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AUGMENTATIVE AND ALTERNATIVE COMMUNICATION (AAC) APPRAISAL FOR SPEECH

PATHOLOGISTS WHO SUPPORT PEOPLE WITH A DISABILITY

Before undertaking the Augmentative and Alternative Communication (AAC) appraisal speech pathologists
should have read the Augmentative and Alternative Communication Guideline and undertaken any relevant
further study.

It is important that the person wanting to be assessed arranges a time with the WPSP and use this as part
of their professional supervision and mentoring sessions. This appraisal consists of three sections – theory
(question / answers), discussion regarding application of the principles to work practice, and direct
observation of the skills. There is not a scoring system in this appraisal. All questions are to be answered to
a satisfactory level, and there must be satisfactory demonstration of application to the speech pathologist’s
work in the areas outlined.

Question / answer

• the information under each question is intended to provide the key points each speech pathologist
should address. A speech pathologist can provide more than is itemised. The WPSP will sign off
each question when they are satisfied the required information has been presented
• questions may be answered verbally or in writing
• questions may be answered in the context of a group discussion as long as the WPSP is present
and satisfied with the speech pathologist’s response.

Application to work practice

• case discussion / examples must have been completed within the previous 12 months
• case discussion / examples are acceptable if completed in collaboration with another practitioner as
long as the WPSP can identify the practitioner’s level of contribution and is satisfied that the
requirements are met
• all cases discussed must have consent from all persons’ concerned, including the person with a
disability, any family members or carers and other professionals.

Observation: With the consent of the person with a disability and / or their person responsible, the
assessor must observe the speech pathologist demonstrating the requirements.

Speech Pathologist: Date Core Standard commenced:
Positions:

WPSP Name:
Position:

DEFINITIONS:
Work Practice Support Person (WPSP):
As this is a speech pathology core standard the WPSP must be a speech pathologist. This person supports
the speech pathologist and can be a professional supervisor or other speech pathologist with appropriate
skills and experience. An alternative WPSP may be identified if the current supervisor/s believe another
person may be better suited to reviewing a speech pathologist’s knowledge.

Service Delivery Approaches Appraisal. Developed by Clinical Innovation and Governance, ADHC, Family and
Community Service. Version 1. 2014

Developed by Clinical Innovation and Governance. • the information under each question is intended to provide the key points each speech pathologist should address. 2014 . What is Augmentative Communication? 1b. Version 1. Workplace Observations Questions WPSP Comments Meets requireme nts (date) 1a. CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 2 Augmentative and alternative communication appraisal. What is Alternative Communication? • Augmentative Communication strategies are designed to support a person’s speech abilities. Workplace Examples 3. for varying reasons. Questions 2. 13). Speech pathologists can provide more than is itemised • questions may be answered verbally or in writing • questions may be answered in the context of a group discussion as long as the WPSP is present and satisfied with the speech pathologist’s response • case discussion / examples are acceptable if completed in collaboration with another practitioner as long as the WPSP can identify the speech pathologist’s level of contribution and is satisfied that the requirements are met • case discussion / examples/observations must have been completed within the previous 12 months. • Augmentative and Alternative Communication (AAC) is “an area of clinical and educational practice that provides communication interventions for people who have little or no functional speech or who have complex communication needs (CCN)” (SPA 2012 p. speech development is not possible. There are three sections to the appraisal which follow. GUIDELINES: The WPSP will sign below when they are satisfied the requirements for each section below have been met. They are: 1. Alternative Communication strategies are designed to replace speech when. Family and Community Service. such as physical disability. ADHC.

g. What is unaided AAC? Give some examples. ADHC. 3. Unaided AAC refers to communication strategies which do not require the use of an external aid: • gestures • pointing • vocalizations • body language • behaviours (e. Developed by Clinical Innovation and Governance. Family and Community Service. Version 1.Who might be involved in an AAC team? 2b. taking a person’s hand and leading them to the door) • eye contact / eye gaze (within an environment) • facial expression • touch cues • tactile signing CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 3 Augmentative and alternative communication appraisal.. Why is team work important? The person • immediate or extended family • paid or voluntary carers • teachers and teachers aids • speech-language pathologist • physician • occupational therapist • physiotherapist • social worker • education specialist • psychologist • rehabilitation engineer • vision specialist • others Working on a team provides different perspectives and skills and allows collaborative decisions to be made about AAC systems. 2014 .Questions WPSP Comments Meets requireme nts (date) 2a.

