Once a communication difficulty has been identified and a referral has been made, an AAC specialist will complete an assessment of the person with complex communication needs (CCN). The “assessment is a flexible, collaborative decision-making process in which teams…repeatedly revise their decisions and reach consensus about the ever-changing abilities, needs, and expectations” (DeCoste & Glennen, 1997, p. 34) of the potential AAC user.
During an assessment the AAC team members should complete the following:
1. Identify participation patterns and communication needs (Beukelman & Mirenda, 2012, p. 109): When initially assessing a person with complex communication needs several factors need to be taken into account to find the most appropriate AAC system for that individual. In order to identify participation patterns and communication needs the AAC team must first:
Obtain information specific to the person who will potentially use AAC: When looking at the person with CCN, four broad questions should be asked: “What does the [person with CCN] need to be able to do that is difficult or impossible to do independently at this time? What are the [person with CCN] special needs that contribute to these concerns? What are the [person with CCN] current abilities related to these concerns? What are the [person with CCN] interests?” (Zabala, 2005, p. 1).
2. Identify participation barriers (Beukelman & Mirenda, 2012, p. 109): There are two kinds of barriers which can affect a person’s ability to use their AAC system(s) and participate in communication. The barriers may be:
– opportunity barriers: These types of barriers are those which are imposed on the person using AAC by outside sources such as policies and practices that are set in place, the attitudes of family, friends, therapists and other communication partners, and therapist and communication partner knowledge and skill (Beukelman & Mirenda, 2012, p. 109). To address opportunity barriers the AAC team needs to:
Identify the environments in which the person using AAC must function: These include environments such as home, school, work, and community. During examination of each of these environments it is important to ask questions such as: “What is the physical layout? How much support is available from and to staff? What materials and equipment are being used…? Are there physical access issues? What services are being provided?” (Zabala, 2005, p. 2). Furthermore, “What are the attitudes and expectations of others in the environment?” (Zabala, 2005, p. 2).
– access barriers: These types of barriers include those which are internal to the person using AAC such as attitude, capabilities and constraints (e.g. motor, literacy, cognitive-linguistic, and sensory-perceptual skills) (Beukelman & Mirenda, 2012, p. 109). To find access barriers the AAC team must:
Identify the tasks that need to be completed: The tasks include what is actually happening within each environment, and the expectations required of the person using AAC can affect access to a task. For example, if the goal of a person using AAC is “communication” it is important to determine what exactly is being required (Zabala, 2005, p. 2). Do they currently need to communicate only at the word level or be able to communicate in conversation? Depending on the tasks, the access barriers will change and therefore may affect the type of tools needed to complete the tasks.
3. Plan and implement interventions (Beukelman & Mirenda, 2012, p. 109): After examining all relevant factors the AAC team will collaborate to:
Determine the tools required to meet the needs of the environment, tasks, and abilities of the person using AAC. Tools can be “devices, services, and strategies – everything that is needed to help [the person using AAC] succeed” (Zabala, 2005, p. 2).
4. Evaluate intervention effectiveness: Once the initial evaluation has been completed and intervention strategies have been implemented, continual follow up assessments should be conducted to assess if the interventions have been effective. The AAC team should identify what is working for the person using AAC and what is not working by re-examining all factors involved and make adjustments to the intervention plan as needed (Beukelman & Mirenda, 2012, p. 109).