Purpose: There are few measurement tools or frameworks for profiling the communication skills and generating diagnostic profiles of children who use augmentative and alternative communication (AAC). These children are particularly difficult to assess because they do not use speech for expression but instead use a variety of non-speech behaviors and devices to communicate. Diagnostic frameworks would not only assist educators with accurately assessing the children's educational and developmental needs and skills, they also would help educators document appropriate Individualized Education Program goals and target interventions to a child's unique profile.

The purpose of this project is to develop such a diagnostic framework, the Augmentative and Alternative Communication—International Classification of Function. The framework will tailor the International Classification of Function—Children & Youth to profile the skills and needs of children who use AAC. The International Classification of Function—Children & Youth is a coding scheme that is used in clinical and research settings to describe and measure children's health and disability. The researchers plan to extract items from the International Classification of Function—Children & Youth that are most relevant to communication skills of AAC users and can be used to create diagnostic profiles. In addition, the researchers will further develop the framework to be responsive to changes in the children's environment and development of new skills. Child profiles that are obtained through the new framework will be used to match instruction to children's communication strengths and needs, with the goal of improving communication outcomes.

Project Activities: During the first two years, the Augmentative and Alternative Communication—International Classification of Function measure will be developed and its inter-rater reliability will be examined. The measure will be comprised of items from the International Classification of Function—Children & Youth that are related to children's communication skills and use of assistive devices to support communication. In the second year, the researchers will also examine the utility of the measure for developing Individualized Education Program goals. During the last two project years, a final version of the Augmentative and Alternative Communication—International Classification of Function will be developed and field-tested.

Products: The project will result in a new framework, Augmentative and Alternative Communication—International Classification of Function, which will profile AAC users' skills and needs. Other products include publications and presentations related to the development and utility of the framework.

Setting: The research will occur in elementary, middle, and high schools throughout the United States.

Population: Approximately 600 special educators and speech-language pathologists from elementary, middle, and high schools will participate in the field testing of this new framework. The educators will have on their caseload at least one student who is an AAC user.

Research Design and Methods: An iterative process for assessment development will be implemented. During the first two years, the Augmentative and Alternative Communication—International Classification of Function measure will be developed. The measure will be comprised of items from the International Classification of Function—Children & Youth that are related to children's communication skills and use of assistive devices to support communication. Participants will use the new framework to profile the needs of one of their students, and the inter-rater reliability of the new profile will be examined. In the second year, the researchers will examine the utility of the framework for developing Individualized Education Program goals. During the last two project years, a final version of the Augmentative and Alternative Communication—International Classification of Function will be developed and field tested with educators from elementary, middle, and high schools.

Key Measures: The researchers will collect data on the consistency of paired evaluators using the diagnostic profile. In addition, data will be collected on parents' satisfaction with Individualized Education Program goals created using the framework and teachers' satisfaction with the utility of the framework.

Data Analytic Strategy: A series of analytic procedures, including hierarchical linear modeling, will be used to evaluate the inter-rater reliability of the Augmentative and Alternative Communication—International Classification of Function and the quality of Individualized Education Program goals derived from using the measure.

Assessment: The Augmentative and Alternative Communication—International Classification of Function

Control Condition: During year two, the researchers will evaluate the quality of IEP goals derived using the ICF-CY for AAC profile. Participants will be randomly assigned to develop IEPs using the ICF-CY for AAC or to develop them as usual.

Products and Publications

Journal article, monograph, or newsletter

Clarke, M., Newton, C., Petrides, K., Griffiths, T., Lysley, A., and Price, K. (2012). An Examination of Relations Between Participation, Communication and age in Children With Complex Communication Needs. Augmentative and Alternative Communication, 28(1): 44–51. doi:10.3109/07434618.2011.653605

Ellingsen, K.M., and Simeonsson, R.J. (2011). WHO ICF-CY Developmental Code Sets. Full text

Fried-Oken, M., and Granlund, M. (2012). A Good fit to Emphasize Outcomes. Augmentative and Alternative Communication, 28(1): 1–2. doi:10.3109/07434618.2011.652782

Klang, N., Rowland, C., Fried-Oken, M., Steiner, S., Granlund, M., and Adolfsson, M. (2016). The Content of Goals in Individual Educational Programs for Students With Complex Communication Needs. Augmentative and Alternative Communication, 32(1): 41–48. doi:10.3109/07434618.2015.1134654

Murphy, J., and Boa, S. (2012). Using the WHO-ICF With Talking Mats to Enable Adults With Long-Term Communication Difficulties to Participate in Goal Setting. Augmentative and Alternative Communication, 28(1): 52–60. doi:10.3109/07434618.2011.653828

Pless, M., and Granlund, M. (2012). Implementation of the International Classification of Functioning, Disability and Health (ICF) and the ICF Children and Youth Version (ICF-CY) Within the Context of Augmentative and Alternative Communication. Augmentative and Alternative Communication, 28(1): 11–20. doi:10.3109/07434618.2011.654263

Raghavendra, P., Olsson, C., Sampson, J., McInerny, R., and Connell, T. (2012). School Participation and Social Networks of Children With Complex Communication Needs, Physical Disabilities and Typically Developing Peers. Augmentative and Alternative Communication, 28(1): 33–43. doi:10.3109/07434618.2011.653604

Rowland, C., Fried-Oken, M., Steiner, S.A.M., Lollar, D., Phelps, R., Simeonsson, R., and Granlund, M. (2012). Developing the ICF-CY for AAC Profile and Code Set for Children Who Rely on AAC. Augmentative and Alternative Communication, 28(1): 21–32. doi:10.3109/07434618.2012.654510

Rowland, C., Quinn, E.D., and Steiner, S. (2015). Beyond Legal: Crafting High-Quality IEPs for Children With Complex Communication Needs. Communication Disorders Quarterly, 37(1): 53–62. doi:10.1177/1525740114551632

Sanches-Ferreira, M., Simeonsson, R.J., Silveira-Maia, M., Alves, S., Tavares, A., and Pinheiro, S. (2013). Portugal's Special Education Law: Implementing the International Classification of Functioning, Disability and Health in Policy and Practice. Disability and Rehabilitation, 35(10): 868–873. doi:10.3109/09638288.2012.708816

Simeonsson, R., Bjorck-Akesson, E. and Lollar, D. (2012). Communication, Disability, and the ICF-CY. Augmentative and Alternative Communication, 28(1): 3–10. doi:10.3109/07434618.2011.65382

Stahl, Y., Granlund, M., Simeonsson, R., Andersson Gare, B., and Enskar, K. (2013). Psychological Health Information in Free Text Notes of Swedish Children's Health Records. Scandinavian Journal of Caring Sciences, 27(3): 616–623. doi:10.1111/j.1471–6712.2012.01059.x