Family and Community Service. ADHC. C. Developed by Clinical Innovation and Governance. Light. (Beukelman & Mirenda. Version 1.Questions WPSP Comments Meets requireme nts (date) 4. 2013) (J C. J. What are Janice Light’s 4 AAC competencies? Describe the meaning of each of these competencies. List some critical aspects you need to consider when doing an assessment for AAC. 1989) 5. 2014.refers to the technical skills required to operate the system • Pragmatic/Social. (J C. C. external and social validity • determining if the evidence is valid • discussing the findings with relevant CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 4 Augmentative and alternative communication appraisal. physical and sensory abilities • social. Light & McNaughton. Light.includes all the skills required for social interaction • Strategic. • Linguistic. J. 1989) 6.refers to a person’s receptive expressive language skills • Operational. Light & McNaughton.means having the flexibility to adapt communicative style to suit the communication partner. How do you work as an evidence based speech pathologist with AAC? The process of EBP in AAC includes: • asking a well-built question • conducting a search of the literature • examining and appraising the evidence for internal. personal emotional preferences • literacy/symbolic abilities. • person centredness • goals • participation needs • AAC competencies • environments • communication situations and partners • self advocacy/choice/adaptability • intellectual. 2014 . 2014.

Version 1.15) 7. preferences. Define and give some examples of low tech and high tech aided AAC. High tech generally refers to a computer-like device that generates speech output to convey a message. letters or word boards • calendars • shopping lists • daily planners • diary • labels and signs • continuum lines • timers • small objects • cue cards • memory books • memo boards • memory wallets • reminiscence (generic) photos • photo albums & individual photos • communication books • communication boards • generic greeting cards (i. 2012 p. concerns and expectations that people may have. holidays) • phone lists. Low tech AAC strategies involve the use of aids that do not require a power source to be operated. an increase in the availability of systematic and narrative reviews and a growing interest in evidence-based practice have resulted in a wider appreciation of the benefits of AAC across many populations… (Speech Pathology Australia. 2014 .Questions WPSP Comments Meets requireme nts (date) people • identifying and exploring the views.. • dedicated communication devices • general computerised devices with communication apps or programs often called “mainstream” devices such as CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 5 Augmentative and alternative communication appraisal. Developed by Clinical Innovation and Governance. ADHC. In the field of AAC.e. Family and Community Service. Some examples are: • schedules • timetables • choice-making supports • community request cards • communication boards • talking mats • picture exchange communication (PECS) systems • Pragmatic Organisation Dynamic Display (PODD) • alphabet display • pictures.

By using the ICF framework the outcome of using AAC can directly measure people’s functioning in their daily lives.11) 10a. Why is literacy an important consideration with AAC systems? CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 6 Augmentative and alternative communication appraisal.) but the assessment framework is focused on everyday functioning rather than disability or systems changes (Simeonsson. Family and Community Service.Questions WPSP Comments Meets requireme nts (date) tablets or hand held devices. List some AAC assessment tools See Appendix 2 in Guidelines for examples 9. The ICF is a tool for “moving the goal of health services away from body function and towards involvement in life situations” (Pless & Granlund. training. cultural and personal factors. 2007). within the context of any interaction. social. activity. For example the efficacy of an AAC intervention can be measured by being able to do an activity or participate in a social engagement (Lund & Light. Version 1. access. 2012) • Application of the ICF framework changes and widens the overall focus of evaluation of AAC interventions. (Lund & Light. ADHC. & Lollar. All the components of an AAC system assessment still happen (i. 2006). What relevance does the International Classification of Functioning ICF have to AAC? • Using the ICF framework defines a person’s level of functioning in different environments and takes into account health. 2012 P. vocabulary. Developed by Clinical Innovation and Governance.e. devices. etc. choice of modality. 2014 . 8. Bjork- Akesson.

