Overview of Assessment

Initial Information taken fromPatricia Ourand, MS, CCC-SLP

AAC Assessment-feature matching

Devices/ Tablets

Specs of the devices and tablets

Human Factors

• Diagnosis• Motor abilities• Sensory issues• Cognition• Language Development• Academics

Goals of AAC

Temporary Temporary means of communication

Long TermLong Term means of communication

TherapeuticFacilitate development ofNatural, spoken communication

Goals of AAC• Communicate Self Care needs

• Communicate Emotional status

• Engage in Social communicative interaction with family and friends

• Engage in Community communicative interactions

Systematic Selection Process• Initial interview• Needs assessment• Client/student strengths and limitations• Access methods• Feature match• Trial (test out several devices, especially if going through insurance)

• Final device analysis• Purchase• Follow-up

• I also think the process involves teaching of the device.

Interview

DemographicsState home vs birth parentsForeign country with non-native language

Background/cultureDifferent views regarding education for those with disabilities

Caregiver interview- family, friend guardian, etc.

Client/student observationHow are they currently communicating?What are they communicating?To whom are they communicating?

Need assessment

Adapted from Dowden

et al., 1986

Environment

Messages

Modes

Partners

Assessment Data

Cognition Language

Motor Sensory

Team• Client/student, family and caregivers• SLP• Medical Staff• Nursing staff• OT• Psychology • PT• Social Services• Vocational staff• Audiology• Ophthalmology-vision specialist• Orthopedics- motor specialist• Neurology• Pharmacist• Teachers

Can you think of anyone else?

Assessment Data: Cognition• Include a clinical assessment:

Formal or informal

Discussing and describing the severity of cognitive impairment if present

If no impairment is present or suspected, state as such

Where available, include a statement from the neurologist, pediatrician, primary care physician ( I would also add a school psychologist to this list)

You may include things such as… Cause and effect, object permanence, representational level (picture, line drawings, etc.), rate of learning, can they learn from exposure or do they require direct teaching

Assessment Data: Receptive Language

• This may include results from subtest, standardized tests, or informal specifics. (This would include checklists and files, also.)

Following directions Comprehending conversations Yes/no reliability Ability to recognize and comprehend symbols (possibly more cognition)

Understand vocabulary in their environments (names of things)

Categorize (ex. using AAC folders such as animals)

Associate symbols (spoon and food go together)

Assessment Data: Expressive Language

• As appropriate describe the individuals ability to:

Do they show intent?

What communications functions do they display?

Combine symbols to generate language

Choosing an access

• Anatomic Site• Action

VolitionalControl

Consistently Accurate

Comfort

Force

Speed

Range of Motion

Presenceof Reflexes

Positioning Mounting

Change

Status

Environment

Technology

Assessment Data: Sensory• Describe the individual’s visual skills

• Locate target messages by searching or navigating through multiple displays (scanning a page)

• What size button can they see.

Provide subjective assessment based on the individual using the actual device.

• Describe the individual’s auditory skills

Consider the communication partner

Provide subjective assessment based on the individual using the actual device.

Bottom Line?

Needs Assessment

WrittenReport

Data Collection

Standardized Assessment• They don’t always give us the information we need.• What do their scores really tell us?• How do you do the expressive sections?• What if they have aged out of a test?• What impact do these scores have on the parents?

• Examples:1. Preschool Language Scale2. Peabody Vocabulary Test3. Artic or phono test4. Test for Auditory Comprehension of Language

Published Assessments/Checklists • Communication Matrix by Charity Rowland …for individuals at the earliest stages of communication development - Look at 4 basic reasons for communication: refusal, obtaining things, social interactions, providing or seeking information If they obtain the 4 reasons for communication, then…

- Look at 7 levels of competence: pre-intentional, intentional unconventional, conventional, concrete symbols, abstract symbols and Language (combining symbols)

Functional Communication Profile – sold by ProEd 10 areas: sensory, motor, attentiveness, receptive, expressive, pragmatic/ social, speech, voice, oral and fluency

Communications Functions-this is the“how we communicate”

Functions of communication; a few to consider:• Calling attention• Denying or protesting• Requesting object, action or event• Initiating communication with a question or comment• Directing action of another person• Social comments, exclamations in appropriate contexts• Calling attention to self-achievement• Combining thoughts into longer utterances to expand an idea• Using words to describe location• Asking simple questions• Ask permission

Assessments/Checklist cont.

