Analysis of Preferences Regarding Augmentative Language System for Children with Autism Spectrum Disorders Among Speech Language Pathologists

Abstract

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition marked by communication and social challenges. Augmentative and Alternative Communication (AAC) systems are widely recognized for supporting children with limited or absent speech, yet professional preferences for specific systems remain underexplored in low-resource contexts such as Pakistan. Speech-Language Pathologists (SLPs) play a crucial role in AAC selection and implementation, making their perspectives vital for optimizing clinical practice. Objective: To analyze the preferences of SLPs in Lahore, Pakistan, regarding augmentative language systems for children with ASD, and to identify demographic and professional factors influencing these choices. Methods: A descriptive cross-sectional study was conducted among 127 SLPs using purposive sampling. Data were collected via a structured questionnaire assessing demographics, training, AAC system use, and perceived effectiveness. Descriptive and inferential analyses were performed using SPSS version 25.0, with chi-square tests and odds ratios applied for group comparisons. Results: Most participants were female (74.8%) and early-career clinicians (63.0% with 1–3 years’ experience). PECS was overwhelmingly preferred (93.7%) and perceived as most effective (94.5%), while VOCAs were rarely endorsed (6.3%). AAC use was limited, integrated in only 10–15% of cases for 80.3% of SLPs. Although 86.6% considered AAC effective, 36.6% reported potential drawbacks. Conclusion: SLPs in Lahore strongly favor PECS over VOCAs, reflecting accessibility and familiarity, but report limited AAC integration and uncertainty about drawbacks. Enhanced training, exposure to diverse AAC tools, and culturally adapted resources are needed to improve AAC practice and outcomes for children with ASD.