Assessment
Assessment is the first step to better communication. Assessment routes vary depending on your age and where you live. Contacting your local speech and language therapy services is generally the place to start. Children and young people may also start the assessment process through school services. You may be referred on to a specialist assessment service.
AAC assessment services are staffed by professionals who can assess, advise and make recommendations.
Process
An AAC assessment begins with the recognition that you have communication difficulties that might be helped by communication aids or systems. An AAC assessment ends with recommendations for you – and perhaps for your environment. How long this takes and how many people are involved depends on the complexity of your needs and abilities. Also, your needs may change over time and technology and techniques improve, so you may need to be reassessed – perhaps more than once.
Types of Assessment Services
There are four main groups of service providers
Specialised (England)
These regional services, funded directly by NHS England assess the 10% of the AAC population with the most complex AAC needs. They provide equipment following an assessment for clients who meet the NHS England eligibility criteria.
Local (England)
The community, local authority or health based team of individuals and organisations provide assessment and ongoing AAC support if you have communication difficulties. These include specialist Speech and Language Therapists (SLTs) with AAC skills with allocated time to deliver a service.
Independent (England)
There are a number of independent organisations and charities that provide private assessments. A fee would normally be charged for these services.
Scotland, Wales & Northern Ireland
The AAC services in these lists may be at the local, regional or national level.
Suppliers
Suppliers that offer an AAC service generally provide only their own range of equipment. You should consider more than one device.
Who will be involved?
This will depend on the service carrying out the AAC assessment and what your needs are. Usually you can expect to see a speech and language therapist, an occupational therapist and/or a physiotherapist. You may also see a teacher, rehabilitation engineer or clinical scientist. You are central to the assessment process, along with your family and personal assistants.
Where should the assessment take place?
This depends on who is being assessed, but the assessment should take place in a quiet environment with limited distractions. For example, the service may find it useful to see you communicating in your 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?
You can expect plenty of talking about your needs, and you should have 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 afterwards they may recommend that you trial some equipment. This is part of the assessment process as well.
When does the assessment end?
Once you have trialled some AAC equipment and strategies and everyone agrees, the service will recommend which tools and/or strategies they will provide for you. In some instances the equipment may be provided, but sometimes you may need look to education authorities or charitable funding.
What happens next?
Your AAC needs are likely to change over time, so you may need a new assessment in the future. This time, a re-referral request can be made, or it could happen as a matter of course. You may need to undergo some training to use any equipment provided by the AAC assessment service, local team or supplier.
Referral
Anyone who needs AAC should be referred to an appropriate team or service as early as possible. A child or young person should be referred at as early an age as possible. Don’t wait for their speech to develop – evidence shows that the introduction of AAC does not stop children from talking.
For someone who has acquired disabilities, referral should be as soon it is clear their speech is deteriorating, unintelligible or absent. Even if their loss of speech is temporary, some strategies and tools may be helpful in the short term.
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:
- How is the adult or child communicating now?
- Are they 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 all the professionals involved with the AAC speaker.
Equipment-Only Requests
Quality Assurance of ‘Equipment only’ requests for individuals who meet the eligibility criteria for Specialised AAC services
It is recognised that there will be some instances where it won’t be necessary for commissioned Specialised AAC services in England to undertake an assessment of an individual meeting the eligibility criteria within the service specification D01 S/b and that funding may be sought for equipment provision only. These instances may include but are not exclusive to:
- Referrals for individuals who are competent and experienced in the use of a communication aid, but whose existing equipment is malfunctioning frequently or has ceased to work.
- Referrals from local AAC services and professionals with a significant level of AAC expertise and competency
When requests are received for funding equipment only, a Quality Assurance Framework has been developed for use by specialised AAC services to ensure that a comprehensive assessment has taken place in order to:
- Ensure equipment recommendations are made that are appropriate to the needs of the individual
- Ensure national equity of provision across all services in line with the Quality Standard for AAC services
- Support the maintenance and development of local AAC services
- Develop cost efficient and timely delivery of NHS funded services
- Identify training needs within local AAC services
A joint Quality Assurance working party, supported by funding from a DfE Project and in partnership with Communication Matters and 1Voice, has developed a document which enables the report author/referrer to complete the assessment report template whilst ensuring that sufficient evidence is reflected in the documentation to enable specialised services to make an informed judgement on the robustness of the assessment process:
> Download the NHS Specialised AAC Service Equipment Request report template
Note: This template replaces the following draft documentation that has been used for this purpose to date:
– Specialised AAC service assessment report checklist – draft
– Assessment matrix – draft
– Mounting Electronic Assistive Technology to Wheelchairs: Assessment and Risk Tool – draft