AAC for Prader-Willi Syndrome: Communication Planning Guide

Planning AAC for Prader-Willi syndrome starts with a person, not a diagnosis or device. An evaluation can help the person, family, speech-language pathologist (SLP), and other team members describe what communication needs to do across daily life, then explore systems and supports that fit those needs. This guide offers practical questions to bring to that conversation. It does not prescribe a device, predict an outcome, or guarantee funding.

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What should an AAC evaluation help us decide?

An evaluation is a collaborative process for understanding communication needs and comparing possible supports. The goal is not to pass a test or prove that someone deserves a device. It is to gather information about how the person communicates now, what they want to communicate, and what may make communication easier in situations that matter to them.

Augmentative and alternative communication (AAC) can include unaided methods, such as gestures or facial expressions, and aided supports such as pictures, communication boards, speech-generating devices, and software. A person may use more than one method. They might point to a picture in one setting, use a device in another, and rely on a familiar partner who understands their signals in a third. An evaluation should explore this range rather than assume one product or method must replace everything else.

Before the meeting, ask who will lead the evaluation and who should contribute. The person using AAC is central, even if they need support to share preferences. Family members, caregivers, teachers, support staff, and clinicians can describe different routines. Their observations add context; they should not speak over the person whenever the person can communicate for themselves. Ask how the person will be offered time, accessible choices, breaks, and a way to decline or change the activity.

Useful opening questions include:

• What decisions are we hoping to make, and what will remain open for later?

• How will the person show preferences, discomfort, interest, or a wish to stop?

• Which people and settings should be represented?

• How will we record what works, what is difficult, and what needs more trial time?

• What information can the person share directly, and what can partners add from observation?

A useful evaluation may lead to more questions rather than an instant choice. That is progress when the next question is specific and the team has a plan to answer it. Ask for a plain-language description of each proposed next step, who will take it, and what information would help resolve uncertainty.

How do we describe the person's communication now?

Begin with what the person already does to communicate, including signals that may not be obvious to everyone. A person may use speech, vocalizations, movement, facial expression, gestures, objects, writing, pictures, or a communication system. A familiar partner may recognize a signal that a new partner misses. The evaluation can identify these methods and consider how communication can be understood across partners and situations.

Bring examples instead of relying only on broad labels. Describe the setting, communication partner, message, and what happened next. Note whether the person reached toward an item, looked between choices, used a gesture, selected a symbol, or spoke. Record whether the partner understood and what helped when they did not. An unfamiliar message is not the same as an absent message; the person may need more time or a partner who knows how to observe and confirm signals.

A short observation log can make the meeting more concrete. For a few days, write down naturally occurring moments rather than creating a testing schedule. For example: “At breakfast, when offered two cups, Sam looked toward the blue cup, then pushed the other cup away. The caregiver named the choice and waited; Sam reached toward blue.” This describes an event and a possible interpretation without claiming certainty. The team can ask how Sam might confirm, reject, or clarify that interpretation.

A brief communication snapshot can include:

• Current methods:

  What does the person use, including methods understood mainly by familiar partners?

• Messages understood:

  Which messages are recognized reliably and which are often missed?

• Context:

  What changes across home, school, community, work, or care routines?

• Preferences:

  What signals interest, refusal, humor, attention, fatigue, or a wish to change activity?

• Helpful conditions:

  What positioning, pace, materials, or partner behavior seems to help?

• Repair:

  What happens when the partner gets the message wrong, and what helps the person try again?

Keep notes descriptive rather than judgmental. Instead of writing that someone “does not cooperate,” describe the activity, how it was presented, what the person did, and whether a pause or different format changed the interaction. This gives the team information it can use without guessing at a motive. It also helps avoid confusing a mismatch in timing, access, or understanding with a lack of communication intent.

Ask whether the evaluation will consider communication partners who know the person well and partners who are less familiar. A method that works only with one person may still be valuable, while the team can also explore ways to make messages more accessible to others. Note what partners do: Do they ask one question at a time? Do they wait? Do they confirm an interpretation without insisting? Partner behavior is part of the communication environment, not a side issue.

Which situations should we bring to the meeting?

