AAC Skills Assessment-R

Student/Patient Name: __________________________Date of Evaluation: ______________________

Method of Access: _____________________________ Screen Size Presented: ___________________

Early Skills for AAC Use

Discontinue administration of this section when subsequent skill is not observed with indirect or natural cueing.

If a student does not touch the screen for cause/effect activities, it is unlikely that using a screen to display choices
and words is going to be effective at this point for natural communication. Consider the student’s visual skills to
determine if there are any hidden visual impairments, i.e. cortical visual impairment, which may hinder him from
seeking out the visual display. Check to see if cause/effect is seen in other ways, ex: touching a switch/screen to
elicit an auditory response; gestural or physical movements which are used to elicit a response from an object or
person, ex: hands up to get picked up or swiping at beads to hear the sounds/feel the sensation. This person may
benefit from auditory scanning selection. Continue the assessment giving a sequence of verbal choices to see if the
student response/accepts in any way. You can assess choice making, core word use, noun categories in this manner.

A. ON-SCREEN CAUSE/EFFECT ASSESSMENT

Directions: Does the student understand that touching/looking at a screen causes a response? Activating a switch?

Apps to Trial: Big Bang Pictures, Big Bang Patterns, Children’s Switch and Touch Progression, Teenager Switch and
Touch Progression, Counting Songs 1, Counting Songs 2, Peek-A-Boo Barn, Fisher Price Baby, Finger Paint with Sounds
(free), Rad Sounds Cause Effect, Sesame Street Beginnings (more complex visual), Real Fireworks (visual and auditory),
Baby View (good visual and auditory), Forest Fighter (visually complex), Cause and Effect Sensory Sound Box, Bubble
Popper (minimal visual, good popping sound effect), EDA Play or Hidden Grid.

SKILL ANALYSIS PROMPTING LEVEL

CAUSE/EFFECT # ACTIVATIONS VISUAL Natural Cue Indirect Cue Direct Hand NR
ATTENTION? Point Cue Under
Hand
Apps/Toys/Electronics
Presented:

NOTES:

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 B. TARGETING ON-SCREEN ASSESSMENT
DIRECTIONS: Does the student target a specific area of the screen to activate a desired on-screen effect? You want to
choose an app that has a limited number of items to activate so that your student doesn’t activate by just touching
anywhere. You also want the on-screen effect to be pretty OBVIOUS. Look for apps that have minimal visual complexity
and big, obvious visual effects/auditory effects that the student will not miss. Be aware of your student’s sensory needs.
Most sound effects can be muted if necessary.

Apps to Trial: Tap-N-See Now, Peeping Musicians, WordToob (create your own videos!), Shhh!, Racing Cars, Big Trucks,
Bumper Cars or Baby View

SKILL ANALYSIS PROMPTING LEVEL

TARGETING # ACTIVATIONS SIZE OF TARGET VISUAL Natural Indirect Direct Hand NR
ON-SCREEN ACCURATELY ATTENTION? Cue Cue Point Under
SELECTED Cue Hand
App/Program
Presented:

NOTES:

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 C. PICTURE DISCRIMINATION ASSESSMENT
DIRECTIONS:

Can the student target a specific image/symbol/picture to get a desired effect with other distracting images on screen?
Look for indications that the student is deliberately targeting specific items: repetition and enjoyment of selected item.

Apps to Trial: Sound Touch Animals, Sound Touch Vehicles, Sound Touch Musical Instruments…Video Touch Animals,
Video Touch Vehicles, Video Touch Musical Instruments…See N’ Say Animals or Inclusive Smarty Pants

SKILL ANALYSIS PROMPTING LEVEL

PICTURE # SIZE OF TARGET VISUAL Natural Cue Indirect Cue Direct Hand NR
DISCRIMINATION ACTIVATIONS ACCURATELY ATTENTION? Point Under
SELECTED Cue Hand
App/Program
Presented:

Motivating
Subjects/Activities
Presented:

NOTES:

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Language Representation Elements for AAC Use
A. NOUN SYMBOL USE FOR FUNCTIONAL COMMUNICATION
Discontinue administration of this section when subsequent skill is not observed with indirect or natural cueing.

