Aac Device Trial Data Form: Core Scanner

AAC   D evice   T rial   D ata   F orm:   C ore   S canner  

 

Name   o f   S tudent   _ _____________________________________________  

 

Date   _ ____________________  

 

Person   c ollecting   d ata   _ _______________________________________  

 

Start   T ime   _ _____________  

 

Device   u sed   _ ___________________________     A ctivity   _ ______________________                 End   T ime   _ ______________  

 

Core   S canner   U sed?     C orner   S tone   ( 8   w ords)     ☐     P rePathway   ( 8   w ords   o n   8 4   l ocation)     ☐              

Pathway   ( 84   l ocation   w ith   8 4   s ingle   h it   w ords)     ☐               J AM!   ( 84   l ocation   w ith   s equencing)   ☐    

 

Access   M ethod:   A uto   S can   ☐  

Step   S can   ☐    

Scan   P attern?         _ ____________________  

 

Message  

 

 

+   =   s aid   m essage   i ndependently      

Message   P urpose    

 

 

 

 

   =   s aid   m essage   i ndependently   b ut    

 

 

 

 

                  w ith   a   p rompt      

 

 

(request,   d escribe,    

 

 

 

 

 

 

 

 

 

 

direct   a ction,   c omment,  

 

 

 

 

 

 

 

 

 

 

show   h umor,   e tc)  

 

1.     _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

2.     _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

3.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

4.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

5.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

6.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

7.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

8.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

9.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

10.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

11.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

12.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

13.   _ _____________________  

___/___/___/___/___/___/___/___/___/___  

___________________________  

 

 

Notes   o r   C omments: