2003 Conference Proceedings

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The Fundamentals of AAC: An Approach to AAC Assessment

Juli Trautman, MS, CCC-SLP
Duke University Medical Center
DUMC 3887
Durham, NC 27710
Phone: 919-684-5417
Fax: 919-684-8298
Email: juli.trautman@duke.edu

Patricia Ourand, MS, CCC-SLP
Associated Speech & Language Services, Inc.
100 E. Pennsylvania Avenue, Courtyard Suite
Baltimore, MD 21286
Phone: 410-825-9445
Fax: 410-296-5710
Email: Pourand@aslsinc.com

The direct goals of AAC are to enhance functional communication skills while increasing or enhancing participation and/or independence. In order to properly and systematically address these issues an evaluation by a team including the individual and communication partner(s), therapist(s) (e.g., SLP, PT, OT), assistive technology specialist(s), educator(s), physician(s) vocational rehabilitation specialist(s), and others is critical.

This process necessitates a comprehensive assessment that begins with specific demographic and evaluator information. Next, the primary medical diagnosis is documented in order to understand the current and future needs for AAC. This is followed by the expressive communication disorder, which must be one of the following: dysarthria, aphasia, apraxia, and/or anarthria.

While completing this assessment process, the team must be cognizant that here are four basic categories of AAC devices, as well as a category for software, mounts and accessories that are being considered for the individual. These categories are:

  1. digitized speech, pre-recorded messages, 8 minutes or less recording time
  2. digitized speech, pre-recorded messages, more than 8 minutes recording time
  3. synthesized speech, spelling, access by physical contact with device
  4. synthesized speech, multiple methods of message formulation, multiple methods of device access

Before any equipment can be recommended for an individual, an assessment with formal and informal data must be completed. The "data" being gathered addresses four essential skills areas, which are:

  1. Cognition
  2. Language
  3. Motor
  4. Sensory

When gathering assessment data regarding cognition, the team should be sure to describe attention and concentration, memory (e.g., visual and auditory, short and long term), and abilities for decision-making and problem-solving. The assessment data describing language skills is familiar to all certified speech-language pathologists. Specifically, the clinician should provide data and clinical analysis regarding any and all formal or informal assessments and observations gathered during this process. This aspect of the assessment should document the individual's skills in the areas of receptive language, expressive language, reading, and writing, as well as competency or ability to develop functional language skills, while addressing form, content, and use. In addition to cognitive linguistic functioning, the AAC assessment process must also address the individual's motor skills. Specifically, the assessment should address ambulatory status, seating and positioning, and current and future operating techniques. Finally, the individual's sensory skills, including vision and hearing must be defined and described with regard to the use of an AAC device.

Once all of the information described above is amassed, a written summary with recommendations must be developed. This section should describe specific equipment and procedures used for practice with this specific individual, as well as specific equipment that did or did not meet the person's needs. This aspect of the assessment process must list and describe each specific piece of equipment, mounts and/or accessory(s) being recommended. This section should also include specifics regarding the recommended frequency and length of treatment (e.g., speech-language pathology, occupational therapy) being recommended. Be sure to include measurable goals with achievable timelines.

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