AAC assessment

Also called Communication aid assessment, Assistive technology assessment, AAC evaluation

Finding the right AAC system is a process of matching person, vocabulary, access method and setting, not a single appointment.

What it is

An AAC assessment is the work of finding out which augmentative and alternative communication system will work for a particular person: which vocabulary, on which display, accessed how, in which situations, supported by whom. It is done by a team, usually a speech and language therapist with an occupational therapist and often a clinical scientist or technologist, and it takes weeks, because it includes trials.

It is different from a general communication assessment, which establishes what a person can understand and express; the AAC assessment starts from the assumption that the person needs another way to say it, and asks how.

Who it can help

Anyone whose speech does not meet their communication needs, at any age and any level of language. That includes a three-year-old with cerebral palsy, a teenager with autism who speaks but not reliably, an adult with motor neurone disease planning ahead, and an adult with a learning disability in their fifties who has never been offered anything. There is no minimum ability. Prerequisite skills are a myth, and a service that still uses them is behind the evidence.

It is not something a person has to wait for before using AAC. Simple boards and free apps can and should start now; the assessment refines, it does not permit.

How it works

The team looks at four things together. The person: language, literacy, vision, hearing, motor control, attention, and what they want to say. The access method: touch, switch scanning, eye gaze, head tracking, or partner-assisted. The system: symbol-based or text-based, static or dynamic, what vocabulary organisation, what grid size. The environment: who will support it, where it will be used, how it will be mounted and charged.

Then the team trials one or two candidate systems for a period, usually several weeks, in real settings, with the people around the person trained to model it. See device loans and trials. The recommendation follows the trial, not the catalogue.

Getting started

Ask the local SLT service for an AAC assessment by name, and ask whether it is done locally or by referral to a specialised service. In England the specialised hubs take referrals only through local services, so the local team is always the first door. See local AAC services.

While you wait, gather the evidence the team will want: a video of the person communicating in their own way, a list of what they try to say and to whom, and what has been tried. Try a free board. The Fiducia Talk board has 308 symbols in 14 sets, a phonics keyboard and switch scanning, all free, and how the person takes to it, which cards they reach for, whether they prefer symbols or letters, is exactly the kind of information that speeds an assessment.

Where to get help

Communication Matters explains the process and lists services. ACE Centre is an assessment service and a specialised AAC hub in England. CALL Scotland is the Scottish centre. RCSLT sets the professional standards. For funding after the assessment, see funding a communication aid.