Increasing literacy skills can increase communication options. 1). 2010. text comprehension children who use AAC. 2008. Michalicek et al. 11. List some factors which should be considered to enable a successful AAC intervention. & Vass. Bain. 2014 . 1992 p. The Centre for AAC and Autism. phonics. vocabulary. Caulfield & Carillo.Questions WPSP Comments Meets requireme nts (date) 10b. Version 1.body CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 7 Augmentative and alternative communication appraisal. ADHC. their family and people with whom they interact • changes to any of the five domains. Describe what areas you could measure to evaluate an AAC implementation • goals made by the person using AAC. 2010. (2010) found that systematic instruction strategies were best for teaching literacy skills such as phonemic awareness.. These strategies include: • scaffolding • direct instruction • least-to-most prompting with time delay. What are effective strategies for teaching literacy with AAC users? Development of literacy skills for those using AAC has traditionally lagged behind peer literacy development – with “approximately 70% of individuals with severe communication impairments are significantly behind their peers in literacy learning”(Koppenhaver & Yoder. Developed by Clinical Innovation and Governance. • selection and trial of appropriate aids/tools/devices/systems/vocabulary • back up systems • ease of access • training in systems for the person and communication partners • communication opportunities • participation needs and changes in communication requirements • consideration of communication partners • environments and use of systems • mentoring for the user and clinician (Bech. Family and Community Service. Michalicek et al. 2009) 12.

literacy. environmental factors and personal factors using ICF codes and tools developed to measure (World Health Organisation. 2003) • changes in other areas of communication skills and abilities (like speech. 13. and pragmatics) which are targeted goals within the AAC intervention. C.Questions WPSP Comments Meets requireme nts (date) functions and structure. Beukelman. language. 2001) • changes to any of the five domains. Developed by Clinical Innovation and Governance. Version 1. activity. Family and Community Service.body functions and structure. voice. 2012) As mentioned in section 3.. activity. 2013) as discussed in section 7 • changes to communicative competence using Light’s Communicative Competence for Individuals who use AAC (J. ADHC. 2014 . environmental factors and personal factors using the ICF-CY for AAC Profile and Code Set for Children Who Rely on AAC (Rowland et al. fluency. participation. What are some tools might you use to measure outcomes in AAC intervention? • ICF codes • COPM • GAS • specialist tools as per appendix 2 in guideline CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 8 Augmentative and alternative communication appraisal. participation. the ICF-CY will soon be incorporated into the above general ICF codes • participation using the Participation Model of AAC (Beukelman & Mirenda. & Reichle. Light.

Observation Observations must have been conducted within the previous 12 months. intervention trials of equipment. Family and Community Service.Work Practice Sample Work Practice Sample Required WPSP Comments Meets Case discussion / examples must requirem have been completed within the ents previous 12 months (date) Discuss 2 case examples where augmentative and alternative communication was used. ADHC. 2014 . Describe and produce evaluation / outcome measures of two case examples involving AAC. Observation description Comments Meets requirements (WPSP) Observe an interaction where the speech pathologist is incorporating AAC in assessment or intervention: • is the AAC assessment/system/device or intervention appropriate? Does it include person centred and evidence based practice? • is there planned time for training and practice for the system within the intervention? • does the speech pathologist record and measure the interventions and explain changes to the person/family/communication partners? • did the speech pathologist provide information regarding ongoing intervention. Show hard or digital copy examples of AAC systems within 2 of your cases. Describe how the principles and strategies of good practice in AAC were incorporated in each case. Version 1. Name the key elements involved in the examples above. This may incorporate assessment. team cases. progress and review? CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 9 Augmentative and alternative communication appraisal. Developed by Clinical Innovation and Governance.

