Self‐Assessment Instruments Related to Functional Ability for People Who Use Augmentative and Alternative Communication—A Scoping Review

ABSTRACT

Background

Everyone, regardless of whether they have disabilities, has the right to be heard and to participate in decisions that affect them, including their rehabilitation. Right to self‐determination extends to individuals with severe speech impairments who use augmentative and alternative communication (AAC). Self‐assessment instruments can be used when exercising this right. Historically, there has been a limited focus on self‐assessment instruments within the AAC field. This gap highlights the need to explore self‐assessment in AAC, motivating this scoping review.

Aims

The aim was to identify and characterize the self‐assessment instruments developed in the AAC field to date. Our specific aim was to investigate the existing self‐assessment instruments for both adult and paediatric AAC populations and identify gaps. We aimed to describe the availability, administration procedures and intended purposes of these instruments related to functional ability.

Methods

The PRISMA protocol for scoping reviews was followed for the search, inclusion, extraction and analysis of the studies. We included articles where self‐assessment instruments were used by or considered for people who use AAC (PWUAAC). The aims of the instruments were analysed according to the categories in the personal factors domain of the International Classification of Functioning (ICF) framework.

Main Contributions

The review presents a list of self‐assessment instruments along with a thorough description for each. This list can be used in clinical practice and research in the AAC field. The lack of instruments in several areas should inspire their further development. A systematic approach to self‐assessment in AAC could enhance autonomy and improve interventions.

Conclusions

The review identified 22 instruments for self‐assessment for PWUAAC of different ages, and most instruments used scales for responses. The focus of the instruments was on exploring the thoughts and beliefs of PWUAAC. The review revealed a lack of instruments addressing feelings, motives and non‐English languages, as well as a need to improve the instruments' psychometric properties.

WHAT THIS PAPER ADDS

What is already known on this subject

• The importance of involving clients in the planning of their rehabilitation has been widely researched, and clients' own evaluation has been shown to be crucial for understanding their specific daily requirements.

What this paper adds to existing knowledge

• This study identifies and describes the current self‐assessment instruments for PrAAC and highlights the gaps in the psychometric properties of existing instruments as well as their relation to personal factors of functional disability.

What are the potential or actual clinical implications of this work?

• Understanding the full spectrum of existing self‐assessment instruments not only helps clinicians effectively utilize them with PWUAAC but also facilitates the development of appropriate new instruments in collaboration with PWUAAC and researchers.

1. Introduction

Rehabilitation is a goal‐oriented activity in which a client, their partners and professionals should have a similar understanding of what is meaningful to strive for at each stage of life. This common understanding is constructed through the assessment of clients’ functional ability. According to the International Classification of Functioning, Disability and Health (ICF), functional ability consists of four components as follows: body functions, performance and participation, personal factors and environmental factors (WHO ²⁰¹³). Participation is considered a primary component and the most important change indicator (outcome measure) because all other components of functional ability affect participation (Eadie et al. 2006).

Self‐assessment of functional disability has become a crucial method in the field of rehabilitation for promoting autonomy. In recent years, clinicians have shown increasing interest in this approach. Currently, self‐assessment instruments play a critical role in healthcare planning and general life evaluations, with numerous tools available for individuals facing various challenges and medical diagnoses. For instance, the Patient‐Reported Outcomes Measurement Information System (PROMIS) offers a range of validated self‐assessment instruments tailored to physical, mental and social health (https://www.healthmeasures.net/explore‐measurement‐systems/promis). The self‐assessment instruments can be used to assess patients’ experiences of health status, symptoms and quality of life (Patient‐Reported Outcome Measures, PROMs) and their experiences with healthcare services (Patient‐Reported Experience Measures, PREMs).

According to two previous review articles, PROMS specifically developed for people who use Augmentative and Alternative Communication (PWUAAC) are not identified. Gardner et al. (2025) conducted a review and discovered that while there are numerous validated PROMs available to assist speech–language pathologists in assessing patient perceptions across various practice areas for adults, none specifically address PWUAAC. Broomfield et al. (2019) identified 15 self‐assessment tools that have been utilized with individuals who use communication aids. The domains on which the tools focused were communication, cognition, role, health, quality of life, physical, social, spiritual and AAC equipment. However, they noted that the concepts measured by these tools were broad and varied, and the quality of reporting in many studies was limited. This lack of consistency and detailed reporting undermined the reliability and trustworthiness of the findings in several of these studies.

