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 ![[----------------Horizontal Rule----------------]](/webart/hrule.gif){kind=small}  Article 1. AAC assessment: Stakeholder views.Do professionals, consumers, their families and friends, and providers perceive AAC assessments in the same manner? Probably not! Documented examples of differing expectations are: #1: Client: Feels his alphabet board is adequate. Spouse: Wants a laptop computer as an AAC system. #2: Parent: Wants an outside agency to purchase the Lightwriter because parent believes child can use system. Therapist: Believes child would not use device after novelty wears off. Recommends rental of device. #3: Client: Wants computer for writing and communication. Therapist: Wants device for communication only. Let's consider the process of assessment from the perspective of various stakeholders. Consumers One day, an event occurs which causes a severe disruption to your body. This event (e.g., birth, an aneurysm, accident or disease) propels you into a series of interactions with professionals (mostly physicians). Ultimately, you are diagnosed. You and your supporters gradually learn of the devastating impact this "event" has had, and will have, on your ability to communicate. A long, undesired journey begins. Irrespective of whether your diagnosis is cerebral palsy, amyotrophic lateral sclerosis, stroke, autism, developmental delay or traumatic head injury, you and your supporters will participate in an ongoing series of assessments conducted by professionals from an increasing number of disciplines. While goals will vary depending on your diagnosis, your age and the severity and course of your problem, initial intervention probably will focus on ways to remediate your deficits. In fact, by the time you are referred for an AAC assessment, everyone already knows you have a severe communication impairment that isn't likely to resolve anytime soon. Most professionals and family members understand why your speech is severely impaired and what other problems you might have. Whether that first AAC assessment takes place in a hospital, rehabilitation center, your home or your school, it almost certainly won't be your last. A long, undesired journey has begun, but things are looking up. Natural Supports Communication problems are experienced by everyone who interacts with someone who has a severe speech impairment. Supporting roles chosen by family and friends will depend upon the age, competencies, personality, resources, and preferences of all involved. Roles will vary over time. Supporters also have stresses in their lives. Complex family dynamics and financial difficulties can easily override concerns about communication. Supporters bring their own agendas to AAC assessment, which may (or may not) be consistent with the agendas of the consumer, professionals, etc. Professionals AAC professionals (e.g., clinicians, engineers, manufacturers) generally work in teams. They see hundreds of individuals with severe communication problems, and are familiar with a range of tools, strategies and techniques. Their opinions often are highly valued. However, these "experts" can focus on only one individual at a time, and then only for very brief periods. AAC intervention is time-intensive, ongoing, environmentally based, and often technologically complicated. Thus, other professionals and support persons often must carry out AAC team recommendations. No wonder community professionals feel overwhelmed! They may not know what to do when something does not work, or what to do next when something does! AAC specialists, on the other hand, may feel swamped by the amount of work they need to accomplish. If only there were 100 hours in each day! Providers/payers Agencies, governments, and institutions who pay for AAC assessments expect them to be done in a cost effective manner. They look for functional outcomes and consumers who are satisfied with services/technologies provided. In Summary Participants bring different perspectives to the AAC assessment process. However, only one group of them is always present at an assessment–the consumer. Shouldn't consumers (and those who support them) be taught to be active participants in the assessment process from its onset? Shouldn't they take charge of the assessment process? This article appears in ACN Volume 7, # 1. You may order this issue by clicking on Ordering Home Page Online Ordering 
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