Someone has suggested your child get an AAC evaluation. Maybe it was their pediatrician, a therapist, or a teacher. Or maybe you've been researching what AAC is on your own and decided it's time to take the next step.
Either way, walking into your first evaluation can feel uncertain. What will they do? How should you prepare? What if the evaluator recommends something you don't agree with?
Here's what actually happens, from start to finish.
Who Conducts the Evaluation?
An AAC evaluation is typically led by a speech-language pathologist (SLP) with specialized training or experience in AAC. This is important. Not every SLP has deep AAC expertise. If you have the option to choose, look for:
- An SLP who lists AAC as a clinical specialty or area of focus
- Experience with a range of AAC systems (not just one app or brand)
- Experience working with your child's age group and diagnosis
- ATP certification (Assistive Technology Professional), which indicates additional AT training
In some settings, the evaluation team also includes an occupational therapist (to assess motor skills and positioning) and an assistive technology specialist (particularly in school-based evaluations).
Before the Evaluation: How to Prepare
Preparation makes a real difference. The evaluator needs information from you that they can't get anywhere else.
Gather your observations
Write down (or record video of) how your child currently communicates. Be specific:
- What do they communicate? Requests, protests, greetings, comments?
- How do they communicate? Pointing, pulling your hand, crying, using a few words, using signs, using an app?
- Who do they communicate with most? You, siblings, therapists, specific teachers?
- What frustrates them most? When can't they get their message across?
- What motivates them? Favorite foods, toys, activities, people?
Bring relevant documents
- Any existing therapy reports (speech, OT, developmental evaluations)
- IEP or IFSP (Individualized Family Service Plan) if applicable
- Medical records related to the communication difficulty
- A list of words or signs your child currently uses
Plan the timing carefully
Schedule the evaluation for when your child is typically at their best. For most toddlers and young children, that means morning or right after a nap. A hungry, tired child will not demonstrate their true abilities. If traveling to a clinic is difficult, ask whether a virtual evaluation is available. AAC evaluations conducted via teletherapy have become increasingly common and can be a practical option for families with limited local access to AAC specialists.
Bring comfort items and motivators
If your child has a favorite toy, snack, or comfort object, bring it. The evaluator may use motivating items to elicit communication attempts. The more comfortable your child is, the more accurate the evaluation will be.
During the Evaluation: What They Assess
An AAC evaluation is not a pass/fail test. There is no score and no threshold your child needs to meet. The evaluator is trying to understand your child's communication profile so they can recommend the best tools and strategies. Here is what they typically look at.
Current communication skills
The evaluator will observe how your child communicates right now. They'll note:
- Intentional communication (does the child direct behaviors toward a communication partner?)
- Types of communication functions (requesting, protesting, commenting, greeting)
- Existing modalities (speech, gestures, sign, existing AAC use)
- Comprehension of language (how much does the child understand?)
Motor skills and access
How will your child physically interact with an AAC system?
- Can they point or tap a screen accurately?
- How large do targets need to be?
- Do they need a keyguard (a physical overlay that prevents accidental hits)?
- Would an alternative access method be needed, such as switches or eye tracking?
The occupational therapist may assess positioning, seating, and hand function during this part.
Visual and cognitive skills
- Can the child match a symbol to its meaning?
- Do they understand that pictures represent real objects or actions?
- Can they scan across a grid to find what they're looking for?
- How many items can they process on a screen at once?
Trial with AAC systems
This is the most hands-on part. The evaluator will introduce your child to one or more AAC systems and observe how they respond. They might try:
- A simple communication board with 4 to 6 symbols
- A tablet-based app with different grid sizes
- Different symbol sets (photos, line drawings, text)
- Different access methods if standard touch isn't working
They're watching for which system the child engages with most, which layout supports the most successful communication, and which features matter most for your child's specific profile.
