Aac Device Evaluation Form

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Name of intervention or device:
Dates:
Please indicate yes (Y) or no (N) under “before intervention” and “after
intervention”.
Before Intervention
After Intervention
IEP Goal Item
Initiates
Independent
Number Levels
Number Pictures per level
Combining Symbols (#)
Responds
Makes Choices
Requests
Negates
Greets
Comments
Participate in class
Argues
Express Feelings
Comments:

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