Abstract
People with complex communication needs often require a comprehensive augmentative and alternative communication (AAC) assessment to maximize participation in daily interactions. Assessment of AAC is a complex process and limited practice guidelines exist. The purpose of this qualitative study was to explore how 25 speech-language pathologists with varying levels of experience approach the AAC assessment process. Participants were classified as either (a) General Practice Speech-Language Pathologists (GPSLPs), (b) AAC Clinical Specialists (AAC-CS), or (c) AAC Research/Policy Specialists (AAC-RS). In-depth, semi-structured interviews were conducted to explore the participants’ approach to AAC assessment. The results revealed that GPSLPs approach AAC assessment differently than the AAC-CS and AAC-RS; however, the Specialists reported a similar approach that may help guide the development of practice guidelines for AAC assessment.
Author Note
Aimee Dietz, Department of Communication Sciences and Disorders, University of Cincinnati, United States of America; Wendy Quach, Department of Communicative Disorders and Sciences, San José State University, United States of America; Shelley Lund, Department of Communication Sciences and Disorders, University of Wisconsin-Milwaukee, United States of America; Miechelle McKelvey, Department of Communication Disorders, University of Nebraska-Kearney, United States of America.
All four authors contributed to the design, development, execution, data analysis, and writing for this project. Aimee Dietz took lead responsibility for organizing the findings into this final manuscript form.
The authors would like to thank Brittany Sileo, Julie Griffith, Morgan Lee, Madonna Lazo, Rebecca Bovee, Heather Povletich, and Morgan Pillen for their assistance on this project
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper
Appendix
SLP/AAC Decision-Making Guiding Questions
Tell me about your experience in speech pathology.
How did you get involved in AAC?
What populations do you work with?
Have you worked with other populations in the past?
How do you get your referrals?
Tell me about your case history format where you currently work.
What kind of case hx information do you typically get?
Other documentations (previous evals, tx plans, etc.)
What kind of information do you want to have going into an eval (even if it is not on your case hx form)?
Talk about the evolution of the case hx at your site?
How do you use this information to prepare for the eval?
What do you do in between the time you receive the case hx and you complete the evaluation?
How much time do you spend prepping for the evaluation?
How long does it generally take you to prepare for the evaluation?
What would be an ideal amount of time to prepare for an evaluation?
Tell me how you approach an evaluation.
How do you determine the best type of “symbols” for message representation?
Physical abilities/considerations
Cognitive-linguistic considerations
How do you determine the navigation system
Physical abilities/considerations
Cognitive-linguistic consideration
Have you ever walked into an eval and realized that the client/patient had different needs/abilities than expected based on the case hx?
How did you handle this?
Does it happen often?
What professionals do you collaborate with during evaluations?
What professionals do you WISH you could consult with during your evaluations
As you think back over all the clients you have examined who needed AAC, tell me about a case that was particularly memorable in terms of the initial assessment
Can you describe that case?
Can you describe how you decided what to include in your assessment?
Was there anything that limited your assessment?
How did you use the information you gathered from the assessment?
Is there anything from your case history form that influenced your decisions in the Ax?
As you think back over your clinical experience, has your approach to AAC assessments changed? Why or why not?
What have you learned?