The Relationship Between Race, Rural Living Status, and Access to AAC Services

Abstract

Research suggests that rural Black families in the U.S. are less likely to receive equal access to speech-language pathology services. Additionally, Black children may receive less augmentative and alternative communication (AAC) intervention than their otherwise similar white peers. However, limited empirical research has analyzed the effects of both racial and geographical disparities on accessing AAC devices and supports. To fill this gap, the current study consisted of a nationwide survey of caregivers of children 18 and under who use or would benefit from AAC, collecting relevant demographic information and information regarding AAC supports and services. The study addressed the following research questions: 1) How are race and rural living status associated with AAC access for children with disabilities and complex communication needs age 18 and under in the United States?; and (2) How are race and rural living status associated with caregivers’ perceptions of the cultural appropriateness and cultural responsiveness of AAC systems and services? Results of regression analyses did not reveal a statistically significant predictive effect of rural living status on either research question, potentially related to the small representation of rural participants in the sample. However, initial correlation analyses did suggest that rural living status may be associated with higher perceptions of culturally responsive services. When investigating the Deep South respondents specifically, Black caregivers reported that their children were significantly less likely to have access to aided AAC than white caregivers. Additional demographic factors were also significantly predictive of access to aided AAC (e.g., income, insurance, child diagnosis) and culturally responsive services (e.g., income, disability type, access to aided AAC). These results suggest that in at least the Deep South, race may be a unique predictor of access to aided AAC, though other demographic factors are also impactful.