Reflections on Building a Multi-Country AAC Implementation Guide.

Augmentative and Alternative Communication (AAC) implementation at any level is a multifaceted process that requires selection of relevant and appropriate systems to suit individual users who may have complex communication needs and other co-occurring difficulties. Careful and systematic action may be required to develop skills and abilities in the use of chosen technologies with suitable ongoing support within a wide range of settings. The wider milieu in which services are provided must also be considered in order to provide a firm foundation for capacity building alongside considerations for multilingual and multicultural factors. UNICEF with the Global Symbols team supported by local professionals working with AAC users, their families and carers set out to collaboratively provide an implementation guide based on their experiences in several Eastern European countries. The aim of the guide was to illustrate work already being undertaken in the area and to ensure the sharing of knowledge and resources where gaps were discovered. The result became a series of linked webpages in an online framework that covered practical aspects for the development of policies and procedures to support early intervention for those with severe speech, language and communication needs across countries of differing cultures and languages. The actual AAC implementation required ingenuity on all sides with translations for pictographic symbol and software adaptations with Cyrillic and Latin alphabets, new synthetic voices alongside deployment and capacity development. Considerable local support was forthcoming and captured with interviews by those working with AAC users as technology was introduced and outcomes measured. As the guide was completed several videos were shared publicly by carers with examples of AAC and assistive technology use. Policies and procedures were also shared in the form of tables, charts, symbol sets, communication boards and software that illustrated not only the occurrence of knowledge transfer and the use of open licenses, but also differences in strategies and the way they were adapted to suit the range of settings in the various countries.