Augmentative & Alternative Communication (AAC)

Augmentative & Alternative
Communication (AAC)
Assessment Sourcebook
Alexa Okrainec
Brandon University
AAC - Definition
• “An area of clinical practice that
attempts to compensate (either
temporarily or permanently) for the
impairment and disability of
individuals with severe expressive
communication disorders” (ASHA,
1989, p. 107).
Statement of the Problem
• Students with limited speech/nonverbal: a lowincidence population.
• Only two formal AAC assessment tools currently
available - Mental Measurements Yearbook:
1. Analyzing the Communication Environment
(Rowland & Schweigert, 1993),
2. INteraction Checklist for Augmentative
Communication Revised Edition (Bolton & Dashiell,
The Problem (continued)
• Available tools focus on limited, specific
aspects of communication (e.g., the
environment, interaction).
• No new formal tools since 1993.
• An older formal tool, Comprehensive
Screening Tool for Determining Optimal
Communication Mode (House &
Rogerson, 1984), has been out of print since
Current Practice
2003 Omnibus Survey Caseload Report: SLP
• 50.8% of school Speech-Language
Pathologists serve students who are
nonverbal & require AAC, and
• School clinicians on average have 4.8
clients requiring AAC services on their
caseloads (ASHA, 2003).
Implication. Clinicians require assessment
tools to work effectively with these
Current Practice (cont’d)
• “there are few assessment protocols for evaluation
in AAC. Practitioners tend to adopt models from
the literature…and tend to develop their own
protocols for assessment” (Huer, 1997, p. 25).
• Questions: What are the protocols
described in the literature? What protocols
have practitioners developed on their own?
Research Objectives
• To locate informal assessment strategies
and techniques published in books,
journals/newsletters, or on the web over the
past 10-15 years.
• To develop a reference guide listing these
informal tools and AAC assessment
Target Population
• AAC assessment tools and strategies
suitable for use with children birth to age
– Early intervention is desirable, and
– Students requiring AAC can attend school until
age 21.
Research Procedures
• The Reference Manager/End Note
software will be used to manage the
bibliography and assist with sorting and
coding the available references.
• The Dreamweaver software will be used
to develop a website to help practitioners
locate references about informal AAC
assessment procedures.
Sourcebook Entries
• For each assessment instrument, it may be useful
to indicate:
Description of the instrument
Comments about the instrument
(Freeze & Updike, 2000)
Classification of the AAC Tools
• Classification of the assessment tools will arise
from the data. Some possible ways to classify
the instruments are:
• 1. By type of tool (checklist, interview, rating
scale, rubric, etc.) (Linn & Gronlund, 2000),
• 2. By domain of communication performance
(receptive language, expressive language, speech,
social interaction, literacy, environment etc.)
(Beukelman, 1998),
Sorting the AAC Tools
• Software packages could be used to sort the
informal assessment tools that are identified
by the search of the literature (e.g.,
Statistical Analysis Software (SAS)
Potential Research Outcomes:
• Gaps in the available assessment strategies
may be identified,
• New tools may be developed,
• Existing tools may be revised or
standardized to better meet the needs of
children living with communicative
Early Project Status
Information gathered from:
1. Practitioners in the field – Rehabilitation
Centre for Children, I Can Centre, SET-BC
2. ERIC Search (1966-2003/9)
Search terms:
• “augmentative and alternative communication”
• “assessment” OR “evaluation”.
Yielded 123 references for consideration.
AAC Assessment Tools Located
– To date, informal tools have been located for:
• Gestural Communication
• Evaluation of Programs and Services
• Assessing use of a Speech Generating
Device (SGD)
• Assessing the Environment
• Determining the Need for Assistive
AAC Assessment Tools Located
– To date, informal tools have been located for:
• Conducting Culturally Inclusive
• General Assessment
• Screening and Intake
• Literacy
AAC Assessment Tools Located
– To date, informal tools have been located for:
• Evaluation of Parent Training
• Language & Communication
• Social Networks
• Comprehensibility of speech
AREA: Gestural
– Gesture Dictionary (Beukelman &
Mirenda, 1998), and
– Checklist of Communicative Functions
and Nonsymbolic Forms (Siegel-Causey
& Wetherby, 1993).
AREA: Evaluation of
Programs & Services.
Supports Checklist
(for Programs
serving individuals
with severe
Overall support for
Assessment Practices,
Goal-Setting Practices
Team Competencies
• Communication
Supports Checklist –
Action Plan
(McCarthy & Coauthors, 1998).
AREA: Assessing Use of a Speech
Generating Device (SGD)
• A. Forms for Teaching Target Skills
• B. Forms for Teaching an Introduction
Strategy: 1. Baseline Data Collection Form, 2. Instructional Data Collection
Form, 3. Generalization Data Collection Form, 4. Consumer Feedback Questionnaire, 5.
Facilitator Feedback Questionnaire
• C. Forms for Teaching Nonobligatory Turns
• D. Forms for Teaching Partner-Focused
(Light & Binger, 1998).
AREA: Assessing the
• Home Questionnaire (also called the Home
– Solicits information about the child which is
used to plan messages and activities specific to
the child.