List situations in which the person needs or wants to communicate, not only activities adults think should be practiced. Consider a morning routine, a meal, a conversation with a friend, a class activity, an appointment, a community outing, or time alone. The person may want to ask questions, make comments, tell a story, joke, disagree, or talk about a topic that is not part of a planned lesson.

Ask what happens when the person wants something out of sight. How do they indicate no, not that, wait, help, or I changed my mind? How do they get attention, share information, repair a misunderstanding, or continue a conversation? These questions keep planning from focusing only on requests. A system should also make room for social connection, personal opinions, and messages that are not predictable in advance.

Choose a few important settings and identify communication opportunities in each. During a shared activity, the person might want to choose, comment, ask for help, reject an option, or invite someone to join. During a community visit, they may want to greet someone, ask a question, share a preference, or express discomfort. These are discussion prompts, not requirements every person must meet.

For each situation, ask who is present, what messages the person may want to send, what access conditions are available, and who can help keep communication supports within reach. Include a situation that is already going well. Existing successes show what the person and partners know how to do. An evaluation is not a reason to discard effective communication strategies.

It can help to describe one situation in detail using a simple sequence:

1. Before:

   What is happening, where is the person, and what communication materials are nearby?

2. Opportunity:

   What might the person want to say or ask, including a message adults cannot predict?

3. Access:

   What movement, positioning, sensory conditions, or time is available?

4. Partner response:

   What does the other person say or do, and how long do they wait?

5. After:

   How can the person signal that the message was understood, misunderstood, or no longer relevant?

For example, a family might describe a weekly visit with a relative. The person greets the relative through a familiar gesture, but has difficulty joining a conversation when the topic changes. The evaluation can explore whether a portable board, a device, or partner strategies could support greetings, comments, questions, and topic changes. It should not conclude from one visit that a particular system will work in every social situation.

Include environments that are less predictable. A quiet table may make communication easier to observe, but daily life includes transitions, background activity, different partners, and competing demands. Ask which settings can reasonably be observed during an evaluation or trial and which need reports from people who know the routine. A plan can identify the gap instead of treating limited observation as proof.

How should we talk about vocabulary?

Vocabulary should reflect the person's life, relationships, interests, and ways of taking part. A system containing only object labels or answers to adult questions can leave out much of what people say. Ask how the person can request and refuse, describe, ask, comment, greet, tell someone what happened, share an opinion, direct an activity, and talk about something not immediately present.

Ask how words, symbols, photographs, or other representations will be chosen. A picture that looks clear to an evaluator may not be meaningful to the person. The team can offer options, observe responses, and revisit decisions rather than treating one brief reaction as final. Consider both vocabulary for familiar routines and words that can be used in many settings. Ask who can update vocabulary and how the person will help decide what belongs.

Questions to raise include:

• Can the person communicate yes, no, stop, different, not sure, and I need help?

• Can they initiate a topic or ask a question rather than only answer prompts?

• Are important names, places, activities, and personally meaningful words represented?

• Can the person say something unexpected or clarify a message a partner missed?

• How will useful vocabulary be available across settings?

• Can the person express a message even when the partner has not offered it as a choice?

Vocabulary planning is not just a list-making exercise. Ask how the system supports combinations and new messages, and whether the layout gives the person a way to move between topics without losing useful words. The SLP can explain the communication approach under consideration and how the person will learn where messages are located. Families can bring examples of names, favorite topics, routines, jokes, and phrases that matter to the person, while leaving room for interests that have not yet been anticipated.

Consider how vocabulary changes across communication partners. A person might need words for a family routine, a classroom activity, a health appointment, or a community interaction. Some messages will be specific to one setting, while other messages—such as “I have a question,” “wait,” or “tell me more”—may be useful in many places. Ask how the team will balance familiar words with a system that can support varied conversations.

Avoid treating a limited vocabulary sample as a ceiling on what the person might communicate. If the person has not used a word before, that does not by itself answer whether the word should be available. Ask how new vocabulary can be introduced without pressure, how partners can model use, and how the person's response will guide changes. The evaluation should include opportunities to explore, not only repeated tests of known messages.

Communication planning should support the person's ability to express preferences, ask questions, set boundaries, and take part in decisions. Medical, behavioral, or dietary concerns belong with the relevant professionals; AAC is a communication support, not clinical guidance. If a team discusses a specialized topic, distinguish the communication goal—being able to ask, answer, or express a concern—from clinical advice about what the person should eat, do, or receive.

