysis as a method for identifying and interpreting patterns of meaning within qualitative data. Their approach helped me understand that analytical rigour does not depend solely on the number of times a topic appears. It also requires attention to the context in which participants discuss an issue and the significance of that issue to the research question.

For instance, caregiver involvement emerged as an important aspect of AAC implementation. It would have been easier to interpret this as evidence that successful communication depends primarily on caregivers. However, such an interpretation risks ignoring the wider conditions that affect implementation, including access to devices, affordability and opportunities for training. The accounts therefore encouraged me to consider how individual actions interact with structural constraints.

This distinction also influenced how I approached the presentation of findings. I recognised that the barriers discussed by the practitioners were not reflective of how prevalent these constraints were beyond the interview sample. With only five participants, numerical summaries risk overstating how representative the data actually is.

The experience taught me that a clear presentation should not come at the expense of methodological accuracy. In future projects, I will distinguish more explicitly between interpretative claims, descriptive patterns and conclusions that would require additional evidence.

Representation and power

A second important consideration was the relationship between practitioners’ accounts and the experiences of autistic people themselves. Interviewing practitioners provided valuable insight into the everyday use of AAC within a therapeutic setting. However, practitioners interpret communication through their experiences, professional roles and expectations. Their accounts cannot automatically be treated as equivalent to the perspectives of people using AAC.

This distinction is integral when considering communication, participation and independence. A practitioner may interpret a child’s use of a device as evidence of progress, but the meaning of that interaction for the child cannot be established through the practitioners’ account alone. Similarly, difficulties with device use may reflect limitations in the accessibility or design of a system rather than an individual’s inability to communicate.

Milton’s (2012) double empathy problem challenges explanations of communication difficulties that locate the problem exclusively within autistic individuals. It draws attention to differences in perception and understanding between people. Although this concept does not directly explain every challenge highlighted in the interviews, it encouraged me to question interpretations that locate responsibility solely within the autistic person or their family. For instance, discussions of caregiver acceptance could be interpreted as evidence of insufficient understanding. Yet this interpretation would remain incomplete without considering families’ financial resources, access to information and previous experiences of support. A critical approach requires recognising these contextual factors rather than reducing complex circumstances to individual attitudes.

The project thus highlighted an important question: ‘Whose knowledge informed the research?’ The study examined practitioner perspectives and did not directly interview autistic AAC users or caregivers. This was appropriate to the defined research question but restricted the conclusions I could draw about the wider experience of AAC. I learnt that clearly defining the scope of a study is as crucial as recognising what remains outside it.

Positionality and ethical responsibility

The research also encouraged me to reflect on my position as a student researcher interpreting accounts from a specialist organisation in India. My research questions and analytical choices were shaped by my academic understanding of autism and psychology. Although I aimed to represent the participants’ accounts accurately, I could not assume that my interpretations were exhaustive.

Positionality concerns how a researcher’s background and assumptions influence the research process. In qualitative research, reflexivity involves examining these influences rather than assuming they can be entirely removed. Braun and Clarke’s (2019) research on reflexive thematic analysis reinforced the importance of treating the researcher as an active participant in the production of knowledge.

This became particularly relevant when considering family attitudes and cultural fit. Participants discussed how stigma, language and screen-related concerns could affect AAC implementation. These accounts offered important context but also required careful interpretation. It would be misleading to treat the experiences described by five practitioners at a single organisation as representative of all families in India. Doing so would risk reproducing broad cultural assumptions on the basis of a limited dataset.

Moreover, I recognised the importance of privacy while discussing children and families during the interviews. The research involved practitioners’ accounts of working with autistic young people, making anonymisation of identifiable details essential. Ethical responsibility therefore extended beyond obtaining consent from interview participants. It also involved considering how examples and quotations might represent people who had not participated directly.

These considerations changed how I understood a researcher’s role. Producing an accessible account of the findings was important, but so too was ensuring that clarity did not become oversimplification. I needed to communicate patterns while preserving the diversity, complexity and uncertainty that qualitative findings inevitably capture.

Evaluation

The project’s strength lay in its ability to capture practical experiences that may be difficult to understand through numerical measures alone. Through semi-structured interviews, practitioners were able to describe their experiences with AAC and share perceived benefits and challenges in their own words. As such, the qualitative design was well-suited to an exploratory research question concerned with experience and implementation.

The development of four connected themes also helped move the analysis beyond a simple list of advantages and disadvantages. Together, the themes suggested that AAC should not be understood as a device operating independently of its environment. Rather, its practical value was described in relation to individual needs, caregiver involvement, system design and access to resources.

However, the project’s small sample, drawn from a single organisation, limited the range of perspectives represented. The interviews also relied on practitioners’ recollections and interpretations rather than on direct observation or independent measures of communication outcomes. Consequently, the findings were able to illuminate perceived benefits and implementation challenges but could not establish the effectiveness of a particular AAC system or demonstrate causal relationships.

Another challenge was communicating qualitative findings within the limited space available on a research poster. Condensing the analysis required selecting particular themes and quotations, which inevitably gave some aspects of the data greater visibility than others. This made me more aware that dissemination is itself an interpretive process, as the format in which research is presented influences what an audience notices and remembers.

Overall, I learnt that a successful research project is not one that eliminates every limitation. Rather, it is one that understands the relationship between its research question, methods, evidence and claims. Acknowledging limitations strengthens the study by making the boundaries of its conclusions explicit.

Future planning

This experience will inform my future research in three ways. First, I will make reflexivity a more deliberate part of the research process. I intend to record my initial assumptions, revisit them during coding and document why those particular interpretations developed. This will help me identify where my expectations may be influencing the analysis.

Second, I will give greater consideration to whose perspectives are included in research design. Future investigations of communication support should actively involve autistic individuals and AAC users. Whenever ethically possible, studies must use accessible, tailored methods that promote full participation. Caregiver perspectives could also provide insight into experiences outside educational settings.

Finally, I will pay closer attention to the distinction between individual and structural explanations. When participants describe barriers involving attitudes or engagement, I will consider how resources, institutional practices and wider social conditions might shape those experiences. This will help avoid interpretations that place disproportionate responsibility on individuals or families.

These changes will be particularly relevant to my continuing interest in psychology and neuropsychology, where research can influence how people’s experiences are understood and how support is designed.

Conclusion

This project extended my understanding of qualitative research beyond data collection and thematic analysis. It demonstrated how the production of knowledge involves methodological choices, interpretative judgements and ethical responsibilities concerning whose perspectives are represented.

The findings highlighted practitioners’ perceptions of AAC as a potential support for participation and communication, while emphasising the importance of accessibility, support and individualisation across settings. Equally, reflecting on the project revealed the limits of relying exclusively on practitioner accounts and the need to avoid generalising from a small, organisation-specific sample.

Ultimately, the experience reinforced that research rigour involves more than producing coherent findings. It requires being transparent about how interpretations are developed, attentiveness to whose voices are absent and caution regarding the claims that the evidence can support. These lessons will shape my future research by encouraging a more reflexive and inclusive approach to understanding human experience.

Glossary

Augmentative and Alternative Communication (AAC): Tools and strategies that support communication alongside or instead of speech.

Positionality: The ways a researcher’s background, assumptions and social position may influence research.

Reflexivity: The ongoing examination of how a researcher’s perspectives and decisions influence the research process.

Thematic analysis: A qualitative method for identifying and interpreting patterns of meaning across a dataset.

Generalising: The extent to which findings can be applied beyond the people, settings or circumstances studied.