1 Introduction

Regular classrooms are experiencing a growing population of learners with divergent needs in the area of communication [25, 31]. Teachers face a multifaceted challenge in dealing with these learners. Supporting these learners in inclusive classroom settings is proving to be challenging, especially where the use of Augmentative and Alternative Communication (AAC) is concerned. AAC involves any approach to communication that complements or entirely replaces spoken and/or written language in cases of impairment. As a result, it empowers children facing complex communication needs (CCN) to unlock their complete communication capabilities [4]. Teachers are tasked with serving as the main facilitators of learning for both AAC users and other learners with varying needs and abilities within their classrooms such as those with complex communication needs (CCN). It is important for teachers to identify suitable curriculum objectives and devise strategies to ensure the achievement of these goals by all learners, who rely on AAC. The role played by teachers in ensuring that learners who use AAC are successfully integrated is crucial [25].

Researchers have observed that in spite of teachers recognising the potential advantages of AAC, they are reportedly encountering countless challenges in the area of supporting learners who are making use of AAC 29]. This study sought to investigate the knowledge and preparedness of teachers in implementing AAC and finding strategies to improve these attributes. This study has the potential of bringing about a positive change by informing teachers about effective AAC implementation strategies that could contribute significantly to learners’ achievement of curriculum objectives.

1.1 Augmentative and alternative communication

Augmentative and Alternative Communication (AAC) is a therapeutic and pedagogical practise as well as a topic of study. In the school setting, AAC is used to support access to learning and communication for students with language disabilities [17]. The main goal of AAC is to identify and, as necessary, treat the temporary or long-term impairments, activity constraints, and participation limitations that people with severe speech-language production and/or comprehension issues experience. This includes various modes of communication, both spoken and written [5]. This is the main concept in this study, and it refers to various methods of communication that can be used by learners with communication and speech challenges.

AAC could either augment speech to learners with little speech or be used by learners with no speech as an alternative method of communication [5]. There are two types of AAC, namely: the unaided and the aided. The aided AAC is when there is external use of devices for communication, for example, speech-generating devices. Unaided is the use of the body, facial expressions, and gestures for communication. In Ref. [46] further elaborate that AAC was created as a communication method aimed at assisting students who have difficulty in communicating. This communication tool was created to ensure that these students can operate optimally within and without the classroom. This approach encompasses the utilization of communication boards, sign language systems, and advanced computer-based systems that often generate a voice. These specialized assistive technology devices can offer much needed support to individuals in a variety of aspects of their daily and vocational activities. These may be extended to include academic tasks such as reading, hearing, writing, and listening.

AAC plays a crucial role in supporting students with complex communication needs and their teachers. Research has shown that peer assisted aided AAC modelling can significantly increase the communication abilities of students with complex communication needs [27]. Furthermore, interventions involving peer networks and aided AAC modelling have been found to increase peer interaction and the use of symbolic communication for students with complex communication needs [6].

1.2 Knowledge and readiness of teachers

The effective utilisation of AAC in the classroom setting is strengthened when teachers provide support and implement AAC strategies alongside well-prepared AAC intervention procedures [29]. This can only be possible if the teacher understands the implementation process and all barriers are removed. Therefore, teachers need to understand the AAC process and its interventions.

Enrolling learners with AAC needs in the general education classrooms can present various obstacles to their engagement in literacy instruction, particularly when functional AAC systems are not readily accessible for these students. Consequently, these students may face challenges in responding to the teacher’s questions, joining discussions, interacting with classmates, or initiating conversations [22].

Due to a lack of preparedness, general education teachers often struggle to deliver suitable and personalized instruction to students with AAC needs. Therefore, these students may physically be present in the classroom, but their active involvement in the curriculum may be hindered [46]. Ensuring children with complex communication needs could obtain suitable AAC systems is crucial for promoting their engagement in classroom activities and, ultimately, enhancing their learning [9]. The appropriateness of the AAC resource highly depends on the teacher being able to match the device with the learners’ strengths. This is only possible when the teacher is knowledgeable about AAC resources [46]. It is especially important to ensure the provision of appropriate AAC systems when equipping learners with communication difficulties. This enables the development of language and communication skills, active engagement in academic learning, and the attainment of satisfactory progress [1].

