For SLPs working in the schools, AAC evaluations are an extremely important and challenging component in developing a treatment plan for those students needing augmentative communication devices.
The University of Nebraska YaacK website suggest four basic questions that should be at the core of any AAC assessment:
- “What are the child’s communication needs or goals?”
- “What are the child’s strengths and abilities?”
- “What barriers are preventing the child from achieving his or her full communication/participation potential?”
- “What aids and adaptations (e.g. AAC devices or systems, environmental modifications, policy changes, etc.) will best accomplish the child’s goals given his or her strengths and abilities, and current circumstances?”
The YaaCK site also points out that the mutable nature of a child’s needs, including their growth, changing communication strategies, and expanding environments, should be taken into account when providing an assessment. This is a critical consideration that is not often given sufficient attention in these evaluations.
Another often ignored consideration for a comprehensive AAC evaluation is that there are areas within the scope of other allied health professionals can help in the assessment as well. This is important particularly when you are working with device users that have fine motor or gross motor skills needed.
An occupational therapist can assist with areas related to alternative access and visual processing or scanning of symbols. When considering types of switches, where switches may need to be placed or additional supports (like wrist guards), the occupational therapist’s input is vital. A good OT can also give support to the family once the device is received. The OT can educate the family with changing the position of the switch depending on the user’s motoric skills (which can vary greatly from day to day).
There are occasions when consultations with the physical therapist are also warranted. When a user changes wheel chairs or requires a wheel chair mount, it is important for the PT to provide input. Neck support and positioning information is also needed, particularly when a user accesses the device via head tracking or eye gaze.
Teachers and support staff in the school can also provide information related to the environment that the user has in the classroom. Does the user remain in his or her chair at school? Are there distractions that interfere with device usage? Does the vocabulary on the user’s device accurately reflect how the user is expected to participate in learning? Can the user’s educational expectations be expanded with device use?
For children with multiple impairments, getting all stakeholders involved in the process of evaluating or implementing the use of a communication device can lead to a much higher level of communication success. Communication success leads to improved safety, improved behavior and most importantly an independence that cannot be obtained otherwise.
Robert Hoyt, Ph.D.
Allied Health Professionals, LLC
Michael Gamel-McCormick and Stacy Dymond have created a Augmentative Communication Assessment Protocol for Symbolic Augmentative Systems checklist which provides specific questions to be addressed during an evaluation. Most of the questions would also be relevant for an assessment for a text-based system.