Posted on 02/05/2023
AAC Assessment – an evidence-based approach and supporting documentation
How did this work come about?
AAC Executive Leads (the senior person in a health board who has responsibility for driving forward AAC services) and Specialist Speech and Language Therapists (SLTs) attended a workshop hosted by the Scottish Government (pre-pandemic). Practitioners confirmed an evidence-based approach to underpin their assessment in AAC was required across the whole of Scotland, to increase consistency and support the best possible outcomes for AAC users. Three boards shared examples of their practice: NHS Western Isles, NHS Greater Glasgow and Clyde (NHSGGC) and NHS Lothian (NHSL). The outcome of discussions at the workshop were to continue with the current approach of separate documentation for children and adults. NHS GGC and NHS L agreed to progress this work.
What happened in each local area?
Adult AAC Assessment Tool – NHS GGC
The AAC assessment tool used by SLTs in NHSGGC began development during the Right to Speak project in 2014 and is based on extensive clinical experience and relevant research from the AAC evidence base. A successful poster presentation was delivered by Laura Renfrew and Nicola Woodside, the two SLTs leading this work, to the NHS National Conference in Glasgow 2016 and to Communication Matters UK conference in Leeds that year.
The document was further developed, refined, and successfully piloted in local multi-disciplinary teams across the Acute sector and Health and Social Partnerships. Standardising this framework in which to capture and present information, increases clarity in exchange of information for individuals moving between teams and aids the formation of a generally agreed dataset upon which to base clinical decision making in AAC.
The Adult AAC Assessment Tool can be used by clinicians to gather and maintain a repository of crucial information about an individual and their communication networks, which can inform clinical decision making around Augmentative and Alternative Communication. Developed to support both AAC users and staff, allowing those working with the person to collate all the relevant clinical information, and store it in a standard format, in a single location, in the person’s health record. From here it can be accessed by those authorised to see it; updated over time; used to provide a comprehensive basis for sound, person-centred, informed clinical decision making, with clearer outcomes for AAC users.
Working across NHSGGC in partnership with practitioners, managers, SLT professional networks and medical illustration, has produced the current version of this document.
Children and Young Peoples AAC Assessment Tool - NHSL
NHSL’s specialist AAC partnership service (Keycomm), with Local education authorities, focussed on capturing what needs to be considered by SLT’s and their partner practitioners for inclusion in the children’s’ AAC assessment documentation. This work was led by Debbie Jan’s, then lead SLT at Keycomm, who are committed to working in partnership with children and young people and their families and carers aiming for the best possible communication outcome. The development of this reflective document for use in Lothian along with wider sharing across the country, will support practitioners in the completion of their assessment.
Links to these resources, developed by SLTs using current available evidence, will be included in the online AAC Assessment module for SLTs and other specialists working in this area. Those registered with NHS Education for Scotland (NES) can then access this training on the NHS online learning platform TURAS.
Local leadership, tenacity and working in partnership with wider networks have been critical to the successful conclusion of this work.
The process has built local buy-in to progressing and implementing increased consistency in AAC assessment, along with other boards and practitioners from across Scotland who can now access and benefit from this work.
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