Children who use augmentative and alternative communication (AAC) are a heterogenous group with differing needs and skills. In fact, “there is no typical person who relies on AAC. They come from all age groups, socioeconomic, ethnic and racial backgrounds. They have a wide range of communication needs and capabilities. Their only unifying characteristic is the fact that they require adaptive supports to communicate effectively” (Beukelman & Light, 2020, p. 5). The purpose of AAC is to assist individuals who are unable to communicate effectively using speech alone to develop, maintain, or regain communication and enhance participation in daily life (Beukelman & Light, 2020). The goal of AAC assessment is to gather necessary information to find an AAC system that works well for an individual and leads to maximal self-determination, in other words, control over his or her life (Lund et al., 2021). AAC is determined based on a comprehensive, person-focused assessment.
Appropriate AAC system selection for a student is critical. An AAC system that is a poor fit for an individual is a leading contributor to device abandonment, discontinuation of an AAC system when the need remains (Johnson et al., 2006; Moorcroft et al., 2019). However, “it has become a common practice for teams to introduce a student to an AAC system, generally AAC apps, exclusive of an AAC evaluation. The reasons this occurs are numerous, some of which are understandable, but it is not considered best practice to recommend an AAC system without a formal AAC evaluation” (Dodd, 2017, p. 32).
The use of a single preferred communication book, board, app, or device across an entire US school or district is becoming a frequent topic of discussion on social media; however little is known about this practice. The purposes of this study were to determine: 1) When a single preferred communication book, board, app or device is adopted by a school or district, how does frequency of input from other stakeholders compare to when a single preferred system is not used; 2) When a single preferred communication book, board, app or device is used are data collected; and 3) When a single preferred communication book, board, app or device is adopted by a school or district, are criteria specified and what criteria are used to determine which students receive which levels of support?
A link to an online survey was shared with professionals providing AAC services in schools via social media, listservs, and direct email. The survey items were arranged into three blocks and consisted of open-ended, Likert, and discrete-choice questions. Out of 221 total respondents, thirty-eight (17.19%) reported using a single, preferred communication book, board, app, or device throughout their school or district. Those who reported using a single preferred system were statistically less likely to involve other professionals, families, and the student in the decision-making process. Only 28.9% reported always collecting ongoing data, 23.7% reported always having clearly defined criteria for success, and 18.4% reported always having clearly defined criteria for further evaluation (i.e., increasing supports). Qualitative data themes suggest use of strategies such as trial and error, clinical judgment, or lack of success in lieu of defined criteria or data, are being used to make decisions about device selection.
