Alternative and Augmentative Communication Interventions for Students With Visual Impairment and Complex Communication Needs: A Systematic Literature Review

For several years, research efforts have focused on identifying effective practices for developing symbolic communication among individuals with multiple disabilities. However, a paucity of research and guidelines for children with visual impairments (VIs) and complex communication needs (CCNs) remains a persistent issue. The purpose of this study was to examine factors affecting school-based alternative and augmentative communication (AAC) interventions and instruction for children with VIs and CCNs through a systematic review of experimental research on AAC. We aimed to expand our understanding of “for whom” and “under what conditions” AAC interventions were effective for the participants. We used the PICOs framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify experimental and quasi-experimental studies published in peer-reviewed journals or as dissertations/theses between 2006 and 2025. We evaluated methodological rigor and outcomes using the outcomes section of the Single Case Analysis and Review Framework (SCARF) quality indicators and What Works Clearinghouse (WWC) quality indicators. Our results show AAC interventions for students with VIs and CCNs primarily targeted requesting skills, demonstrated inconsistent methodological rigor, and provided minimal information on participant profiles and durability of outcomes. Improving practices necessitates organizing research and practice activities with heterogeneity as the principal factor, with sustained attention to implementation conditions, generalization, and social validity. Implications for practice and future research are discussed.