How to Find an Augmentative Communication Professional

http://atcoalition.org/article/how-find-augmentative-communication-professional

An evaluation of appropriate augmentative and alternative communication(AAC) equipment, performed by one or more professionals, is often a critical component of successful AAC use. This article talks about what to look for in an AAC evaluator, and how to find evaluators in your area.

Credentials

AACevaluations are frequently performed by speech-language pathologists (SLPs) who have additional training in AAC equipment and strategies. However, they may be only one member of a team. The American Speech-Language-Hearing Association (ASHA), which provides credentials for SLPs, recommends the following:

Selecting the best way to communicate is not as simple as getting a prescription for eyeglasses. It is important to obtain an evaluation by a group of professionals to develop the best communication system to meet your needs.
You can have an evaluation at a:

• medical facility
• private practice
• school district
• center-based program

An evaluation should involve a team of professionals working together. In addition to the AAC user and his or her family and caregivers, this team often includes the following:
    * Speech-language pathologist
    * Physician
    * Occupational therapist
    * Physical therapist
    * Social worker
    * Learning specialist
    * Rehabilitation engineer
    * Psychologist
    * Vision specialist
    * Vocational counselor
    * AAC user and family/caregivers

Team members evaluate the person's needs, current means of communication, and potential for using different kinds of AAC. Over time, team members may change as the person's needs change.
After a decision has been made to select an AAC system, it is important to have professional follow-up. This may simply be a one-time training or may require speech-language services that focus on the development of communication using the system over a period of time.
Professionals need to help the individual and communication partners learn a variety of skills and strategies (e.g., meaning of hand signs and operating a piece of electronic equipment).

Selecting an AAC Evaluator

ASHA suggests asking the following questions when determining who is most qualified to perform an AAC evaluation:

• Do you typically provide services in the area of AAC?
• How long have you worked in the area of AAC? Have you worked with anybody who has a similar problem?
• Do you work as part of a team? What members are on the team?
• After evaluation, what will you do to make the communication plan work? Will you do the follow-up treatment?
• What specific kinds of communication options (e.g., additional treatment, gesture, sign language) do you recommend?
• Where can I go to see and talk with people using AAC?
• How soon can you schedule an evaluation? What will it cost? What kinds of payment do you accept?
• If you recommend a particular device, will you help me find funding for its purchase?
• Will I be able to see actual equipment that might be recommended? If not, where else could I go to see it?

The following are questions you should be able to answer after an AAC evaluation:

• What communication approaches have been recommend?
• Which approaches will be used for various modes of communication? Quick phrases? Expressing feelings? Giving and getting information? Conversation with family and friends? Written communication?
• What symbols (e.g., letters, pictures, graphics, words, or phrases) will be used on boards or devices?
• Is there enough flexibility in the recommended communication system so that communication is possible in a variety of settings?
• Will special equipment or switchesneed to be bought or made?
• What body positions can be used to increase communication and function?
• Can the recommended system be modified as capabilities and needs change?
• Why were the recommended techniques chosen?
• Which professionals will be carrying out the recommended communication plan and how often must they be seen?
• Can I talk with current users of the system I am thinking about?

Finding an AAC Evaluator

ASHA maintains a database of credentialed professionals, although it does not permit searches specifically on AAC expertise. If you bring up a list of professionals in your area, make sure to look for both "AAC" and "augmentative alternative communication," since the specialty may be listed either way.
If you can't find a nearby evaluator in this database, try contacting the following local agencies or professionals:

• Hospitals
• SLPs in private practice
• School districts
• Gerontologists
• Rehabilitation centers

What to Expect in an AAC Assessment

http://atcoalition.org/article/what-expect-aac-assessment

A formal evaluation by a speech-language pathologist may be necessary before an appropriate augmentative and alternative communication(AAC) is acquired; e.g., if Medicare funding is necessary to cover the cost of the device. Assessments for AAC strategies are somewhat different for children and for adults. This article covers what to expect and look for in evaluations for either audience.

AACEvaluations for Children

The Individuals with Disabilities Education Act (IDEA) definition of assistive technology covers "[a]ny item, piece of equipment, product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities." According to the National Early Childhood Technical Assistance Center, this definition includes AAC. Because the IDEA definition of assistive technology also specifies the need for an evaluation, AAC evaluations are covered by IDEA.
The PBSParents Inclusive Communities website has a page on How to Get an AAC Assessment. Suggested resources include the child's school district and the speech/language therapy departments of local postsecondary institutions.
The University of Nebraska YaacK website suggest four basic questions that should be at the core of any AAC assessment:

• "What are the child’s communication needs or goals?
• "What are the child’s strengths and abilities?
• "What barriers are preventing the child from achieving his or her full communication/participation potential?
• "What aids and adaptations (e.g. AAC devices or systems, environmental modifications, policy changes, etc.) will best accomplish the child’s goals given his or her strengths and abilities, and current circumstances?"

The YaaCK site also points out that the mutable nature of a child's needs, including their growth, changing communication strategies, and expanding environments, should be taken into account when providing an assessment.
Michael Gamel-McCormick and Stacy Dymond have created a Augmentative Communication Assessment Protocol for Symbolic Augmentative Systems checklist which provides specific questions to be addressed during an evaluation. Most of the questions would also be relevant for an assessment for a text-based system.

AAC Evaluations for Adults

There are no general parallels to IDEA for adults in terms of requiring the provision of AAC devices or evaluations. For adults who are employed or seeking employment, AAC devices are likely to be considered "personal devices" on a par with wheelchairs, glasses, or hearing aids, and the employer therefore does not have an obligation to provide them.

In many cases, adults being evaluated for AAC use will have prior language skills but have acquired a disability that makes using these difficult. These disabilities can include stroke, traumatic brain injury, ALS, and multiple sclerosis. In other cases, the adult may have a congenital condition such as cerebral palsy but may not have had a prior opportunity for an evaluation. Evaluations are generally performed by a speech-language pathologist affiliated with a hospital or university or in private practice.

Once the need for a communication aid is determined, an evaluator needs to figure out what type of device will be most appropriate. The Augmentative Communication, Inc. website lists several considerations for adult evaluations, including the ability to independently generate messages, the need for storing preprogrammed messages, the optimal access strategy (e.g., whether switchuse is required), and whether the user is likely to benefit from a trial period using one or more device options. The Speech Pathology Guru site provides an example of one type of report that may be generated as the result of an adult AAC evaluation.