Conference Program

Hospital school services are designed to guarantee educational continuity for students experiencing illness and prolonged hospitalization.

Hospital teachers work within a care-centered environment, significantly different from traditional classroom settings, in which the student’s health status is the priority (Benigno et al., 2017). Within this context, however, education is not a secondary activity but a constitutive dimension of the therapeutic pathway (Rodríguez et al., 2023).

Among the critical competencies required of professionals working in pediatric hospital settings is the ability to communicate effectively with children who present Complex Communication Needs (CCN), whether due to temporary or permanent disabilities (Costello, 2000).

The absence of effective communication strategies may represent an additional source of stress, frustration and isolation for hospitalized students, especially in contexts where speech is compromised (Pina et al., 2020). Augmentative and Alternative Communication (AAC) has been described as an effective strategy to enhance interaction, safety, and participation, also in intensive care and pediatric settings (Costello, 2000). At the same time, research on complex AAC interventions underscores the need for structured, systemic approaches that include training and coordinated support of all the communication partners involved (Costello, 2000; Rodríguez, 2023). The successful implementation of AAC in hospital school therefore requires a shared commitment and aligned practices between educational and healthcare professionals.

As research highlights the need for specific AAC training among health care professionals in clinical contexts, comparable structured preparation is equally necessary for hospital teachers, who operate within the same care-centered environment and support children with CCN (Woodring & Harmon, 2023). Building on these considerations, this paper argues that accessible communication in hospital schooling should be conceptualized as a shared domain of educational and health services. AAC is examined not merely as a compensatory tool, but as an infrastructural condition enabling agency, participation, and continuity for students with CCN, including those with neurological impairments, developmental disorders, medically induced communication limitations or non-native speakers.

The theoretical discussion is informed by preliminary findings from an exploratory survey conducted with Italian hospital teachers (n = 24). The majority of respondents report working regularly with students presenting CCN. While most of the participants declare familiarity with AAC strategies, only a minority indicate having received structured or formal training in AAC implementation. These data, while based on a non-representative and exploratory sample of Italian hospital teachers, suggest a structural asymmetry: communicative complexity is recurrent in hospital school, yet, unlike special education teachers, hospital teachers are not formally required to receive specific preparation in working with students with CCN.

From this perspective, accessible communication emerges as a systemic responsibility rather than an individual initiative. If communicative mediation depends primarily on personal experience or informal knowledge, students’ effective access to both learning and care may vary across contexts, raising concerns of educational and health justice. The paper calls for the integration of communicative accessibility into teacher training models and interprofessional collaboration in hospital schooling, framing it as a foundational condition for inclusive and equitable continuity in clinical-educational environments.