AAC for Landau-Kleffner Syndrome: Questions for an AAC Evaluation

Planning AAC for Landau-Kleffner syndrome begins with the person’s communication needs, not a device or a preset list of words. The person may communicate differently across activities, partners, and environments, so a useful evaluation asks what helps them understand, express themselves, make choices, and take part in daily life. This guide offers questions for caregivers and professionals to discuss with a speech-language pathologist (SLP) and other relevant team members. It is educational information, not a diagnosis or treatment recommendation.

device trial information can help the team understand the distinctions.

A trial may also expose practical setup questions. Who charges the equipment? Where is it stored when not in use? Who can position it safely? Does the person need it available in more than one room? Who has permission to change vocabulary or settings? Which partners should know how to turn it on or locate the person’s frequently used messages? Assigning these responsibilities in advance prevents basic logistics from obscuring what the team is trying to learn.

If an initial trial does not go as expected, identify the specific barrier before deciding what the result means. Was the activity unfamiliar? Was the device placed out of reach? Did partners ask too many questions or move on too quickly? Was the vocabulary not relevant? Did the person have an alternative way to say no or request a change? Naming a concrete barrier gives the team something to adjust and retest, instead of treating one session as a final verdict.

How can caregivers, educators, and professionals collaborate?

The person should be central to planning. Family members, caregivers, teachers, SLPs, and other assistive-technology professionals may each have useful observations. A medical care team can coordinate with communication professionals where appropriate, but AAC planning is not a substitute for medical advice and should not be used to infer a diagnosis or treatment effect. Clear roles help everyone contribute without assuming that one person has the whole picture.

At the start of the discussion, agree on who is responsible for which next steps. One person might gather examples from home. An educator might note communication opportunities during a group routine. The SLP might coordinate evaluation activities and discuss language or access. Another professional might help consider positioning or equipment logistics. The person using AAC should be included in each decision to the extent possible, with communication supports that make participation accessible.

Use a communication profile to share practical information across settings. Keep it brief enough that partners will read it. It might describe how the person currently communicates, what they are interested in, how they show yes or no, what helps them have enough time, what to do when a message is unclear, and how to locate backup communication tools. Include a date and a way to update it. Avoid private details that partners do not need to support communication.

Partners may need different approaches for different situations. At home, a familiar person may understand a gesture that a new partner does not recognize. In a classroom, the person may need a board or device positioned consistently. On a community outing, portability and noise may matter. Coordination does not mean forcing identical methods everywhere; it means helping the person’s communication remain available and helping partners respond respectfully in each setting.

Agree on a simple routine for communicating updates. For instance, caregivers and educators could share a short note when a new message is especially useful, when a system was unavailable, or when the person expressed a clear preference. The purpose is to notice patterns and make adjustments, not to create a daily data burden. If frequent logs are not useful or realistic, a brief review at an agreed interval may be better.

Discuss how partners can handle communication breakdowns. A practical shared plan could be: pause, acknowledge that the message was not understood, offer the person a chance to try another method, ask a respectful clarifying question, and check that the proposed interpretation is correct. Do not repeatedly guess while the person has no way to correct the guess. Make sure the person has ways to say “no,” “not what I meant,” or “try again,” and treat those messages as meaningful.

Plan for access even when a primary device is unavailable. Depending on the person, a backup could be a familiar low-tech board, written choices, gestures, or another method already used by the person. A backup should be accessible, stored where it is needed, and understood by communication partners. It complements the main plan; it is not a reason to withhold the person’s preferred communication system. Ask who will prepare it, how it will be kept available, and how partners will support it.

Collaboration also includes checking assumptions. If one partner reports that a person “does not understand” or “is not interested,” ask what observable event led to that conclusion. Was the person offered a way to respond? Was there enough time? Did the partner present an accessible choice? Could another meaning explain the behavior? This does not invalidate a partner’s concern. It turns the concern into a clearer question the team can examine with the person.

What should families ask about device options and practical fit?

Device selection is one part of an evaluation, not the starting point or the only decision. Ask the SLP and specialist to explain why a particular family or configuration is being explored in relation to the person’s goals, access, language, and settings. Find out which features matter for the evaluation and which are simply available. A feature list is useful only when the team can connect each feature to a real communication need.

For example, portability may matter if the person communicates across several rooms or locations. A larger display may make some layouts easier to see, but a larger device may also change how it can be positioned or carried. A particular access option may be relevant, but it must be considered for the specific model and configuration. A tablet-based device can offer flexibility, but software compatibility, device settings, and intended use all need to be checked. The point is to compare real-world fit, not assume that more features automatically mean a better match.

Use a simple comparison conversation. For every option, ask: What communication goal is this option meant to support? What evidence from the person’s routines suggests it could help? What will the person need to do physically and visually to access it? What must partners learn? What could make it hard to use? What other method should remain available? These questions make it easier to compare an option that is technically impressive with one the person can actually use in the settings that matter.

Consider reliability and setup as well as the device itself. How will it be charged? Is the sound appropriate for the environment? Can the device be positioned safely and comfortably? What happens if the person moves between activities? Are there accessories that need to be evaluated with the device, and has compatibility been confirmed? Who can resolve a technical problem? These are not minor details: a system that is out of reach, uncharged, or difficult to set up may not be available when the person wants to communicate.

Discuss communication software separately from hardware. Ask which language system is being considered, how it supports the person’s messages, what changes can be made, and what the person and partners will need to learn. Do not assume an app works on every device. Forbes AAC describes ProSlate as an iOS family and WinSlate as a Windows family, with model-specific access and software options. The names alone do not establish compatibility for every application, accessory, or feature. Verify the configuration under consideration with the relevant professionals.

