AAC and assistive technology — branching viva

Opening (2–3 minutes)

Examiner: How will you open this consultation? [13]

Strong answer: Ask the family’s goals for what the child needs to communicate this month. Validate worry about speech. State that AAC is multi-modal and can run with speech attempts. Map current means and failure points at home and preschool. [2] [13]

Branch A — Myth and evidence

Examiner: They insist AAC stops talking. Evidence? [1]

Strong answer: PECS meta-analysis supports requesting; speech effects are limited/variable — I will not over-promise fluent speech. Naturalistic SGD and preschool SGD reviews support early aided communication for participation. Waiting for speech failure costs relationships and behaviour regulation. [1] [2] [3]

Branch B — Assessment

Examiner: What will you assess before buying a device? [14]

Strong answer: Participation goals; comprehension vs expression; vision/hearing; posture and hand/switch/eye-gaze access; partner skills; school context. Feature-match after team assessment, then trial. [14]

Branch C — Seating and abandonment

Examiner: A prior tablet failed. Next step? [11]

Strong answer: Re-check seating and access; train school and family; re-trial with low-tech backup; do not label the child incapable after a single unsupported demo. [11] [13] [14]

Branch D — Powered mobility

Examiner: When would you discuss powered mobility? [9]

Strong answer: For severe motor impairment limiting exploration; frame as potential developmental/participation intervention with therapy-led trial, not only late transport. [9]

Branch E — Hospital safety

Examiner: The child is admitted tonight. Communication plan? [13]

Strong answer: Bring device; document yes/no and pain signals; low-tech board for core needs if high-tech unavailable; never leave the child without a communication channel. [13]

Examiner scoring cues

Pass: early multi-modal AAC; honest PECS/SGD evidence; feature-match and training; seating/access; participation outcomes; hospital backup. [1] [2] [13]
Fail: wait-for-speech-only advice; device-first shopping; ignore seating; confiscate AAC without alternative; promise fluent speech from PECS alone. [1] [11] [13]