I-ASC: Identifying appropriate symbol communication aids for children who are non-speaking: enhancing clinical decision making.

Background
Children who need to use symbolic communication aids are the most challenging population accessing specialised communication aid services. Currently there is a lack of understanding of the most valuable aspects of clinical expertise and a poor understanding of patient values within the clinical decision process (Scherer et al, 2007). Without research evidence to reinforce clinical expertise there is no means of determining the actual quality of provision (Batorowicz & Shepherd, 2011; Dietz et al, 2012).

Aims and objectives
The overall aim is to improve the outcomes for children with little or no intelligible speech, who need symbol communication aids to communicate.

The specific aim is to influence current practice to improve the consistency and quality of clinical decision making in the provision of symbol communication aids.

Methods
Through five related work packages and a purposive recruitment process, health and educational professionals, family members and young people who use symbol communication aids will be interviewed and surveyed (a minimum of n=400). Respondents will be sought from the well-established AAC (specialised) centres across the UK and leading charitiable organisations, ensuring appropriate and sufficient respondents.

Informed by focus groups and interviews with all stakeholder groups, two Discrete Choice Experiments (DCE) will be conducted. Experiment A) symbol communication system choice, where a child with communication difficulties is described along with 2 or more attributes from a symbol communication system and the respondent chooses which to provide; and Experiment B) Recipient/Child choice, where a symbol communication system is described along with 2 or more children with communication difficulties and the respondent has to choose which child is the best match for the symbol communication system.

Analysis will use choice modelling techniques to identify the importance of each device and child attribute in the choices of respondents.

These experiments and the qualitative findings from the other work packages will inform the development of a clinical decision making heuristic.

NIHR HS&DR: Project 14/70/153 Identifying appropriate symbol communication aids for children who are non speaking: enhancing clinical decision making

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Contact
Project Lead: Janice Murray (j.murray@mmu.ac.uk)

Partners and collaborators
Janice Murray, Research Institute for Health and Social Change, Manchester Metropolitan University
Juliet Goldbart, Research Institute for Health and Social Change, Manchester Metropolitan University
Simon Judge, Barnsley Assistive Technology Service, Barnsley Hospital NHS Foundation Trust
David Meads, Academic Unit of Health Economics, University of Leeds
Stephane Hess, Institute for Transport Studies, University of Leeds
Yvonne Lynch, Manchester Metropolitan University
Stuart Meredith, Manchester Metropolitan University
Elizabeth Moulam, Manchester Metropolitan University

Funding Agency: National Institute for Health Research (NIHR) HS&DR Project:14/70/153
Grant Value: £669,946.75