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Students with complex communication needs encounter unique and difficult challenges everyday. They battle to fully participate in school activities, they struggle to interact with friends and family, and they have difficulty conveying what they know and how they feel.

Finding effective ways to enhance your students’ communication — both through AAC technology and speech therapy — requires a focused consideration process.

With so many AAC technologies and therapy options available, what steps should you take when you notice your student’s communication needs are not being met?

Phase 1: Information gathering

Once it has become evident that your student requires an AAC assessment, the information gathering phase begins. Information gathering, like any other process, can be learned and improved upon over time by doing.

The composition of your assessment team will include the student and perhaps family, teachers, occupational therapists, physical therapists, speech-language pathologists, assistive technology specialists, and others with knowledge of and interest in your student’s communication skills and needs.

Upon identifying the appropriate assessment team, many experts in the field use the Student, Environment, Tasks, and Tools (SETT) Framework for collecting information. The SETT framework is centered upon gathering information that is relevant to the student, the environments he/she participants in and tasks that are important to the student’s success.

The following questions from Paul Visvader’s School-based AAC Evaluation: Choosing Effective Assistive Technology Strategies for Students with Complex Communication Needs will help guide your team as you gather meaningful assessment information:

What are the specific concerns? What tasks are we asking the student to perform (goals)?

What is already known? (age, medical history, cognitive, communicative, physical considerations, family, culture, community)

What should be assessed and how should it be assessed?

Are AAC device(s)/system(s) currently being used? If so, are they meeting the student’s communication needs in some capacity?

Are additional strategies or services needed to improve success?

Once you’ve gathered assessment information and derived your hypotheses, then you can test them with observational evaluations.

Phase 2: Observational evaluations

Observational evaluations are used to conduct specific tasks with an assortment of toys, symbols and devices in order to assess how your student uses them to interact with others.

Flexibility is critical when performing these observations. You’ll be required to adapt to changing circumstances as your initial hypotheses and assumptions may have been flawed or incomplete.

Additionally, your student’s response patterns will be influenced by the contexts in which the evaluations are performed (e.g., classroom with peers vs. home with adult caregivers). It’s important to account for these variations, and to increase the sample size of your observations in order to prevent outlier data from impacting your findings.

After completing your observations and curating your data it’s then time to try and make sense of it all.

Phase 3: Interpreting the data, feature matching and generating an action plan

From the data, you, your team and your student’s family will be in a position to consider possible interpretations and pose hypotheses based on the evaluations. The interpretations and hypotheses derived from the data should account for the following:

Reliability and validity

Consistency and repeatability

Logical explantations (e.g., if this action is taken in this setting, this is the likely outcome)

Predictive value from taking specific actions

Also, this is a time to consider revisions and reinterpretations of your assessments. If they are ambiguous or inconclusive, you’ll be required to continue with additional observational evaluations and obtain more data. If your results are conclusive, it’s then time to perform feature matching.

Feature matching involves carefully evaluating and identifying available AAC solutions (both low-tech or high-tech) that are best positioned to address your student’s unique communication needs. Once you’ve identified the appropriate AAC solution it’s time to put an action plan in place.

In short, your action plan will identify what is to be done and how it is to be done. I.e.,

How will you go about obtaining and programming your student’s AAC device?

What steps will you take to educate your student about how to use the device? What can they do to get the most out of it?

What steps will you take to show their family how to use the device?

What usage data should you collect? How will you go about doing so?

With your action plan in place you then should schedule opportunities to follow up, review use case data and confirm whether or not the selected AAC device adequately satisfies your student’s communication needs.

Phase 4: Monitoring, following up and adjusting

Maintaining contact and successfully monitoring your student’s development is critical after you’ve identified an AAC device for their use. For this, you’ll rely heavily upon information from your student’s family and their peers. From the anecdotal evidence you will be able to make adjustments to your strategy and action plan.

Maybe your student requires additional guidance regarding how to use their device? Perhaps the device needs to be reprogrammed? Maybe a re-evaluation is required if circumstances have changed dramatically?

The process of identifying and assessing your student’s feature matched AAC device is never in a state of absolute completion. Instead, as things change you must adjust your strategies and iterate upon them accordingly.