Speech Pathology — Referral to Specialist AAC Service for a Non-verbal Adult
A speech-language pathologist refers a 24-year-old non-verbal man with autism spectrum disorder and moderate intellectual disability to a specialist augmentative and alternative communication (AAC) service for device assessment. The proficient challenge is presenting the communication profile and the AAC rationale while cutting the extensive developmental and educational history.
Letter type
Referral
Write to
Specialist Communication Therapist
Target length
210–240 words
The case notes
Patient: Mr Ethan Larsson, 24 years old; autism spectrum disorder and moderate intellectual disability; lives in supported accommodation
Current communication: Non-verbal (no functional speech); uses approximately 50 Makaton signs and 30 PCS symbols (carried on a printed communication card); communicates basic needs (eat, drink, toilet, pain, stop); cannot initiate social interaction or express choices, preferences, or emotions beyond immediate needs
Receptive language: Understands simple 2-step instructions in familiar context; object recognition reliable; responds to visual schedules; limited response to spoken-only instruction without visual support
Cognitive level: Non-verbal reasoning (Leiter R): moderate intellectual disability range; VABS-3 (adaptive behaviour): communication domain 5th percentile for age
Current device trials: Tried a 32-cell static PECS-style board — too limited; tried a 7-inch AAC tablet with Proloquo2Go (32 cells, basic vocabulary set) — demonstrated emerging interest; problem: does not independently navigate to vocabulary beyond the home screen
Goal: Expand communicative vocabulary for expressing choice, refusal, and social initiation; a high-tech AAC device assessment is required to determine whether a dynamic display with personalised vocabulary set is appropriate and which device/vocabulary system best matches his profile
Carer involvement: Support workers at accommodation are committed; carer training in AAC will be required alongside device prescription
Task: Write a referral letter to the specialist AAC service, Ms Brigid Flynn, requesting a comprehensive device assessment for Mr Larsson.
Writing task
Write a referral letter to the specialist AAC service, Ms Brigid Flynn, requesting a comprehensive device assessment for Mr Larsson.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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Current functional communication: 50 Makaton signs, 30 PCS symbols, basic needs only — cannot express choice, preference, or social initiation
The specialist needs to know the current ceiling — what he can do and what is currently beyond his system. This defines the gap the AAC device must fill.
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The Proloquo2Go trial result: demonstrated emerging interest; limit is navigating beyond the home screen
The device trial data tells the AAC specialist what the starting point for device training is. Emerging interest is a positive prognostic indicator; the navigation limit identifies the training challenge.
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That carer training alongside device prescription is required
An AAC device without carer training is rarely used. The AAC service must factor this into their plan — the referral must make clear that the full implementation pathway is being requested, not just a device recommendation.
Leave out
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The full developmental and educational history
The AAC specialist needs the current communication profile and the device trial findings — not a developmental timeline. A brief diagnostic context — 'autism spectrum disorder with moderate intellectual disability, non-verbal throughout' — is sufficient.
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The detailed Leiter R subtest scores
State the outcome: 'non-verbal reasoning in the moderate intellectual disability range.' The full cognitive assessment report is attached. Reproducing subtest scores in the referral letter adds length without adding clinical decision value for the AAC specialist.
Criterion in focus · Content
AAC referral letters are assessed on whether the referral question is specific and the clinical picture is complete. The referral question must name what is being requested: 'a comprehensive device assessment to determine whether a high-tech dynamic display AAC device with a personalised vocabulary set is appropriate, and which device and vocabulary framework best matches his profile.' A referral that only says 'please assess for AAC' does not give the service the information needed to prepare the assessment.
Now write the letter — and find out what is blocking your Grade B
Write a 210–240 words referral letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.