• WATI- Wisconsin Assistive Technology Initiative 1. Present Means of Communication/Purposes 2. Assistive Tech Assessment 3. Needs related to Devices 4. Reading Skills Related to Communication 5. Visual Abilities Related to Communication 6. Sensory Considerations 7. Communication Expectations in Different Environments 8. Concerns Related to Past Devices Used

• Augmentative & Alternative Communication Profile -LinguiSystems Assesses 4 areas of Learning• 1. Operational: Orientation/Awareness, Manipulation, Focused Use, AAC Navigation, Programming 2. Linguistic: Communication Awareness, Specific Meaning, Combining Words, Syntax & Morphology, Refined Language 3. Social: Natural Behaviors, Regulatory Behaviors, Practiced Interaction, Awareness & Competence, Social Mastery 4. Strategic: Pre-intentional, Intentional, Programmed Message Use, Appropriate Message Selection, Strategic Mastery

Assessments/Checklists cont.• ACES- Augmentative Communication Evaluation Simplified – AAC TECH Connect

1. Medical History/background 2. Hearing/Vision 3. Communication Skills 4. Present Means of Communication 5. Forms of Communication 6. Communication Situations/Partners 7. Physical Abilities/Positioning 8. Interests 9. Information from Previous Reports 10. Communication Functions

INCH-Interaction Checklist for Augmentative Communication 1. Initiation Strategies- skills for starting communication 2. Facilitation Strategies-skills that keep the flow of communication going 3. Regulation Strategies-skills needed to correct or adjust a message based on feedback from a communication partner 4. Termination Strategies-skills to end the conversation

More Assessments/Checklists• Evaluation Genie by Celeste HellingThe purpose : not to identify a particular speech generating device, but rather build a framework for selecting an appropriate augmentative communication device for ongoing evaluation and / or device trial. There are 14 subtests that can be administered or screened.Uses Unity symbolsGunner video

• TASP -Test of Aided Communication Symbol Performance by Mayer-JohnsonThis test of symbolic skills provides a starting point for designing or selecting an appropriate page set for an AAC device. The test can also be used to help design communication boards. Subtests included are symbol size and number, grammatical encoding, categorization and syntactic performance. Basals and ceilings are established for each subtest. The test can be administered to children or adults who have the physical ability of functional pointing and are not at an object level.Administration time is 10 to 20 minutes, and scoring procedures are objective and rapid. Test forms are reproducible.

Environmental Observations

• Functional Ecological Inventory (Discrepancy Inventory) You have a copy in Resources on ReggieNet Can be used in any environment.

What are the other individuals communicating? What does the AAC user communicate? What do I teach my AAC user to be competent like others?

• Observing The Classroom Environment Procedure –Tobii DynaVox Technologies

You have a copy in Resources on ReggieNet Used for school environments Same as above but also includes Learning contexts and Teacher Communication Behaviors

• Language Sample

A Word about the Report.

Most device companies have templates you may use to write your report.

Consultants are your friends.

•AAC Tech Connect• TOBII-DynaVox-Funding Overview•Prentke- Romich-Funding Assistant• Saltilo-Partner with Prentke Romich

Let’s look at the Feature Match

ACES includes it own Feature Match and APP Match

SETT by Joy Zabala

• Many times a tool or strategy can allow the student more success in completing activities. An AAC device is a tool.

• A SETT considers : - The Student (strengths and needs)

- Environments

- Tasks

The information gathered helps the team to develop a list of tools or strategies to try.

SETT steps1. Initial meeting to discuss the student, environments, task and

tools

2. The team makes a determination of what tool to trial. More than one tool may be tried. (companies have trials, sometimes consultants let you use their devices, IATP, etc.)3. The trial. Data is collected.

4. The team meets again to discuss the results.

5. The tool may be adopted or a new tool may be trialed again.

Final Steps- Funding• Complete your funding packet: Client Information Page Your assessment Physician’s Script- The doctor makes the diagnosis Medicaid or Medicare forms (these go by state) If using insurance you must have a copy of the front and back of insurance card. Implementation Plan (maybe)

• Mail it off to the Device company where they review it and send it on.• Cross your fingers and rub a rabbit’s foot.• Approval….yeah• Appeal – you consultant is your best help here

• Process can take from 3 weeks to a few months