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The Autism Society Inland Empire has received a grant to gather baseline information about how knowledge and access to different types of Augmentative and Alternative Communication (AAC) devices and techniques here in the Inland Empire. AAC refers to ways, other than speech, that are used to send a message from one person to another.

We appreciate your time in helping us determine what resources are available and being utilized here in the Inland Empire.

* 1. What is your profession?

* 2. What is the primary age group of clients/students you currently have?

* 3. Which county are most of your clients/students live in?

* 4. How long have you been working with individuals with disabilities?

* 5. How much of an impact do you think augmentative communication devices and methods could make in improving your non-verbal and partially verbal students/clients to communicate?

* 6. Do you currently have any students or clients that use AAC (PECS, sign, iPad, Go Talk, etc) to communicate?

* 7. Do you know how students/clients funded their AAC device?

  n/a Don't Know School District Parents Health Insurance
Student One
Student Two
Student Three

* 8. How would you report your level of knowledge of augmentative communication methods and devices? We are talking about using these techniques to communicate only. Not for recreational, educational or reinforcement purposes.

  Not Knowledgeable Somewhat Knowledgeable Very Knowledgeable
Apple Products (iPads, iPods, iPhones)
Dynovox devices (i.e. Dynawrite)
Go Talk
Letterboards or Numberboards
Prente Romich devices
Sign Language

* 9. If you have students/clients that use AAC, can they use AAC to:

* 10. If you have used an Apple product (iPad, iPod, iPhone), which communication programs have you used? (Choose as many as apply)

* 11. Who do you think the main person is who should be responsible overseeing an augmentative communication device assessment and intervention?

* 12. Which agency should be responsible for funding AAC? (Choose as many as you believe applies)

* 13. What do you think are some of the barriers for more individuals to have access to AAC information and resources?

* 14. When was the last time you received instruction or training on augmentative and alternative communication devices or techniques?

* 15. What kind of AAC training have you attended within the last 3 years? (choose as many as apply)

* 16. Are there any areas you would like more training/resources?

* 17. If you would like to be entered into the raffle drawing for a $50 gift card to Target, please complete the information below. Two winners will be chosen at random. Winners will be notified on Mon, Feb 3, 2014.