A survey of learners with complex communication needs (CCN) in the foundation phase of selected special schools in the Western Cape Province of South Africa

Abstract

Background: Persons with complex communication needs (CCN) can be described as individuals who require augmentative and alternative communication (AAC) to compensate for impairments in speech-language production and/or comprehension. In South Africa, children with CCN often attend public special schools that are mandated by the Department of Basic Education to provide rehabilitation services and communication support, including AAC. Although previous studies helped describe the provision of aided AAC and communication support at certain special schools in the Gauteng province, not much is known about it in other parts of the country. The lack of prevalence data on children with CCN in Western Cape special schools may result in the inadequate provision, monitoring and implementation of AAC and communication supports. Thus, the aim of this study was to gather province-specific data regarding the prevalence of learners with CCN at public special schools in the Western Cape, as well as to describe some of the AAC support made available for them.

Methods: An online questionnaire was developed to determine the prevalence of learners with CCN in the foundation phase at selected special schools in the Western Cape, to describe their concomitant difficulties, the communication support provided to them, and teacher training in AAC. A non-experimental quantitative survey research design and a combination of purposive and comprehensive sampling were used in this study. The responses from 56 teachers were analysed using descriptive statistics.

Results: A prevalence of 23% of learners with CCN was found among learners in the foundation phase of 17 selected special schools in the Western Cape. Learners with CCN had concomitant difficulties such as difficulties remembering or concentrating for the purpose of learning and difficulties with self-care activities, such as washing and dressing themselves. A higher proportion of learners with CCN used informal methods of communication as opposed to AAC methods that are formally introduced and taught (e.g., keyword signing or speech generating devices), and a higher proportion of learners used unaided AAC rather than aided AAC. The majority of aided AAC communication boards/books and speech generating devices were provided by private individuals or outside institutions and not by the education department. Based on a subsample, about three-quarters of learners with CCN had communication support mentioned in their Individual Education Development Plan or Individual Support Plan but less than half received communication support from speech-language therapists based at the school. In addition, only two-thirds of the 56 teachers indicated that they had received AAC training, while one-third of teachers indicated that they had not received any AAC training.

Conclusions: The results of this study indicate the significant need for efficient monitoring of communication support in the Standardised Identification, Assessment and Support policy, the need to consider alternative therapeutic communication support practices (i.e., classroom-based intervention and a focus on upskilling teachers), as well as considering increased departmental funding towards aided AAC provision and AAC teacher training. Improved AAC service delivery must thus be driven by impactful policy, effective AAC practice, and sufficient and appropriate funding. More research is needed in the other provinces of South Africa.