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The OT's Role in AAC Assessment and Intervention

In occupational therapy graduate school, the curriculum briefly addressed assistive technology (AT) and augmentative alternative communication (AAC) and the OT's role in assessment and treatment related to AT and AAC.

  • At the time, it seemed interesting, but wasn't something I thought I would become passionate about in my OT career. Fast forward six years and I am an OT who specializes in AT/AAC working in a pediatric clinic on the Assistive Technology (ATEC) Team at Children's Therapy Center in Columbia, MO.

  • I even went on to get my ATP (Assistive Technology Professional) Certification through RESNA, which required me to sit through an exam. This helped to educate me in broad analysis and training of assistive technology. Individuals seeking support in assistive technology can also search for professionals who are certified in their local area through RESNA’s website. Checkout their Certified Professionals Directory here:

As an occupational therapist on an ATEC team, I specialize in access to communication. Each week, I participate in evaluations in which I work collaboratively with speech-language pathologists.

  • In these evaluations, for those with complex fine and/or gross motor needs, we trial various means of access and follow up as needed. I have found that the sky is the limit when it comes to being creative and figuring out alternative ways for access. With one client, we may present multiple access methods (touch, eye gaze, switches, etc.) and see how they respond.

  • Often, clients are successful with multiple access methods, but it is important to choose the method that they like best, along with considering other factors including fatigue, speed, and efficiency.

As mentioned earlier, our team works with many clients who present with complex needs. For example, our team may work with a child who has gross and fine motor delays, along with vision impairments.

  • In one particular case, our team was able to rule out directly touching the screen and use of eye gaze due to the child's fine/gross motor impairments and visual deficits.

  • Following collaboration between the OT, ST and parents, it was decided that auditor switch scanning would be the most appropriate alternative access method.

  • While the speech therapist determines the most appropriate language system, the OT is busy determining most successful access point for switch access along with most appropriate type of switch.

  • Teamwork is such an important part of the process. The therapists, family, and client need to work together to ensure that all needs are being met and carry through will occur with the equipment being recommended.

Many people associate speech generating devices (SGDs) solely with speech therapy, but it has been a privilege to educate others on the important role that OT holds in this area of practice.

  • It's an incredible feeling when a child is able to access a device for the first time because of an alternative access method. I'm happy to say that assistive technology and alternative access to communication has become a passion of mine and I am excited to see what the future holds in this field!

Megan Henzel, MOT, OTR/L, ATP is an occupational therapist who works at Children’s Therapy Center in Columbia, MO. She specializes in AT and AAC and also works with children who have neurological disorders as part of a multidisciplinary intensive therapy program. She has over 5 years of experience in pediatric care.

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