PWUAAC form a heterogeneous group with varying medical diagnoses and utilizing a range of communication means, such as manual signs, communication books, and speech‐generating devices (SGDs). Martinsen and Von Tetzchner (1996) categorize PWUAAC into the following three functional groups: (a) those with the capability to understand spoken language but who struggle to speak themselves, known as the expressive language group; (b) the supportive language group, which has two sub‐categories, with one being children who use AAC means temporarily to aid in both understanding and expressing spoken language (developmental group), and the other being persons who can speak but have difficulties in making themselves understood in specific situations (situational group) and (c) the alternative language group, for whom using AAC means supports both understanding and expressing language.

During the rehabilitation process, an assessment can be done by employing measurements and tests conducted by professionals, surveys and interviews designed for partners and the client's self‐assessment. The purpose of self‐assessment is to understand the client's experience and view of their ability to contribute to daily life and to demonstrate change over time. In this article, self‐assessment refers to the process of mapping the experiences or perspectives of PWUAAC regarding their functional ability. In the literature, many concepts, such as tools, materials, methods and instruments, for describing self‐assessment are used. We will use the term instrument as an umbrella covering these materials and validated tools.

1.1. Meaning of Self‐Assessment

In the 1990s, resistance against the oppression experienced by people with disabilities was sparked within the societal disability movement. The idea spread through the slogan ‘Nothing about us without us’, which emphasized every person's right to control their own life, including bringing the voices of people with disabilities into the political decision‐making process (Charlton 1998). Gradually, the inclusion of the client's own voice has started to manifest itself in concrete actions within various rehabilitation, research and development projects, highlighting the importance of partnership with parents and relatives as well as with the clients themselves, from childhood to adulthood (e.g., Lehtonen et al. ²⁰²⁰). Over the last decade, client‐centredness has become the prevailing value in the field of rehabilitation, also affecting assessment practices. Public and patient involvement (PPI) has gained ground in intervention and research on people with disabilities (Staniszewska 2009). Traditional disorder‐ and expert‐centred evaluation is slowly morphing into a more collaborative process, where a common understanding of the client's functional ability is developed, together with various stakeholders (Maynard and Turowetz 2019; Rautakoski et al. ²⁰⁰⁸). Even though the rehabilitation paradigm is changing slowly, building partnerships and collaborating with all stakeholders is essential for successful implementation (Anaby et al. 2022).

Clients' participation in the planning of rehabilitation has been extensively studied, and it has been shown to strengthen the everyday impact of rehabilitation (Batorowicz et al. 2017; Eadie et al. ²⁰⁰⁶). No other approach discloses the client's individual daily needs and own assessment (Eadie et al. 2006), which in turn supports the design of goals that are meaningful to the client (Sakzewski et al. 2014). In studies involving PWUAAC using communication aids, listening to the client's views has been found to help re‐shape the social environment, strengthen participation, increase the efficiency of communication, improve the acceptance and adoption of communication aids and reduce frustration (e.g., Batorowicz et al. ²⁰¹⁴). The client's own assessment is also a socially valid way to demonstrate change achieved through rehabilitation (Eadie et al. 2006). By listening to the client's perspective, we gain information on what is not working in daily life, reducing professionals' erroneous assumptions (King et al. 2014). Furthermore, self‐assessment allows us to consider how a disorder affects the client's activities since the severity of the disorder does not necessarily predict the level of challenge it causes in daily participation (Dattilo et al. 2008; Hartelius et al. ²⁰⁰⁸). A professional's assessment, for instance, on the communication needs in daily communication situations (Gray et al. 2012) or on the preferred method of intervention (Clarke et al. 2001) can differ greatly from the client's own views, and thus, the professional's perspective should be approached with caution.

1.2. Adapting Self‐Assessment Instruments

According to the United Nations´ Convention of Rights of Persons with Disabilities, the right to make choices and decide on one's own affairs, including rehabilitation, is part of every person's right to self‐determination (United Nations ²⁰⁰⁶). There is, however, evidence that cognitive and language disorders may exclude participation when self‐assessment instruments are used (e.g., Cohen et al. ²⁰²¹), which can lead to decreased autonomy and significantly compromised and misleading research results (Duncan et al. 2002).

PWUAAC may, however, face challenges, especially in understanding language, expressing themselves and cognitive functions (such as memory, reasoning, visual perception and metacognition) (Beukelman and Mirenda 2013; Binger and Light ²⁰⁰⁸), and all these skills are required for self‐assessment. Professionals, therefore, have a special duty to support the inclusion of the voices of those in vulnerable positions, and often self‐assessment requires adapting existing materials and supporting the assessment process in situ. If a client cannot contribute to self‐assessment, a proxy may respond to a survey in the way that they think the client would reply (Duncan et al. 2002).

