2001 Conference Proceedings

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The AAC Assessment Process: Tools for the AT Professional

Yvonne Smith
PT, PCS, ATP
Arlington Independent School District
Arlington, Texas

Many professional disciplines have developed established assessment procedures based upon a long history of experience within the field. In contrast, the field of augmentative and alternative communication (AAC) has yet to develop a consensus concerning best practices for conducting an AAC assessment. As a result, AAC evaluation procedures vary widely from facility to facility, producing inconsistent and varying outcomes.

The lack of systematic AAC evaluation procedures has caused difficulty for many individuals who are nonverbal who may require AAC systems. Because recommendations for AAC devices vary widely, it is often difficult for families and consumers to decide which communication options to implement. Third party payers are reluctant to fund AAC devices when the assessment process does not provide sufficient justification or evidence to support the recommendations. AAC devices may be abandoned by users due to mismatches between skills, expectations, and the device’s capabilities.

AAC evaluations are a complex interaction of assessment procedures across multiple domains. This presentation will explore the use of three software programs, AAC Feature Match, ActiveVoices, and AAT Assessment Tool, as devices that facilitate the standardization of the AAC assessment process.

Matching an individual's needs to specific features of a device is an essential element in any AAC assessment. This AAC feature matching procedure, also sometimes referred to as the predictive AAC assessment model, is a complex-decision making process in which the skills, strengths, and needs of an individual are systematically matched to the various features of numerous AAC devices. Far from a standardized procedure, utilization of the feature matching assessment process requires expert knowledge of numerous AAC systems, as well as other related issues, including how well AAC devices integrate with other assistive technology solutions, such as environmental controls and computers. Comprehensive information must be also be obtained about the end user, the communication partners, and environmental variables. Once this information is collected, summarized and reviewed, the feature matching process can begin.

There are many features that should be considered as the assistive technology team completes the feature matching process. These features have been outlined and discussed in the literature by numerous authors (Lloyd, Fuller, & Arvidson, 1997; Glennen, & DeCoste, 1997; McNairn & Smith, 1997; Swengel & Varga, 1993). Although there are general guidelines describing what skills and needs should be addressed in the feature matching process, the practical, clinical implementation of this assessment model is still evolving. The importance of individual device features will also vary according to the needs of the individual users. For example, a priority for an adult who is ambulatory may be a light weight device that can be easily carried. However, a priority for a school-aged child who is nonambulatory may be a device that is easily mounted to a wheelchair and smoothly interfaced with a computer and academic software.

Standardizing the process of identifying appropriate features is an ongoing challenge for the AT professional. Using dynamic screen AAC software, such as ActiveVoices from Doug Dodgen and Associates, to identify a variety of skills facilitates the standardization of the process. Developing page sets to evaluate visual perceptual skills, icon type and size, and access options gives the evaluator the opportunity to assess skills prior to the recommendation of any system.

However, the actual process of matching skills and needs to specific devices can be an overwhelmingly time consuming task. Providing a thorough AAC device feature match requires not only expert knowledge of the many AA C devices on the market, but also numerous hours calling manufacturers for the most current information on products and then collating the product information. To facilitate this decision making process, the AAC Feature Match software program has been designed to aid teams in the feature matching process. The AAC Feature Match software program contains a detailed feature description of over 200 low tech and high devices from more than 30 leading manufacturers. The device database in divided into 9 categories, 24 subcategories, and 108 specific features. The nine categories include information related to (1) language organization/encoding methods, (2) speech output, (3) direct selection and scanning/switch input, (4) keyboards, (5) switch types, (6) display types, (7) mounting options, (8) power sources, and (9) additional features including training/support options. The program provides a composite analysis chart listing identified features matched against all the devices listed in the database, a client profile data sheet, and individual device feature information reports. The program also allows for the AAC professional to update device information or add new devices to the software database.

The feature matching assessment process, when properly implemented, in a powerful clinical tool in the AAC decision-making process. By focusing on the strengths and needs of the individual who is nonverbal, it is possible for the AAC assessment team to develop appropriate AAC solutions.

Once the feature matching process has been completed, a comprehensive evaluation report must be written, justifying the recommendation for an AAC system. One particular software program, AAT Assessment Tool, provides a format for organizing report data and printing unique evaluation reports. Based on the maximal assessment model, this software program leads the AT professional through critical areas of information, resulting in an individualized AAC assessment. The AAT Assessment Tool presents a series of screens that request information about the assessment results. These screens can be completed in any sequence chosen by the evaluator. The screens combine input areas with choice areas to simplify quick entry of information.

The AAC assessment process is a time-consuming, labor-intensive process. However, the proper utilization of AT software tools, can help standardize the procedure and reduce the time needed to complete the process, thus freeing the AT professional to spend more time ding that for which they are trained, conducting evaluations and providing services.

References

Glennen, S. & DeCoste, D. (1997). Handbook of Augmentative and Alternative Communication. San Diego, California: Singular Publishing Group, Inc.

Lloyd, L., Fuller, D., Arvidson, H. (1997). Augmentative and Alternative Communication: A Handbook of Principles and Practices. Needham Heights, Massachusetts: Allyn and Bacon.

McNairn, P. & Smith, Y. (December1996/January 1997). AAC feature match software aids in choosing software, hardware. Closing the Gap, 12.

Swengel K. & Varga, T. (1993). Assistive technology assessment: The feature matching process. Paper presented at Closing the Gap Conference, Minneapolis, MN.




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