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
 GUIDELINES:
The WPSP will sign below when they are satisfied the requirements for each section below have been met.
• the information under each question is intended to provide the key points each speech pathologist should
address. 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.

There are three sections to the appraisal which follow. They are:

1. Questions
2. Workplace Examples
3. Workplace Observations

Questions WPSP Comments Meets

requireme
nts
(date)
1a. What is Augmentative Communication?
1b. What is Alternative Communication?
• Augmentative Communication strategies
are designed to support a person’s
speech abilities. Alternative
Communication strategies are designed to
replace speech when, for varying reasons,
such as physical disability, speech
development is not possible.
• 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. 13).

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Questions WPSP Comments Meets
requireme
nts
(date)
2a.Who might be involved in an AAC team?
2b. 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.

3. What is unaided AAC? Give some

examples.
Unaided AAC refers to communication strategies
which do not require the use of an external aid:
• gestures
• pointing
• vocalizations
• body language
• behaviours (e.g., taking a person’s hand
and leading them to the door)
• eye contact / eye gaze (within an
environment)
• facial expression
• touch cues
• tactile signing

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Augmentative and alternative communication appraisal. Developed by Clinical Innovation and Governance, ADHC,
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Questions WPSP Comments Meets
requireme
nts
(date)
4. What are Janice Light’s 4 AAC
competencies? Describe the meaning of each
of these competencies.
• Linguistic- refers to a person’s receptive
expressive language skills
• Operational- refers to the technical skills
required to operate the system
• Pragmatic/Social- includes all the skills
required for social interaction
• Strategic- means having the flexibility to
adapt communicative style to suit the
communication partner.
(J C. Light & McNaughton, 2014; J. C. Light,
1989)

5. List some critical aspects you need to

consider when doing an assessment for AAC.
• person centredness
• goals
• participation needs
• AAC competencies
• environments
• communication situations and partners
• self advocacy/choice/adaptability
• intellectual, physical and sensory abilities
• social, personal emotional preferences
• literacy/symbolic abilities.
(Beukelman & Mirenda, 2013) (J C. Light &
McNaughton, 2014; J. C. Light, 1989)
6. 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, external and social validity
• determining if the evidence is valid
• discussing the findings with relevant

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Augmentative and alternative communication appraisal. Developed by Clinical Innovation and Governance, ADHC,
Family and Community Service. Version 1. 2014
Questions WPSP Comments Meets
requireme
nts
(date)
people
• identifying and exploring the views,
preferences, concerns and expectations
that people may have.

In the field of AAC, 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, 2012 p.15)

7. Define and give some examples of low tech
and high tech aided AAC.
Low tech AAC strategies involve the use of aids
that do not require a power source to be
operated. 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, 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.e., holidays)
• phone lists.

High tech generally refers to a computer-like

device that generates speech output to convey a
message.
• 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,
Family and Community Service. Version 1. 2014
Questions WPSP Comments Meets
requireme
nts
(date)
tablets or hand held devices.

8. List some AAC assessment tools

See Appendix 2 in Guidelines for examples

9. 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, activity, social, cultural and
personal factors, within the context of any
interaction. All the components of an AAC
system assessment still happen (i.e.
access, devices, choice of modality,
vocabulary, training, etc.) but the
assessment framework is focused on
everyday functioning rather than disability
or systems changes (Simeonsson, Bjork-
Akesson, & Lollar, 2012)

• Application of the ICF framework changes

and widens the overall focus of evaluation
of AAC interventions. By using the ICF
framework the outcome of using AAC can
directly measure people’s functioning in
their daily lives. 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, 2006), (Lund & Light, 2007). The
ICF is a tool for “moving the goal of health
services away from body function and
towards involvement in life situations”
(Pless & Granlund, 2012 P.11)

10a. Why is literacy an important

consideration with AAC systems?

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Questions WPSP Comments Meets
requireme
nts
(date)

10b. 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, 1992 p.
1). Increasing literacy skills can increase
communication options.

Michalicek et al. (2010) found that systematic

instruction strategies were best for teaching
literacy skills such as phonemic awareness,
phonics, vocabulary, text comprehension children
who use AAC. These strategies include:

• scaffolding
• direct instruction
• least-to-most prompting with time delay.

11. List some factors which should be

considered to enable a successful AAC
intervention.