How can the person express choices and boundaries?

A system should offer meaningful ways to communicate beyond choices selected by someone else. Ask how the person can say yes, no, not now, stop, I do not understand, I want another option, or I need a break. These messages matter during evaluation activities and in daily life. The person should have a way to decline an activity or ask for a change, and partners should respond.

Choices should be genuine. If an evaluator offers two options, the person needs a clear way to reject both, ask for something else, or show that they did not understand. Ask how partners will recognize hesitation and avoid interpreting every movement or selection as agreement. Discuss communication for privacy, personal boundaries, asking for an explanation, or seeking help. Partners can model messages while speaking, pause, and accept communication through AAC or another method without demanding imitation.

Ask what the team will do if signals are ambiguous. A respectful process may involve pausing, describing what the partner observed, offering a neutral clarification opportunity, and accepting that the message may remain uncertain. It should not require the person to prove a preference through repeated questioning. Discuss how the team will avoid asking leading questions or praising one answer more than another, especially when the adult has a strong preference.

Choice-making is only one part of self-expression. The person may want to reject the options, change their mind, ask why a choice is being offered, or communicate something unrelated. Plan for those possibilities. A useful question for each activity is: “What can the person say if neither offered option is right?” If there is no answer, the evaluation has identified a gap worth addressing.

What access methods should be explored?

Access is how a person selects or creates a message. Touch is one option. Depending on the individual, an evaluation may explore direct selection, a keyguard, a switch, head movement or head mouse, eye gaze, or another approach. These are options to assess, not assumptions about what a person with Prader-Willi syndrome will use. The person's motor, sensory, visual, positioning, and practical needs should guide the discussion.

Ask how the team will compare methods in real activities. Selection that works at a table in a quiet room may be harder in another position or with a different partner. During a trial, note whether the device needs a different angle, more time, larger targets, or a way to reduce accidental selections. The evaluator can help distinguish access issues from vocabulary, layout, partner pacing, or positioning. A brief observation should not be treated as proof that one method will or will not work everywhere.

One helpful comparison is to identify what each method requires from the person and the environment. Direct touch may depend on reaching a target accurately and comfortably. A keyguard may help separate targets for some users, but the evaluator must assess fit and compatibility. Switch access involves a selection method and a scanning or control arrangement; the team should observe timing and effort. Eye gaze depends on appropriate setup and positioning, and the team should consider how the person can communicate when gaze access is unavailable or tiring. These descriptions are prompts for evaluation, not judgments about which method is best.

Ask the evaluator to explain what will count as a reliable selection in the particular activity and how uncertainty will be handled. If a person touches one symbol while intending another, the team might test target size, spacing, positioning, or timing before concluding that the vocabulary is wrong. If the person looks toward a symbol but does not select it, ask whether the access method requires a different dwell time or confirmation step. Keep the variables separate when possible so that one difficulty does not obscure a potentially useful feature.

Practical access questions include: Can the person get into a comfortable position? Is the support available where communication happens? Can the device be placed within reach and remain stable? Does the person need time to orient to the display? Can they access the system during transitions? What happens if the preferred access method is not available for a short period? Answers may require input from the SLP and other professionals who know positioning, motor access, or assistive technology.

Forbes AAC's product families include iOS-based ProSlate and Windows-based WinSlate devices, with model-specific access features and accessories. This general description does not establish suitability for an individual. Ask the SLP or assistive-technology professional to verify the exact model, app, accessory, and access configuration. See ProSlate AAC devices and the WinSlate series as product information to discuss with the evaluator.

How do trials work?

A trial gathers information about fit in relevant situations. It does not guarantee a purchase, payer coverage, or a particular result. Before a trial, ask what question it is meant to answer, what the person will try, who will support it, and how observations will be recorded. Agree on ordinary activities and include more than one partner if possible. Observe whether the person can reach the system, locate messages, start an interaction, and repair a misunderstanding. Also note whether partners make the system available and allow time to respond.

