JCPSLP Vol 18 no 2 2016

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68 JCPSLP Volume 18, Number 2 2016 Journal of Clinical Practice in Speech-Language Pathology
AAC consumers, and yet there is a dearth of research into
the on-line information search behaviours of people who
use AAC and their support networks. Further, despite the
large amount of AAC information available on the web
little is known about its visibility and accessibility to naïve
stakeholders (i.e., first-time AAC searchers). The aim of this
study was to examine the range, relevance, and credibility
of AAC information retrieved as the result of conducting
a series of keyword searches, using the popular search
engine Google.
Research questions
The study sought to answer the following questions, using
descriptive analysis of search-engine results:
• When a naïve (first-time) keyword search relating to AAC
is performed:
– what percentage of the resulting websites bear
relevance to Australian AAC stakeholders?
– what is the primary purpose of resulting websites,
and how does this vary based on the type of search
performed?
• For sites with the primary purpose of information or
knowledge translation:
– which populations and ages does the information
focus on?
– how do the sites perform against common credibility
measures?
– is there any relationship between these credibility
measures?
Method
To sample the range of asynchronous AAC resources
available, we conducted a targeted English-language
search from an Australian location, using the popular engine
Google ). Our method was largely
borrowed from the field of search-engine optimisation (SEO)
research. Engines such as Google employ a set of rules
(search algorithms) to determine the placement of websites
in the resulting hierarchy. These algorithms are based on a
number of factors (e.g., the number and source of links to
the site, the number of social media shares, and the
frequency of traffic), with some factors weighted as more
important than others. In the current study, SEO keyword
methods were applied to predict the public search
behaviours associated with a specific concept (AAC).
Selection of search terms
When a member of the general public is looking for
information on AAC, which keywords are they likely to
search? We probed this initial question using the free
keyword research tool from SEOBook: http://tools.
This tool shows the
approximate usage frequencies of keyword search strings,
based on data published by Google and Yahoo. Two
keyword branches (communication and communication
device) were used as starter strings for this investigation.
Table 1 lists the first five AAC-related terms that appeared in
the top-100 keywords containing these two search strings.
In addition to these 10 terms, the acronym “AAC” and three
terms relating to diagnostic populations who frequently use
AAC (aphasia, autism, and cerebral palsy) were included. A
final term, communication app, was also included. Although
this term did not appear within the top-100 keywords for
communication, the recent rise in mobile AAC technology
warrants its use in this study. The full list of terms and their
usage frequencies can be seen in table 1.
of health-information searchers reported starting at a general
search engine (Fox & Duggan, 2013), with Google being the
most preferred by far. Thirteen per cent started at a familiar
health hub (e.g., WebMD), while others follow recommendations
from friends or family (Fox & Duggan, 2013).
In a review of search trend research from 1997 to 2003,
Spink and Jansen (2004) reported that around 1 in 3 web
searchers used only one search term, and that 2 in 3
web users did not reformulate or modify their terms after
an initial query. Few searchers make use of advanced
features, such as Boolean operators. Users on average
viewed only 5 documents per query, and most did not look
beyond the second page of results (Spink & Jansen, 2004).
Finally, only a quarter of health searches consistently check
for the source and recency of on-line information (Fox,
2006). While it would appear that the search strategies of
the average user are not sophisticated, there are certain
exceptions. Parents of children with disability or health
conditions, for instance, exercise greater caution on
average than other on-line health searchers. Parents of
children with hearing impairment interviewed by Porter and
Edirippulige (2007) expressed a desire for more unbiased,
objective, and evidence-based information available to
families on-line. Parents spent longer on each search than
non-parents, visited multiple sites, and were more likely
to check their findings with a health professional (Porter &
Edirippulige, 2007).
The on-line search behaviours of parents have been
examined extensively. Parents of children with genetic
disorders interviewed by Roche and Skinner (2009)
reported high rates of health-related internet use, with
83% of parents receiving on-line information about their
child’s condition, and 69% searching for this information
themselves. Like most health searchers, parents typically
begin their searches in engines, using keywords relating
to their child’s symptoms or diagnostic label (Porter &
Edirippulige, 2007; Roche & Skinner, 2009). Their reasons
for searching the Internet vary greatly. In a UK survey of
788 carers of children with disability, 72% of those who had
used the Internet had searched for general information on
benefits, services, or their child’s medical condition, while
36% had used it to locate and make contact with specific
service providers (Blackburn & Read, 2005).
While many parents report success in locating relevant
information, their success often depends on the type of
guidance being sought. For some parents in Roche and
Skinner’s study (2009), Internet searches about their child’s
condition resulted in unwanted clinical images, genetic
information or prognostic predictions, while guidance
around broader issues such as inclusion was scant. As one
parent reflected: “[The Internet] doesn’t really have what
I’m looking for. I know what’s it’s like to be the parent of [an
affected] child. I need to know [how to] help them succeed,
help them be productive citizens” (p. 124). In Porter and
Edirippulige’s study (2007), parents of Australian children
with hearing loss wanted more on-line information on topics
such as education, intervention, and technology options,
and guidance around family support services, as well as
personal stories from other families. Parents of children who
use AAC technology have described similar information
needs (Anderson, Balandin, & Stancliffe, 2016).
In their review paper concerning parents of children with
disability, Zaidman-Zait and Jamieson (2007) stress that
professionals should be: “aware of the Web sites most
likely to be accessed by the parents with whom they work
… parents may be accumulating both information and
misinformation” (p. 20). The same could easily be said for