Furthermore, while AAC proves highly advantageous for individuals with diverse communication needs, it also serves to promote communication effectively, language, and literacy development in young children who have communication difficulties and those with speech developmental delays [18] augmentative and alternative communication becomes the tool that will enable them to learn and participate in the classroom.

1.3 Implementing augmentative and alternative communication

Before teachers can implement AAC, it is essential to offer them training and support. Currently, teachers have limited to no exposure or training in the AAC implementation and its usage [29]. A study on ‘….empowering students and maximising inclusiveness and equality through ICT’ [37], observed that several challenges exist in implementing augmentative and alternative communication in the South African context. These challenges encompass financial resources allocations for acquiring and maintaining assistive devices, the availability of AAC devices in various languages, educators' limited proficiency in supporting communication and curriculum using AAC devices, and concerns regarding the safety of assistive devices when taken home by learners. However, these obstacles can be mitigated by offering comprehensive in-service training to educators on AAC. Another challenge in the implementation of AAC by teachers is the socioeconomic deprivation in South Africa. This greatly affects the process because the only time the innovation could be implemented is when it is available in schools. It means most of the schools must wait for the Government to provide AAC resources.

As per the 2017 World Health Organization report, in countries such as South Africa that are classified as developing nations, only a small fraction, ranging from 5 to 10% of individuals in need of assistive devices can access them. Unfortunately, South Africa remains an unequal society, with reports indicating that 53.8% of the population lives in poverty [37]. Furthermore, teachers have a role to play in ensuring that students have access to their AAC system in the classroom [42]. All these roles that teachers must play for a learner with complex communication needs (CCN) may be affected if the teacher has challenges in the implementation of AAC. It means that learners with CCN may not fully gain from the education system.

Most children with CCN do not engage in daily learning because they do not have the means to access the curriculum as being verbal is one of the requirements for learning. Scholars [22] concur, that the level of a child’s inclusion in the classroom interactions is influenced by the teacher’s facilitation of communication opportunities for the child. The more limited a child’s speaking abilities are, the more challenging it becomes for the teacher to facilitate their participation in interactions.

The level of success in including non-speaking children in classroom interactions relies on factors such as the teacher’s attitude towards non-speaking children, their understanding of the significance of interaction for improving the non-speaking child's intelligibility, and their skill in actively involving the non-speaking child in interactions [44].

When teaching students to utilise AAC, teachers must employ successful techniques since how students are taught to use their technology affects the possibility that they would use it on their own initiative later [12]. Effective teaching strategies should be used when teaching AAC use. These strategies include customising the system to meet the needs of each individual student, collaborating with carers to support AAC use, modelling AAC use and offering guided practice to enable students to use the technology, making sure the student has access to the AAC for all remote lessons and that the device is charged daily, offering continuous opportunities for students to use AAC in daily lessons, and reteaching AAC skills as necessary [34].

1.4 Utilising AAC in inclusive educational settings

The integration of AAC within inclusive educational settings plays a vital role in assisting students with CCN. Studies have indicated that the incorporation of AAC methods within school environments can effectively reinforce inclusivity, advance academic performance, and support speech and language capabilities.

A significant discovery highlighted in the scoping review conducted in this field is the scarcity of research conducted within inclusive educational settings [24]. In fact, only 17% of the 167 studies analysed in the review were carried out in such environments. Nevertheless, the review underscores the significance of AAC within inclusive settings, underlining its essential contribution towards promoting academic and social inclusivity for students with CCN.

Regarding teacher readiness, research suggests that a considerable number of teachers lack the essential expertise and training to proficiently incorporate AAC systems. One research [52] revealed that educators in South Africa, for instance, expressed a shortage of professional training in utilizing AAC devices and strategies. This underscores the necessity for more extensive training and guidance to ensure that teachers are adequately prepared to seamlessly integrate AAC into their instructional methodologies.

Several studies have delved into the effects of AAC on student outcomes. For instance, one study discovered that the implementation of AAC systems, such as Picture Communication Symbols (PCS), can result in heightened language proficiencies and enhanced communication within preschool environments [2]. Similarly, other researches scholarly researches continue to illustrate that AAC serves as a productive tool in reducing challenging behaviours within school settings [55].