Trials are more informative when the team names the question in advance. One trial might explore whether a particular access arrangement is comfortable. Another might examine whether vocabulary is easy to find during a familiar routine. A third might ask whether the equipment can be positioned consistently in a classroom or at home. Trying to answer every question at once can make the result hard to interpret. If the person has a difficult session, ask what conditions may have contributed before making a broad conclusion.

Record the date, setting, activity, partner, device or method, access setup, messages attempted, what helped, and questions that remain. Include the person's reaction and preferences, not only adult judgments about accuracy. If a message is missed, describe what happened instead of labeling the attempt a failure. For instance, note that the person selected a symbol after a long pause while the partner asked repeated questions, rather than simply noting “slow response.” The detail suggests a possible change to test: allow more wait time and reduce prompts.

A simple trial record can use these headings:

• Purpose:

  What question is this session intended to answer?

• Activity and setting:

  What ordinary interaction took place, and where?

• People:

  Who supported the person, and was the partner familiar?

• Setup:

  What device, method, position, vocabulary, and access settings were used?

• Person's communication:

  What did the person attempt, choose, reject, or initiate?

• Partner actions:

  How did the partner model, wait, clarify, and respond?

• Next question:

  What one change or additional observation would be useful?

Forbes AAC describes distinct pathways. A licensed SLP may request available equipment for clinician-held evaluation sessions, with a standard term of up to four weeks and availability constraints. A home trial is initiated by the user's SLP after a benefits check and coverage confirmation. An SLP evaluation kit is a conditional loan of selected accessories for eligible evaluators or facilities that already have an iPad; it is not ownership of an SGD. Review the current device trial information with the SLP. Ask which pathway, eligibility rules, location, and timing apply.

Do not assume that the word “trial” means equipment can be sent directly to any household or kept for an unrestricted period. The clinician-held loan, home trial, and evaluation kit have different purposes and conditions. Ask who must apply, what equipment is included, where it may be used, when it must be returned, and whether current availability affects the plan. If the proposed route does not fit the evaluation need, ask whether another way to gather the information is available.

How do we compare options thoughtfully?

Start with the communication needs identified in the evaluation. A longer feature list does not automatically mean a better fit. Consider whether the person can access the system, communicate messages they want, use it in relevant settings, and have it supported by partners. Discuss what is known, what is uncertain, and what further trial would answer open questions.

Question	What to check	Who can help
Communication fit	Can the person express a range of messages in activities they care about?	Person, family, and SLP
Access and setup	Can the person use the method with practical positioning and supports?	SLP and assistive-technology professional
Use across settings	Where will the system be available, and who will help?	Family and support team
Compatibility	Are the exact app, device, access method, and accessories compatible?	Evaluator and product specialist
Funding	Which process applies and what documentation is requested?	Funding specialist and payer
Continuity	What communication options remain if the primary system is unavailable?	Person, family, SLP, and support team

Ask what would change a recommendation. If it depends on an untested assumption, plan to test it or identify who can verify it. A system may have a useful feature and also require a support routine that is difficult for a family or program. Consider both communication value and the practical work needed to make a system available. Ask how communication can continue if a device is unavailable, needs charging, or is being repaired.

It can be useful to compare options against the same situations rather than compare product descriptions in the abstract. Suppose the team wants to know whether the person can contribute during a shared craft activity. For each option, ask whether the person can select materials, comment, ask for help, reject a suggestion, and start a message without a prompt. Then ask what the partner must do and how the equipment is positioned. The comparison is not a contest; it is a structured way to learn what conditions support communication.

Another practical example is a transition from one setting to another. The team can ask whether the communication system is easy to bring along, whether it remains available after arrival, and whether the next partner knows how to support it. If one option is easier to carry but another offers an access feature the person needs, the decision may require balancing both findings. Record the tradeoff and identify whether a mount, storage plan, partner routine, or second communication method could address it.

Compatibility should be checked at the level of exact components. A device family may have multiple configurations, and not every app or accessory works with every model. Ask the evaluator or product specialist to verify the specific device, software, access method, mounting or positioning support, and any additional feature restrictions. Do not infer that a function is included simply because it appears in a general product description. Product information can inform a discussion but is not a clinical recommendation.

What partner support belongs in the plan?

