by Penny Tonn, MS, CCC-SLP (Speech-Language Pathologist); NWACS Contributor & Cassandra Stafford, MS, CCC-SLP/L, ATP (Speech-Language Pathologist and Assistive Technology Professional), NWACS Board Member

The process of receiving services can be daunting. Add in the potential need for Augmentative and Alternative Communication (AAC), many questions may come up while finding your loved one the support they need, regardless of their age. Below is a crash course on the process of getting a referral for an AAC evaluation with a specialized provider.

Is AAC appropriate for my loved one?

AAC is appropriate for anyone who is not able to meet all of their communication needs through spoken language. This may include someone who has difficulty using or understanding language, is minimally verbal, or who speaks but has difficulty being understood by others. AAC can be a temporary or long term solution and can be a great tool for learning and using language across the lifespan.

Yes! It looks like my loved one could use AAC! How do I start the referral process?

There is no one path to getting an AAC evaluation. How you proceed may depend on several factors, including the age of your loved one, how the evaluation (and AAC system) will be paid for, and the setting in which services will be provided.

Possible starting places include (look for the age group of your loved one below):

I am looking for AAC for my young child who is not yet in school.

• If your child is preschool age or younger and you suspect that they would benefit from AAC, a good starting place is seeking early intervention services (if your child already receives these services, start a conversation with your provider about your interest in an AAC evaluation):

  • Birth to Three (click to learn more and for contact information)

  • Three years and older - contact your local school district’s “Child Find” program

• You may also choose to explore services through a private provider paid either through your insurance (if the provider accepts your insurance) or through other funds (such as private pay, grants). Such SLPs may be in private practice, based in a clinic, part of a university program, or at a local hospital. In some cases you can self-refer (the provider will then let you know if you need to call your child’s pediatrician for a referral or prescription for an evaluation). If you plan to use your insurance, it is a good idea to research what your insurance plan does and does not cover (this can vary from plan to plan with the same insurer), and any needed preauthorization/pre-certification.

• Your child’s pediatrician may be able to help you locate a speech-language pathologist (SLP) with experience in AAC. Word of mouth (e.g., from other families) can also be helpful in finding an SLP who specializes in AAC.

Then, schedule an appointment with an SLP who specializes in AAC. The provider you are scheduled to see may ask for additional information about your child, such as vision, fine or gross motor skills, early intervention services, and more. This will give the provider a thorough view of what supports your child may need.

Pro Tip: You will also want to ensure that you can be trained in strategies to support language development and AAC use at home!

I am looking for AAC for my school-age child.

• Speak with your child’s school providers, including teachers, special educators, SLP, or behavior analyst. Discuss with them your interest in using AAC to support your child’s learning and communication development. There may be a school SLP who is versed in AAC who is already providing services to your child on a regular basis who can guide you in establishing an effective communication system!

• You may need (or choose) to seek out an evaluation from an outside (community-based) provider. You can do this in different ways:

  • Call your child’s pediatrician and request a referral for an evaluation with an SLP for AAC. Often an insurance company will require a prescription from the doctor for an AAC evaluation (and possibly a preauthorization or pre-certification) which will allow you to be seen by an SLP who can assess your child’s unique needs.

  • You can try asking your child’s teacher (or other provider) to see if they have recommendations for a community-based provider. They may or may not be able to provide you with suggestions.

  • Directly contact a private/community-based SLP who provides AAC evaluations. Such SLPs may be in private practice, based in a clinic, part of a university program, or at a local hospital. If you plan to use your insurance, it is a good idea to research what your insurance plan does and does not cover (this can vary from plan to plan with the same insurer), and any needed preauthorization/pre-certification.

• If your child has a case manager with the Developmental Disabilities Administration (DDA), they can also be a good resource to talk with about your desire to get an AAC evaluation for your child.

Then, schedule an appointment with an SLP who specializes in AAC. The provider you are scheduled to see may ask for additional information about your child, such as vision, fine or gross motor skills, school IEP, other therapies, and more. This will give the provider a thorough view of what supports your child may need.

Pro Tip: Collaboration with the school team and the community-based/private providers will be a powerful tool to support your child’s communication!

I am looking for AAC for an adult.

Obtaining a referral for an adult loved one may require accessing the medical system in a savvy way. If your loved one is already receiving services, such as occupational therapy, physical therapy, or speech language therapy, discuss your concerns and wish to explore AAC with the provider(s) and seek out a referral for an AAC evaluation. If you plan to use insurance (including Medicare or Medicaid), it is a good idea to research what your insurance plan does and does not cover (this can vary from plan to plan even with the same insurer), and any needed preauthorization/pre-certification.

• If the adult has acquired communication difficulties due to a neurological event (such as stroke) or a degenerative disease (such as ALS), a complete evaluation may be necessary to determine needed communication supports in relation to the diagnosis and prognosis. This referral will require documentation of a medical diagnosis and a reason of medical necessity for the requested evaluation.

• If the adult has an intellectual/developmental disability (IDD), a good place to start is with current team member supporting the adult (e.g., program managers, current therapy providers, DDA case manager). Depending upon your adult loved one’s funding source, you may also be able to self-refer to an SLP specializing in AAC. Such SLPs may be in private practice, based in a clinic, part of a university program, or at a local hospital.

Then, schedule an appointment with an SLP who specializes in AAC. The provider you are scheduled to see may ask for additional information about your loved one, such as vision, fine or gross motor skills, diagnosis, other therapies, and more. This will give the provider a thorough view of what supports your loved one may need.

Pro Tip: It is never too late, and no one is ever too disabled (or old, or anything) to benefit from AAC!

Additional information to note:

In many instances, regardless of age, the referral may require documentation of the individual’s current communication system and the need (or medical necessity) for finding an alternative system. AAC providers often have specific forms that they will require you to complete to gather information, such as regarding sensory abilities, literacy abilities, psychosocial factors, available support systems, or previous communication systems and outcomes.

Other paths for obtaining an AAC referral may present themselves as you make attempts. No matter the path that you take, support for your loved one is key. Be persistent and provide plenty of information to your providers to indicate a need for AAC. Collaboration between providers, caregivers, and patients is crucial.

What other processes have you experienced in seeking out an AAC referral? Share your experiences in the comments or the NWACS Facebook page!