To summarize, the body of research on AAC implementation in inclusive educational settings emphasizes the critical need to furnish teachers with requisite training and guidance to effectively embed AAC practices into their teaching approaches. This can lead to improved outcomes for students with complex communication needs, including enhanced academic achievement and social inclusion.

1.5 Research methodology revisited

The research approach employed in this study is qualitative. The nature of the study significantly influenced the selection of this method because the researchers intended to probe and interrogate teachers regarding teaching challenges in the implementation of AAC when teaching learners with communication difficulties.

The researchers utilized semi-structured questions, observations, and document analysis. These methods were employed to facilitate a comprehensive understanding of the prevailing dynamics within the educational setting. Document analysis, focusing on lesson plans, AAC devices, and rubrics, shed light on the extent of teacher preparation and strategies devised to cater to learners with CCN right from the planning phase to the incorporation of relevant rubrics in oral lessons. These analyses served as tangible evidence of the commitment to inclusive education.

Passive observations were conducted to offer insights into the actual implementation of planned strategies and the level of involvement of CCN learners in classroom activities. Through interviews, the researchers gained valuable perspectives and experiences from teachers regarding the implementation of AAC tools for CCN learners, enriching the academic depth of the study.

Data was collected through individual face-to-face interviews with teachers. These interviews allowed us to interrogate every teacher’s practice and experience in including learners with complex communication needs in regular classes [38, 57].

1.6 Data collection and sampling techniques

This study was conducted with teachers at a full-service primary school in Johannesburg. The selection of the school was done through purposive sampling [38]. Teachers were chosen based on their experience with complex communication learners, as well as their willingness to participate in the study. Homogenous sampling was used to select participants [20], with the inclusion criterion being a minimum of 3 years of experience in teaching learners with CCN. Out of the 12 selected teachers, 10 accepted and 2 declined to participate.

A combination of document analysis, non-participant observations, and individual interviews were employed in the current study. If data is based on a variety of sources, it is more likely to be accurate and convincing [57]. Using a variety of multiple data sources can assist in increasing the validity of the study's findings and can also make it possible to saturate the data. Triangulation is the term for this [21].

1.7 Individual interviews

Semi-structured interviews were conducted with participants and audiotaped with their consent. Additional notes were taken while the interview recording was being conducted. The interviews took place during the participants’ free time in classrooms, and arrangements were made with the principal to avoid disrupting contact time. 9 out of 10 teachers participated in the interviews, with responses collected in the form of handwritten notes and audio recordings. The interviews were conducted in both English and IsiZulu, the teachers' native language, to facilitate engagement and expression. Additionally, one senior manager and one Speech Therapist were also interviewed due to their involvement in the subject under study. The interviews aimed to encourage creativity and individual responsibility, with open-ended questions and a two-way conversation approach. The researchers also adjusted questions as needed to ensure understanding by the participants [3, 30].

1.8 Non-participant observation

Data for this study was collected through non-participant observation to closely observe teachers as they implemented Augmentative and Alternative Communication (AAC) for learners with CCN [38]. Non-participant observation was chosen as the method to assess teachers' knowledge and readiness and to gather additional information for analysis [40]. Field notes were taken during the observations, providing a comprehensive description of the teachers' environment and behaviours. The study focused on various aspects of teaching, including content, physical environment, classroom management, teaching and learning activities, assessment, and socialization. Among the 10 teachers interviewed, 7 allowed the researchers to observe their lessons, while the remaining 3 were busy preparing for an upcoming Autism Day event at school.

1.9 Document analysis

In this study, data gathering was expanded to include document analysis [15]. The researchers wrote a letter to the school Principal and participants to request permission to analyse relevant documents such as teachers' lesson plans, AAC resources, rubrics, and an inventory of AAC devices. This process helped the researchers understand how the school implemented AAC. Through critical analysis of the documents, the study explored how learners with CCN were taught at the school and the extent of AAC implementation [38]. The researchers retrieved a document inventory list from the archives and obtained AAC resources from the Speech Therapist.

1.10 Data analysis methods

The current study utilized a thematic approach for data analysis, following the method outlined by other scholars in the field [13]. All recorded information, such as interview notes, observations, and document analysis, were carefully categorized into manageable units. This initial stage is referred to as familiarization. The data was then transcribed and disaggregated into smaller fragments, which were organized in a matrix table to support the coding process. Coding involved assigning names, phrases, or symbols to each data segment. Similar codes were grouped together to create categories. This stage was completed by compiling all the codes and relevant data excerpts. Next, the researchers constructed themes based on their analysis, aligning with description of this stage as a search for themes [13]. The final step involved producing a report, where the researchers synthesized the extracted data into a narrative that aligned with relevant literature, as described by [13].

