The relevance of teachers’ perceptions on the inclusion of students who use AAC

Teacher perceptions on the use of AAC address a complex phenomenon, in which different areas are distinguished. In the current study, we specifically focus on the perceptions of teachers regarding four variables: the importance of the communication environment, the needs of students who use AAC, the usefulness of AAC, and the functions and roles of teachers in its implementation. First, perceptions on the importance of the communication environment are crucial indicators of how students who use AAC can be included in both educational and social aspects. In this sense, various studies highlight the importance of understanding the value given by teachers to coordinating with families as a vital aspect of the students’ communication context. A study carried out with 16 parents participating in a training program (Fäldt et al ., ²⁰²⁰ ), obtained results that highlighted the importance of including the family environment in communication interventions. Along these lines, a study on the myths and realities of AAC (Romski; Sevcik, ²⁰⁰⁵ ) concluded that families play a central and crucial role in navigating the introduction of AAC systems. However, in the socio-family environment there is still a general lack of knowledge about the introduction and use of AAC, as indicated by a recent review of 19 documents about perceptions and experiences related to AAC in family environments (Berenguer et al ., ²⁰²² ).

In addition, we must consider the combined efforts of the professionals who serve the students. This implies coordinating closely between each other and establishing and developing shared objectives, aspects closely linked to positive results for the students (Soto et al. , ²⁰⁰¹ ; Lillehaug; Klevberg; Stadskleiv, ²⁰²³ ).

Furthermore, incorporating peers as communication partners is also a relevant aspect when it comes to maximizing participation opportunities. This aspect is reflected in previous research carried out in contexts as different as Malaysia (Joginder; Diong; Kamal, ²⁰²⁰ ), South Africa (Tönsing; Dada, ²⁰¹⁶ ), or the USA (Andzik et al. , ²⁰¹⁹ ; Lorang et al. , ²⁰²² ).

For all the above, we recognize how important individual perceptions are in the communication environment for students who use AAC, given how coordination and combined work contribute to their inclusion, as indicated by various reviews of the existing literature (Costigan; Light, ²⁰¹⁰ ; Perfect et al ., ²⁰²⁰ ).

Second, it is relevant to analyze the perceptions in terms of the needs of students who use AAC. Current research indicates that aspects such as the time of introduction or the decrease in disruptive behaviors can give us an idea of the usefulness of these systems.

Regarding the time of introduction, a systematic review conducted in Spain, analyzing over twenty AAC interventions, concludes the importance of early introduction (Pereira; Pérez-Izaguirre; Apaolaza-Llorente, ²⁰¹⁹ ), given that it will benefit the communication-linguistic development of the users (Romski; Sevcik, ²⁰⁰⁵ ). Similarly, a recent study with preschool students with motor difficulties highlights the importance of using AAC in the early years of life to ensure their right to access language (Lillehaug; Klevberg; Stadskleiv, ²⁰²³ ).

Regarding disruptive behaviors, different studies have shown that using AAC leads to improved communication and a decrease in these behaviors (Joginder; Diong; Kamal, ²⁰²⁰ ).

Third, it is interesting to understand the perceptions regarding the usefulness of AAC systems. Research has shown the importance of professionals considering these systems as useful tools when it comes to enhancing the inclusion opportunities of students who use AAC (Aldabas, ²⁰¹⁹ ; Soto et al ., ²⁰⁰¹ ). Furthermore, it is important to keep in mind that introducing AAC will enhance the communication development, as well as the independence and social relationships of students with communication difficulties (Lillehaug; Klevberg; Stadskleiv, ²⁰²³ ).

Fourth and final, the relevance of teachers’ perceptions on their own functions and roles in the educational environment. Analyzing these perceptions is important because these individuals are responsible for overseeing activities in which the students who use AAC participate with their peers (Soto et al ., ²⁰⁰¹ ), which is a key aspect of inclusion. Furthermore, they also play a crucial role in fostering students’ acceptance of differences (Odom et al ., ²⁰⁰⁶ ), as well as in creating communication opportunities (Suhr et al ., ²⁰²³ ).

When studying teacher perceptions, understood as the set of ideas, beliefs, knowledge, and attitudes exhibited by education professionals, they should not be seen as a fixed and unchangeable construct. Instead, they should be viewed as a variable that can be influenced by various factors. For this study, we will address some of the factors explained below.

Factors that can influence teachers’ perceptions on the inclusion of students who use AAC

In this research we will focus on three of these factors: teaching in settings where there are students who use AAC, specific training in AAC, and experience with individuals who use AAC.

