AAC Assessment Overview

Individuals who may require AAC are individuals first with skills, interests and personalities spread across every continuum of consideration.  Assessment in the area of AAC begins first with the student and includes information about the communication skills and needs along with the individual student's required environmental supports critical for language and communication learning.  The AAC assessment provides information regarding the type of AAC device that is appropriate for the student based on specific feature match to needs and addresses the way in which the student will access core and fringe vocabulary for generative language, strategic use of full utterances and the use of letters, numbers and editing tools.  

Addressing the Needs of All Students in the School Caseload

School-based assignments for SLPs, teachers and other educators can include a range of students with significant communication difficulty.  The students with the most complex communication needs (CCN) may require AAC to provide the opportunity to maximize language and communication learning .  In order to address the needs of all students, the SLP, along with other educators, can ask a 5 specific, targeted questions to provide an indication of who may or may not require AAC.  By asking these initial questions, SLPs and educators can equitably consider the AAC requirements for all students.  

A Five(5)-Step Process for AAC

This process for addressing the needs of all students is divided into five (5) steps.  Steps 1 and 2 only are completed for all students and include questions that help to quickly identify and screen students with significant communication difficulty for the possibility of required AAC.   Based on responses to these questions, a student may or may not move on to Step 3, AAC assessment.  Step 4 provides guidance for comprehensive inclusion of AAC assessment information and recommendations in the IFSP or IEP.    Step 5 provides resources to support accountability for the provision of AAC devices, services and support.    Step 5 includes resources for language and communication learning and provides a structure that encourages the use of data to support intervention decisions.  

This 5-Step Process for AAC provides teams with  guidance to: 

• Systematically  consider a learner’s need for assistive technology related to communication through AAC.  (Steps 1 and 2)

• Use a data-based decision process to determine appropriate AAC (including support for a learner’s developing language and use of AAC to increase communication).  (Step 3) 

• Comprehensively include  AAC requirements in the IEP.  (Step 4) 

• Document provision of AAC and of the support required for effective use of AAC by the learner.  (Step 5)

STEP 1  AAC Indicator Question:  

Is the  learner demonstrating significant difficulty/delay  in communication based on age?  

• • • Use this indicator question to determine if further consideration should be given to a learner’s need for AAC.  

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RATIONALE:  How does the team know if a learner may require AAC?  Should every student with an IEP be considered?  If a learner is demonstrating difficulty in communication that can be described as “significant” for age, there is a need to consider whether the student may benefit from AAC.  Significant communication difficulty or delay at any age can affect other areas of development and limit a learner’s participation in age appropriate  social and academic activities.  For this reason, any learner designated as having significant  difficulty or delay in the area of communication would require the further consideration provided in  Step 2.  A YES response indicates the need to proceed to Step 2.  A NO response indicates that the student does not have significant communication difficulty or delay for age and it is unlikely that AAC is required. 

STEP 2   AAC Screening Questions:  

Screening questions provide further information regarding the need for AAC assessment.  If the answer to each of the four screening questions is NO, it is likely that the student does not require AAC, though special circumstances could apply.  If there is a single YES response, comprehensive AAC assessment should be considered.  

❑YES ❑NO       1.   Does the child 3 years or older have significant limited speech intelligibility for familiar people (e.g. parents, guardians)?

❑YES ❑NO       2.   Does the child have a diagnosis that is significantly impacting communication or that you anticipate has a high risk of impacting communication in the future (e.g. Down syndrome, brain injury, muscular dystrophy, cerebral palsy, autism, Rett syndrome)?

❑YES ❑NO       3.   Does the child have a diagnosis with a developmental delay and/or receptive language difficulty significantly impacting communication?

❑YES ❑NO       4.   Does the child demonstrate significant difficulty/delay with oral motor/speech? 

Use the Documentation of Completion of the 5-Step Process for all Students to document these steps/activities for all students within a caseload or roster. 

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RATIONALE:  What questions will further help to determine if AAC is required? 