1.11 Research findings and their thematic representation

The theme on Knowledge and Readiness emerged as one of the themes from the thematic content data analysis. Figure 1 presents the theme and its categories.

Fig. 1
figure 1

A summary of the theme and their associated subthemes

Full size image

1.12 Theme: knowledge and readiness

This theme encompasses three categories, namely: teachers’ understanding of AAC, teachers' perspectives on AAC, and teachers' readiness to use AAC. It explores the level of knowledge teachers possess regarding AAC, including their understanding of its principles, strategies, and benefits for complex communication needs learners. Additionally, it delves into teachers' perspectives on AAC, examining their attitudes, beliefs, and perceptions towards its implementation in the classroom. Furthermore, it investigates teachers' readiness to use AAC, considering factors such as their confidence, competence, and comfort levels in utilizing AAC methods and tools. Understanding the knowledge, perspectives, and readiness of teachers in relation to AAC is crucial in identifying barriers, addressing gaps, and in developing targeted interventions to support successful AAC implementation in educational settings.

1.13 Sub—theme 1: teachers’ understanding of AAC

Responses varied but frequently included references to non-verbal and pre-verbal communication, devices, pictures, signs, pointing, Go Talks, laptops, and gestures. All definitions emphasized the use of alternative means of communication.

Participant A highlighted the use of laptops as AAC.

‘Laptop use…means of making people /or stimulating people who cannot communicate to communicate.’

Participant B identified AAC candidates as typical children whose only challenge is their speech.

‘A child who can listen, understand, and see but does not have speech and struggles to respond. Those who can lip-read. It is a child with sight and hearing.’

Some of the participants mentioned AAC simply as devices used to communicate easier with learners with different disabilities.

Participant C described it as:

‘It is to do with aid. I heard about the word that it is about children who need to be aided with speech, who cannot pronounce or have hearing problems.’ ‘AAC is for learners who are unable to express themself verbally. Having a challenge with……... ah I can't remember.’

Participant D identified cognitive challenges as a factor affecting the suitability of candidates for AAC.

‘It is children without speech. Less cognitive understanding so pictures and sound from the devices help with understanding.’

Participant H described AAC as:

‘Devices for children with special needs, are devices to teach them, especially the non-verbal using devices like Go Talks. These devices help us to teach autistic learners.’

Participant J had a different understanding and believed that AAC is a voice for learners.

‘Communication…means of communication because communication is key. It enhances communication. It is a voice for learners.’

1.14 Sub—theme 2: teachers’ perspectives on the AAC usage

Most teachers indicated that they were not making use of AAC devices in their classrooms, citing the ease and efficiency of using gestures and body language as their preferred means of communication.

Participant A expressed the following;

I do not use those devices, not at all. They are too much for me. The Department gives us a lot of work, they just give us the D-CAPS curriculum and we have to make our own lesson plans and IEPs.

Researchers: Are you able to use a Go-Talk?

Participant A responded:

‘ I can use a Go-Talk but I feel it is overwhelming. I did not even take them to my class. I use these charts with voice output.”

Participant C reported confidently that she frequently utilises AAC devices in her classroom and found them to be valuable tools in assisting her learners in pronouncing words and understanding pictures.

Participant C stated that:

The verbal learners are viewing the AAC device as a toy, once my non-verbal learner starts using the device, the other learners get distracted and they want to play with the device as a toy.

Reseacher: Does your learner use the device effectively and understands how to use it?

Particpant C:

He can use it but the challenge is that he cannot find all the words he needs and ends up using gestures and body language.

Participant E pointed out another new, non-verbal learner in his class who had been experiencing difficulty adjusting to the school environment due to a lack of effective communication.

Participant E:

‘……….Nhlanhla, do you want to go to the toilet? ( Nhlanhla nods) ....so you see, I predicted right but sometimes I am wrong.’

Researchers: ‘ If you were to be given the devices back, will you be able to use them?

