I-ASC: Identifying Appropriate Symbol Communication

Available resources

available resources
Available resources

Available resources include comment on other influencing factors summarised as attitudinal support, financial resources, intervention input, general practical support, team-around-the child knowledge and skills, and on-going training available to support the aid recommendation. 

Attitude

This describes any attitudinal influence on the child/young person’s AAC journey. Findings suggest that teams make decisions influenced by the attitudinal support of those around the child.

Implications
girl communication book direct access
girl communication book direct access
  • Be aware that attitudes can have a considerable influence on decision making and implementation.
  • Draw on those with positive attitudes to support the development and delivery of the AAC implementation plan.
  • Engage in an open and honest discussion where there are negative or unrealistic attitudes present during the assessment process, e.g. unrealistic attitudes may relate to what people think the technology can do for the child or young person.
  • Consider addressing attitudinal change through listening and supporting, education and training, defining roles and responsibilities, providing an increased timeframe for the decision making process and agreeing on the contexts for using AAC.
I-ASC Resources
Other Resources

Please email i-asc@mmu.ac.uk if you know of resources that should be included here

Learn more

Lynch, Y., Murray, J., Moulam, L., Meredith, S., Goldbart, J., Smith, M., Batorowicz, B., Randall, N., and Judge, S. (2019) Decision making in communication aid recommendations in the UK: Cultural and contextual influencers Augmentative and Alternative Communication

Webb, E.J.D., Meads, D., Lynch, Y., Randall, N., Judge, S., Goldbart, J., Meredith, S., Moulam, L., Hess, S., and Murray, J. (2019) What’s important in AAC decision making for children? Evidence from a best-worst scaling survey, Augmentative and Alternative Communication, doi: 10.1080/07434618.2018.1561750

Cost

This refers to the financial cost incurred for the provision of a symbol communication aid and the ongoing support costs. Findings indicate that where service models ensure access to communication funding, cost becomes less prominent in decision making and is line with a right’s based philosophy of service provision.

Implications
girl communication aid direct access
girl communication aid direct access
  • Where funding is available, value for money should be considered through the provision of the most appropriate but cost-effective AAC solution for individuals.
  • Costs related to the teaching and learning support and the aid maintenance support should be estimated and included in any decision recommendation.
  • Where funding is more variable, there is a need to advocate to service commissioners and service providers to ensure clinical need determines system choices rather than the economic cost.
I-ASC Resources
Other Resources

Please email i-asc@mmu.ac.uk if you know of resources that should be included here

Learn more

Lynch, Y., Murray, J., Moulam, L., Meredith, S., Goldbart, J., Smith, M., Batorowicz, B., Randall, N., and Judge, S. (2019) Decision making in communication aid recommendations in the UK: Cultural and contextual influencers Augmentative and Alternative Communication

See also information the UK policy context under policy and legislation

Intervention

This refers to intervention which includes all implementation supports post-recommendation (who, what, where and how). Findings suggest that the intervention supports available to the child or young person influences the recommendation choice. All communication aids are an investment in the child’s future achievements. Different systems have different intervention implications for both the child or young person and the support team.

Implications
  • Most children and young people will require high levels of intervention support, identify who will provide this support before making a recommendation.
  • Team buy-in is critical for implementation. Ensure the recommendation process incorporates building consensus and a shared view on the child’s long term developmental pathway.
I-ASC Resources
Other Resources

Please email i-asc@mmu.ac.uk if you know of resources that should be included here

Learn more

Lynch, Y., Goldbart, J., Dada, S., Moulam, L., Randall, N., Judge, S. Meredith, S., & Murray, J. (2018). A literature review on the language abilities of children and young adults who use aided AAC during language development. Communication Matters Journal, 32(3), 16-20.

Lynch, Y., McCleary, M., and Smith, M. (2018). Instructional strategies used in direct AAC interventions with children to support graphic symbol learning: A systematic review. Child Language Teaching and Therapy, 34(1), 23-36. doi:10.1177/0265659018755524.

Lynch, Y., Murray, J., Moulam, L., Meredith, S., Goldbart, J., Smith, M., Batorowicz, B., Randall, N., and Judge, S. (2019) Decision making in communication aid recommendations in the UK: Cultural and contextual influencers Augmentative and Alternative Communication

Support

This explores the support needed to fulfil the aid recommendation. It includes language scaffolding, customisation and personalisation. Findings suggest that child or young person’s available support influences the communication aid recommendation.

  • The demands of learning AAC are high on families and those around the child. It is critical that families are supported to be active within the decision making process.
  • Identify what supports can be put in place to assist those around the child (both family and immediate team).
I-ASC Resources
Other Resources

Please email i-asc@mmu.ac.uk if you know of resources that should be included here

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Goldbart, J., & Marshall, J. (2004). “Pushes and pulls” on the parents of children who use AAC. Augmentative and Alternative Communication, 20, 4, 194-208. doi: 10.1080/07434610400010960

Lynch, Y., Murray, J., Moulam, L., Meredith, S., Goldbart, J., Smith, M., Batorowicz, B., Randall, N., and Judge, S. (2019) Decision making in communication aid recommendations in the UK: Cultural and contextual influencers Augmentative and Alternative Communication

Team knowledge and skill

This includes the knowledge and skills of any team member in supporting AAC decision making. It includes confidence with AAC, prior knowledge and experience, familiarity and training and continuing professional development needs. Findings suggest that team knowledge and skills, including the family, influences communication aid recommendations.

Implications
  • Be aware that pre-existing familiarity and confidence with particular systems may bias decision making towards those systems. Reflect on whether the familiarity/confidence is a justifiable reason in each instance.
  • Be mindful of the long-term implications of choices and recommendations. In choosing a particular graphic representation system as part of the first aid, a child will have to continue with that type of representation or be forced into a situation where they lose learning and have to learn new language construction skills.
  • Be sure to discuss expectations and dispel any misperceptions arising from the media portrayal of communication aid technology, e.g., the speed of AAC mediated communication or apparent ease of use.
I-ASC Resources
Other Resources

Please email i-asc@mmu.ac.uk if you know of resources that should be included here

Learn more

Dietz, A., Quach, W., Lund, S. K., & McKelvey, M. (2012). AAC assessment and clinical decision-making: The impact of experience. Augmentative and Alternative Communication28, 148-159. doi:10.3109/07434618.2012.704521

Lynch, Y., Murray, J., Moulam, L., Meredith, S., Goldbart, J., Smith, M., Batorowicz, B., Randall, N., and Judge, S. (2019) Decision making in communication aid recommendations in the UK: Cultural and contextual influencers Augmentative and Alternative Communication

Training

This refers to the development of communication partner knowledge and skill. Findings suggest that the opportunity to provide and receive child specific AAC training varies.

Implications
  • As all AAC intervention place high demands on the child/young person, family and support team, aim to include training as part of a communication aid purchase and set-up plan.
  • Consider if training supports can be accessed through commercial suppliers and specialized service providers. Include these components in your recommendation plan.
I-ASC Resources
Other Resources

Please email i-asc@mmu.ac.uk if you know of resources that should be included here

Learn more

Lynch, Y., Murray, J., Moulam, L., Meredith, S., Goldbart, J., Smith, M., Batorowicz, B., Randall, N., and Judge, S. (2019) Decision making in communication aid recommendations in the UK: Cultural and contextual influencers Augmentative and Alternative Communication