1. EARLY CHOICE MAKING ASSESSMENT

DIRECTIONS: Can the student touch/look at a desired picture/symbols/image to request a desired off-screen activity in a
field of 2 choices? 4 choices? 6 choices? Can the student effectively shift his/her attention from the iPad/screen to their
partner and the requested activity? *Can use auditory scanning by listing a verbal sequence of choices.

Simple AAC Apps to Trial: Go Talk Now, Choice Board Creator, Talking Cards, So Much 2 Say or Point to Pictures
Simplified Comprehensive AAC apps/dedicated devices to trial: present with decreased field of choices (use pages with
less choices or hide buttons to simplify the presentation) and navigate to the page of choices for the user (partner
assisted navigation)

NOTES: Trials with Early Choice-Making should include real choice-making with activities, objects, subjects that the
student has already shown an interest in/motivation.

This is not a “show me” task. Ask student to choose what s/he wants from the board presented. You will determine
accuracy of the selection based on whether the student appears satisfied with his selection. If you are not sure they are
selecting an item deliberately, offer them the device to select first. Once s/he chooses a symbol, offer a few of the
options by showing the items to see if s/he picks the items she originally selected on the device. This only works for
objects. Allow the student ample time to try out different symbols to “learn” what they mean. Making a mistake only
teaches the meaning of the symbol. Document any improvements you note over time. Showing an ability to learn is a
valuable piece of information!

SKILL ANALYSIS PROMPTING LEVEL

EARLY CHOICE- HIGHEST SIZE OF PERCENTAGE SYMBOL Natural Indirect Direct Hand NR
MAKING NUMBER OF TARGET OF CHOICES TYPE: Cue Cue Point Under
SYMBOLS/PAGE ACCURATELY WITH PHOTO, Cue Hand
WITH SELECTED SATISFACTORY PICSYM
ACCURACY 2-6 OUTCOMES
App/Program/Light
Tech Option
Presented:

Motivating
Subjects/Activities
Presented:

Presentation:
Visual or Auditory
(circle one)

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 2. LATER CHOICE-MAKING ASSESSMENT
DIRECTIONS: Presented in the same manner as above but with an increased number of symbols available.

SKILL ANALYSIS PROMPTING LEVEL

LATER CHOICE- HIGHEST SIZE OF TARGET SYMBOL TYPE: PHOTO, Natural Indirect Direct Hand NR
MAKING NUMBER OF ACCURATELY PICSYM Cue Cue Point Under
SYMBOLS/PAGE SELECTED Cue Hand
WITH
ACCURACY >6
App/Program/
Light
Tech Option
Presented:

Motivating
Subjects/Activiti
es Presented:

Presentation:
Visual or
Auditory
(circle one)

NOTES:

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B. NOUN SYMBOL USE FOR COMMENTING/LABELING

DIRECTIONS: Using the same apps as above, model and encourage the student to use noun symbols to comment or
label and item they are enjoying. For example, you are actively playing with “bubbles” and the student selects
“bubbles!” on their AAC system. You respond, “I know! We are playing with ‘bubbles!’”

SKILL ANALYSIS PROMPTING LEVEL

LATER CHOICE- HIGHEST PERCENTAGE SYMBOL TYPE: PHOTO, Natural Indirect Direct Hand NR
MAKING NUMBER OF OF CHOICES PICSYM Cue Cue Point Under
SYMBOLS/PAGE WITH Cue Hand
WITH SATISFACTORY
ACCURACY OUTCOMES
App/Program/
Light
Tech Option
Presented:

Motivating
Subjects/Activiti
es Presented:

Presentation:
Visual or
Auditory
(circle one)

NOTES:

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B. CORE WORD COMPREHENSION AND USE

1. CORE WORD USE ACTION/OBJECT REQUESTS-REOCCURENCE, CESSATION, ACTION

DIRECTIONS: Using the same AAC app, see if the student can use core words “more” “go” and “stop/all done” to
control the activity. Usually these words are on a main page or a specified “core” word page. Model asking for “more”
snack, video, music. Model “go” to wind up a wind-up toy, push a swing, slide down the slide, start a song. Give a verbal
prep statement such as “ready, set…” Gradually decrease prompting from a direct point cue to the symbol to a point in
the general area of the symbol with a verbal cue, “do you want MORE?” Ultimately stop cueing and see if the student
will start to touch the symbol independently. When s/he begins to show waning interest, encourage use of “stop” and
offer another choice. Check to see if over several trials, the student begins to use these spontaneously.