(Hough & Coauthors, 1994)
AREA: Screening
• Augmentative Communication Inventory
– Screens: initiation of communication, making
choices, modes of communication, motor responses and
switch use, equipment in use, pragmatic skills, display
set-up, and target objectives
– Measures progress, completed twice annually.
(Hough & Coauthors, 1994).
AREA: Intake
• Intake Questionnaire for Augmentative
and Alternative Communication
– A set of intake questionnaires provides the team
with a starting point in the assessment process.
(Manitoba Education & Training, 1995)
AREA: Need for Assistive
• Assistive Technology Consideration Quick Wheel
(AT Quick Wheel)
Considers the student’s need for AT for:
communication, reading, learning/studying, math, motor aspects of
writing, computer access
as well as
composing written material, mobility, activities of daily living,
control of the environment, position & seating, vision, hearing, and
(ILIAD IDEA Partnership and Penny Reed (TAM
Division). ( 2002).
AREA: Conducting Culturally
Inclusive Assessments
• Culturally Inclusive Assessments for
Children Using Augmentative and
Alternative Communication
– I. Self-Assessment: Extent of Multicultural
– II. Assessment of Communication Needs
– III. Capability Assessment
– IV. Technology Assessment
(Huer, 1997)
AREA: General Assessment
Augmentative and Alternative Communication
– A hierarchy of assessment steps:
1. Determining Preferences,
2. Determining Reinforcibility,
3. Determining Signal/Mode of Communication,
4. Indicating Desire,
5. Indicating Choice between Two Objects,
6. Indicating Choice among Four Objects,
7. Indicating Choice as Depicted by Two Pictures,
8. Indicating Choice as Depicted by Four Pictures
(Manitoba Education & Training, 1995)
AREA: General Assessment
• Preschool AAC Checklist
– Considers: AAC system components, symbol system,
vocabulary used for expression and vocabulary
organization, making choices, physical abilities,
classroom independence, communicative interactions,
use of visual symbols, special AAC strategies, emergent
literacy, math readiness, music/art/graphics, team
meetings, strategies used to gather vocabulary,
classroom strategies to increase communication, oral
speech strategies, modifications needed for testing,
tests given .
(Henderson, 1992)
AREA: Literacy
• Phonological Processing & Literacy
Assessment Tasks:
I. Retrieval of Whole-word Phonology
II. Phonological Recoding
III. Phoneme Awareness
(Vandervelden & Siegel, 1999)
AREA: Parent Training
• Outcomes in AAC
– A strategy for evaluating the effectiveness of a
parent training program
• Documents home use of a communication system
• Evaluates the parent’s skill with the child’s AAC
device, and the parents interaction patterns with the
child AAC user.
(Bruno & Dribbon, 1998)
AREA: Language &
• Beginning Augmentative Communication Skills
– Outlines a sequence of 32 augmentative communication
skills :
Early Skills: Shared Referent, Shared
Interaction/Turn taking, Calling Attention
Later Skills: Asking Why? Indicating past or
future in a general sense, Responding to yes/no
questions that relate to characteristic of items,
Delivering Messages.
(Burkhart, 1993)
AREA: Language &
• Measurement of Growth in Communication
Skills for the Child Using Augmentative
– Periodic language sample to reveal functional use of
– Codes mode of communication and type of utterance,
records the selections that comprise an utterance, notes
intelligible utterances
– Option to count various language behaviours
(Burkhart, 1993)
AREA: Social Interactions
• Social Networks: A communication
inventory for individuals with complex
communication needs and their
communication partners
– Looks at “Circles of Communication Partners”
as well as strategies that support interaction.
(Blackstone & Berg, 2003)
AREA: Comprehensibility of
• Index of Augmented Speech
Comprehensibility in Children (I-ASCC)
– Examines how well an individual’s message
can be understood in the natural context.
• Varies the listening context (no cue vs. semantic
cue) as well as the type of listener (familiar vs.
unfamiliar) to assess speech comprehensibility.
(Dowden, 1997)
Need to Learn More About…
• Augmentative & Alternative
Communication in Pres-school Programs:
Pre-school Teacher Survey (Johnston & coauthors,
• A Universal Logging Format for
Augmentative Communication (Lesher &
Coauthors, 2000),
• Language Activity Monitor (Hill & Romich, 1999),
Need to Learn More About…
• Wisconsin Sensorimotor Pointing
Assessment (Huebner & coauthors, 1995),
• Preschool Checklist: Integration of
Children with Severe Disabilities (Drinkwater &
Demchak, 1995),
• Augmentative Communication Profile (Haney
& Quinlisk-Gill, 1988),
…and others…
Need to Find References For…
• The Student Access Map: Ensuring access
to the general curriculum (?Dacey, 2002),
• Environmental Observation Guide
(?Wisconsin Assistive Technology Initiative, 1998),
• AAC Evaluation Worksheet (Synergy, no date),
• Assessment for Semantic Compaction (Elder,
no date, ?source)
…and others….
• Informal tools and strategies for AAC assessment
are available, for various areas of practice.
• There is a fairly wide range of sources for AAC
assessment strategies.
• To date, tools for examining the receptive
language of AAC users have been difficult to
• This research remains in progress. Update to be
Link to list of references (Word Document)