Several studies introduce different methods to support and facilitate clients' responses. Cohen et al. (2021) refer to other researchers' articles and summarize the following supportive practices for people with cognitive and/or linguistic challenges: (a) using simple sentences, (b) writing or circling key words and phrases, (c) gesturing, (d) summarizing, (e) asking yes or no confirmation questions, (f) observing and allowing nonverbal language and (g) allowing plenty of time to respond. Finlay and Lyons (2001) also provide recommendations for creating questions for people with developmental disabilities. They advise avoiding questions that require (a) assessing time, frequency or degree; (b) understanding comparisons or references; (c) understanding abstract concepts such as independence and responsibility; (d) understanding complex language, such as the passive voice and negative form; (e) describing other people's emotions or thoughts; (f) talking about things on a general level and (g) discussing issues unfamiliar or sensitive to the evaluator. They also believe it is important to pay attention to the form of questions, as individuals with developmental disabilities are more likely to respond affirmatively to yes–no questions. Moreover, oral multiple‐choice questions require memory capacity, and open‐ended questions may go unanswered if expression is challenging for the evaluator. Finlay and Lyons (2001) also state that it is probably impossible to develop an assessment tool for people with developmental disabilities that would work for everyone since each person with developmental disabilities is unique.

The right to self‐determination also applies to children and means different things at different ages. A child always has the right to influence their rehabilitation and to express their needs and the issues that are important to them (Koivikko and Sipari 2021). Adults must enable children to be heard and adapt their own actions as needed. Nilsson et al. (2015) proposed similar principles for child self‐assessment as those described by Finlay and Lyons (2001) above. Nilsson et al. (2015) also introduced other more indirect ways of exploring a child's world besides asking questions, such as organized puppet play, photography and video recording of daily life. Vänskä et al. (2020) have successfully used photographs when interviewing children receiving rehabilitation about their participation and agency in their everyday lives. Observing daily life videos also enables self‐reflection on intervention by the client, as demonstrated, for instance, for facilitating the social play skills of children (Wilkes‐Gillan et al. ²⁰¹⁷).

The use of pictures, drawings and other visual materials alongside individual communication are common ways to support PWUAAC in language comprehension and expression. Talking Mats is a systematic method developed for expressing opinions, utilizing graphic symbols in interviews (https://www.talkingmats.com). In practice, an open‐ended question is presented to the client (e.g., ‘what do you think about school?’) together with a graphic symbol (or written word) representing the topic. The client evaluates the topic by placing the symbol related to the question on a mat at the desired position on a 3–5‐point scale. According to a review article by Stans et al. (2019), the Talking Mats method has been researched in people who have dementia, aphasia, developmental disabilities, learning difficulties and are in intensive care or use AAC means. In these studies, Talking Mats was used for facilitating communication and involvement, goal‐setting and diagnostic processes. Experiences of the method were mostly positive, but there was also criticism regarding the method's slowness and unnaturalness. On the other hand, the slower pace also supported the evaluators' ability to focus peacefully on the assessment. Utilizing Talking Mats has also been reported to surprise partners positively and to enable full‐fledged contribution for PWUAAC (Rabiee et al. 2005).

1.3. Subjective Experience of Functional Ability

Nowadays, ICF classification and framework of functional ability are universally accepted and have received praise as a comprehensive model that covers physical, psychological and social functioning. A criticism has focused on the component ‘personal factors’, which is not categorized hierarchically by four level codes, unlike the other components (Jelsma 2009). In the manual of ICF classification, personal factors are described as a general list including, for example, age, lifestyle, habits, coping styles and past and current experience (WHO ²⁰¹³). The reason for personal factors not being coded, but only listed, is the large social and cultural variance in this component.

In response to the criticism, Geyh et al. (2019) developed a classification for the personal factors according to the principles of ICF. They divide personal factors into three parts. The first part covers individual facts, the second subjective experience and the third recurrent patterns of behaviour.

The second part consists of the areas of feelings, thoughts and beliefs and motives. The area of feelings covers emotions and moods of the person. Thoughts and beliefs address attitudes and evaluation. Motives focuses on needs, interests and goals of the person. The second part of personal factors works as an umbrella that covers all other ICF components (body functions, performance and participation and environmental factors). It means that a person's feelings, thoughts and beliefs and motives are coded in relation to (1) one's own person; (2) one's health condition, body or activities and participation; (3) other persons; (4) the physical environment, including events, time and space; (5) services, systems and policies; (6) transcendence and spirituality (7) and other (un)specified factors (see classification in Geyh et al. ²⁰¹⁹). Feelings, thoughts and beliefs and motives are not directly accessible to outside observers as the first and the third parts of personal factors are. Assessing them always necessitates hearing the client´s opinion, particularly relevant for self‐assessment.