*Can use auditory scanning by listing a verbal sequence of core word choices.

SKILL ANALYSIS PROMPTING LEVEL

CORE WORD USE HIGHEST SIZE OF PERCENTAGE SYMBOL Natural Indirect Direct Hand NR
ACTION/OBJECT NUMBER OF TARGET OF CHOICES TYPE:, Cue Cue Point Under
SYMBOLS/PAGE ACCURATELY WITH PICSYM, Cue Hand
REQUESTS- WITH SELECTED SATISFACTORY WORD
REOCCURENCE, ACCURACY OUTCOMES
CESSATION,
ACTION
App/Program/Light
Tech Option
Presented:

Motivating
Subjects/Activities
Presented:

Presentation:
Visual or Auditory
(circle one)
NOTES:

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 2. CORE WORD USE COMMENTING (SHARING INFO, OPINION…)

DIRECTIONS: Using the same core word page on your AAC app, watch for the student to give an indication of their
opinion of the activity/item. Does s/he like it or not? Gain the students attention to the AAC app and model the word
“like” (or “not”) to reflect what the student’s body language tells you. For example, when tasting lollipops of different
flavors, my student wrinkles his nose. I over exaggerate my response and say, “oh gross! You do NOT (point to “not”)
like that one!” If he smiles and giggles when we swing. I stop him, show him the app and say “You LIKE it!!!” with claps
and laughs, immediately returning to swinging. After several repetitions with decreasing prompting, see if your student
begins to use these words with the new function of commenting.

*Can use auditory scanning by listing a verbal sequence of core word choices. Be sure to scan the words in the same
order ever time.

SKILL ANALYSIS PROMPTING LEVEL

CORE WORD USE HIGHEST SIZE OF PERCENTAGE SYMBOL Natural Indirect Direct Hand NR
COMMENTING NUMBER OF TARGET OF CHOICES TYPE:, Cue Cue Point Under
SYMBOLS/PAGE ACCURATELY WITH PICSYM, Cue Hand
(SHARING INFO, WITH SELECTED SATISFACTORY WORD
OPINION…) ACCURACY OUTCOMES
App/Program/Light
Tech Option
Presented:

Motivating
Subjects/Activities
Presented:

Presentation:
Visual or Auditory
(circle one)

NOTES:

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C. SINGLE BUTTON PRE-STORED PHRASE USE FOR MULTIPLE PURPOSES:

DIRECTIONS: Assist the student in getting to a topic based page during an activity. Model the use of pre-stored
messages, for example, “Can you help me?” “Let’s change it,” “That’s awesome!” etc. Does the student use pre-stored
phrases to interact? For what functions?

SKILL ANALYSIS PROMPTING LEVEL

PRE-STORED HIGHEST MESSAGE FUNCTIONS Natural Indirect Direct Hand NR
PHRASE USE NUMBER OF Cue Cue Point Under
SYMBOLS/PAGE REQUEST QUESTION COMMENT Cue Hand
WITH
ACCURACY
App/Program/Light
Tech Option
Presented:

Motivating
Subjects/Activities
Presented:

Presentation:
Visual or Auditory
(circle one)

NOTES:

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Vocabulary Organization Comprehension For AAC System Navigation
Discontinue administration of this section if student is unable to navigate by noun categories or visual scene display
with indirect or natural cueing.

A. NAVIGATION BY NOUN CATEGORIES

DIRECTIONS: Once your student has shown an interest in choosing a desired item out of a field of choices, navigate back
one page to see if the student can learn to select a noun category button to get to their desired item/activity page. Use a
*Comprehensive Dynamic Display AAC Systems (see ADDENDUM)

* Can use auditory scanning by listing a verbal sequence of categories for each targeted selection, for example, “you like
the guitar! Let’s go find the guitar. Where should we look? “animals, clothes, music, toys…” If the student doesn’t
respond to your directive, give them the auditory selection and look for their response. If they consistently respond to a
specific category and show satisfaction over time, that suggests purposeful selection.

