Do you wonder why a clinician recommends an AAC system that the communicator did not demonstrate AAC proficiency during the AAC assessment? Are you worried that your communicator will not know how to use the AAC system when it arrives because they have never been exposed to AAC before they had an AAC assessment?
Have no fear! Clinicians inherently consider such things during the AAC assessment process.
The Participation Model was developed to guide AAC assessment and intervention by identifying participation barriers and supports for the communicator (Beukelman & Mirenda, 2013). The Participation Model examines two separate overarching types of barriers related to the communicator's use of AAC: opportunity barriers and access barriers.
Opportunity barriers refer to policies, practices, skills, knowledge, and attitudes regarding AAC that inhibit the communicator’s opportunities in various aspects of life. Interventions are then planned and implemented to address such opportunity barriers immediately and into the future.
Access barriers refer to how the individual currently communicates, the potential to enhance their speech intelligibility and effectiveness to communicate, the potential for environmental adaptations to enhance their current communication effectiveness, and the potential for the individual to use AAC systems to enhance their communication.
When the clinician looks at the potential for the individual to use AAC systems to enhance their communication, they examine the operational requirements profile, constraints profile, and capability profile of the individual. These profiles provide the clinician with critical information about the communicator's motor skills, cognitive and linguistic skills, literacy skills, and sensory and perceptual skills as they relate to the use of AAC.
AAC candidacy should not be determined by whether the communicator possesses certain skills and meets certain criteria. Instead, it should be assumed that everyone and anyone can use and benefit from AAC.
The goal of the AAC assessment then is to identify the tools and supports necessary for the individual to grow into an effective and efficient communicator via AAC. This is especially important to remember when the individual has had no experience and exposure to AAC, symbolic representations of language, and/or access methods (Beukelman & Mirenda, 2013).
Clinicians use (or should be using) dynamic assessment when evaluating an individual for AAC.
Dynamic assessment uses a teach-test format where the clinician first teaches the communicator skills using a variety of supports to enhance the communicator’s performance in the assessment and then those skills are tested within the assessment (Beukelman & Mirenda, 2013).
Beyond providing information about the communicator’s skills, dynamic assessment also reveals information about their optimal learning conditions.
Because dynamic assessment uses a teach-test format, insights into the rate at which the communicator learns new concepts and the level of support they need to be a successful concept via AAC are revealed (Beukelman & Mirenda, 2013).
The Participation Model guides members of AAC teams to plan and implement interventions for today (now) and tomorrow (the future). Dynamic assessment is a great tool to get started planning.
Dynamic assessment is used to determine the most appropriate AAC system that meets the communicator’s current skills and needs while facilitating learning and skill development.
AAC implementation is a process. AAC proficiency and effective communication cannot be expected upon initial exposure to AAC. Skills are developed over time and the learning process looks different based on the communicator.
As David Beukelman once said, “Just like a piano alone doesn't make a pianist, nor does a basketball make an athlete, an AAC device doesn't make one a competent, proficient communicator. Those who rely on AAC strategies begin as AAC novices and evolve in competence to become AAC experts with support, encouragement, role models, and teaching strategies.”
References
Beukelman, D. R., & Mirenda, P. (2013). Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs. Paul H. Brookes Publishing Company.
Hannah Foley, B.A. is the Content Creator at Forbes AAC. She has over four years of experience in AAC education and implementation, in addition to over 24 years of personal experience using AAC and AT tools to navigate society as someone who has a (dis)ability. Hannah is dedicated to providing quality training and implementation resources to support teams to facilitate the integration of AAC into all of life's activities to maximize the communicative skill development and meaningful engagement of those who use AAC.
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