Participant E:

‘AAC is very important….very important. We would like them to be brought back to us and we work with our children ummmm… the therapists are teaching in the therapy room…I don’t know if it is called the therapy room and we are here in class, what we experience here, the therapist can not experience, even on the day she comes for assessment, maybe she will come on Term 3 on the 9th month from January we will be struggling with these kids. Even after that assessment, there is nothing that I will see different from this child that the therapist was helping with, to start communicating or using words. She will do her own assessment, then she is gone, the year ends.’

Researchers: So when the Therapists are doing assessments, how much are you involved?

Participant E: ‘No, we are not involved, that is another problem, they take the child to whatever corner they assess. We are told to respect each other’s profession like the teacher…Ummm, I must be here and the Therapist there. You see… there is no link.’

Participant F shared similar views to those of Participant E.

I do not have Go-Talks in my classroom because the Therapists are the only ones permitted to use the devices but I have never received any training from the Therapists so far.

Researchers: If you had the devices, would you use them and believe your learners would benefit?

Participant F:

I believe that my learners will benefit from AAC. I need a refresher course on AAC because I do not think I have confidence to use the devices anymore, it was a long time since we had the training.

1.15 Sub- theme 3: teachers’ readiness to use AAC

The teachers interviewed did not demonstrate a high level of readiness to implement AAC devices in the classrooms, citing different reasons as follows:

Participant A expressed the following:

‘I am not using AAC in my class because I do not have the time to include it in my teaching. AAC requires a lot of time to prepare and I do not have that time. My learners use gestures and body language to communicate… with time some can now produce speech.

Participant B expressed a need for additional training and practical demonstration to enable her to effectively use the devices:

‘I will be ready and willing to use AAC if I get more training. The one we had was not a practical one, I need a demonstration on ..uhm how to include devices in my class. My learners need devices.’

Participant B reiterated that: “Training was not enough…”.Footnote 1

Participant J reported that:

‘I already have a way to communicate with my learners.They point at pictures but some pictures are difficult to understand. Sometimes they use gestures and body language if they can’t find the picture.

More teachers expressed the need for additional training and practical demonstrations to enable them to effectively use the devices.

Participant C mentioned that: ‘I will need more training on AAC.’

Participant D expressed the following:

‘I need training because I believe that my learners will communicate better with AAC. I do not know much about it, the training I had was when we were showm some talking devices by the Speech Therapist and I think I need them……training will help me to know how to use them.’

Participant E expressed reservations about implementing AAC in her classroom. She cited concerns that the devices would not be taken home by learners due to an unsafe home environment.

Participant E reported that:

‘I do not think I can support the use of AAC here because the environment is not conducive. If you can see where these children live, the devices will be stolen if they have to take them home. What is the use of having the learners communicate at school and at 1 pm we pack their voices away…..the devices are their speech. This will not be effective at all. They will be no benefit at all.’

Participant G reported that she has seen a Go-Talk device before and believes it would be beneficial for her learners, who enjoy imitation.

‘I have seen a Go Talk before and I know it will be the right device for my learners…..especially this boy (pointing at him) who is autistic but I know he is clever and once I show him how it works, he will be able to communicate. We are ready to use the devices once I get the proper training……already some of my learners imitate me when I speak to them, they will definetly benefit.’

Participant H reiterated that during her tenure in the autism department, she successfully incorporated Go-Talks into her lesson plans and had sufficient time to create resources for her non-verbal students.

‘I know how to use Go-Talks, I used them when I was in the Autism department. I would like to have the devices back, my children will benefit from them….

Reseacher: ‘What about time for planning for AAC? Do you have it?’.

Participant H responded:

‘The time for preparing for AAC is plenty, we have one hour everyday after the children leave to plan, so time is not a problem.’

Participant J responded:

‘I have never included my non-verbal learners in my lesson plan…Ummmh there is no way that I could teach speaking to non-verbal they are given an opportunity to use gestures to be included. I have different resources to assess them. I create rubrics…..

2 Discussion

The Knowledge and Readiness theme focuses on understanding the knowledge level, perspectives, and readiness of teachers in implementing AAC strategies. The research conducted in this field aimed to ascertain the elements that contribute to teachers' ability to effectively employ AAC techniques and to highlight the importance of training and support in promoting successful AAC implementation.

