1. AAC Assessment
March 12 & 19, 2018

2. Reality Check
There are a lot of models/frameworks about how to do AAC evaluations and we’ll discuss a few.
In practice, it’s very challenging to get everyone on the team to sit down and discuss and come to consensus on much of anything.
Most of the time, you use the information you can gather, from the people who will talk to you, try a few things, and come to the best decision you can with the information you have available, all before the deadline.
Use the principles of the model as a guide, may look differently in practice

3. Traditional SLP Evaluations (Helling & Minga)
Describe the nature and extent of the communication disability
Estimate prognosis for treatment and recovery
Design the initial framework for intervention

4. AAC Evaluations (Helling & Minga)
Describe the nature and extent of the communication disability
Estimate prognosis for treatment and recovery
Design the initial framework for intervention
Determine current communication capabilities
Identify a symbol system for an external means of language representation
Evaluate assistive devices to aid in the access and operation of the AAC system

5. AAC Evaluations My conceptualization:
Traditional SLP evaluations are looking to find and clearly describe what the individual is NOT able to do, in order to direct therapy
AAC evaluations are looking to figure out what the individual CAN do and problem solve to figure out which combination of supports will allow him/her to communicate most effectively and efficiently

6. Historical Perspective
Candidacy Models:
Potential AAC users had to:
have a gap between higher cognitive scores than language scores
be a certain age (which age varied)
have (or not have) a specific diagnosis
meet certain prerequisites
have the financial resources to access a device and services
Unfortunately these myths can be persistent.

7. Participation Model (Beukelman & Mirenda)
Identify participation patterns and communication needs
Assess Opportunity Barriers (Extrinsic Factors from Light’s CC model)
policy & practice, knowledge & attitudes of team members/Environment
Assess Access Barriers (Intrinsic Factors from Light’s CC model)
knowledge/skills, attitudes, access potential of individual with CCN
Plan and Implement Interventions
select AAC and provide instruction to individual and team
Evaluate Intervention Effectiveness
Is the person with CCN participating? ---> start over or continue follow-up

8. SETT Model (Joy Zabala) Student, Environment, Task, Tools, (Trials)
Commonly used in school systems for AAC and Assistive Technology evaluations.
What are the student’s strengths to build on and team concerns?
What supports/barriers are present in the environment?
What tasks is the student expected to accomplish in the environment?
Are there tools- high or low tech- that could enable the student to accomplish the expected tasks in the environment?
Big Question: Is this technology REQUIRED in order for the student to make academic progress?
Model can be adapted to use with non-students in non-school environments

9. AAC Chicks Evaluation (Clarke & Coyer)
AAC Skills and Communication Direct Assessment
Structured Observation
Interviewing parents, teachers, and other communication partners
Vicki Clarke has written up her protocols and collected a variety of assessment materials within a number of posts for PrAACtical AAC:

10. Assessing the Individual with CCN

11. Discovering the Capabilities of the Individual with CCN
There are no standardized assessments for this
There are some criterion based assessments
There are many checklists
You can adapt some standardized tests to gather information, even though you can’t determine a standard score with a non-standardized administration
Be careful if you use a test designed for a lower age that you look for other communication skills not captured in a test designed for early communicators-
most older kids will have developed some scattered functional skills
Don’t report age equivalents! Describe skills!

12. Considering Commercially Available Tests:
What does this test assess and how does it assess that area?
How is it useful to use with individuals with CCN?
How is the information gained useful when determining appropriate AAC?

13. Tests Functional Communication Profile
Every Move Counts, Clicks & Chats
WATI- online
Aphasia AAC Assessment- online
Communication Matrix- online
TASP
AAC Profile
AAC Evaluation Genie (iPad)

14. Functional Communication Profile
from 3 years to adults
informal assessment- checklist format
adaptable to a wide range of abilities/level of communication

15. Every Move Counts, Clicks and Chats
dynamic assessment across sessions
determine sensory responses, which leads to how to access a switch, which leads to potential voice output
helps to define a consistent motor pattern that allows for purposeful activation of a switch

16. WATI - Wisconsin Assistive Tech Initiative
Technically called the ASNAT- Assessing Student Need for AT
goes through many domains: visual, communication, motor, sensory issues
paper checklist
continuum of AAC considerations
team approach

17. Aphasia AAC Assessment
8 tasks, selecting 1or more targets of pictorial symbols
looks at accuracy, attempts and level of independence
partner dependent or independent, determine most successful strategies
includes a self-rating checklist and type of aphasia communicator
screener for visual fields

18. Communication Matrix https://www.communicationmatrix.org/
checklist for any chronological age that is in the language development 0-2 years
available in several languages
Lots of helpful videos of early communication skills
Has a message board/community where you can ask questions and get advice on therapy

19. TASP- Test of Aided-Communication Symbol Performance
4 subtests:
symbol size/number
grammatical encoding
categorization
syntactic performance

20. AAC Profile
I’ve found this most helpful to use as ongoing assessment/tracking progress for kids who already have a system; not as useful for initial assessment

21. Other Options TACL-3 Test for Auditory Comprehension of Language
CELF- with adaptations
CASL- with adaptations
EASIC
May or may not be able to use standardized scores, but can be useful to show what can be done with and without AAC support

22. CELF Adaptations

23. CASL Adaptations

24. EASIC- Evaluating Acquired Skills in Communication

25. IASCC- Index of Augmented Speech Comprehensibility in Children

26. AAC Evaluation Genie iPad App
14 subtests with full or screener version
differential reinforcement for right/wrong choices
has a scanning option
collects data in a one page summary

30. Quick Assess by Linguisystems
Brief “Physical Assessment” looks at touch and vision
Phrase completion task
Categorization task
Device use simulation task at restaurant

31. Quick Assess by Linguisystems

32. Quick Assess by Linguisystems

33. Assessing the Environment

34. Opportunities and Barriers in the Environment
No standardized tests here, either
handout from SET-BC
Communication Supports Inventory, based on ICF-CY
Framework from the Praactically Speaking book
When observing, make sure to note what peers are doing
Interviews of caregivers, family and AAC user for adults to determine communication breakdowns- may be less observable

35. Making a Choice of AAC Systems

36. Participation Model (Beukelman & Mirenda)
Identify participation patterns and communication needs
Assess Opportunity Barriers (Extrinsic Factors from Light’s CC model)
policy & practice, knowledge & attitudes of team members/Environment
Assess Access Barriers (Intrinsic Factors from Light’s CC model)
knowledge/skills, attitudes, access potential of individual with CCN
Plan and Implement Interventions
select AAC and provide instruction to individual and team
Evaluate Intervention Effectiveness
Is the person with CCN participating? ---> start over or continue follow-up

37. What to pick? No substitute for clinical experience
Need to know about the choices- keep up with your options
Traditionally: Pull together information about client and environment, and match features of devices to client characteristics
Feature Matching has been the main component of AAC evaluations for some time
As differences between devices/apps have shrunk, this is less important BUT providing AAC users and their families with choices is important!
Present options with appropriate features and make a collective choice to trial

38. Working with Vendors

39. Working with Vendors