What We Wish Administrators Knew: Results from a Survey of School-Based AAC/AT Specialists

Brianna Hughes
May 12
6 min read

As an AAC/AT Specialist, I’ve often felt outnumbered. So few people know what I do, and there are so many people I need to reach. Last summer, I invited my fellow school-based AAC/AT Specialists to fill out an informal, anonymous survey describing their experiences, their caseloads, the problems they face, and what they would tell administrators, if given the chance.

The results were validating, fascinating, and full of novel insights!

Limitations:

This survey included a small sample of 33 respondents, spread across 22 U.S. States. Not all respondents answered all of the questions. I only asked them to answer those questions which applied to their current role. Someone more qualified than I could surely collect more accurate and rigorous qualitative and quantitative data. Alas, you’re getting my very imperfect version, and further study is absolutely needed. But in the meantime, read on for my 10 key takeaways:

1. AAC Specialist & AT Specialist roles are different

While some people (such as this author) can learn to play both parts, the qualifications for these two roles are distinct from each other in terms of job duties and caseload/workload. Respondents emphasized the importance of having separate, clear job descriptions and pay scales, and administrators who understand the differences.

2. A Capacity-Building Model is the goal for most AAC/AT Specialists

Here’s a quick crash course on AAC/AT service models:

In an “expert” model, the AAC/AT specialist provides direct assessments and therapy services to each student.

In a “capacity-building” model, the AAC/AT specialist uses a collaborative considerations process for device selection, then trains everyone around the AAC/AT user on how to work with them and their device.

There are lots of reasons to use capacity-building, and it’s generally considered a more modern and effective approach.

64% of the AAC/AT Specialists said they are using a capacity-building model, whereas only 7% are using an “expert” or “direct services” model.

The remaining 29% used a blend of both, and many remarked they were trying to move more towards capacity-building.

3. Capacity-Building isn’t realistic for AAC Specialists with high staff turnover (But it works for AT Specialists!)

Of the AAC Specialists who spoke about a blended model, a majority commented they were doing so in response to high turnover in their special education departments. One shared that an expert model was still in place in their district for assessments, but capacity-building had started for device implementation.

This made perfect sense to me, as I’ve sometimes referred to my own service model as, “hands-on consultation.” My goal is to train everyone, but often teachers, para’s, and SLPs leave mid-year, and I have to start over. Plus, staff training in a classroom (capacity-building) can look a lot like push-in therapy used to when I was in an SLP role (expert model), because there are times when we need to “model modeling.”

AAC Specialists in the survey sometimes provided direct services, but the AT Specialists did not. This is likely because of the inherent complexity and variety involved in serving AAC users. For AT specialists, who are often focused on supports for high-incidence disabilities, a capacity-building model was both more attainable and more helpful.

4. A Caseload Model works OK for AAC Specialists

ASHA recommends a workload model for all SLPs, and that includes AAC Specialists. It’s important to factor in the number of sites and staff members, and other duties that might be required of each AAC/AT team member. But many AAC Specialists still think in terms of caseload, perhaps because it is nice to have a concrete number.

5. AAC Specialist Caseloads should factor in service model

What is a realistic and fair caseload cap for an AAC Specialist? School districts can refer to the following recommendations, averaged across all responses from survey participants’ highest estimates:

For a capacity-building model: 70 students per 1.0 FTE*.
For an expert model: 25 students per 1.0 FTE. This is because the expert model involves so much more time spent with each individual student.

6. A Workload Model is better than caseload for AT Specialists

AT Specialists are less likely to need to provide direct services. AT tools for reading and writing are used by larger numbers of students, and are usually simpler to learn, as compared to AAC tools. For these reasons, among others, survey participants were hesitant to recommend a caseload number for AT Specialists, and only two actually provided a guess about what would be realistic (if you’re curious, one said 75, the other said 150).

Others advised that teams should look at how many schools or staff members are served, rather than how many students. More data is needed, but as a ballpark estimate, school districts should plan for about one full-time AT Specialist per 10 to 15 schools.

7. Current caseloads are TWICE as high as they should be, but we’re probably only identifying HALF the students we need to see

I asked respondents if their district was currently under-identifying for AAC/AT needs. A majority of respondents (68%) said “yes” or “somewhat yes”. They were then prompted, “By how much?” and on average, participants estimated that their districts were only providing AAC/AT devices and services to half of the kids who actually needed them.

This is in line with national data at least for AAC: whereas an estimated 2 million people in the USA use AAC (ASHA, 2024), there are about 5 million who need it (Beukelman & Light, 2020).

Yet, on average, after adjusting for FTE, the AAC Specialists had a caseload of 150 students per full-time employee. The AAC/AT Specialists had it even worse, with an average caseload equivalent to 499 students per full-time employee.

The few, lucky AAC Specialists who were in a direct services model fared better, though they were still serving more students than what they considered reasonable, at an average caseload of 33 per full-time employee.

To put this another way: on average, participants estimated that districts need to hire about 4 times more FTE of AAC/AT specialists than they actually do.

8. We would seriously love an AAC/AT assistant

If you have an AAC/AT specialist or AAC/AT team with a workload that is too high, consider whether a clerical assistant, IT assistant, or SLPA might be able to help. There are some tasks that an AAC/AT Specialist can turn over to someone else (e.g. device troubleshooting), and this frees up your specialist to focus on the job duties that only someone with their expertise could do (e.g. staff training, assessments, program development, etc.).

9. A well-informed School Administrator makes a HUGE difference

Just about all of the problems identified by AAC/AT Specialists could be solved if all school district administrators understood:

What AAC/AT means,
What AAC/AT specialists do,
The rare combination of technical proficiency, advanced education, and personality traits that someone must have to become a successful AAC/AT specialist, AND
What realistic expectations are for caseload and workload.

And hey, admins, to be clear: if you didn't know this stuff before, it's not your fault. This used to be really hard to find, even "un-google-able" information. But now you that you have this article series to reference, you're about to be someone's favorite boss ever!

10. There is good news!

There are districts out there who are doing AAC/AT the right way, and respecting and supporting their specialists!

When asked about the problems they face, one respondent said this: “None; I’ve really been given free rein to make this what I want it to be... My salary is competitive... It took the district 1.5 years to find me. I have a vision that is shared by the Pupil Service director.”

Another said, "I have been living this journey for the past two years. It has certainly been the most rewarding of my career but also the most challenging!"

The impact that an AAC/AT specialist can have for students, families, and entire districts, is profound.

AAC/AT specialists can thrive if their directors offer fair compensation and a reasonable workload, plus respect, trust, and autonomy.

To School Administrators and AAC and AT Specialists, I hope this series of articles has helped you to partner together in this critical work.

Thank you to the respondents of this survey for your time, your candor, and for being who you are, and for doing what you do!

Sources Cited:

American Speech-Language-Hearing Association. (2022). 2022 Schools Survey report: SLP caseload and workload characteristics. www.asha.org/Research/memberdata/Schools-Survey/
Beukelman, D. R., & Light, J. C. (2020). Augmentative & alternative communication: Supporting children and adults with complex communication needs (5th ed.). Brookes.