It forms part of the supporting resource material for the Core Standards Program developed by ADHC. ADHC does not accept any liability to any person for the information (or the use of such information) which is provided in this practice package or incorporated into it by reference. Reproduction of this document is subject to copyright and permission. ADHC. Signed: Name: Position: Date: Disclaimer: This appraisal was developed by the Clinical Innovation and Governance Directorate of Ageing. Whilst the information contained in this appraisal has been compiled and presented with all due care. Family and Community Service. New South Wales. ADHC gives no assurance or warranty nor makes any representation as to the accuracy or completeness or legitimacy of its content. Australia (ADHC). Developed by Clinical Innovation and Governance. Access to this document by practitioners working outside of ADHC has been provided in the interests of sharing resources. It has been designed to promote consistent and efficient best practice. ADHC does not intend nor guarantee the use of the appraisal as assessing a level of competence by practitioners working outside of ADHC. Disability and Home Care in the Department of Family and Community Services. Version 1. 2014 .   CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 10 Augmentative and alternative communication appraisal. This appraisal has been developed to indicate whether a practitioner 1 has increased their knowledge through the completion of the core standard. Please refer to the website disclaimer for more details.I confirm that all requirements have been met for this AAC core standard (WPSP).

Version 1. R.. http://www. A. .2014.aacandautism. J.885080 Light. (2010).. 1). & Mbeseha.. M. J. Brookes. (2010). A (Producer). Steiner. S.K. Developed by Clinical Innovation and Governance. pp. Literacy Interventions for Students with Physical and Developmental Disabilities who use Aided AAC Devices: A Systematic Review. (2006). J. Beukelman.. N.idahoat. Disability and Health (ICF) and the ICF Children and Youth Version (ICF-CY) Within the Context of Augmentative and Alternative Communication. Fried-Oken. and Health (ICF) CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 11 Augmentative and alternative communication appraisal. M.3-10. Light. (2008). 30(1). D.3109/07434618.org/Portals/0/Documents/200%20a%20Day%20the%20Easy%20Way. D. Implementation of the International Classification of Functioning. 28 . Bjork-Akesson. A. Long-Term Outcomes for Individuals Who Use Augmentative and Alternative Communication: Part I – What is a ‘‘Good’’ Outcome? Augmentative and Alternative Communication. 1 . 219-240. (1989). & Granlund. Augmentative and Alternative Communication. Lollar. doi: 10. (2012). Bain. (2003). Long-term Outcomes for Individuals Who UseAugmentative and Alternative Communication: Part II – Communicative Interaction. J C. R. J C. & Light. Light. (2013). pp..speechpathologyaustralia. 284 . (2014). R. (2012). Developing the ICF-CY for AAC Profile and Code Set for Children Who Rely on AAC. R. & Vass.au/docs/trainingcatsp..K. J C. Phelps. pp. 22. 28. C. pp.closingthegap. Lund. Toward a Definition of Communicative Competence for Individuals Using Augmentative and Alternative Communication Systems: Williams & Wilkins. . M. Lang.R. & Carillo. http://www. & McNaughton. Communicative Competence For Individuals Who Use AAC: From Research To Effective Practice.References Bech.1-18. Simeonsson.. R.. . M. C. from http://www. Molfenter. M. Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs: Paul H. The Centre for AAC and Autism. C... J. D. P. M. F.org. Communication Disability and the ICF-CY.au/. Augmentative and Alternative Communication.pdf Beukelman..com/therapists/evaluation-points World Health Organisation. 4). W. Points to Include in an AAC Evaluation for Individuals with Autism.15. 21-32. Journal of Developmental and Physical Disabilities. Rispoli. & Reichle.).pdf: WWW. D. Augmentative and Alternative Communication Clinical Guideline In The Speech Pathology Association of Australia Ltd (Ed.com. Simeonsson. Clinical Guidelines. & Lollar. & Mirenda. A. Augmentative And Alternative Communication 28(1). Communicative Competence for Individuals who require Augmentative and Alternative Communication: A New Definition for a New Era of Communication? Augmentative and Alternative Communication. 11–20 Rowland. & Granlund. D. Putting it in Practice. 200 A Day the Easy Way. (2012).. 2014 . J. Michalicek. Speech Pathology Australia.org. 22(December. M. Pless. (2012). A. Disability. D. Baltimore:: Paul H. S.. Family and Community Service. Caulfield. S.agosci. Sanford. E. 23(march. (2001). Lund. (2009).. (2007). & Light. Training of the Communication Partner provides positive outcomes in facilitating communication of children with Cerebral Palsy who use Speech Generating Devices Retrieved from http://www..299. International Classification of Functioning. ADHC. Brookes Pub.