1.4. Research Aim

Previous research has shown the importance of giving all people, especially those who are vulnerable, the possibility to affect their rehabilitation and express opinions about their functional ability. Despite the significance of self‐assessment in the target group of PWUAAC, there seems to be a knowledge gap concerning materials that exist and their potential use (Broomfield et al. 2019). This study aims to identify, describe and find the gaps in existing instruments for self‐assessment related to functional ability for PWUAAC. Research questions are the following: (1) What self‐assessment instruments exist for PWUAAC? (2) For what purposes, related to personal factors, have the instruments been used? (3) How are the instruments conducted for self‐assessment? and (4) If measured, what are the psychometric properties of these instruments.

2. Method

2.1. Study Design

A scoping review format was chosen as the study design. Scoping reviews can be used to map existing literature in a field, to summarize research findings and to identify research gaps (Armstrong et al. 2011). The reasons for choosing a scoping review format for this study were that self‐reported tools in the field of AAC are fairly new phenomena, and we expected to find a limited number of studies. The procedure for the search, analysis and report was conducted according to the checklist in Preferred Reporting Items for Systematic Reviews and Meta‐analysis Extension for Scoping Reviews (PRISMA‐ScR, Tricco et al. ²⁰¹⁸).

2.2. Search Strategy

Searches were performed in six databases as follows: Scopus, PubMed, Ebsco, ComDisDome, Psych Info and ProQuest. These databases include studies from the field of speech and language therapy and AAC. The following search statement was used uniformly in all the databases: (aac AND communication AND self AND (asses* OR evaluat* OR rat* OR repor* OR estimat*)). AAC and communication were used to limit the search to the target group with communication impairment, relying on AAC. The word ‘self’ was included to find materials where the persons who use AAC themselves do an assessment. Synonyms to ‘assessment’ were included—evaluation, rating, report and estimation. In our search statement, we also tried ‘tools OR materials’, but it did not add any new articles. Due to the expectation that there would be a scarcity of materials, no time limit for the publications was indicated in the search. However, the articles were required to be in English and published in international peer‐reviewed journals. The search was done between 9 February 2023 and 25 May 2023.

2.3. Study Selection

The digital search yielded 443 articles, and, in total, 21 articles met the eligibility criteria for data extraction for the review. Descriptive data of the included articles (authors, title, journal and year of publication) are provided in the Supporting material (Table S1). Figure 1 presents a summary of the selection process.

FIGURE 1.

Identification of studies via databases.

After the deletion of duplicates, the articles were divided between the two authors to be checked for studies matching the research questions. Reasons for inclusion and exclusion were discussed several times during the process. Finally, we conducted manual searches by reviewing the reference lists of articles that had already been identified in our initial search.

The eligibility criteria are outlined in Table 1. Any conflicts, doubts or discrepancies about the inclusion or exclusion of studies were discussed and resolved between the authors. Two inaccessible articles were excluded after author contact, as they did not meet the inclusion criteria. The instruments used in the data collection were designed either for a selected study or for general use. We decided to include both types of instruments to examine whether they could be utilized in clinical work with clients. The articles employing solely the method of Talking Mats were excluded because a scoping review of studies using Talking Mats already exists (see Stans et al. ²⁰¹⁹), and Talking Mats is a general tool without a specific focus, used also for other purposes than self‐assessment. Due to the limitations of the scope of the current review and the availability of studies, the quality or rigour of the studies was not considered eligibility criterion.

TABLE 1.

Eligibility criteria.

Inclusion criteria	Exclusion criteria
Published in English	We did not have access to the article.
Peer reviewed	Talking Mats was the only instrument used.
Included self‐assessment instruments, utilized or mentioned that they could be utilized, with people who have severe speech or language impairment (permanent or temporary) and use AAC.	The instrument was created solely to explore a specific research question and could not be used in another context.
Participants were of different ages.	Procedure was not clearly documented.
Participants used different communication means, including speech.	The self‐assessment instrument was not introduced in the article.
	The aim of the study was to develop a technical system for controlling communication devices.

