An Adapted Delivery of the Brick-by-Brick™ Programme to Develop Communicative Competence in Children with Acquired Brain Injury (ABI) who use Augmentative and Alternative Communication (AAC) Systems

ABSTRACT

Background: Communicative rehabilitation can be complex and challenging for children with an acquired brain injury (ABI) who use augmentative and alternative communication (AAC) systems. The development of communicative competence (CC) in children with use AAC systems is in itself complex and multifaceted (Light, 1989, Light and McNaughton, 2014) and it can be challenging for clinicians to target multiple competencies effectively through direct intervention. The Brick-by-Brick™ programme (previously known as LEGObased therapyR) has an evidence base routed in research with verbal young people with Autism Spectrum Condition. The programme is a collaborative play therapy originally designed as a social intervention to target the development of social communication and interaction skills (LeGoff, 2004). Introduction: The presentation aims to explore a use of the Brick-by-Brick™ programme with children with ABI who use AAC to support or replace their verbal communication, as well as the areas of potential clinical need for adaptations to its delivery to increase access for this client group. It will also discuss the theory behind adaptations and the need for evidence to support decision making clinically around this topic. The aims and methods of the presenter's current research will be discussed using Janice Light's framework of communicative competence (Light, 1989;Light and McNaughton, 2012) to discuss areas of competence during the presentation. Methods: The research agenda of an embedded quasiexperimental mixed methods design will be shared, along with considerations for the commencement of data collection in a country still significantly affected by the health, social, and educational repercussions of the Covid-19 pandemic. Clinical adaptations to the programme made by the presenter in her role as highly specialist speech and language therapist will be discussed and linked to her current research. Discussion, Conclusions and Recommendations: Adapting the delivery of the Brick-by-Brick™ programme for use with AAC users with ABI is not without difficulties, but these are not insurmountable. Practical and theoretical recommendations for the adaptation of the programme in both educational and healthcare rehabilitation settings will be shared. Future thoughts on the development of the current research base will also be discussed.