Aim
Children who use AAC may spend many years in speech therapy addressing goals related to linguistic, operational, social, and strategic competencies needed. Currently, there is limited guidance for clinicians on how to best develop treatment plans for children who use AAC based on their unique characteristics such as age, diagnosis, language, and medical complexities. The purpose of this study was to identify and describe key variables that impact patients who use AAC and their time in outpatient speech therapy as well as explore how this information informs transition to different models of care available. Currently, there is limited information available regarding the time and intensity of treatment needed for children who use AAC. Our field lacks dosage information specific to AAC and there is no information as to whether there are benefits to individual, co-treatment, or group therapy sessions.
Method
Participants included children between the ages of 2 and 18 who had completed a functional communication evaluation (evaluation for any child over the age of 4 described as nonspeaking), AAC Direct Evaluation (evaluation for an AAC device where the child is physically able to touch the device to activate vocabulary), or AAC Complex Evaluation (evaluation for an AAC device where the child uses eye gaze or switch scanning to activate vocabulary). A child completing any of these visit types would be seen for AAC services at our hospital. The research team collaborated with our hospital’s Information Technology Research and Innovation Center to extract data from patient charts in our electronic medical record system, Epic.
The following data were collected: patient age, patient diagnosis/diagnoses, patient language, interpreter status, treatment type (individual, co-treat, group), model of care (weekly, every other week, episodic, consultative), length of time between physician referral and initiation of treatment, length of time in treatment, AAC competency level (Direct, Complex), socioeconomic status data (housing, food, transportation). The data represented a year of patient charts from December 31, 2023 to December 31, 2024.
Results
A total of 578 charts were identified as part of the chart review. Diagnoses varied across the sample with many patients having a diagnosis of autism spectrum disorder or a language disorder. A total of 419 patients completed a functional communication evaluation and 159 completed either an AAC Direct or AAC Complex evaluation. In regard to treatment type, individual 45 minute therapy sessions were the most commonly recommended with 264 patients receiving this method of intervention. Co-treat sessions were also recommended at times with 108 patients receiving this method of intervention. Housing, food, and transportation difficulties were not frequently reported. Additional data analysis is ongoing.
Conclusion
Examining initial characteristics of children who use AAC and the types of treatment they are provided may provide an initial view of how to provide services to this population. This study serves as an exploration of possible variables that may impact decisions for treatment planning.