2.4. Data Charting Process and Data Items

The charting process enables the authors to identify commonalities, themes and gaps in the literature (Armstrong et al. 2011). The data extracted should contribute to the response to the research questions of the scoping review (Hansen and Nørgaard 2023). The data analysis process was characterized by an inductive approach, at first, finishing with a deductive approach. Initially, we familiarized ourselves with the included studies and extracted information about participants, research purpose and the country of the data. Thereafter, we created a tentative extraction sheet related to our research questions. A pilot extraction was conducted by both authors using the same five articles. Following the pilot extraction and after discussion, the extraction sheet was revised. Each author independently extracted information from the studies included. We exchanged articles with each other during the charting process to ensure that both authors became familiar with all studies. Throughout the process, disagreements and doubts were resolved by the authors.

In the next step, we extracted the instruments used in the articles. We categorized the instrument data into the following categories: name of instrument, original reference to instrument and instrument aimed or used for the adult or child population. To characterize the instruments, we noted whether the instrument was designed originally for PWUAAC and the original language of the instrument. Further, we charted the number of items in the instrument, the procedure of the instrument, the response method, the psychometric properties of the original and applied versions and the availability of the instrument.

In addition, in order to analyse the instruments with regard to purpose and the personal factors in the ICF, we used a combination of directed content analysis and summative content analysis (Hsieh and Shannon 2005). We charted the reported focus of self‐assessment and coded the subjective experience according to the predetermined codes of Geyh et al. (2019). Then we counted the occurrences of each category. We chose Geyh's et al. model to explore the purpose of self‐assessment because it utilizes the framework of the ICF, and its second part, ‘beliefs, thoughts, and motives,’ approaches functional ability from a person's own perspective. The coding was done separately, and thereafter, disagreements and doubts were resolved jointly by the authors.

3. Results

The search resulted in 220 studies after removing duplicates, of which 17 studies and another four studies manually found were considered eligible for this review. See Table 2 for the characteristics and purposes of the 21 included studies. Publication dates ranged from 2002 to 2023. Data were generally collected in English‐speaking countries (Australia, Canada, South Africa, United Kingdom and United States), but three other countries were also represented (Finland, the Netherlands and Sweden). The purpose of 16 studies was to explore a specific research question by utilizing a self‐assessment instrument, and in four studies, the purpose was to assess and develop a self‐assessment tool. One article had both aims.

TABLE 2.

Characteristics and purposes of the studies included.

		Participants
	Authors	Age, y	N/PrAAC	Description	Research purpose	Country of data
1	Balandin et al. (2006)	>40	20/9	Cerebral palsy	1. Explore and compare the levels of loneliness between the two groups 2. Test the reliability of the UCLA Loneliness Scale	Australia
2	Batorowicz et al. (2014)	5–14	16/8	Cerebral palsy (7), not defined (1), parents (8)	Examine the views on social participation, communicative interactions and relationships	Canada
3	Batorowicz et al. (2017)	19–51	16/5	AAC professionals (11), AAC users (5)	1. Describe the development of SEAS‐PCS 2. Explore the equivalency of the SEAS and SEAS‐PCS	Canada
4	Baylor et al. (2013)	24–99	701/0	Multiple sclerosis (216), Parkinson's disease (218), ALS (70), head and neck cancer (197)	1. Finalize the item set for the CPIB item bank 2. Assess the ability of the CPIB to serve as a cross‐disorder instrument 3. Generate a clinic‐ready short form	United States and Canada
5	Beringer et al. (2013)	35–81	20/10	Moderate to severe aphasia (10), partners (10)	1. Determine the topic preferences 2. Compare the self‐selected and partner‐predicted topic preferences	South Africa
6	Clarke et al. (2011)	7–16	10/10	Cerebral palsy (7), other neurological (3)	Examine short‐term outcomes of AAC provision by exploring the views of children receiving new communication aids	United Kingdom
7	de Knegt et al. (2016)	20–66	40/0	Down syndrome	Study usability of Self‐Reporting Tool on Pain (STOP)	The Netherlands
8	Grace et al. (2019)	13–40	6/6	Mentees (4), mentors (2)	Examine the potential contributions of cross‐age peer e‐mentoring intervention to enhance participation in online conversations	Australia
9	Grace et al. (2023)	13–40	10/6	Mentees (4), mentors (2), parents (4) a	Investigate the effectiveness of cross‐age peer e‐mentoring for personal goal attainment and describe the experiences of participants and parents	Australia
10	Happ et al. (2014)	48–68	119/30	Intubated intensive care unit (ICU) patients (30), nurses (89)	Test the impact of intervention on communication frequency, quality, success and ease between nurses and intubated intensive care unit patients	United States
11	Huang & Dodder (2002)	NR	519/519	Mental retardation, received creative therapy (168), control group (351)	Examine the relationship between participating in creative therapy and engaging in initiative activities outside of therapy	United States
12	Hynan et al. (2014)	14–24	25/25	Cerebral palsy	1.Study the accessibility and use of the internet and online social media 2. Explore the perceived role and importance of the internet and online social media for self‐determination and self‐representation 3. Establish how online social media is perceived in terms of social ties	United Kingdom
13	King et al. (2014)	16–22	12/7	Physical disability	Examine the leisure activity setting experiences	Canada
14	Lilienfeld & Alant (2005)	12–16	14/1	Cerebral palsy (1), peers (13)	Determine the effect of a peer‐training program on interaction patterns	South Africa
15	Lund & Light (2006)	19–23	7/7	Cerebral palsy	Explore the long‐term outcomes of AAC interventions using a theoretical framework based on the ICF	United States
16	Nilsson et al. (2012)	3–9	42/0	Typical development	Test the reliability and validity of the modified short STAI using the framework of Talking Mats	Sweden
17	Peters et al. (2023)	21–89	206/206	ALS	1. Investigate the effects of aided communication on self‐rated communicative participation 2. Examine the relationship between speech function and participation at various stages of speech impairment and communication aid use	United States
18	Raghavendra et al. (2011)	11–14	39/14	Physical disability and CCN (14), physical disability (11), typical development (14)	Examine the impact of communication difficulties on activity participation	Australia
19	Rautakoski et al. (2008)	26–65	70/18	Aphasia (35), partners (35)	1. Ascertain how people with aphasia evaluate their own communicative skills during rehabilitation by means of modified assessment tools 2. Compare their estimations with those of their significant others	Finland
20	Taylor et al. (2021)	18–65	16/7	Cerebral palsy (5), dysarthria (1), stroke (1), clerks (9)	1. Identify what facilitates retail communication access for people with complex communication needs 2. Study the impact of communication in the retail context on social inclusion	Australia
21	Thirumanickam et al. (2011)	6–9	10/5	Typical development (5), physical disability and CCN (5)	Describe and compare the participation and social network patterns of children with and without physical disabilities and complex communication needs	Australia