A learner with significant difficulty or delay  in the area of communication does not indicate a learner’s need for AAC.  However, the presence of significant difficulty or delay does signal that the learner is not communicating at age level and additional information is needed.   The screening questions are intended to provide the next level of consideration to a learner’s need for AAC.  These questions can serve as a  guide when considering  which learners may need more  in-depth AAC assessment and data-based review of requirements for AAC.  

Screening Question #1:   Does the learner, 3 years or older,  have significant limited speech intelligibility for familiar people (e.g. parents, guardians)?  By age three, young children are typically able to produce words and sentences that are intelligible to people who are familiar with the learner’s developing speech and language.  If a learner is significantly delayed in this area,  AAC may provide the beginning support for experiences with more successful communication.  

• A YES response to this question suggests  that there is a very significant communication disability at this time and additional diagnostic and intervention information would be needed to determine the requirement for short or long-term AAC to support communication development. +

• A NO response to this question  may suggest that there is not a need for AAC based on intelligibility.  After age three, the standard for intelligibility expands to unfamiliar adults and consideration would be given to that in the determination of a need to progress to Step 3 to obtain more information.  

Screening Question #2:  Does the child have a medical or educational diagnosis that is significantly impacting communication or that you anticipate has a high risk of impacting communication in the future (e.g. Down syndrome, brain injury, muscular dystrophy, cerebral palsy, autism, Rett syndrome)?  Understanding the implications for communication development of specific medical or educational diagnosis can help to identify a student’s current and/or future potential requirements for AAC.  Additional diagnostic and intervention information would be required that may result in effective and timely introduction of AAC. 

• A YES response to this question may indicate that, though the learner may or may not be currently demonstrating communication difficulty or delay,  a specific medical diagnosis exists that is highly associated with communication difficulties. At the time of known significant delay or risk of significant communication delay, AAC can be considered and data-based assessment and decisions related to AAC should be completed.  At-risk status may suggest the need for special attention to assisting care providers and educational staff implement early interventions.  

• A NO response to this question is considered along with other screening questions.  Alone, this NO response indicates that there is not a medical or educational diagnosis that specifically signals the possibility of an associated communication delay through the information known about the particular diagnosis.   A NO response to this question does not preclude a requirement for AAC.  However, with all other NO responses, it may suggest that there is less reason to suspect the emergence of more specific communication difficulty or delay associated with  a known diagnosis. 

Screening Question #3:    Does the child have a diagnosis with a developmental delay and/or receptive language difficulty significantly impacting communication?  The presence of a diagnosis of developmental delay may indicate that current or future significant communication difficulty or delay may be observed.  Assessment of the requirement for short or long term AAC may assist decisions and timely provision of AAC to maximize communication development. 

• A YES response to this question indicates that there may be a requirement for AAC based on the existing communication delay affected by developmental and/or receptive language delays.   Additional assessment information is required through Step 3.  

• A NO response to this question is considered along with other screening questions.  Alone, this NO response indicates that there is not a current diagnosis of developmental or receptive language delay that specifically signals the potential for communication delay through the information known about the particular diagnosis.   A NO response to this question does not preclude a requirement for AAC.  However, with all other NO responses, it may suggest that there is less reason to suspect the emergence of more specific communication difficulty or delay associated with  known diagnosis. 

Screening Question #4:  Does the child demonstrate significant difficulty/delay with oral motor/speech?  The presence of oral motor/speech difficulty or delay in development can affect intelligibility at any age.  

• A YES response to this question indicates that oral motor skills and speech are significantly affected.  Additional assessment and intervention information would be needed to determine the requirement for short or long-term AAC to support communication development. 

• A NO response to this question is considered along with other screening questions.  Alone, this NO response indicates that there is not currently significant oral motor or speech difficulty that is contributing to a significant communication difficulty or delay.  Although oral motor and speech difficulty are almost always noted for individuals who require AAC, a NO response to this question does not preclude a requirement for AAC given special circumstances that would need to be considered.