AAC Assessment and Clinical-Decision Making: The Impact of Experience

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.

Assessment With Children Who Need Augmentative and Alternative Communication (AAC): Clinical Decisions of AAC Specialists

“…Our previous research highlighted AAC specialists' comprehensive and holistic approach to assessment (Dietz et al, 2012). The results of this study further clarified the methods AAC specialists used to assess children with CCN for AAC systems, but it also highlighted some of the gaps in current theoretical models of AAC assessment.…”

“…These participants were a subset of the individuals who took part in our previous study on clinical decision making (Dietz et al, 2012). Participants were classified as either AAC clinical specialists (n = 4), or AAC research specialists (n = 4), according to the Personnel Framework for AAC Assessment (Binger et al, 2012).…”

“…However, assessing children for AAC systems can be overwhelming for speech-language pathologists (SLPs) who do not perform these assessments on a regular basis (Dietz, Quach, Lund, & McKelvey, 2012). Various factors contribute to the challenge of completing these assessments: the heterogeneity of individuals who require AAC (Light & McNaughton, 2012), the large amount of information that must be collected and integrated (Beukelman & Mirenda, 2013), rapid changes in technology (Abbot & McBride, 2014;McBride, 2011), and limited research on clinical decision making in AAC assessments (Schlosser & Raghavendra, 2004).…”

“…The decision making that describes how SLPs arrive at their diagnostic conclusions has not been widely or systematically studied. Dietz et al (2012) discussed the relative discomfort of general practice SLPs while conducting AAC assessments and identified a need for assessment protocols or decision-making guidelines to assist the process. Better understanding of how AAC specialists make clinical decisions is needed to help develop such protocols.…”

The Impact of Interface Design During an Initial High-Technology AAC Experience: A Collective Case Study of People with Aphasia

“…These devices, along with the advent of relatively inexpensive communication applications ("apps"), have created an opportunity to facilitate the integration of augmentative and alternative communication (AAC) into the aphasia rehabilitation process. In fact, people with communication disorders, including people with aphasia, are embracing these technological advances because of increased social acceptance of AAC (McNaughton & Light, 2013) and often seek assistance from speech language pathologists (SLPs) to integrate these tools into their communication repertoire (AAC-RERC, 2011;Dietz, Quach, Lund, & McKelvey, 2012). However, SLPs may find themselves overwhelmed by the vast array of downloadable communication apps and their various interface features.…”