Assessment is the first step to better communication. Assessment routes vary depending on the person's age, and where they live. In general, the first point to contact is the local speech and language therapy department. Children and young people may also start the assessment process through school services. The local service may refer on to a specialist assessment service.
AAC assessment services are staffed by professionals who can assess, advise and make recommendations.
An AAC assessment begins with the recognition that a person has communication difficulties which might be helped by communication aids or systems. An AAC assessment ends with recommendations for the individual - and perhaps for their environment. The time taken and the number of people involved varies widely according to the complexity of the individual's needs and abilities. Also, the process may need to be repeated over time because technology and techniques develop, and a person's needs may change.
See the section on Accessing assessment services.
Types of Assessment Services
There are four main groups of service providers:
Local Service (a team or an independent professional)
The community, local authority or health based team of individuals and organisations who provide assessment and on-going AAC support to a disabled adult or child. These include specialist Speech and Language Therapists (SLTs) with AAC skills with allocated time to deliver a service.
AAC Assessment Service (including independent 'consultant' level professionals)
Specialist AAC Services may sit at local, regional or national levels. Regional and national services are currently provided by the statutory, voluntary or independent sectors.
NHS AAC Hubs (England)
These are regional services in England assessing 10% of the AAC population with the most complex AAC needs (see our section on Hubs). They will loan equipment for trial and provide equipment following an assessment (see section on equipment requests). They may accept reports from local services for people who meet the criteria in the service specification:
The AAC service provided by suppliers is limited to their own range of equipment. Generally, an individual will need to consider more than one device.
Anyone who needs AAC should be referred to an appropriate team or service as early as possible. With a child or young person, this should be at as early an age as possible. With those who have acquired disabilities, it should be as soon it is clear that speech is deteriorating , unintelligible or absent. Even if loss of speech is temporary, there are strategies and tools that may be helpful in the short term. Don't wait to see if speech will develop - evidence shows that the introduction of AAC does not stop children from talking.
The first step is to contact your local service or an external assessment service. The service will need some specific information in order to plan an assessment, e.g. how is the adult or child communicating now?; is the individual using any AAC systems (paper-based, sign or VOCA) now?; understanding of language; access to communication tools and strategies; information from any previous assessments.
The AAC service can plan most effectively when they have information from the range of professionals involved with the AAC speaker.
See section on AAC Assessment Services.
Who will be involved?
This will depend on the service carrying out the AAC assessment and the needs of the individual. Usually there will be a speech and language therapist, occupational therapist and/or physiotherapist. There may be a teacher, rehabilitation engineer or clinical scientist involved. Central to the assessment process is the person who needs AAC, their family and personal assistants.
Where should the assessment take place?
This depends on the person who is being assessed, but the assessment should take place in a quiet environment with limited distractions. For example, it may be useful to see the AAC speaker communicating in their own environment with regular communication partners. Other people may prefer to travel to an assessment centre where all the tools and strategies are available.
What happens in the assessment?
There will be lots of talking about the needs of the individual and the opportunity to try different tools and strategies for communication. It is not always possible to make a definite recommendation at the end of an assessment visit, but often equipment may be trialled following the assessment. This is part of the assessment process as well.
When does the assessment end?
Once the person who needs AAC has trialled equipment and strategies and everyone is agreed, a recommendation will be made for the tools and/or strategies to be provided for the individual. In some instances the equipment may be provided, but sometimes if is necessary to look to education authorities or charitable funding.
See section on Funding and support.
What happens next?
The person who uses AAC will have changing needs, so the process begins again. This time, a re-referral request can be made or may indeed happen as a matter of course. Training with the equipment may be required and provided by the AAC assessment service, local team or supplier.