Augmentative Communication Survey for Parents & Individuals with Special Needs

The ability of people to communicate to others is one of our most basic needs.

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 that may help some people communicate.

AAC refers to ways, other than speech, that are used to send a message from one person to another. Please take 15 minutes to complete this survey.

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

1. Are you a
2. Age of person with disability?
3. What type of disability do you or your loved one have?
4. Which county do you live in?
5. Which race/ethnicity best describes the person with the disability?
6. What is the primary language spoken at home? (Please choose only one.)
7. How many people are in your household?
8. Please check all the services the person with the disability currently has:
9. What is your approximate average annual household income? (Each year)