^a Parents’ age is not reported.

The total number of participants was 1918, PWUAAC comprising 893 participants. Ten studies targeted children and youth, nine targeted adults (18–99 years), and three targeted subjects of all ages. Except for one study (Nilsson et al. 2012), the studies involved people with varying diagnoses. In two studies, a control group with typical development also participated (Raghavendra et al. 2011; Thirumanickam et al. ²⁰¹¹), and in eight studies, parents, significant others, peers, clerks or professionals were also involved.

3.1. Characteristics of Existing Instruments

The review identified 22 self‐assessment instruments: nine for adults, 10 for children and young adults and three for people of all ages (Table 3). Most of the instruments were used in only one study, but four instruments (ALSFRS‐R, CPIB, CAPE, SEAS‐PC) were utilized in several studies.

TABLE 3.

Origin of self‐assessment instruments as reported in the included articles (IA).

Instrument	Original author(s) a	Original target group and age	Original for PrAAC	Original language b	#IA
Adults
Physical function part of ALSFRS‐R	Cedarbaum et al. (1999)	Patients with ALS	No	English	4, 17
CETI (Communicative Effectiveness Index)	Lomas et al. (1989)	Significant others of people with aphasia	No	English	19
CPIB Communicative Participation Item Bank (short)	Baylor et al. (2009)	Community‐dwelling adults across different communication disorders and life situations	Yes	English	4, 17
EC c (Ease of communication scale)	Authors of article number 10	Adult patients in intensive care unit	Yes	English	10
PCR (Pictographic Communication Resource)	Kagan et al. (1996)	People with aphasia	Yes	English	5
Questionnaire I d on communication access in the retail context	Authors of article number 20	Adults who use AAC	Yes	English	20
STOP‐ID! (Self‐reporting tool on pain for intellectual disabilities)	Authors of article number 7	Adults with intellectual disabilities	Yes	Dutch	7
UCLA Loneliness Scale	Russell (1996)	Adults, college students, nurses, teachers and the elderly	No	English	1
UDCM (Use of Different Communication Methods)	Authors of article number 19	People with aphasia	Yes	Finnish	19
Children and youth
ASDS (The Arc's Self‐Determination Scale)	Wehmeyer and Kelchner (1995)	Adolescents with cognitive and developmental disabilities	No	English	15
CAPE (Children's Assessment of Participation and Enjoyment)	King et al. (2004)	6–21 years, individuals with and without disabilities	No	English	13, 18, 21
MSCS (Multi‐dimensional Self Concept Scale)	Bracken (1992)	9–19 years, students in both regular and special education programs	No	English	14
Multi‐part Instrument d on outcomes of communication aid provision	Authors of article number 6	7–16 years, aided communicators	Yes	English	6
PAC (Preference for Activity Participation)	King et al. (2004)	6–21 years, individuals with or without disabilities	No	English	21
PNS (Peer Nomination Scale)	Lilienfeld (2003)	Adolescents who use high‐tech devices	Yes	English	14
Questionnaire II d on communication and friends	Authors of article number 2	5–14 years, who use communication aids	Yes	English	2
Questionnaire III d on use of digital technology and social media	Authors of article number 12	14–24 years, who use communication aids	Yes	English	12
SEAS‐PCS (Self‐Reported Experiences of Activity Settings adapted to AAC)	Batorowicz et al. (2017)	From 8 to 9 years developmental age, PWUAAC with or without physical impairments	Yes	English	3, 8
SEAS (Self‐Reported Experiences of Activity Settings)	King et al. (2014)	From 8 to 9 years developmental age, with or without physical impairments	No	English	13
All ages
COPM (Canadian Occupational Performance Measure)	Law et al. (1990)	Consumers of occupational therapy	No	English	9
DDQAQ (Development Disabilities Quality Assurance Questionnaire)	Nihira et al. (1974)	People of all ages with developmental disabilities	No	English	11
Short STAI (State‐Trait Anxiety Inventory)	Apell et al. (2011)	5–16 years and adults, typical development	No	Swedish	16

