Augmentative Communication Evaluation

When an individual is unable to efficiently use spoken language (speech) for communication, one role of the Speech-Language Pathologist is to determine if there are ways to augment the person’s speech attempts to compensate for their errors and improve efficiency and clarity of their communication. Perhaps the individual’s spoken communication is so disrupted that speech may no longer be a viable option. In that case, the role of the Speech-Language Pathologist becomes one of finding an alternative communication method, such as using a computer to "speak" for the individual.

May injuries, diseases, or conditions can interfere with the production of spoken language. They can occur at any age, and the effects may be permanent or temporary. For example, some children are born with cerebral palsy, a neurological condition that limits their ability to move their muscles, including the muscles used in speech production. Consequently, these children may be unable to master the motor (muscle) movements necessary to produce intelligible speech. Disease processes, such as amyotrophic lateral sclerosis (ALS – Lou Gerhig’s Disease) or mysathenia gravis may weaken the muscles so that adequate strength to produce spoken language is unavailable. Others may be of a more temporary nature, such as in the case of surgical removal of the larynx following cancer. A temporary communication system might be used until the individual is surgically healed and masters communication using a tracheal-esophageal prosthesis.

Augmentative and alternative communication systems come in many different forms. "Low Technology" systems may consist of a notebook, pad, or chart containing commonly used words and phrases or symbols representing them. The user points to the words or symbol for the idea they wish to communicate. "High Technology" systems may utilize a laptop computer specifically designed to be used for communication. Symbols, words, or concepts are presented on the computer screen, and the user selects the appropriate words or symbols via a variety of switches. Using computer generated or digitally recorded speech, the computer then "speaks" for the disabled individual.

Augmentative and Alternative Communication System Evaluation

Interdisciplinary Approach: The nature and severity of the disability determines the nature of the AAC evaluation. If the disability is primarily a communication disorder without accompanying serious medical conditions and/or motor difficulties, the Speech-Language Pathologist may conduct all or the majority of the evaluation. If the disability encompasses moderate to severe motor impairments, significant cognitive impairments, and/or impacts on academic or occupational performance, several other disciplines may be involved in the evaluation. These include:

  • Audiologists
  • Psychologists
  • Education/Special Education Teachers
  • Bio-Mechanical Engineers
  • Neurologists, Neurosurgeons, or other physician specialties
  • Nurses
  • Occupational Therapists
  • Opthomalogists and/or Optometrists
  • Physical Therapists
  • Social Workers
  • Speech-Language Pathology
  • Vocational Rehabilitation Counselors

Speech-Language Pathologist’s Roles & Responsibilities in AAC Evaluations: these may include evaluating

  • Integrity of Oral Communication Mechanism: (integrity of the structure and functioning of respiratory, phonatory, resonatory & articulatory systems)
  • Ability to Receive & Process Auditory Information: (hearing acuity, auditory perception and processing such as word discrimination testing; ability to follow oral directions)
  • General Communication Skills: (receptive and expressive language ability; ability to use expanded vocabulary – both in terms of comprehension and production)
  • Present Means of Communication: (use of gestures, facial expressions, vocalizations, verbalizations, reliability of yes/no; intelligibility, sign, communication devices, preferred strategy, etc.)
  • Type & degree of communication interaction in which individual engages: (desire to communicate, knowledge of social rules, functions of communication useful to individual; current system use/interaction/effectiveness)
  • Nature of the individual’s communication needs: (type of communication in which will be engaged, nature of communication partners, where communication will take place, etc.)
  • Of the usable strategies, which would be optimal for meeting the person’s communication needs: (cost, portability, intelligibility to others, training requirements, interference with other activities, etc.)