Distributing Expertise in Augmentative and Alternative Communication Intervention Through Codesign

Purpose: Collaboration with clients and their families has long been emphasized in augmentative and alternative communication (AAC). However, clinical interventions often reflect practitioner-centered models that prioritize clinical outcomes and professional expertise. Research across health, education, and rehabilitation sciences demonstrates that codesigned interventions can support shared decision making, strengthen the connection between intervention and the contexts where it is naturally implemented, and redistribute power within the therapeutic relationship in ways that elevate the perspectives of clients and their significant others. A smaller but growing body of AAC research indicates that codesign can support system development, goal setting, and the creation of AAC tools that reflect user identity and better respond to user needs. The purpose of this clinical focus article was to examine how codesign can help reframe AAC intervention by centering families and clients as active contributors across all stages of the intervention process. Conclusions: This clinical focus article examines codesign as an approach for reframing AAC intervention. A structure for applying codesign within AAC is proposed. The structure focuses on centering families and clients as contributors across stages of the intervention process, including system development and goal setting. Implications for practice, research, and professional preparation are discussed.