SKILL ANALYSIS PROMPTING LEVEL

NOUN CATEGORY HIGHEST NUMBER OF SYMBOL TYPE: Natural Indirect Direct Hand NR
BASED NUMBER OF ACCURATELY PHOTO, Cue Cue Point Under
SYMBOLS/PAGE SELECTED PICSYM Cue Hand
NAVIGATION ON WITH ACCURACY CATEGORIES
DYNAMIC (LIST
DISPLAY CATEGORIES)
DEVICES/APPS
App/Program
Presented:

Motivating
Subjects/Activities
Presented:

Presentation:
Visual or Auditory
(circle one)
NOTES:

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 B. NAVIGATION BY VISUAL SCENE DISPLAY/CONTEXT BASED TOPIC

DIRECTIONS: If you have a student who struggles with navigation via noun categories, s/he may be able to match
her environment to a photograph to navigate to a page of environment related messages (“context based page”).
You will need a photograph which matches the assessment environment. You can use a photograph of your
treatment room/classroom with recognizable items placed obviously on the photograph. We use a photograph of
our therapy table with an iPad, stack of books, clear jar of wind-ups and markers and paper placed around the table.
Each item is a “hotspot” which, when touched, links to a page with social messages, requests and items related to
the selected item. For example, when students touch the iPad, a page opens with several app choices, “let me
pick,” “you do it,” “that’s funny,” and “did you see that!?” Some apps may not use “hot spots” but rather several
linking buttons which have a photograph of different areas (ex: kitchen, bathroom, therapy room).

AAC Apps to Trial with Visual Scenes: ChatAble, Compass, GoTalk Now, Snap Scene (offers a Lite version), TouchChat,
Scene Speak or Scene & Heard

Dedicated Speech Generating Devices with Visual Scenes to Trial: Prentke Romich Accent Series, Saltillo NovaChat
Series or Tobii Dynavox T-Series

Apps/Devices/Software With Context Based Topics: TouchChat, NovaChat, Word Power, Snap! Plus Core First, Indi,
Sonoflex, and SonoPrimo

* Can use auditory scanning by listing a verbal sequence of contexts/topics for each targeted selection, for example,
“Let’s play! Where should we look for your toys? ‘kitchen, bathroom, playroom, bedroom’”. If the student doesn’t
respond to your directive, give them the auditory selection and look for their response. If they consistently respond to a
specific topic/context and show satisfaction over time, that suggests purposeful selection.

SKILL ANALYSIS PROMPTING LEVEL

NAVIGATION BY VISUAL SCENE SELECTED MESSAGE Natural Indirect Direct Hand NR
VISUAL SCENE TRIALED HOTSPOTS TYPE: SOCIAL, Cue Cue Point Under
(LIST) REQUEST, Cue Hand
DISPLAY COMMENT
App/Program
Presented:

Motivating
Subjects/Activities
Presented:

Presentation:
Visual or Auditory
(circle one)

NOTES:

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 C. NAVIGATION BY GRAMMATICAL CATEGORIES
DIRECTIONS: Assess whether the student can locate desired items in grammatical categories such as “Actions,”
“Things,” “Places” and “People.” Try to make this activity meaningful. Look for activities that requires use of these
categories. If your student has shown an interest in specific items (snacks, videos, animals, vehicles, musical
instruments), model the use of navigating to the “dictionary” category page. This is different on the different apps
and can be called “My Words,” “Pages,” “Things,” “Nouns.” Look for the button that takes you to a page of
category based folders.

To target accessing the verb/actions page, choose action words that are meaningful and easily observable such as
“read,” “open,” “sing,” “play,” “sleep” (pretend to snore!).

To target “People” or “Places” go visiting. Let your student pick people or a place to visit. Play a game and let your
student choose who goes next. See if your student can access the “People” button to find his friends.

* Can use auditory scanning by listing a verbal sequence of grammatical categories for each targeted selection, for
example, “Let’s go visiting! Who should we see? “Actions, People, Places, Things…” Be sure your activity is motivating
for the student!