• 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, Bain, & Vass, 2008; Caulfield & Carillo,
2010; Michalicek et al., 2010; The Centre for AAC
and Autism, 2009)

12. Describe what areas you could measure to

evaluate an AAC implementation

• goals made by the person using AAC,

their family and people with whom they
interact

• changes to any of the five domains- body

CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 7
Augmentative and alternative communication appraisal. Developed by Clinical Innovation and Governance, ADHC,
Family and Community Service. Version 1. 2014
Questions WPSP Comments Meets
requireme
nts
(date)
functions and structure; participation;
activity; environmental factors and
personal factors using ICF codes and
tools developed to measure (World Health
Organisation, 2001)

• changes to any of the five domains- body

functions and structure; participation;
activity; environmental factors and
personal factors using the ICF-CY for
AAC Profile and Code Set for Children
Who Rely on AAC (Rowland et al., 2012)
As mentioned in section 3, the ICF-CY
will soon be incorporated into the above
general ICF codes

• participation using the Participation Model

of AAC (Beukelman & Mirenda, 2013) as
discussed in section 7

• changes to communicative competence

using Light’s Communicative Competence
for Individuals who use AAC (J. C. Light,
Beukelman, & Reichle, 2003)

• changes in other areas of communication

skills and abilities (like speech, language,
literacy, fluency, voice, and pragmatics)
which are targeted goals within the AAC
intervention.
13. 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

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Augmentative and alternative communication appraisal. Developed by Clinical Innovation and Governance, ADHC,
Family and Community Service. Version 1. 2014
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. This
may incorporate assessment,
intervention trials of equipment,
team cases.
Name the key elements involved
in the examples above. Describe
how the principles and
strategies of good practice in
AAC were incorporated in each
case.
Describe and produce
evaluation / outcome measures
of two case examples involving
AAC.
Show hard or digital copy
examples of AAC systems within
2 of your cases.

Observation
Observations must have been conducted within the previous 12 months.

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, progress and review?

CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 9

Augmentative and alternative communication appraisal. Developed by Clinical Innovation and Governance, ADHC,
Family and Community Service. Version 1. 2014
I confirm that all requirements have been met for this AAC core standard (WPSP).

Signed:
Name:
Position:
Date:

Disclaimer:
This appraisal was developed by the Clinical Innovation and Governance Directorate of Ageing, Disability
and Home Care in the Department of Family and Community Services, New South Wales, Australia
(ADHC).

This appraisal has been developed to indicate whether a practitioner 1 has increased their knowledge
through the completion of the core standard. It has been designed to promote consistent and efficient best
practice. It forms part of the supporting resource material for the Core Standards Program developed by
ADHC. Access to this document by practitioners working outside of ADHC has been provided in the
interests of sharing resources. Reproduction of this document is subject to copyright and permission.
Please refer to the website disclaimer for more details.

Whilst the information contained in this appraisal has been compiled and presented with all due care,
ADHC gives no assurance or warranty nor makes any representation as to the accuracy or completeness
or legitimacy of its content. 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. ADHC
does not intend nor guarantee the use of the appraisal as assessing a level of competence by practitioners
working outside of ADHC.

 
CORE STANDARDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION APPRAISAL | 10
Augmentative and alternative communication appraisal. Developed by Clinical Innovation and Governance, ADHC,
Family and Community Service. Version 1. 2014
References

Bech, A., Bain, A., & Vass, A (Producer). (2008). 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.agosci.org.au/docs/trainingcatsp.pdf
Beukelman, D.R., & Mirenda, P. (2013). Augmentative and Alternative Communication: Supporting
Children and Adults with Complex Communication Needs: Paul H. Brookes Pub.
Caulfield, F, & Carillo, D. (2010). 200 A Day the Easy Way, Putting it in Practice.
http://www.idahoat.org/Portals/0/Documents/200%20a%20Day%20the%20Easy%20Way.pdf:
WWW.closingthegap.com.
Light, J C., & McNaughton, D. (2014). Communicative Competence for Individuals who require
Augmentative and Alternative Communication: A New Definition for a New Era of
Communication? Augmentative and Alternative Communication, 30(1), pp.1-18. doi:
10.3109/07434618.2014.885080
Light, J. C. (1989). Toward a Definition of Communicative Competence for Individuals Using Augmentative
and Alternative Communication Systems: Williams & Wilkins.
Light, J. C., Beukelman, D. R., & Reichle, J. . (2003). Communicative Competence For
Individuals Who Use AAC: From Research To Effective Practice. . Baltimore:: Paul H. Brookes.
Lund, S.K., & Light, J C. (2006). Long-Term Outcomes for Individuals Who Use Augmentative and
Alternative Communication: Part I – What is a ‘‘Good’’ Outcome? Augmentative and Alternative
Communication, 22(December, 4), pp. 284 - 299.
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(2012). Developing the ICF-CY for AAC Profile and Code Set for Children Who Rely on AAC.
Augmentative and Alternative Communication,, 28, 21-32.
Simeonsson, R, Bjork-Akesson, E, & Lollar, D. J. (2012). Communication Disability and the ICF-CY.
Augmentative And Alternative Communication 28(1), pp.3-10.
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http://www.speechpathologyaustralia.org.au/.
The Centre for AAC and Autism. (2009). Points to Include in an AAC Evaluation for Individuals with
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Augmentative and alternative communication appraisal. Developed by Clinical Innovation and Governance, ADHC,
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