Family interview
The evaluator will ask you questions about:
- Your child's daily routines and where communication breakdowns happen most
- Your family's technology comfort level and preferences
- Environmental factors (Wi-Fi availability, school setting, who the communication partners are)
- Your goals for your child's communication
- Any concerns you have about specific AAC approaches
Be honest during this interview. If you're worried about screen time, say so. If your family speaks multiple languages, that matters. If you've tried an AAC app before and it didn't work, explain what happened. This information shapes the recommendation.
After the Evaluation: What Happens Next
The recommendation report
Within a few days to a few weeks (depending on the setting), you'll receive a written report. It typically includes:
- A summary of your child's current communication abilities
- Results from the AAC trials
- A recommended AAC system (specific app or device)
- Recommended vocabulary and layout as a starting point
- Suggested grid size and access method
- Goals for AAC implementation
- Recommendations for training (for you and for school staff)
Understanding the recommendation
The report may recommend a specific app, a dedicated device, or a combination of strategies. If the report uses terminology you're not familiar with, our AAC glossary covers the most common terms in plain language. Here are common outcomes:
A tablet-based AAC app (like SabiKo) for children who can use a touchscreen and whose families have or can obtain a tablet. This is the most common recommendation for children without significant motor challenges.
A dedicated speech-generating device for children who need specialized hardware, alternative access methods (eye tracking, switches), or whose insurance will cover a dedicated device but not a tablet app.
A low-tech system as a supplement or starting point, especially for very young children or situations where devices aren't practical.
A multimodal approach combining sign language, low-tech boards, and a high-tech app. This is increasingly common and well-supported by research.
Insurance and funding
If a dedicated device is recommended, it may be covered by health insurance or Medicaid. The evaluation report serves as the justification for medical necessity. Your SLP can help with the documentation required for funding. Our AAC funding guide walks through the process in detail.
For tablet-based apps, insurance coverage varies. SabiKo is free, which removes the cost barrier entirely.
If the evaluation was conducted through the school, the school district may be responsible for providing the recommended device as part of the IEP.
Implementation and training
The recommendation is just the beginning. What matters most is what happens next:
- You learn the system. Spend time exploring the app or device before introducing it to your child. Know where the words are.
- You start modeling. Use the AAC system during daily routines, tapping symbols as you speak.
- Your child's team gets trained. Teachers, therapists, and caregivers need to know how the system works and how to support your child in using it.
- Follow-up appointments. Most SLPs will schedule follow-up sessions to adjust the vocabulary, grid size, and implementation plan as your child progresses.
What If You Disagree with the Recommendation?
It happens. Maybe the evaluator recommended a system you've tried before that didn't work. Maybe they suggested waiting when you feel your child is ready now. Maybe the recommended app doesn't fit your family's needs.
You have options:
- Discuss your concerns directly with the evaluator. A good SLP will listen and may adjust their recommendation.
- Get a second opinion. You are always entitled to seek another evaluation from a different professional.
- Request an Independent Educational Evaluation (IEE) if the evaluation was done through the school and you disagree with the findings.
- Start with what works for your family while continuing to work with the professional team. If the evaluator recommended a system but you've had success with SabiKo at home, share that data and advocate for what's working.
The Most Important Takeaway
An AAC evaluation is not a gate you must pass through. It's a tool to help you and your child's team make informed decisions. The evaluation doesn't determine whether your child "qualifies" for AAC. Everyone who needs communication support qualifies.
If you're waiting for an evaluation, you don't have to wait to get started. When the evaluation happens, you'll walk in with real experience and valuable observations that make the whole process more productive.
Download SabiKo free and start exploring AAC before your evaluation.
References
- Beukelman, D.R., & Light, J.C. (2020). Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs (5th ed.). Paul H. Brookes.
- Dietz, A., Quach, W., Lund, S.K., & McKelvey, M. (2012). AAC assessment and clinical-decision making: The impact of experience. Augmentative and Alternative Communication, 28(3), 148-159.
- Zabala, J.S. (2005). Using the SETT framework to level the learning field for students with disabilities. Governor's Alliance of Technology and Education.