SKILL ANALYSIS PROMPTING LEVEL

NAVIGATION ON LIST ACCURATELY SYMBOL TYPE: Natural Cue Indirect Direct Hand NR
DYNAMIC DISPLAY SELECTED PHOTO, Cue Point Under
CATEGORIES PICSYM, WORD Cue Hand
DEVICES/APPS USING (PEOPLE, PLACES,
GRAMMATICAL THINGS/NOUNS,
CATEGORIES ACTIONS,
DESCRIPTORS)
App/Program
Presented:

Motivating
Subjects/Activities
Presented:

Presentation: Visual or
Auditory
(circle one)

NOTES:

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 D. NAVIGATION BY MULTI-MEANING ICONS
DIRECTIONS: This is best assessed using a Prentke Romich device, the LAMP app or the Speak For Yourself app, which
include multi-meaning icons. These are symbols that can mean more than one concept: noun, action, descriptor.
Selection of one of these icons navigates the user to a page of words which are associated with the selected icon. Model
the use of the symbol on the main page to access a page including previously motivating items. For example, select the
“Apple” to get to a snack folder. Select the “Dice” to get to a toy folder. Model the use of the symbols get to specific
action requests or descriptor requests (remember “fast/slow” “go,” etc)

*Can use auditory scanning by listing a verbal sequence of icon choices. Be sure to scan the words in the same order
every time. Given the demand on attention and memory for auditory scanning, you may opt to begin with a smaller
selection of icons.

SKILL ANALYSIS PROMPTING LEVEL

NAVIGATION BY LIST ACCURATELY LIST THE Natural Cue Indirect Direct Hand NR
MULTI-MEANING SELECTED MULTI- MESSAGES Cue Point Under
MEANING ICONS CONVEYED Cue Hand
ICONS
App/Program
Presented:

Motivating
Subjects/Activities
Presented:

Presentation: Visual or
Auditory
(circle one)

NOTES:

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Novel Utterance Generation With Symbol Pairing
A. MULTI-SYMBOL PHRASES- CORE, NO NAVIGATION

DIRECTIONS: Model the use of two core words to comment or request, for example, “want + it.” Some early developing
2 word phrases:

“want + it”
“you + do” (as in, “you do it” “you make it go again,” “you help me,” “you take a turn”)
“I + do” (as in, “let me pick a movie by myself,” “let me pick a wind-up toy from the bin”)
“want + go”
“want + help”
“I + can” (as in, “I can do it”)
“not + like”

*Can use auditory scanning by listing a verbal sequence of core words for each word in the phrases. Once the student
selects a word, encourage them to add another word and reinitiate scanning core word selection. Be sure to scan the
core words in the same order every time!

SKILL ANALYSIS PROMPTING LEVEL

MULTI-SYMBOL Subjects/ Action/Verb Descriptors, Avg. MLU Natural Indirect Direct Hand NR
PHRASES- CORE, Pronouns(list) Negative (#words/phrase) Cue Cue Point Under
Cue Hand
NO NAVIGATION
App/Program/Light Ex: “I” “go” “not” 3.0
Tech Option
Presented:

Motivating
Subjects/Activities
Presented:

Presentation:
Visual or Auditory
(circle one)

NOTES:

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B. MULTI-SYMBOL PHRASES- WITH NAVIGATION

DIRECTIONS: Model use of a core word + a specific item, for example, select “want” then navigate to the snack food
page and pick a snack. You can also model a core word paired with a descriptor, such as “go,” navigate to
describing words page and select “fast” or “slow” followed with a fun activity- swing fast/slow, run fast/slow, sing a
song super fast or really slow, read a book fast/slow. Remember to over-exaggerate the rate so it’s fun and silly! Use
backward chaining with your prompts to see if your student begins to independently navigate.

* Can use auditory scanning by offering a sequence of all options on a particular page. This requires significant
attention, planning, memory and motivation. Give prompts as needed and note these on the chart below.

SKILL ANALYSIS PROMPTING LEVEL

MULTI-SYMBOL Subject/ Action, Descriptor, Avg. MLU Noun Natural Indirect Direct Hand N
Generative Pronoun Verb Negative (#words/ Category Cue Cue Point Under R
(list) phrase) Used Cue Hand
Language with
Navigation
App/Program Ex: “I” “go” “not” 3.0
“fast”
Presented:

Motivating
Subjects/Activities
Presented:

#messages/page
(locations)

Presentation:
Visual or Auditory
(circle one)

NOTES:

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Message Window/Text Box Management
DIRECTIONS: Once the student is using 2 or more words sequentially, model the use of the message window to speak
the entire phrase. Model clearing the message window. Use backward chaining with your prompts to see if the student
begins to use the message window independently.