The theme encompasses categories such as teachers' understanding of AAC, their perspectives on AAC implementation, and their readiness to use AAC [50]. By exploring these categories, educators and policymakers can gain valuable insights into the factors that influence teachers’ ability to implement AAC strategies effectively and to tailor support systems accordingly.

Based on the interview regarding teachers’ understanding of AAC, the responses obtained were predominantly characterized as verbal and partial verbal. The majority demonstrated an understanding that AAC serves to facilitate speech for individuals who are unable to speak. It is imperative to ascertain participants’ comprehension of this terminology to ensure a shared understanding as the study progressed [10]. Participants must possess a fundamental understanding of the study’s purpose, including any technical terms or jargon employed, to adequately respond to inquiries. AAC was commonly associated with devices, with Go-Talks being the most frequently mentioned. In summary, while teachers possessed a general understanding that AAC helps with communication for individuals without speech, they were unable to provide further elaboration.

Policymakers conduct research and create national policies. They also have the chance to grasp the innovation of Assistive Technology (AT/AAC) and decide whether to incorporate it. However, teachers have limited time to learn about AAC and schools are not given a choice in its adoption. Teachers are included in the implementation stage; observation suggests that teachers may be inadequately prepared for the implementation of AAC. Involving teachers in research and surveys related to innovations such as AAC before the adoption may provide valuable insights into their perspectives. Studies on the adoption and implementation of these new technologies also showed that teachers are frequently left out of decision-making processes involving the implementation of AAC, which can lead to low adoption rates because of a lack of support and knowledge of the advantages of the technology [39]. When teachers were unable to elaborate on their expertise of AAC, this became clear.

One of the conditions of change that can affect the implementing of AAC is the availability of resources [19]. A lack of resources can pose a challenge to the implementation process. Some teachers have cited this as a reason for not using AAC in their school, stating that the available resources, such as Go-Talks, are not enough to be shared. They believe that if they had access to more devices, they would be able to implement AAC.

Despite some educators’ belief that certain learners lack the cognitive ability to effectively use AAC devices, it is essential to adhere to the principle of presumed competence. This principle asserts that people relying on AAC should be assumed to possess language and cognitive abilities until proven otherwise [5]. As such, these individuals should be provided with ample opportunities to communicate in all situations and their messages should be treated with respect and value [32]. This approach serves as the foundation for all communication interventions and promotes the inclusion and empowerment of AAC users.

The adoption of AAC at this Primary school is hindered by the perception among some teachers that it is incompatible with the needs of their learners. Compatibility, it has been argued, is about the level at which experiences, values, and the need for potential adopters align with an innovation [26],. Innovations considered to be incompatible are more likely to be rejected or used less frequently than those that are compatible.

In this case, some teachers at the school do not perceive AAC as aligned with their current values and teaching philosophy, and therefore see no need to adopt it. This highlights the importance of considering compatibility as an attribute that impacts the rate of adoption, as potential adopters need to understand how an innovation aligns with their goals and values.

Despite recognizing the potential benefits of AAC for their learners, some teachers at the school are not currently using it due to a lack of training or inadequate training. These teachers perceive themselves as lacking the necessary skills to effectively incorporate AAC into their daily teaching. Some teachers at the school are dissatisfied with the current communication methods used in their classrooms and believe that AAC could enhance their learners’ understanding of the curriculum. This dissatisfaction with the status quo signals a readiness to adopt new innovations such as AAC. However, these teachers have identified a need for more support and capacitation to enhance their knowledge and abilities regarding AAC. This is consistent with findings that reported that teachers frequently expressed dissatisfaction with the status quo of communication in their classrooms and a desire to improve their students’ communication abilities, but also expressed concerns about their own knowledge and skills related to AAC technology and implementation [45], who.

Nevertheless, the study's findings on the issue of inadequate training were added to the body of work already written by South African writers who aver that teachers are poorly trained in the field of AAC [9, 16, 28]. Speech therapists have also noted difficulties with the use of AAC in special schools. Teachers have expressed worries about their own knowledge and abilities linked to AAC technology and implementation. These findings suggest a need for greater support and training to enable teachers to effectively implement AAC strategies and technology in South African classrooms.