^a The references are written as they are mentioned in the included articles of this study.

^b Inferred from the country of the data.

^c The acronym was assigned by the authors of this article.

^d The original authors do not use any specific name for the instrument.

The instruments were created from 1974 to 2021. Most of the instruments were in English. The included self‐assessment instruments were applied with PWUAAC, or the authors mentioned that they could be used with PWUAAC. Half of the original instruments were designed for PWUAAC. Three of the original instruments were designed for people with typical development (CETI, UCLA Loneliness scale and STAI), 15 for people with medical diagnoses and four for people in both groups (CAPE, MSCS, PAC and SEAS).

3.2. Focus of Assessment and Relation to Personal Factors

All instruments assembled focused on all three areas identified under subjective experiences: (1) Feelings, (2) Thoughts and Beliefs, and (3) motives in the domain of personal factors according to Geyh et al. (2019) (Table 4). Four instruments focused on more than one area. Both the Arc's Self‐Determination Scale (ASDS) and the Canadian Occupational Performance Measure (COPM) covered different aspects related to all three areas. A majority of the instruments (n = 19) focused on thoughts and beliefs, exclusively or among other areas.

TABLE 4.

Personal factors and focuses of self‐assessment instruments.

Code	Focus		Instrument
i4	Feelings
i410	Emotions
i4104	Activities and participation	Enjoyment	CAPE
i4106	Physical environment	Anxiety in context	Short STAI
i4107	Services	Communication access in retail context	Questionnaire I
i498	Feelings, other specified
i4981	Own person	Self‐determination	ASDS
		Loneliness	UCLA
i4982	Health condition	Current or remembered pain	STOP‐ID!
i4984	Activities and participation	Activities of daily living	COPM
i5	Thoughts and beliefs
i530	Personal attitudes
i5307	Services	Outcomes of communication aid provision: SLT services and AAC systems	Multi‐part instrument
i560	Personal evaluation
i5601	Own person	Self‐concept	MSCS
i5603	Body	Speech function	ALSFRS‐R
i5604	Activities and participation	Self‐determination	ASDS
		Leisure activity	CAPE
		Communicative effectiveness: verbal and non‐verbal communicative abilities	CETI
		Activities of daily living	COPM
		Communicative participation	CPIB
		Initiative activities	DDQAQ
		Ease of communication	EC
		Use of digital technology and social media	Questionnaire III
		Communication and friends	Questionnaire II
		Leisure activity	SEAS
		Leisure activity	SEAS‐ PCS
		Use of different communication methods	UDCM
i5605	Other persons	Self‐determination	ASDS
		Communication and friends	Questionnaire II
i5607	Services, systems, policies	Communication access in the retail context	Questionnaire I
i570	Personal preferences
i5704	Activities and participation	Activities of daily living	COPM
		Preference for activity participation	PAC
		Topic preferences	PCR
		Use of digital technology and social media	Questionnaire III
i5705	Other persons	Sociometric status	PNS
i6	Motives
i620	Personal interests
i6209	Unspecified	Self‐determination	ASDS
i630	Personal goals
i63019	General life, unspecified	Self‐determination	ASDS
i63024	Specific behavioural, activities and participation	Activities of daily living	COPM
i63027	Specific behavioural, services	Outcomes of communication aid provision: SLT services and AAC systems	Multi‐part instrument

There were seven instruments in the area of Feelings. They addressed leisure enjoyment, anxiety, loneliness, pain and feelings about communication access and self‐determination. Three instruments were aimed at adults, two at children and youth and one at persons of all ages.

