Abstract
The purpose of this article is to provide speech-language pathologists with a systematic decision-making process to guide evaluation and implementation of augmentative and alternative communication (AAC) systems and strategies for persons with dysarthric speech. Three cases are described, which are combined profiles of different clients with similar etiologies and communication challenges. Clinicians are guided to consider whether the underlying condition is temporary or permanent and the prognosis for improved speech. Prognoses may be chronic and stable, improving, or there may be an expectation of deterioration of speech and overall health. Clinicians are guided to consider the communicator's attitude and motivation and to identify communication partners and their motivation to achieve better communication. The contributions of various speech intelligibility and effectiveness measures are considered, as well as the specific need to evaluate language, literacy, and symbolic understanding. The decision process leads to high-tech and low-tech AAC strategies for each case.
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