Some teachers at the school have expressed dissatisfaction with AAC due to its perceived limited vocabulary. These teachers have reported that their learners are unable to find all the words they need to communicate effectively during lessons, leading some learners to resort to gestures and body language instead. Literature has adequately captured this perception of limited vocabulary in AAC systems [33, 42, 48], particularly among individuals with more advanced language skills, they criticized it for their limited vocabulary and inflexibility. However, recent advances in technology and a shift towards individualized vocabulary selection are helping to take care of these shortcomings and in so doing ensure that AAC interventions are effective. More emphasis on this notion argues that literacy is a skill that can be taught to individuals who use AAC systems [11]. Their research delves into the development of AAC apps with Transition to Literacy (T2L) features, demonstrating how redesigning AAC apps to include dynamic text and speech output can positively impact the sight-word reading skills of individuals with complex communication needs.

One teacher raised concerns about the use of an AAC device by a non-verbal learner. The device was perceived to be a toy by the learner’s verbal peers, leading to classroom distractions. Additionally, the limited vocabulary of the device caused the learners to lose interest and to revert to using gestures and body language for communication. As a result, the device was abandoned. Existing literature has explored the phenomenon of toyification in AAC devices, particularly those with voice output capabilities [14]. These devices have been found to elicit curiosity among learners, who are often fascinated by the emitted sounds. Recent research has shown that toyification can pose challenges to the implementation of AAC devices [36].

When individuals perceive AAC devices as playthings rather than tools for communication, their effective use may be hindered. Scholars describe this process as the ‘…toyification’ of communication [33]. Research continues to show that children who perceive AAC devices as toys may not use them properly, leading to implementation challenges [7]. Similarly it has been observed that some children without disabilities view AAC devices as toys and may not understand their importance for communication, hindering their implementation [8]. These findings suggest that efforts are needed to combat the toyification of AAC devices and to promote their effective use for communication purposes.

A significant number of teachers expressed concerns regarding their readiness to incorporate AAC due to a lack of knowledge and skill. Empirical evidence has demonstrated that the readiness of teachers to utilize AAC within the classroom setting is a crucial determinant of successful implementation. Within the South African context, where linguistic diversity is a prevalent concern in schools, it is of importance that teachers possess skills and knowledge to support learners with communication difficulties. One study found that many South African teachers reported feeling unprepared to work with learners with disabilities including those who use AAC [53]. Similarly, another study found that many South African teachers felt they lacked the resources and training needed to effectively use AAC [41].

These findings suggest that efforts are needed to increase teacher training and support around AAC use in South African classrooms to make it a point that access to communication aids which are effective was extended to all students. According to the Senior Manager interviewed, teachers’ readiness to implement AAC is hindered by the absence of practical training. The manager emphasized the necessity of hands-on instruction, in which a trainer demonstrates the utilization of AAC within the context of a lesson plan in a real classroom set-up, to bolster teachers’ confidence in their know-how of incorporating AAC into their daily teaching effectively.

Conversely, some of the teachers reported readiness to implement AAC, on condition of the availability of requisite resources. These individuals expressed a willingness to proceed with implementation without delay if provided with the necessary tools. Furthermore, several participants indicated that they had already initiated the incorporation of AAC into their teaching and observed positive outcomes among their learners. One participant noted an enhancement in speech intelligibility among their learners because of utilizing AAC systems, a finding corroborated by previous research [51].

All teachers did not have any evidence of lesson plans or rubrics that include AAC except for one teacher who had rubrics she creates for non-verbal learners who use pictures to communicate. Although this teacher did not have any AAC incorporated into her lesson plans, she had evidence of including non-verbal learners in her speaking lessons. These findings add to the existing research case studies t within South Africa that were conducted to investigate the notion of inclusion of AAC in lesson plans [54]. They found that teachers frequently lacked awareness about AAC and its integration into lesson planning. The authors assert that a need for the capacitation of teachers in AAC and in incorporating it into their daily teaching routine does exist. They further state that proper planning in this may lead to better communication outcomes for AAC learners. Furthermore, the authors suggest that creating rubrics to assess the communication skills of AAC learners can be an effective way to measure progress and provide feedback to both teachers and learners. This study highlights the importance of including AAC in education and providing adequate training and resources for teachers to effectively support AAC learners in the classroom.

