Supporting Communication Access of People With Communication Disabilities and Communication Differences in UNCRPD-Ratified Countries: An Integrative Review.

backgroundThe United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) recognizes communication accessibility as a fundamental human right. Communication plays a key role in facilitating belonging, sharing and engaging with communities, allowing individuals to connect and forge relationships. Communication is fundamental to well-being and building a sense of self and identity, as well as establishing and maintaining social roles and vocation. Those with communication disabilities or differences can face many barriers to social participation, inclusion and potential financial implications.

aimsThis integrative review explores policy, practices and guidelines that support communication access of adults with communication disabilities and differences in selected English-speaking countries with UNCRPD-ratified status and well-established speech and language therapy services.

methodsAn integrative review of the literature was undertaken. A systematic search of the published, peer-reviewed literature was conducted for empirical research, and a manual search was undertaken to obtain policy, practice, or guidelines, to support communication access at a sectoral/service or community level. A multi-scalar approach situates the findings within several contexts: international law, national legislation and policy, professional guidelines and evidence from local/national projects. MAIN CONTRIBUTIONS: A multi-scalar map was developed that positions the findings on communication access within the included countries (Republic of Ireland, Northern Ireland, United Kingdom, Canada, Australia and New Zealand), across local/national programmes and projects (n = 11), professional body and civil society guidance, regional/national legislation and policy specific to communication access and finally the international normative instrument of the UNCRPD. The findings indicate that communication accessibility is recognised as a fundamental human right, but signatory states are required to take appropriate measures to ensure access to information and communication for persons with disabilities. National legislation, policy and practice need further scrutiny in this regard.

conclusionsThis review examines the complex phenomenon of communication access for people with communication disabilities and differences. The findings of this review can inform and shape practice with regard to communication accessibility as well as support advocacy efforts and future research in this area. WHAT THIS PAPER ADDS: What is already known on the subject Communication accessibility is a fundamental human right. It can be characterized by the respectful and responsive treatment of individuals with communication disabilities and differences, along with the implementation of strategies and resources and the adaptation of environments, process and systems to facilitate effective communication. What this paper adds to existing knowledge A multi-scalar map was developed that situates the findings on communication access within the included countries (Republic of Ireland, Northern Ireland, United Kingdom, Canada, Australia and New Zealand), across local/national programmes and projects (n = 11), professional body and civil society guidance, regional/national legislation and policies specific to communication access, and finally the international normative instrument of the UNCRPD. There is a lack of a shared understanding of communication access within empirical research, policy and local and national guidelines across the included countries. In addition, the focus on the right to communication is addressed more explicitly in some groups (and country contexts) than others. What are the practical and clinical implications of this work? This review highlights how multimodal communication is important for accessible communication. Co-design can also be harnessed to enhance communication access. The review provides an integrated set of data (empirical research, policy and guidelines) that can be used in future research, practice development and advocacy.