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Building National Capacity to support Augmentative and Alternative Communication as an Early Intervention Method in Croatia

Communication represents an essential human need as well as basic human right. One of the essential rights for the youngest children who have complex communication needs and cannot use standard means of communication is to have access to intervention and support mechanisms that improve communication, including the right to have access to Augmentative and Alternative Communication (AAC) and other assistive technology (AT) services and devices at all times (Communication Bill of Rights, National Joint Committee for the Communication Needs of Persons with Severe Disabilities). Providing assistive technology to children with developmental delay/disabilities as early as possible facilitates their development and prevents social exclusion. Available and affordable assistive technology reduces costs when it supports early childhood development and educational achievement, reducing the need for formal support services, time and physical burden on caregivers and further impairment. Implementing AAC at an early age is vital for children's interaction with others, learning, education and participation in everyday activities. Over the last few years, Croatia has undertaken many efforts to advance the use of AAC. Education of speech and language pathologists and special teachers has been improved in recent years through the introduction of courses on AAC. Alongside other improvements in education, changes have also begun at the University of Zagreb in terms of multidisciplinary collaboration focused on the development of high technology tools for children with complex communication needs. Despite these changes, AAC is still rarely used within early intervention in Croatia. Research into the use of AAC in Croatia seems to indicate a low level of awareness of the concept. Not all professionals understand that AAC is one segment of early intervention and a path to achieve functional communication and better inclusion. Unaided methods were predominantly used among Croatian professionals with the rare usage of high-technology tools (Horvat, 2014). Many parents and people who are in contact with the youngest children still have reserves about the use of AAC and tend to lean on the common myths about its use. Slow progress in implementation of AAC methods for the youngest children who have complex communication needs and cannot use standard means of communication is an example of the need to improve early intervention and support for young children in Croatia. Trained personnel are essential for the proper use of AAC, as well as for beneficiary training and follow-up. If these key steps are not present then assistive products are often abandoned or they are of little benefit and even harmful, resulting in extra healthcare/welfare costs. The lack of trained personnel also means low number of community based services. Another challenge is access to assistive technology. The high cost, limited availability and inadequate financing as well as widespread lack of awareness and suitably trained professionals have resulted in only limited access to AAC devices for children with disabilities in Croatia. There is a need to increase awareness among decision makers and to create an enabling environment that will foster the creation of policy and legislative frameworks that will improve access to high quality affordable ACC devices and services. It is for these reasons that UNICEF Croatia has partnered with the Faculty of Education and Rehabilitation Sciences to provide technical assistances to the relevant organizations: (1) 32 civil sector organizations (CSO) and institutions from the health, education and social sector ; (2) Key stakeholders for setting up assistive technology service provision, especially ACC devices and services, for children aged 0-8 years. The main goals of the technical assistance programme are to: (a) Build the capacity of the healthcare, education and social institutions, and CSO through training on ACC and early childhood intervention concept, and (b) Increase awareness and knowledge among key stakeholders that will initiate national policy dialogue on creating assistive technology service provisions, standards and financing mechanisms related to access to ACC devices and services. The poster depicts the current status of the use of the AAC in Croatia, the goals and activities developed within the programme as well as the future directions.

Alternative and Augmentative Communication, Assistive technology, Early Intervention

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