The complex relationships between best practice, augmentative and alternative communication assessments, and organizational change

Abstract

Current anecdotal evidence suggests that speech-language pathologists (SLPs) encounter barriers when attempting to complete comprehensive augmentative and alternative communication (AAC) assessments for persons with complex communication needs; however there is no reported research about how SLPs overcome these barriers. In addition, there is a paucity of research surrounding speech-language pathologists and their views about creating meaningful change in their work environments. The purpose of the current study was to a) identify specific barriers that are present for SLPs when completing comprehensive AAC assessments, b) identify SLPs' individual beliefs about the AAC assessment process, c) identify SLPs' beliefs about organizational change as it affects the AAC assessment process, d) identify strategies that might assist SLPs in implementing change to their current AAC assessment practices, and e) identify guiding principles that SLPs enact when creating change. Through the study barriers were identified, it was determined that SLPs feel that the AAC assessment process is complex and requires internal, external, and mental effort, SLPs believe that change in their organization in regard to current AAC practices are needed, that their organization is capable of making changes, and that their organization supports a change. Successful change strategies and guiding principles for making change were also identified. These findings suggest that change in regard to how SLPs currently perform AAC assessments should and could be addressed. A proposed model for creating meaningful change, the Decision-Making Map for Changing AAC Assessment Practices (DMMCAACAP) was proposed as well as a step-by-step process for SLPs to begin to enact change.