Exploring augmentative & alternative communication assessment practices for children with limited functional speech & motor skills: a scoping review utilizing the Participation Model of AAC

<b>Purpose:</b> Children with limited speech and motor function, frequently subsequent to neurodevelopmental conditions, often require augmentative and alternative communication (AAC). Assessment practices to inform effective AAC interventions for these children can be challenging because of the considerable heterogeneity and range of factors that require consideration. An improved understanding of current assessment practices is imperative to optimize the provision of AAC. <b>Materials and Methods:</b> We conducted a scoping review to identify the assessment practices used with children with limited speech and motor function subsequent to neurodevelopmental conditions (birth to 18 years) within the Participation Model of AAC. <b>Results:</b> In total, 171 assessment practices were identified. Almost all were related to access supports and barriers, of which the majority focused on children’s capabilities. Relatively few methods were identified to support the assessment of children’s participation patterns and communication needs or opportunity supports and barriers. Twenty-three percent of identified formal assessment practices required modifications to established procedures, and 10% could not be completed by all child participants. <b>Conclusion:</b> Identified assessment practices focused primarily on children and their abilities, whereas very few focused on external factors (e.g., environmental and opportunity supports and barriers). Additionally, identified assessment practices may inaccurately measure the abilities of children with limited speech and motor function, as the procedures often required modification. IMPLICATIONS FOR REHABILITATIONWithout adequate practices to assess all areas of the Participation Model, clinicians may have difficulty providing comprehensive AAC servicesFuture research should focus on developing practices to assess children’s opportunity and environmental supports and barriersThere is a need for practices that are more accessible to children with limited speech and motor function Without adequate practices to assess all areas of the Participation Model, clinicians may have difficulty providing comprehensive AAC services Future research should focus on developing practices to assess children’s opportunity and environmental supports and barriers There is a need for practices that are more accessible to children with limited speech and motor function

言语和运动功能受限的儿童（常继发于神经发育障碍）通常需要辅助和替代沟通（augmentative and alternative communication, AAC）。由于这些儿童存在显著异质性且需考虑多种因素，为制定有效的AAC干预方案而开展的评估实践具有一定挑战性。深入了解当前评估实践对于优化AAC服务供给至关重要。本研究通过范围综述，识别了在AAC参与模型框架下，针对神经发育障碍继发言语和运动功能受限的儿童（0-18岁）所采用的评估实践。共识别出171项评估实践，几乎所有均与获取支持及障碍相关，其中大部分聚焦于儿童的能力；而用于评估儿童参与模式、沟通需求或机会支持及障碍的方法相对较少。在已识别的正式评估实践中，23%需对既定流程进行修改，10%无法被所有儿童参与者完成。这些评估实践主要聚焦于儿童及其能力，针对外部因素（如环境和机会支持及障碍）的则极少；此外，由于流程常需修改，其可能无法准确测量言语和运动功能受限儿童的能力。康复启示：若缺乏覆盖AAC参与模型所有领域的充分评估实践，临床医生可能难以提供全面的AAC服务；未来研究应聚焦于开发评估儿童机会及环境支持与障碍的实践方法；需制定更易被言语和运动功能受限儿童接受的评估实践。若缺乏覆盖AAC参与模型所有领域的充分评估实践，临床医生可能难以提供全面的AAC服务；未来研究应聚焦于开发评估儿童机会及环境支持与障碍的实践方法；需制定更易被言语和运动功能受限儿童接受的评估实践。