* Can use auditory scanning by building the sentence with the student and then asking, “Do you have more to say or do
you want to speak your message?” Then scan the entire page again, including the ‘text box’ or ‘message window’ in the
response.

SKILL ANALYSIS PROMPTING LEVEL

MESSAGE Press to Speak Clear Delete Natural Cue Indirect Direct Hand NR
WINDOW/TEXT Character Cue Point Under
Cue Hand
BOX
MANAGEMENT
App/Program
Presented:

Motivating
Subjects/Activities
Presented:

Presentation:
Visual or Auditory
(circle one)

NOTES:

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Spelling to Communicate (Text-To-Speech)

DIRECTIONS : You can use the same techniques for functional evaluation of spelling to communicate that you use
for all of the other skills. Using the keyboard or letter board, model a few object names and comments by spelling
and using word prediction. Offer your student some communication options, “We could read (point to the ‘r’) or
play (point to the ‘p’). Many students don’t have experience with word prediction so you may need to model this
first before using backward cue chaining to see if the student begins to spell on his own. Consider offering
alphabetical organization of the keyboard and QWERTY organization (standard keyboard setup).

Keyboards for iPad: Phonics Keyboard (need to set up accessibility options to allow for full access and turn Speak
Screen on to speak entire message), Keedogo Plus

Text-To-Speech App: Typ-O HD, Proloquo4Text, Verbally, or Predictable

All Complex Communication Apps

Light Tech Alphabet Boards

SKILL ANALYSIS PROMPTING LEVEL

Spelling to Single word Telegraphic Word Natural Cue Indirect Direct Hand NR
Communicate messages only phrases or Prediction Cue Point Under
Sentences? Cue Hand
App/Program
Presented:

Motivating
Subjects/Activities
Presented:

Presentation:
Visual or Auditory
(circle one)

NOTES:

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Addendum
Prompting Levels-
Natural Cue: A cue that occurs naturally during the interaction, for example, a friend says, “Hi” which is a
natural cue for you to say “Hi!” Natural cues or initiation of interaction are all considered independent
communication.

Indirect Cue: A cue which “invites” the student to communicate but does not overtly direct them to say
something specific. Examples include gesturing toward the communication board/device/app; saying “did you
have something to say?” or “what do you think?” A pause cue is also an indirect cue where the partner makes a
comment or statement or asks a questions and then waits expectantly for the student to take a conversational
turn.

Direct Point Cue: The partner points out the symbol/picture to cue the student what to say.

Hand Under Hand Cue: The partner places her hand under the child’s hand (allowing the student’s hand to
“ride” on top of the back of the partner’s hand and messages are generated together. This is a full assist.

**Never grasp a student’s hand in yours and pull his hand toward a message on his screen. This creates a
natural “pull back” reaction in many students and encourages the idea that the message is generated by the
partner instead of the student. Students who don’t pull away will only be encouraged toward learned
helplessness, an issue for many nonverbal students. Students who resist can also develop behavioral issues
including avoidance of their device in subsequent interactions.

NR- No Response: The student does not respond to any cues provided.

Comprehensive Dynamic Display AAC Systems Used at Dynamic Therapy Associates

Apps:
AACSpeak, AVAZ, ChatAble, Compass, Expressive, LAMP, Proloquo2Go, Snap! Plus Core First, SonoFlex,
Speech Hero and TouchChat

Dedicated Speech Generating Devices:

Prentke Romich Accent Series, Saltillo NovaChat Series, Tobii Dynavox T-Series and Indi

HIERARCHY OF SKILLS
The skills on the AAC Skills Assessment Protocol are not inherently hierarchical. There is some general hierarchy in
understanding social cause/effect and understanding the use of symbols (either spoken/written words, pictures,
spelling etc.) in order to communicate symbolically. This does not preclude a student from learning through
exposure, aided language input and motor planning to communicate via augmentative communication.

FINAL NOTES
Once you’ve ascertained the features that a student is able to use, look for devices or apps that have the features
the student is currently able to use and allows him/her to advance their skills to the next level of development. It’s
important to select a system which meets the student’s current needs and allows for language development to
meet future needs.

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