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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.
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