Assistive technology

Assistive technology covers many tools

Examples include communication devices and apps, switches, alternative keyboards, screen readers, visual or vibrating alerts, seating and positioning supports, mobility devices, adapted utensils, timers, environmental controls, and low-tech picture or written supports.

The right category depends on the activity and person. A tablet is ordinary technology until its configuration and use serve an access function. A laminated card can be meaningful assistive technology even though it has no electronics.

AAC is one area within AT

The ASHA augmentative and alternative communication portal places AAC within the wider assistive-technology field. AAC may be unaided, such as gesture or sign, or aided, such as a board, book, tablet, or speech-generating device. People often use several modes.

ASHA states that AAC users should always have access to their communication tools or devices. Communication access cannot depend on behavior, task completion, eye contact, speech, or earning the device. If a primary device is charging, being repaired, or creates an immediate hazard, the plan needs an accessible backup.

Assessment begins with the person and activity

An AT assessment should examine what the person wants to do, where the activity happens, current strengths, sensory and motor access, language, vision, hearing, positioning, fatigue, communication partners, culture, and available support. Trials across real settings can reveal whether a tool remains usable beyond a quiet office.

The qualified professional depends on the need. An SLP may lead AAC work; an occupational therapist may address access methods or daily activities; a physical therapist may address positioning or mobility; vision, hearing, medical, education, engineering, or AT specialists may contribute. Licensure and setting rules vary.

ABA and AT roles can coordinate

An ABA clinician may observe routines, define a personally meaningful participation goal, teach partners to pause and respond, help practice use in agreed settings, and measure whether the environment supports access. The team can share data about opportunities, prompts, breakdowns, repairs, and the person’s experience.

ABA staff should not change vocabulary, access method, device layout, seating, mobility configuration, or clinical recommendations outside their competence and authority. Route proposed changes to the person and responsible professional. Preserve the original settings and document authorized updates.

A fictional school-club example

Fictional student Inez chooses a goal of asking to borrow art materials during an after-school club. Her SLP and AT team configure a familiar AAC page and a laminated backup. Staff define an eligible opportunity as a needed material within reach of a peer and an independent request as Inez selecting or pointing to the message before any prompt.

Across six initial opportunities with the device available, Inez sends four independent messages. Peers respond within ten seconds to two: 2 of 4, or 50%. The main gap is partner response rather than device use.

After peers practice waiting, checking the message, and answering, they respond within ten seconds to 7 of 8 later messages. The team also records Inez’s comfort rating and any access failure. The before-and-after pattern does not isolate a cause because practice, partners, time, and opportunities changed together.

Plan access beyond the session

Record where the tool travels, who charges it, how it is positioned, which backup is ready, and who responds to repair requests. Include home, school, community, transport, telehealth, downtime, and emergencies when relevant.

Train communication partners and support people with the person’s permission. A sophisticated device can fail when partners talk over it, move it out of reach, guess instead of waiting, or treat unfamiliar output as invalid.

Ownership, privacy, and funding matter

Clarify who owns the device and data, who can access settings and logs, how backups are stored, what happens during repair, and which records are shared. Avoid copying sensitive communication history into broadly visible systems.

Funding approval, school provision, insurance coverage, and clinical recommendation are distinct. A funded device may still need training and repair support. A recommended system may not be covered. Families should receive clear information about cost, maintenance, warranties, replacement, and appeal or alternative routes where applicable.

Measure participation and reliability

Useful measures include eligible activities with the chosen tool or backup available, successful access attempts, partner responses within a defined window, repairs completed, device downtime, and the person’s report of ease, comfort, and usefulness.

Keep raw counts and opportunity definitions. A high request count means little if the person lacks a way to decline, pause, correct, or discuss something outside the training goal.