This document appears to be a criteria checklist for determining student eligibility for augmentative and alternative communication (AAC) assessments. It includes yes/no/don't know questions about students' communication abilities, understanding of language, interests, and current use of AAC systems. Further explanatory notes are provided on literacy skills and current use of AAC to clarify the questions on the checklist.

1. Criteria for AAC assessment eligibility DRAFT 2
YES = 2 D/K = 1 NO = 0
Does the student ever make eye contact with you?
(If visually impaired score 1)
Does the student have an understanding of cause and effect?
Is the student able to indicate that they want more?
Can the student indicate that they want to stop an activity?
Can the student make a purposeful choice of food or drink?
(If peg fed score 1)
Can the student make a purposeful choice of activity?
Is the student able to use 2 movements purposefully?
Does the student have a way of indicating YES?
Does the student have a way of indicating NO?
Is the student completely without verbal speech?
Can the student articulate single words intelligibly?
Are there things that the student would like to say but can't?
Can the student press a switch intentionally?
Can the student point to a symbol intentionally?
Can the student point intentionally with some physical
support such as steadying them at the elbow for example?
Does the student understand language at 1 word level?
Does the student understand language at 2 word level?
Does the student understand language at 3 word level?
Does the student understand language at 4+ word level?
Is the student on medication that might affect concentration?
Does the student have any AAC (Augmentative and
Alternative Communication) system? *
Does the student have any literacy skills? **
* Please describe the AAC system being used and the times and purpose for which it is used:

2. ** Please describe the students literacy ability:
Please describe the student's main interests:
Further Information:
Literacy skills: This does not necessarily nean reading or writing in the conventional sense of
the words. It might include understanding the meaning of certain objects, pictures, symbols,
signs. It might be an ability to understand simple sequences.
Current use of AAC: This might include the use of any of the following:
Consistent signs or gestures that others understand.
Using communication symbols, books or charts at any time of the day.
Using a Big Mac to take turns in group activities.
Ability to hit a switch on request.
The student understanding that the student is the one who triggered the reaction when they
hit the switch.
Ability to point to a desired object (might be finger, fist or eye pointing).
Basic choice making by pointing to object, picture, symbol etc.
Using communication aids which you can record your voice on to give choices.
Using sophistucated comunication aids with electronic speech to communicate.