On the one hand, teaching in settings where AAC systems are used intensively, such as mainstream educational centers with a special unit or those that have special language and communication units (SUMC or SULC hereinafter), plays a relevant role in shaping the perceptions they have on AAC. This is because these spaces, found in mainstream education settings, serve the purposes of advising, training, and raising awareness in the educational community. They function as resource units of the centers. Therefore, these classrooms are considered facilitators of inclusion (Lacruz-Pérez et al ., ²⁰²¹ ; Peirats; Cortés, ²⁰¹⁶ ).

As indicated in several descriptive studies (Marín; Lizcano; García, ²⁰¹⁶ ; Mascarell-Borreda; Grau-Rubio, ²⁰¹⁴ ), creating classrooms with these characteristics should be accompanied by training aimed at the entire educational team and related to inclusion and attention to diversity (including AAC). However, another study indicated that a large part of the teaching staff in centers with special units barely have knowledge about this subject (Arnaiz-Sánchez et al ., ²⁰²¹ ). This would make the inclusion of the students who attend these units difficult.

Another influencing factor that will be analyzed is prior training, which is considered a great facilitator of inclusion of students with special educational needs (SEN). This can be seen at different educational stages (Pegalajar; Colmenero, ²⁰¹⁷ ), and with students with needs of a different nature (Ravenscroft et al. , ²⁰¹⁹ ).

In the case of students who use AAC, this training is related to a successful implementation, as suggested by a study carried out with 376 professionals in the field of language and speech (Lorang et al ., ²⁰²² ). In this regard, another study, conducted with a sample of 88 Italian teachers (Racici et al ., ²⁰¹⁹ ), supports this statement, emphasizing the need for more training in this area, which can, in turn, favor an increase in teachers’ confidence in their daily practice (Joginder; Diong; Kamal, ²⁰²⁰ ).

Lack of training influences teaching attitudes towards students with SEN (Eklund et al ., ²⁰²⁰ ), negatively affecting participation opportunities (Suhr et al ., ²⁰²³ ). This could hinder inclusion, according to a study carried out in special education classrooms in 68 mainstream centers in the Spanish region of Murcia (Arnaiz-Sánchez et al ., ²⁰²³ ).

The third factor refers to previous experience with individuals who use AAC. We know that living with individuals who use these systems can increase one’s sense of competence in the field, as shown by research carried out in educational systems as diverse as Finland (Eklund et al ., ²⁰²⁰ ) or Israel (Werner et al ., ²⁰²¹ ). In this regard, the now classic review of 26 studies related to teachers’ attitudes towards inclusion (De Boer; Pijl; Minnaert, ²⁰¹¹ ), also links this previous experience with the development of more inclusive practices.

With all this in mind, based on the importance of teachers’ perceptions on AAC, and taking into account the variables that can influence these perceptions, the objectives of this study were: a) to analyze the perceptions of a sample of active teachers regarding the relevance of the communication environment in school settings, the needs of students who use AAC, the usefulness of AAC, and the functions and roles of teachers in the use of AAC; and b) to analyze whether experience in centers with SUMC/SULC, previous training in the field of AAC, and/or previous experience with individuals who use AAC influences the teachers’ perceptions regarding the inclusion of these students.

Participants

A total of 122 active teachers in mainstream centers in the Valencian Community (Spain) participated in the present study. The main demographic data are summarized in Table 1 .

Instrument

Data collection was carried out using the Perceptions on the Inclusion of Students who use AAC in mainstream classrooms (PSIASAAC), a self-developed instrument designed to get to know teachers’ perceptions regarding the inclusion of students who use AAC in mainstream classrooms.

The process of developing the PSIASAAC started with a thorough review of the models that explain how teachers perceive students who use AAC (Joginder; Diong; Kamal, ²⁰²⁰ ; Ryan et al ., ²⁰²⁰ ; Soto, ¹⁹⁹⁷ ; Tönsing; Dada, ²⁰¹⁶ ).

Based on these models, a total of 22 items that evaluated different variables related to teachers’ perceptions of AAC and its use as a school inclusion tool were developed. The content validity was analyzed through consultation with 6 university teaching experts specializing in the subject (AAC and/or inclusive education), using the method of individual aggregates, who provided their assessment of the coherence, relevance, sufficiency, and clarity of the content items. According to the parameters usually used in terms of content validity (Lawshe, ¹⁹⁷⁵ ), these values can be considered high (CVI close to 1 in most items), which denotes a great consensus among the judges. Despite this, observations and proposals from experts were incorporated in order to improve the content validity of the instrument.