Also be precise about use beyond communication. Dedicated speech-generating devices may have restrictions on non-covered features, and the available capabilities depend on the product and payer context. Do not promise that every app, web function, email, or text feature will be available on a funded device. Ask which functions are included, which require separate configuration or authorization, and which may not be part of the intended setup. Confirm specifics rather than relying on broad marketing language.

How do trial, funding, and purchase questions differ?

Families and professionals may encounter several separate processes, so it helps to name which question is being addressed. An evaluation asks what communication supports may fit. A device trial lets a team explore a configuration under defined conditions. Funding questions concern payer-specific requirements and documentation. A direct-pay purchase involves a sales-assisted quote. One process does not guarantee a particular outcome in another.

If an SLP is considering a clinician-held loan, ask what equipment is available, what credentials or information are needed, how long a loan may last, where it may be used, and who is responsible for it. The standard term described for this type of equipment loan is up to four weeks, subject to availability and limitations; the equipment stays with the SLP. Confirm current terms before planning an evaluation around a loan.

If the person’s SLP is considering a home trial, ask what steps must happen first and who initiates each step. The home trial process described by Forbes AAC begins with the SLP and a benefits check. It is not an automatic home loan for any interested family. A coverage check or an authorization code should not be confused with a guarantee that a payer will cover a purchase. Confirm the terms and timing directly with the appropriate parties.

For a funding request, ask the payer or funding team which documentation is required, who completes it, how the packet is submitted, and what happens if information is missing. Coverage and documentation depend on the payer, state, and individual circumstances. No device or service should be described as universally covered, and a benefits check does not guarantee payment. Forbes AAC’s Funding Portal describes its documentation workflow; use it as a starting point for current instructions, not as a promise of approval.

Direct-pay buyers, including schools, VA hospitals, loan libraries, and other organizations, should distinguish a quote request from a public checkout. Forbes AAC’s process is sales-assisted. Ask for a quote that specifies the proposed configuration, any accessories, the relevant terms, and what information the buyer must provide. Do not assume a public price list, stock status, or delivery date. Those details should be confirmed for the actual order.

Whichever path applies, ask practical support questions before committing: What training is available? Who should be contacted for technical help? What are the repair and return conditions? Which warranty terms apply to the specific model and purchase date? Are accessories covered under separate terms? Policies may differ by product and other conditions, so request the current terms for the exact configuration rather than relying on a general statement.

It can help to write a short “process map” with four columns: the question, the person responsible, the next action, and the information still needed. For example, the SLP may be responsible for clarifying the evaluation loan; a caregiver may collect examples from home; a funding team may explain required documents; and a school buyer may request a quote. A visible map prevents a family from mistaking an evaluation step for a purchasing decision or assuming that one person has completed a task assigned to someone else.

How can the team review and adapt the plan?

A communication plan should be revisited as activities, preferences, and practical circumstances change. Agree on a review point before the trial or evaluation ends. It could follow a set of planned activities or a specific period of use, depending on the process. At that review, ask what the person wants to keep, change, or stop; whether the goals still matter; and whether communication is easier to access in the routines that were chosen.

Look for patterns across people and settings, not isolated successes or difficulties. If a person communicates effectively with one partner but not another, examine what each partner does differently. If a system works at a table but not during a transition, consider positioning, availability, time, and the communication demands of the transition. If a word is hard to find, ask whether layout, vocabulary, or partner familiarity may be relevant. The aim is to understand the conditions that support communication.

Review whether the person has enough ways to communicate different kinds of messages. Can they express preferences and refusals? Can they make comments, ask questions, and repair a misunderstanding? Is there a route for communicating an unanticipated idea? Are familiar words available when the person needs them? These are more useful questions than simply asking how many buttons or words are on a screen.

Check that the communication partners remain part of the plan. A system can become less useful if it is not available, if partners do not know how to support it, or if vocabulary no longer fits the person’s activities. Ask what training or reminders would help, who will update the communication profile, and how new partners can be included. Keep roles realistic: one person should not be expected to manage every device, setting, and partner alone.

If the plan is not working, choose one specific barrier and one next action. “The person is not using AAC” is too broad to guide a change. A more actionable observation might be “the device is not positioned near the person during the activity,” “the available choices do not include a way to decline,” or “partners move on before the person has time to respond.” Decide who can address that barrier and when the team will check whether the adjustment helped.

It is equally important to notice what is working. If a person uses a familiar gesture, symbol, message, or device feature to make a choice, document the conditions that made it accessible. Share the helpful routine with other partners, while checking that the person is comfortable with the strategy. Small, repeatable improvements can matter more than an ambitious plan that nobody can maintain.

Questions to bring to an AAC evaluation

Use this list as a starting point and select the questions that fit the person and meeting. The person’s own priorities should shape which questions come first.

• Which communication situations matter most to the person at home, school, work, or in the community?

• What messages does the person want to express beyond requests, including refusal, comments, questions, and repair?

• How can the person show a preference, say no, or ask for more time during the evaluation?

• What communication methods are already useful, and in which settings or with which partners?

• Which access approaches should be explored, and how will the team consider comfort, position, effort, and setting?

• What language options support familiar routines and new ideas, and how can the person communicate something unexpected?

• How will partners model communication, wait for responses, and respond when they do not understand?

• What specific question will each trial activity help answer?

• Who will record observations, include the person’s preferences, and share information across settings?

• Which trial pathway applies, who initiates it, and what are its current conditions?

• What funding documents or direct-pay quote details are relevant, and who can confirm them?

• What training, technical support, and backup communication methods should be planned?

• When will the team review the plan, and how can the person ask for a change?