Ways of working

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Ways of working

Ways of working define a range of service structures and team processes that potentially influence the way decisions are made.

Balancing decisions

This refers to the process of debating the important elements of the AAC system and set up for the individual child. Where necessary making explicit trade-offs to reach the final decision. Findings suggest that contextual factors influence decisions within the communication aid recommendations process, e.g., service structures, team composition, service delivery and team knowledge.

Basis for the referral

This refers to the reason why a referral for a communication aid assessment is instigated and the influence of referral information received on the recommendation process.

Extraneous factors

This describes factors outside the immediate situation that influence the decision making course of action. This may include access to services, awareness of rights, the impact of chance. Findings highlighted the influence of unpredicted and unconnected extraneous factors within the decision making context.

How decisions are made

This describes how decisions are made and considers the processes used to make decisions within AAC system recommendation. Findings suggest that the way services are organised, and the work methods used may have a considerable impact on recommendation processes.

Information brokering

This refers to the access to, and movement of, information across parties or people within the decision making process. Findings suggest that service constraints in cross-sector (e.g., health and education) collaboration can make accessing all desired information challenging. This constraint results in decision making based on the available information, rather than desired information, which may affect outcomes.

Inheriting decisions

This describes how current actions are influenced by previous decisions. Findings suggest that the type of first aid chosen influences recommendation processes for second or subsequent communication aids. Consequently, extra care is needed in these early decisions, as they will have ramifications for the future.


This refers to any policies that influence access to AAC service support and funding. The findings suggest considerable variability in local interpretation of national policy and guidance.

Roles and responsibilities

This considers information about who does what in the communication aid recommendation process, and to what extent (including discord and unhelpful expectations of each other). Findings suggest that role clarity may be lacking in some communication aid recommendation processes.

Service delivery model

This considers the way a service is delivered which affects resources and services made available to the child. This includes service delivery models, team structures and communication aid recommendation processes. AAC services are delivered using lots of different service models. The findings indicate that different service delivery models had a considerable influence on the recommendation process.

Team theory

This describes AAC theory that may have influenced decisions. Findings suggest that many professionals use implicit theoretical frameworks to underpin their decision making. These related AAC and assistive technology models, professional education and clinical/teaching experience.

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