One teacher expressed concern regarding the AAC implementation exclusively within the school, rather than extending its use to the home environment. The teacher questioned the purpose of teaching learners’ communication techniques that could not be employed outside of the classroom, specifically at home. The teacher observed that learners frequently exhibited regression in their academics when they return from school holidays. This could have an impact on their acquired communication skills as well because the learners will not be permitted to take their devices home. Additionally, the educator cited concerns regarding the suitability of learners’ home environments for the use of AAC devices, which may require batteries or access to electricity for charging which may be unavailable. She further indicated that the devices may not be secured at home. The teacher conveyed a sense of futility considering these challenges and as such identified them as factors contributing to their lack of readiness to implement AAC. This observation was further supported by researches that found out that when AAC was used at school and not at home, it placed a child at a disadvantage [35].

The authors stated that using AAC exclusively in the classroom may limit opportunities for skill generalisation and reduce the relevance of communication for children in their daily lives. The authors noted that a lack of resources and support, as well as poverty, were factors that hindered parents from using AAC at home. They argued that it is crucial for families to have the means and assistance necessary to support them integrate AAC into their daily lives, including the home environment. This study highlights the need for interventions that address the barriers to AAC implementation at home and promotes the generalization of AAC skills to improve the quality of life for AAC learners and families.

Another challenge in the implementation of AAC in schools is staff turnover. Further studies this subject have explained that staff turnover can be a significant challenge in the implementation of AAC in schools in South Africa since new staff may lack the necessary training or experience to work effectively with AAC users [28]. On the other hand, scholars [56] argue that high staff turnover in special education is a crisis that demands attention since it has negative implications on the standard of education received by learners with disabilities. Therefore, it is crucial to address staff turnover and to provide adequate staff training to ensure successful AAC implementation in schools. Another study,] investigated the causes of high staff turnover in special schools in South Africa's Western Cape. [47The study further posits that the reasons for teacher attrition levels included low pay, unpleasant working conditions, a lack of opportunity for professional growth, and burnout. One of the conditions of change is having teachers rewarded or getting incentives as a way of addressing the crisis in staff turnover, especially in special and full-service schools [19].

In the discussion surrounding the implementation of AAC within schools, hesitancy appears to be a prevalent issue. If this hesitancy continues, it could have significant repercussions for students, their families, and society as a whole. The reluctance to embrace AAC may result in limiting the communication abilities of students who could greatly benefit from such technology. This can lead to feelings of frustration and isolation among students who struggle to express themselves effectively through traditional means [43]. Moreover, families of students who require AAC may experience heightened stress and difficulties in understanding and supporting their children’s communication needs [49]. The lack of acceptance and normalization of AAC within schools may further perpetuate societal misconceptions about communication differences and disabilities. By not promoting the use of AAC as a valid communication mode, we risk excluding individuals who rely on these tools to fully participate in educational and social environments [43].

To combat the stigma surrounding AAC, it is essential to highlight that many individuals without communication challenges also engage in multi-modal communication. For instance, individuals often use a combination of speech, gestures, and hand signals to in an effort to clearly communicate and emphasize their messages. By normalizing the use of multiple communication modes, we do not only support students who require AAC but also encourage a more inclusive and diverse communication landscape within educational settings and society at large [23]. In this indepth engagement of inclusivity in the educational setting as discussed above our study used qualitatively engaged the South African educational landscape and in the process chose a number of schools as our case study. However, for the purpose of this particular paper we considered using a single school, as our case study. The findings may differ if replicated in an alternate setting with a different community background. Further, the significance of our case study is the community within which that faces it is located; an area that is deeply mired in South Africa’s socio-economic challenges. It was also on that note that we made a the decision to use this school as a case study with the aim of seeking to also understand the impact of socio-economic challenges on the school’s everyday operations.

3 Conclusion

This South African study significantly highlights the importance of providing practical and hands-on training to teachers for the successful implementation of Augmentative and Alternative Communication (AAC) strategies. Despite the availability of resources, a lack of knowledge and skills among teachers can lead to challenges in effectively utilizing AAC devices. It was further observed that staff turnover further exacerbates this issue; thus emphasizing the need for ongoing training and support. Recommendations include implementing policies requiring all teachers to receive training on inclusive education and assistive technology, as well as establishing collaborations with teacher training institutions to ensure comprehensive training on AAC and inclusive education for all educators.