GUIDANCE ON AT/AAC ASSESSMENT
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CRIS POSITION STATEMENT: BEST PRACTICE IN AT/AAC ASSESSMENT
Our Orthopedic Impairment (OI) team receives occasional requests from school districts to conduct an AT/AAC assessment (or evaluation). These requests are based on the best of intentions, stemming from a parent's or team member's search to identify the tools and supports that will enable a child to communicate more effectively, to access their environment, and/or to participate in daily activities and routines. We drafted this position statement for parents, educators, and administrators to explain our understanding of best practices as they relate to AT/AAC assessment, informed by the professional literature, the consensus among leading experts in the field, and clinical experience.
For those who have previously requested an AT/AAC assessment, we have determined that most were seeking a stand-alone assessment based upon an expert model that would result in a report summarizing the child's skills and culminating in AT/AAC recommendations that the team could use to determine the selection of tools and strategies. Indeed, the special education evaluation process often involves specialists conducting assessments within their discipline that result in a report. Examples include psycho-educational reports produced by school psychologists or speech and language evaluation reports written by speech-language pathologists. Yet, the prevailing view is that an expert model approach with a single professional conducting one-time assessments to produce a report is not best practice with regard to AT/AAC assessment.
Best practice in AT/AAC assessment involves a process that is team-based, dynamic, and involves ongoing collaboration among IFSP or IEP team members - including parents as respected partners. Best practice involves an iterative, team-based process informed by the trial of multiple tools and strategies to identify which work best for the child. Widely recognized among AT/AAC professionals, SETT (Student, Environment, Tasks, Tools) is a structured, student-centered, team-based approach to AT/AAC assessment that leads to intervention planning.
While our OI staff do not provide stand-alone, expert model AT/AAC assessments, we do partner with EI/ECSE and school-based professionals to support teams with the SETT process, working collaboratively to identify tools and supports to assist children with complex communication and/or motor needs. For teams new to the SETT process, we may be available to model the facilitation of a SETT meeting. We provide training and coaching to help teams learn how to use SETT independently. Building capacity is at the core of our service model.
"The prevailing view is that an expert model approach with a single professional conducting one-time assessments to produce a report is not best practice with regard to AT/AAC assessment. Best practice involves an iterative, team-based process informed by the trial of multiple tools and strategies to identify what works best for a child."
APPROACHES TO AT/AAC ASSESSMENT
While there are many tools and approaches to support AT/AAC assessment, we typically utilize and train staff to use the following processes:
SETT (Student, Environment, Tasks, Tools)
SETT is a process in which the team gathers to have an in-depth child-focused conversation to identify (1) the child’s strengths, interests, areas of need; (2) all the locations and supports or barriers where learning takes place and supports are needed; (3) what the child needs to be able to do, based on goals and what other students are doing; and (4) which types of tools, strategies, or devices the child needs. When we assist with SETT meetings, we ask that teams adhere to working agreement guidelines.
Feature Matching
Concurrent with, or following the SETT meeting, feature matching is a process in which you take all of the available information about the child and then select tools and supports that the child is likely to be successful using. In other words, we are ensuring the features of the tool match the needs and abilities of the child. Feature matching is a way to help narrow down the selection of tools, strategies, and devices, while considering all of the features that a specific student needs.
For example, a student with complex motor needs may not be able to access a device in a traditional way with their hands, they may need to use a switch with scanning. So in this case, feature matching would include devices that are capable of working with a switch and exclude devices or tools that do not offer scanning as one of the features. If this student also comes from a Spanish-speaking family, the team may determine that having access to a device or tools in Spanish is a feature that this student needs. Thus narrowing down the device or tools selection even further to only include AT/AAC tools that offer Spanish vocabularies and switch scanning.
Conduct Ongoing Trials of AT/AAC Tools or Devices with Data Collection
Before trials can begin, the student, as well as the staff members that are going to be supporting this student, need to have some training in the basic features and functions of the device, tool or strategies, so that they feel comfortable using the tools. As the student and the team become familiar with the device, tools, or strategies, members of the team can then begin collecting some data on the effectiveness of the particular device, tool, or strategy being trialed. Teams may collect data in a variety of areas, such as communicative functions, vocabulary acquisition, efficiency, and accuracy that the student has with the device or tool as well as the level of prompting required for the student to use the device.
Determine Devices, Tools, and Strategies
Once the team has collected sufficient evidence to make a determination regarding devices, tools, and strategies, they must consider and identify how funding for the devices or tools will be obtained. If the team is pursuing funding through a family’s insurance plan, a funding report will typically need to be generated and submitted. If the team decides not to pursue funding through the student’s insurance, there are a number of grant programs or long-term loans that will fund devices or tools for students. Please see our main AT/AAC funding resources page for more information.
Implement Devices, Tools, and Strategies
Once a student receives their AT/AAC device, tools, or strategies, the team will want to develop an implementation plan to ensure that the student’s device, tools or strategies are being integrated into their daily schedule. The implementation plan should also include documenting the student’s device, tools, or strategies in their IEP/IFSP as well as continued training for the staff members as well as the student in how to use the device, tools, and strategies effectively.
Monitor and Update Tools, Devices, and Strategies as the Needs of the Student Change
Over time, the student’s skills or access method may change. So it is important to continually monitor that the device, tools, and strategies are still a good fit to support them. As their needs change, the device, tools, and strategies may also need to change. In circumstances like this, teams can hold a ReSETT meeting to determine if the device, tools, or strategies need to change in order to support the student.
ADDITIONAL AT/AAC ASSESSMENT RESOURCES
SETT Framework Documents from Joy Zabala
Pragmatics Profile for People Who Use AAC
Assessment Resources for AAC Funding Requests (Insurance Justifications)
Early childhood and school-based SLPs can assist parents in obtaining insurance funding for an AAC device. Although CRP OI team members do not write the actual funding reports, we are available to advise SLPs on the process and can provide sample funding reports in addition to other resources.
Tobii Dynavox has provided a helpful five-step process for completing a funding packet to obtain a speech-generating device. Using either the AAC Report Coach or PRC and Saltillo AAC Funding Source, you simply enter the required information and the site automatically generates a report and then submits the packet electronically to insurers.
Additional resources are available on our general assistive technology funding page.
Return to the assessment resource page.