For construct validity, an exploratory factor analysis (EFA) was carried out and preliminary analyses showed very positive values. The method used to extract factors was a principal components analysis, applying a Promax type oblique rotation. Items with a factor loading of less than .4 were eliminated. The EFA resulted in a 4-factor structure (see Table 2 ), capable of explaining 71.7% of the total variance. The grouping of the factors is supported by a robust theoretical basis and corresponds to the categories defined a priori during the review phase of the explanatory models.

The final version of the instrument was subjected to a reliability analysis obtaining a Cronbach’s alpha coefficient of α=.821, which suggests good internal consistency (Nunnally, ¹⁹⁷⁸ ).

The criterion validity analysis was also carried out by comparing the psychometric properties of the PSIASAAC with a validated instrument about teachers’ perceptions of inclusion (Chiner, ²⁰¹¹ ). The result indicated a statistically significant relationship at the .01 level (bilateral) between the results of both tests (r=.291** ⁴ p=.002), which confirms satisfactory results regarding the criterion validity of the PSIASAAC.

To analyze the feasibility of the instrument, a pilot study was developed with the participation of 15 active teachers. The questionnaire was positively valued as an easy-to-understand instrument, with an accessible and agile format.

The final version of the questionnaire consists of a total of 12 Likert-type items with 5 response options (from 1 Strongly disagree to 5 Strongly agree). The total scores of the questionnaire range from 12 to 60 points, with higher values indicating more accurate perceptions of the possibilities of AAC students. Given that the items in factor 2 have an inverse structure, their scores were recalculated to be analyzed together with the rest of the questionnaire.

Overall, the PSIASAAC is, according to the analyses of content validity and psychometric properties, an instrument with robust, feasible, reliable, and valid content to measure teachers’ perceptions on the inclusion of students who use AAC, which is why it was used for the current study.

Procedure

The questionnaire was distributed in digital format, using the Microsoft Forms platform. Convenience, non-probabilistic sampling was conducted, distributing the questionnaire among the faculty of educational centers with and without SUMC/SULC classrooms in the same locations.

Data collection took place over 8 weeks. The results were analyzed with the SPSS 25.0 statistical package.

Ethical aspects

All participants completed an informed consent prior to accessing the questionnaire. The project was approved by the Research Ethics Committee of the Catholic University of Valencia (UCV/2020-2021/134).

Descriptive analysis

In order to analyze teacher perceptions on the inclusion of students who use AAC, a general descriptive analysis was conducted on the data obtained.

As seen in Table 2 , the total score of the questionnaire reaches an average of 50.94 (out of a maximum of 60).

Analyzing each of the items, 10 of the 12 cases have averages greater than 4 points. Only items 1, 2, 3, and 4 belonging to factor 1 “Importance of the communication environment” exceed 4.5 points.

The lowest results are located in the items of factor 2 “Needs of the students who use AAC”, specifically in item 5 (with x=3.94), and item 8 (with x=3.52).

Analysis of factors that influence the perceptions on the inclusion of students who use AAC

The following are the results obtained from the comparisons made. Due to the non-normality of the data (KS p= .005), non-parametric analyses were carried out in the group comparisons using the Mann-Whitney U test, as they were independent groups (De Diego; Vega, ²⁰¹³ ).

First, the influence of working in schools with SUMC/SULC is analyzed, the data is collected in Table 3 . The existence of significant differences in the scores of factors 1 and 3, as well as the total score is confirmed. In all three cases, the group with experience in centers with special units shows a more adjusted perception of the use of AAC. The Hedges’ G statistic shows, on the total scores, a medium effect size (Hedges’ G =0.426).

Regarding the comparison of the groups with and without previous experience with students who use AAC, Table 4 shows significant differences in the 4 factors, as well as in the total score, so that the group that has previous experience with students who use AAC presents a more adjusted perception of the use of AAC. The effect size suggests, at the total score level, a medium-high effect (Hedges’ G =0.622).

Finally, regarding the influence of AAC training on teachers’ perceptions of the use of these systems in schools, Table 5 shows that participants with previous training obtained significantly higher scores in the 4 factors of the questionnaire and in the total score. The effect size, once again, exceeds 0.5, which is why it is considered between medium and high (Hedges’ G =0.59).