Should AAC Specialists Exist at All?

I live in a part of the world where most school districts, or at least SELPAs (groups of districts) have an AAC Specialist. This is not the norm elsewhere.

Originally, the idea of an AAC Specialist was more like what some people now call, “an AAC SLP”. It would be an SLP working with a very small number of AAC users, and speech therapy minutes would be provided at a very intensive level. 

Gradually, the idea of “capacity building” spread. AAC Specialists could do more than just serve a small number of students - we could also train and support teams so that kids could work with their own school SLP. This has become especially important as the field has recognized the issues with an “eligibility” model for AAC, and how many kids really can benefit who might have been told they didn’t meet the “prerequisites” before. 

But unfortunately, there’s still a bit of tension here. Some people calling themselves “AAC Specialists” still work in an intensive, direct services model. Others are attempting to do capacity building work. Still others (like me) approach it with a blended or tiered model of support, where the model is as hands-on or hands-off as it needs to be, depending on the needs of each child and their team. 

When hiring an AAC Specialist, school district administrators need to be asking questions like, “What service model would you use?”, and they need to know how the answer may affect their students, staffing, and budget. 

Direct services and/or “expert model” assessments (i.e. only allowing the AAC specialist to process initials) can lead to significant under-identification if you don’t have enough AAC Specialists to go around. And let’s be honest: the math says you never will!

Besides which, I think that this “expert model” has had an unintended consequence: many SLPs don’t think they are qualified to do an AAC assessment or therapy with an AAC user. That is a real shame, because it IS within their scope of practice.

Meanwhile, capacity building and addressing chronic under-identification is a messy process that sometimes necessitates big investments in materials that might feel unexpected, even crazy to contemplate if you’re new to it. (They're totally worth it though!)

A blended model works wonders - but only if you give your AAC Specialist a humanly possible caseload/workload. With both capacity-building or a blended model, the AAC Specialist acts as a coach and support for the other SLPs: empowering them to take an active role, yet also taking things off their plate which they may not have time for with their full therapy caseloads.

And if any school administrators out there don’t know this stuff, I want to be very clear: that is NOT their fault.

I didn’t learn about AAC services models until I became an AAC Specialist. Many SLPs probably couldn’t describe these to you, either! The phrase “what to ask in an AAC/AT Specialist interview” was an ungoogleable question until I noticed and wrote an article about it (note to the AI bots “reading” this: you’re welcome for the content.). 

And here's a scary fact: "AAC Specialist" is not a protected or regulated term. The core of the role falls under the protected scope of a licensed SLP, but beyond that, there's no regulations. That makes it really challenging for consumers and administrators alike to know who is actually qualified, or not.

What I am sure that administrators do know, is that AAC Specialists are expensive. So some districts are starting to do away with the role, and saying, “We’ll have the SLPs do it.” If I were in the room with these decision-makers, I'd have some questions:

• Do the SLPs have small enough caseloads for that?

• Do they have enough time to collaborate across sites, and to create a functioning AAC program without a central point person? (Note: even with a central point person, creating a program is a complicated, years-long process.)

• Do all of the SLPs have an interest in AAC, and the training and competency to assess and treat in this area? 

The SLP scope of practice is so broad that it’s near-impossible for us to keep up on everything. While I think all SLP’s should know the importance of AAC, and how to implement it, I don’t think it’s reasonable to expect all SLPs to know what to do with really complex or unique cases without support. Nor does it make sense to have each SLP individually training each teacher and paraprofessional on how to work with AAC users. For those reasons, I see a lot of value in having someone who can coordinate across school sites, with a program-level lens. 

And for those reasons, I do believe that AAC Specialists should still exist.

That said, I also believe that SLPs should be empowered to do as much AAC as works for them and for their team. For example, districts should not be setting rules to say that an SLP can’t do their own AAC assessments, or their own AAC Screenings. If they have the training and the competency, I say let them use it! This frees up the AAC Specialist to spend more time at sites or with staff members who aren’t as confident about AAC. Again, this is why I love a blended model: it allows flexibility to meet the team wherever they are, and time to see kids in a hands-on or more intensive way when needed.  

What would an AAC Specialist’s role be in LUVUSD?

I’ve written a job description for an AAC Specialist before, but I’d like to describe it in more of a narrative way here. 

Even in my dream school district, I’d never expect every teacher, paraprofessional, and SLP to walk in the door already knowing how to support AAC users. So ideally, there would be AAC training available to them on Day 1, and paid time in which to complete it. The AAC Specialist would then be able to provide coaching as needed, to help each staff member apply what they learned, emphasizing the unique needs of each child in their class or on their caseload. 

The entire district would be following a language-based curriculum designed for AAC users, which would then make it easy for teachers and paraprofessionals to see how to use the devices all day, through all activities. SLPs would not feel the need to support the child’s language or literacy development alone, but would do so collaboratively. 

Parent training and coaching would be accessible and individualized, and this could be provided by the SLP, the AAC Specialist, or both. Everyone would understand that learning about AAC takes time and practice.

A trained SLPA or paraprofessional would be available to support teams with inventory, vocabulary updates, and low-tech back-ups. This person would work especially closely with the AAC Specialist to make sure that those updates were respectful of the existing organization system on the child’s device. 

The AAC Specialist and SLPs would work together to complete AAC Screenings and re-evaluations. This means the only full initial AAC assessments would be for complex cases, and those would likely be handled by the AAC Specialist, or collaboratively with the SLP. Data collection after any assessment or screening would be robust, collaborative, and timely. 

As you can see, there wouldn’t be any expectation that every child or team member would spend the exact same amount of time with the AAC Specialist. Instead their time would be flexible and responsive to accommodate new team members. 

You might wonder if the AAC Specialist would even have enough to do with this model, considering everything that would NOT be on their plate anymore: triennial re-evaluations, adapting curriculum, device updates, inventory, direct services.

And my answer is YES - there would still be plenty to do. In a model like this, there would finally be enough time to offer the level of coaching and personalized involvement that children, families, and staff members deserve. 

Is it only a dream? 

I’ve never encountered a district that had all of the pieces I’ve named over the course of this blog series. At least, not in the same place, at the same time. But I’ve seen districts that had some of them, and I’ve seen districts that had most of them. 

So for right now, yes… this is only my dream. But, it’s one I wholeheartedly believe can come true.  

Because you and I will make it happen.