A communication system works within relationships and routines. Ask who will show partners where it is, how to make it available, how to wait, and how to respond. Partners can model a message while speaking and pause without asking the person to copy. They can acknowledge speech, movement, or AAC and ask a respectful clarification question when uncertain. They should avoid taking over the system or prompting the person toward a particular answer.

Make responsibilities clear. Who can update vocabulary? Which partners need an introduction or practice? Who should be contacted when a message is missing or the layout needs adjustment? Where will the system be kept so it stays within reach? What backup method will be available if the primary system cannot be used? A realistic plan names specific actions rather than saying everyone will support AAC. It can build communication into ordinary interactions without turning every routine into a lesson.

Partner learning can begin with a small routine. One adult can make the system available, model a relevant word or phrase while talking, and then continue the activity without testing the person. The partner can pause naturally, respond to the person's message, and make a repair attempt if needed. The goal is not to make every interaction into a drill. Ask the SLP what modeling looks like for the system being considered and how partners can avoid taking over.

Plan for different levels of familiarity. A close family member may know what a particular expression means, while a substitute staff member may not. The team can discuss how to introduce the person's communication methods to new partners without sharing private information unnecessarily. A brief support note might explain where the system is, how the person signals yes or no, how long to wait, and whom to ask when uncertain. The person should have a say in what others are told.

Also discuss the difference between helping and directing. A partner can offer access, point out where a message is located, or ask whether the person wants more time. A partner should be careful not to select a message for the person and treat that selection as their own communication. Ask how the team will notice when prompts are becoming too frequent and how the person can indicate “let me do it,” “help me,” or “stop.”

Support plans work best when they fit real capacity. If several people share responsibility, list who will do what and when. For example, one person may check that the system is available before leaving home, while a staff member makes it accessible during a particular activity. If a task is not sustainable, name that barrier early and look for a simpler routine. A plan that assumes one caregiver can manage every setup, update, and practice task may not reflect daily life.

What funding questions should we ask?

Funding is separate from deciding what communication support may fit. An evaluation can describe needs and support a recommendation, but it does not guarantee that an insurer or public payer will approve an item. Requirements depend on payer, funding source, state, and individual circumstances. Ask the funding specialist or payer what applies to the case.

Ask which route is being considered, what documents are needed, who submits each item, how the family can see what remains outstanding, and what happens if more information is requested or a request is not approved. Direct-pay orders for schools, VA hospitals, loan libraries, and other buyers use a sales-assisted quote process rather than public checkout. Forbes AAC describes its Funding Portal as a place to work through payer documentation and track packet steps. The portal does not make a clinical decision or promise coverage. Verify model-specific restrictions and payer requirements separately.

To keep the process understandable, ask for a checklist organized by responsibility. What does the SLP need to write? What information does the payer require from the user or family? Which forms need a signature? How will the team know a packet is complete? Who will explain a request for more information? The answer may vary, so use the checklist for the person's specific funding route rather than relying on a generic account from another family.

Discuss timing without assuming a particular approval or delivery date. Ask what step is currently underway, whether any information is missing, and when it is reasonable to check status. A stated status-check interval is not a promise of payer review, approval, manufacturing, or shipping. If a request is not approved, ask the payer and relevant funding support contact to explain the available next steps. The evaluation itself remains useful as a record of communication needs even when the funding path takes longer or changes.

For school, institutional, or other direct-pay situations, distinguish the quote process from insurance documentation. The purchasing organization may need its own forms, approvals, or compatibility review. Ask who has authority to request a quote and what specifications should be included. Do not assume that a device configuration, accessory, or software option can be selected through a public checkout process.

What should we write down before we leave?

Ask for a plain-language summary of the person's priorities, communication methods discussed, access observations, and questions that need follow-up. Record who will do each task and when the team will reconnect. Useful notes include the person's goals, current strengths, options explored, trial observations, compatibility questions, funding questions, and next actions.

If a recommendation uses a technical term, request an explanation and example. If the plan says to continue assessing, ask what information is missing, how it will be gathered, and what would count as a useful answer. Revisit a plan when routines, preferences, partners, or access needs change. A system that was a reasonable starting point may later need different vocabulary, positioning, or support.

A meeting summary can be organized in five parts:

1. What matters to the person:

   Include preferred activities, communication priorities, and ways the person expressed preferences during the meeting.

