Let’s stay in touch! Remote communication for people with communicative and cognitive disabilities

Abstract

Introduction: Being able to use remote communication through digital channels is a prerequisite for participation in contemporary society, but some people have difficulties in accessing it. Aim: The overall aim was to explore and describe remote communication for people with communicative and cognitive disabilities. This thesis explored remote communication in relation to self-determination and participation from users’, professionals’ and support persons’ perspectives. Methods: This thesis is based on four studies: three qualitative (I, III, IV) and a mixed method (II). For study I, semi-structured interviews were used, and they were analysed by content analysis. In study II, semi-structured interviews were combined with Talking Mats, a pictorial communication tool, where qualitative data for systematic text condensation and ordinal scale data were obtained. Study III and IV’s focus groups were analysed by focus group analysis. Results: In study I, professionals described how text messaging with both pictures and speech could increase independence and participation, and how individual assessments and user-friendly technology were important. For study II, people with communicative and cognitive disabilities described how remote communication related to self-determination. Having a choice between types of remote communication and levels of independence was important, and technological limitations forced them to find their own strategies to communicate. Support persons discussed how remote communication enabled users to have more control and feel safer while increasing self-determination and participation for study III. The results suggest communicative rights were not met, and there was a need for better provisions of technology and support. In the final study, support persons discussed what enhanced and hindered remote communication. Conclusion: This thesis contributes to the understanding of how people with communication difficulties need access to remote communication to have control, be self-determined and participate in society. It provides knowledge on the needed improvements for access, support and development to improve remote communication use.