AAC Assessment Corner by Vicki Clarke: Is AAC Feature Matching Still Relevant?

Today, we welcome back Vicki Clarke, a regular contributor to PrAACtical AAC, with another edition of AAC Assessment Corner. In this post, Vicki shares her thoughts on feature matching for AAC device selection.

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Feature matching has been the gold standard for AAC evaluation for the last 20 years. It is research based and clinically proven as the best technique for selecting an AAC solution for an individual. The tide of real-life practice, however, is turning and there has been increasing discussion at conferences, in social media and blogs questioning why we continue to use feature matching to place AAC systems in the hands of students. In a recent assistive technology on-line chat, a noted AT specialist remarked: “I wonder if at a district level it might not be better to have a go-to AAC system everyone tries first. If that doesn’t work then adjust.”  Does this mean that we throw feature matching out the window and everyone gets the same device?  I’m pretty confident that’s not where the AT crowd is heading, and they make some valid points we need to consider as we discuss good AAC evaluation strategies, in particular in our schools where the time and resources of AAC specialists are terrifically limited.

At the same time our AT friends are considering using high tech AAC systems as a go-to Universal Design for classrooms, many of us SLPs seem to be heading a different direction. The practice of introducing AAC with light tech pictures and paper continues to be prevalent, with a great deal of hesitancy to consider higher tech if the paper and pictures aren’t successful.  There still seems to be an unspoken rule that you often start with light tech.  Does that sound like a practice from the “good old days?” Not at all. In a recent ASHA sponsored AAC Chat discussing Core Vocabulary this month, over 75% of the 2 hour session was spent discussing how to implement a particular light tech AAC system for core word instruction.  There still seems to be a lot of value in low tech boards and they’re not quite ready for the shredder in our SLP’s rooms.

Where DO we start implementing AAC in classrooms?  Light tech for all?  High tech for all?  What about individual education plans that are “individualized?”

Maybe the answer is a little of both.  Maybe we choose an AAC system (light tech or high tech) to make available to an entire classroom to respect the tenants of UDL.  Once we have a general expectation for and access to communication in the classroom, we use feature matching to help us fine tune an AAC selection for an individual.

What is feature matching for AAC?

In 1994, Shane and Costello defined feature matching as the systematic process by which a person’s strengths, abilities and needs are matched to available tools and strategies. In 1994, AAC solutions were quite widely varied.  We finally had solid evidence that there were no prerequisites for AAC use. (In 1991, we were pretty sure there were, so this was important.)  The vocabulary organization available on the high tech systems was drastically different between the different manufacturers. One company had a strict multi-meaning icon based system, one company had a core word and folders approach and quite a few of the newer systems had no vocabulary at all- build it yourself models.  Some offered visual scanning but not auditory scanning.  Some had keyguards. Some were heavy, some were light (not many!). Some used Picture Communication Symbols, some used Minspeak, and no one had heard of Symbolstix yet. Some let you add your own pictures.  Some made this easy, other made it a pain.

Feature matching helped us figure out which system to go to.  It was important because the choices were so varied.  And then the manufacturers started paying attention to each other, and the research, and us consumers. The systems started to have a more varied vocabulary option.  Most of the systems actually HAD vocabulary (no more build-it yourself only models).  Nowadays all the big companies have provided us with some research based vocabulary (THANK YOU, Big Companies).  If access is not an issue, most of them can be adapted to meet an individual’s needs. Most of the more common dedicated communication devices are highly customizable.  Thank goodness!

SO, why do feature matching now?

Don’t all the AAC systems basically have the same features anyway? Well, no.  Although many of the dedicated device manufacturers have given us a good selection of vocabulary organization types and access options, the AAC app developers have decidedly NOT.  You cannot count on all AAC apps being equal in terms of providing comprehensive communication options.   If you need some help matching the features your AAC user needs to the apps on the market, of course, there’s an app for that!  The AAC Ferret app lets you search apps by feature. Jane Farrall’s AAC App List also gives a good explanation of the app and a rating to help you sort out the comprehensive ones from the more limited options.

Got it!  Now where do I start?

In our classrooms, we began implementing a “Core Vocabulary Project” to help our teachers offer universal access to communication and language for all students.  This looks different across classrooms based on several factors including the teacher’s comfort with either light tech or high tech systems, the classroom’s access to equipment, the general language level of the students in the classroom, and finally the high tech AAC systems already in place in the classroom.

What might this look like in a classroom?

One of our preschool classrooms has a set of communication books with a core board on the cover and categories of nouns on the pages inside.  The teacher has several iPads with the Tobii Dynavox Compass app loaded which she uses to introduce concepts and allow students to meet their basic communication needs throughout the day. Each teacher/paraprofessional has a book that she uses to talk with the students.  All students have access to the teachers’ books.  This classroom will soon have the Compass app loaded on the teacher’s Smart Board so that the students see their language displayed much of the day.  The teacher will use the Smart Board to communicate with the core words and model for the students.

In this classroom there are several students for whom this system is not quite enough.  There are two girls who have profound speech impairments and very high desire to communicate specific pieces of information.  This school year each of these two students participated in an individual AAC evaluation which used feature matching to determine the correct system to meet her needs. Some of the features we considered included the following:

• Access- How many buttons on a page could the child visually scan reliably? How small of a target could she touch? Was her physical skill static or changing due to her diagnosis?  Is her access impacted by any sensory issues?
• Symbolic Understanding- Does she understand picture symbols represent the toys she wants to play with? Does she understand more abstract symbols to request actions? Does she need photographs to reliably match an image to her desired choice?
• Functions of Communication- Does she use language for a variety of functions, like requesting, responding, commenting, greeting, rejecting, responding?
• Language Organization Comprehension- Understanding of noun categories? Grammatical categories? Visual scene displays to match her environment?
• Aided Language Symbol Use- Can she learn to put words together creatively in functional activities- “more play” vs. “stop play?”

Ultimately the two families and school teams decided that both girls needed their own dynamic display communication devices.  As we wait for a response from the insurance companies, we are beginning to analyze the classroom environment more fully and to modify the girls’ programs using our editing software. We plan to print out static boards matching the anticipated devices so that the girls and their teachers can begin to learn to communicate using their new systems.

Feature matching involves consideration of a lot of factors. It can be easily viewed as a formidable task but there are templates to help you.  I shared our clinic based protocol, The Dynamic AAC Evaluation Protocol in my January post.  The Georgia Project for Assistive Technology did a great one many years ago which is still relevant, comprehensive and accessible here.

Don’t let the details scare you away from feature matching for your AAC users.  It may seem simpler to pick one system for everyone but it is unlikely that one system will be effective for each unique student in a classroom.  Let’s make sure we have communication ACCESS FOR ALL, but keep an eye out for those individuals who need a little something special your feature matching might catch!

Stay tuned for upcoming posts on specific feature matching considerations and techniques later this year!