2. What is already working:

   Note successful methods, helpful partners, and accessible routines that should continue.

3. What the team explored:

   List the systems, vocabulary, access methods, and settings discussed without presenting untested ideas as conclusions.

4. What remains uncertain:

   State the specific unanswered question and what observation or trial might help answer it.

5. Who does what next:

   Name the responsible person, the action, and a reasonable follow-up point.

Invite the person to review the summary in an accessible form where possible. That might mean discussing it in conversation, using symbols or a communication system, or revisiting choices with adequate time. Ask whether anything in the notes does not match what the person intended. This is a chance to correct misunderstandings, not an extra test.

As the evaluation continues, keep records useful rather than burdensome. A short note after a meaningful interaction can be more informative than a large spreadsheet no one can maintain. Include enough context to interpret the observation, but do not record private details that are not relevant to communication planning. The person and family can ask who will see the notes and how they will be used.

When the team leaves with several possible routes, identify the next small action. It may be to gather an observation in a different setting, ask a partner to describe an existing routine, check compatibility, or arrange a clinician-led trial. Avoid turning an unresolved question into a conclusion about the person's ability. A clear next step keeps the process collaborative and makes it easier to revisit the plan.

For additional product or program information, review the SLP evaluation kit information with the evaluator. The kit is a conditional loan for eligible evaluators or facilities with an iPad, not ownership of a speech-generating device. Ask whether its purpose matches the question your team is trying to answer.

Review device trial options with the SLP

How can we make the evaluation accessible?

An evaluation is more useful when the person can participate in a way that suits them. Ask the SLP what the schedule will look like, whether there will be breaks, how transitions will be explained, and how the person can indicate that they need a pause. A long meeting with unfamiliar people and materials may provide a limited picture if the person is tired or unsure what is expected. The team can plan a shorter session, more than one visit, or a familiar activity when appropriate.

Share practical information ahead of time, while protecting the person's privacy. Explain communication methods that familiar partners recognize, what tends to make a new interaction easier, and how the person signals discomfort or a wish to stop. If the person prefers to know what will happen, ask whether the team can describe the steps in advance. If a familiar communication partner is helpful, ask how that person can support participation without answering on the person's behalf.

Make materials and instructions understandable. The evaluator can use plain language, demonstrate a task, allow the person to explore materials, and avoid relying on rapid verbal instructions alone. Ask whether the person can see and reach the materials from their usual position. When the person is invited to make a choice, ensure that the options are presented in a way they can perceive and access. If the activity itself is unfamiliar, the team should distinguish learning the task from communicating within it.

Ask how the evaluator will interpret a response when the person needs extra time. A pause is not automatically agreement or refusal. The team can establish a consistent wait period, watch for the person's own signals, and avoid repeating a question in a way that changes its meaning. If the person does not respond, consider whether the question, method, positioning, or environment needs adjustment before concluding that the person has no preference.

People who know the person can help describe signals, but they should identify the basis for an interpretation. A caregiver might say, “I think this means she wants to leave because she uses the same gesture near the door,” rather than presenting the interpretation as certain. The evaluator can then consider how the person might confirm or correct it. Treating interpretations as hypotheses helps preserve the person's role and makes the record more accurate.

How do we turn observations into a useful plan?

At the end of each evaluation activity, separate observations from conclusions. “The person selected a symbol after the partner modeled it” is an observation. “The person understands and prefers this layout” is a broader conclusion that may need more evidence. Ask what else could explain the observation: Was the target easy to reach? Did the person see the options? Was the partner familiar? Was the message already known? What would the team change next time to test the interpretation?

A practical plan connects each finding to an action. If the person communicated clearly with a familiar partner but not with a new partner, the next step might be to observe how the partner introduces the system and waits. If a selection was difficult while seated in one position, the team might compare positioning or target access before changing the vocabulary. If a useful message was not available, the next step could be to discuss how that word or phrase can be represented. Avoid vague notes such as “needs more practice” unless the team explains what practice means, who will support it, and how the person's willingness and response will be respected.

Consider using a question-and-evidence record:

• Question:

  What does the team need to learn?

• Evidence so far:

  What happened, under what conditions, and according to whom?

