Augmentative Communication Service

The Augmentative Communication Service provides specialised assessment for complex augmentative and alternative communication (AAC) systems. The service has been identified by NHS England as one of 13 services nationwide offering this service. This will include assessments for devices, provision of equipment and training, maintenance and support.

Referrals to the service should be made using our referral form and can take two forms: Assessment and Provision and Equipment Only Request. Prior to making a referral, we would encourage referrers to make contact with our service to make contact with our team to discuss the most appropriate referral route. The two routes through our service are as follows:

Where a need for AAC has been identified but further investigation is required to select appropriate hardware, software, access and mounting options, children may be referred to this service for further specialised

This referral route is intended for:

• individuals who are competent and experienced in the use of a communication aid, but whose existing equipment is malfunctioning frequently or has ceased to work
• clients with a local AAC service and professionals who have a significant level of AAC expertise and competency to provide a comprehensive assessment

Our service prioritises paediatric referrals from within the Greater London Area, although referrals from further afield may be considered, depending on capacity. Again, please contact the team to discuss such referrals.

Where children do not meet criteria for this part of the service, it may be possible to arrange an appointment in our Developmental Communication Service to address more general questions about assessment, language understanding, cognition etc. This would always be done in consultation with the child’s family and local team.

The following eligibility and prioritisation criteria are taken from the NHS service specification. You can keep up to date with information about National AAC Commissioning through Communication Matters.

An individual who would access a specialist AAC service would have both of the following:

• a severe/complex communication difficulty associated with a range of physical, cognitive, learning, or sensory deficits
• a clear discrepancy between their level of understanding and their ability to speak

• be able to understand the purpose of a communication aid
• have developed beyond cause and effect understanding

• have experience of using low tech AAC which is insufficient to enable them to realise their communicative potential

• have pre-verbal communication skills
• have not yet achieved cause and effect understanding
• have impaired cognitive abilities that would prevent them from retaining information on how to use equipment

• with a rapidly degenerative condition, e.g. MND, and efforts will be made to ensure these patients are assessed and / or provided with equipment as soon as is practically possible
• who have communication aid equipment currently which has ceased to be functional or is significantly unreliable and does not meet their communication needs
• facing a transition to a new sector / school / college / workplace environment or currently in rehabilitation provision
• who are at risk of developing significant psychological / challenging behaviour as a consequence of their inability to communicate without a communication aid

Our standard assessment takes place over two or three appointments. In some cases it may be possible to complete the process more quickly, depending on the complexity of the case and the amount of information provided at referral. Appointments will generally include a Speech and Language Therapist, an Occupational Therapist and an Assistive Technologist. 

An initial appointment will be arranged with the full team at which we will meet with the child and family to identify what assessments or investigations are required. The team then work/play with the child to complete any remaining aspects of the assessment necessary. Parents are present throughout all parts of the assessment. At the end of the assessment, the child, parents, local team and specialist team members meet together to discuss findings and conclusions.

Where appropriate, our team is able to provide communication aids on loan for approximately six weeks, with mounting solutions put in place to allow children to access them in their preferred seating systems. We will agree targets with the family and local team for the duration of this loan. An evaluation appointment will be arranged to observe and discuss progress made during the loan period. Where a child meets all aspects of the Service Specification, a device will be purchased and provided on long-term loan, with a review appointment scheduled annually.

You can contact the Augmentative Communication Service on 0207 405 9200 ext 1144 or via our email acsadmin@gosh.nhs.uk