• Alternative explanations:

  Could access, partner behavior, unfamiliarity, or timing account for the result?

• Next observation:

  What single change or setting would clarify the question?

• Decision point:

  What would the team do with the information once it is collected?

For example, imagine the team is unsure whether a person can locate a message independently. During one session, the partner repeatedly points to the relevant area, and the person then selects it. That session shows selection with substantial cueing; it does not establish independent navigation. The next observation might reduce prompts, allow time, and include a familiar activity. The team can record whether the person initiates, explores, or asks for help. This yields more useful information than either declaring success or failure after the first attempt.

Another example is a mismatch between a message and a partner's interpretation. The partner may believe the person requested one item, but the person's later behavior suggests otherwise. Rather than treating this as proof that the system is ineffective, the team can ask whether the representation was clear to the person, whether there was a way to correct the message, and whether the partner paused to confirm. A communication plan should include repair: the person needs a way to say “not that,” “I meant something else,” or otherwise try again.

Set a review point even when the plan is provisional. The team can ask what has changed, which strategies are being used, what the person appears to prefer, and whether the current approach still fits. A review is not necessarily a device replacement discussion. It may lead to a vocabulary update, better availability, a different partner routine, or another access observation. Keeping the plan open to revision prevents an early snapshot from becoming a permanent label.

What can families prepare before the appointment?

Preparation need not become a large project. A short list of priorities and a few specific examples can help the team understand the person's life. Start by asking the person, in their preferred way, what they would like to communicate more easily. If the answer is not clear, offer time and accessible opportunities rather than assuming that adults already know. Interests can change, and the person's priorities may differ from the family's first concern.

Choose a small number of examples that show different communication purposes. One might involve a request, another a refusal or correction, and another a social comment or question. For each example, note where it happened, who was there, what the person did, how the partner responded, and whether the message was understood. Include an example that worked well as well as an example that was difficult. A balanced picture helps the evaluation build on strengths rather than focus only on problems.

Collect relevant materials only if they help explain communication. A photo of a familiar communication board, a copy of a schedule, or a list of names and places may be useful; do not bring private records unrelated to the evaluation unless the clinician requests them. Ask beforehand whether the SLP wants any information in advance. If another professional's observations are important, ask the person and family how those observations can be shared appropriately.

Write down questions that are easy to forget during a busy meeting. These could include: How will the person have a way to reject all offered choices? What will we do if the system is not nearby? How will we tell whether a difficulty comes from access, vocabulary, or partner pacing? Which trial route is being discussed, and who initiates it? What does the recommendation not establish? A written list can help the family return to unanswered items without expecting to resolve everything at once.

Consider logistics as part of preparation. Ask how long the session may take, whether the person can bring a familiar item or support, and what arrangements are needed for positioning or access. If the meeting includes multiple people, decide who will help the person communicate and who will take notes. The person should not have to manage a crowded conversation without support, but the support should leave space for their own response.

After the meeting, give the person time to respond to the experience. They may communicate a preference later, after they have had a chance to process what they tried. Ask the SLP how later observations can be shared and whether the plan can be revisited. One meeting is not the only opportunity for the person to express what works for them.

Frequently asked questions

Does Prader-Willi syndrome mean a person needs a particular device?

No. A diagnosis alone does not identify which system, vocabulary, or access method fits. The person and their SLP should consider individual communication, preferences, access, settings, and goals.

Can an evaluation guarantee that AAC will help?

No. An evaluation gathers information and helps plan what to explore. A trial shows how a system works in particular conditions, not what will happen in every setting.

Does a trial mean equipment can go home?

Not necessarily. Forbes AAC describes different loan and trial pathways with different initiators, eligibility, and locations. Ask the SLP which current process applies.

Will insurance or Medicaid cover a recommended system?

A recommendation does not guarantee coverage. Requirements depend on the payer and case. Ask the funding specialist and payer about current documentation requirements.

What should we bring to the meeting?

Bring examples of current communication, meaningful situations and priorities, observations from people who know the person's routines, and questions about vocabulary, access, trials, support, and funding. Plan how the person can participate and express preferences.

With the person's voice at the center, an evaluation can help the team decide what to explore next without treating any single outcome as guaranteed.