Nineteen instruments included the area of Thoughts and Beliefs. Among these, most instruments (n = 12) addressed personal evaluations related to different aspects of the person's activities and participation, e.g., communication and friends and leisure activities. Five instruments addressed personal preferences, and one assessed personal attitudes. Seven instruments were for adults, seven instruments for children and youth and two instruments for persons of all ages.

Regarding the area of Motives, the search identified three instruments. These instruments focused on personal goals related to daily living activities, self‐determination, SLT services and AAC systems. Two of the instruments concerning motives were designed for children and youth, and one for persons of all ages.

3.3. Procedure and Response Methods of the Instruments

The self‐assessment instruments contained 1–150 questions or statements, with a median of 14 (Table 5). Questions used in the instruments were binary, close‐ended or open‐ended. Multiple‐choice questions and ratings were also used in three instruments. A majority of the instruments (n = 17) contained scales that the participant was supposed to point at when answering the questions. Among these, symbols were utilized to illustrate the scale values in eight instruments. A scale could refer to, for example, quality, difficulty, importance or frequency. The scales varied from three to 10 scale bars. In four instruments, the participants were required to use their own AAC systems or partner‐assisted scanning was used.

TABLE 5.

Procedure, psychometric properties and availability of self‐assessment instruments according to the included articles.

Instrument	Items	Procedure	Response method	Psychometrics		Availability	#IA
				Rel	Val
Adults
ALSFRS‐R	1	Score 0–4 (quality)	Activating response in a digital survey	NR	S	Online	4, 17
CETI	16	‘Are you able to…?’ 10‐cm Visual Analogue Scale (quality). Adaptation for applied version: Symbols were added to the questions and scale. Translation in Finnish.	Pointing at the scale	App‐S Or‐S	App‐NR Or‐S	No, but the original version is in the original article.	19
CPIB	10	‘Does your condition interfere with…?’ 4‐point Likert scale (quantity)	Pointing at the scale	NR	S	In appendix	4, 17
EC	1	5‐point Likert scale (difficulty) at the end of each session	Pointing at the scale	NR	NR	In article	10
PCR	37	‘Would you like to talk about…?’ 3‐point scale (yes, maybe, no). Adapted version of Talking Mats.	Putting pictures on a scale	NR	NR	Topics listed in the article. Cards purchased online.	5
Questionnaire I	14	Face‐to‐face or email interview	Using their own high‐tech communication systems	NR	NR	In supplemental material	20
STOP‐ID!	4	(1) Location: Illustration of body, (2) intensity: 0–10 scales, (3) affect and (4) quality: Pictogram symbols. Instructions and questions were provided by written text and recorded voice output.	Activating response in a digital survey	NR	NR	No (digital survey), but introduced in the article.	7
UCLA Loneliness scale	20	‘How often do you…?’ 4‐point Likert scale (frequency). Adaptation for applied version: Added graphic symbols to the existing scale.	Pointing at the scale	App‐S Or‐S	NR	No, but the original version in the original article.	1
UDCM	20	10‐cm Visual Analogue Scale with symbols (frequency)	Pointing at the scale	S	NR	In the appendix without symbols	19
Children and youth
ASDS	72	Multiple‐choice and open‐ended questions	Using partner‐assisted scanning and own AAC systems	S	S	Online	15
CAPE	5	Two stages: (1) Children were asked whether they had participated in each of the 55 activities; (2) 7‐point scale (frequency), 5‐point scale (1 = alone to 5 = with others), 6‐point scale (1 = at home to 6 = beyond your community) and 5‐point scale (quantity of enjoyment).	Pointing at the scale	S	S	Purchased online	13, 18, 21
MSCS	150	4‐point Likert‐scale (agreement)	Pointing at the scale	NR a	NR a	Original version in the original article	14
PAC	6	An extension of CAPE and used after CAPE. 3‐point scale (preference).	Pointing at the scale	S	S	Purchased online	21
PNS	8	Ranking (e.g., You are the group leader for a geography project. Choose three learners from your class to be on your team).	Using their own high‐tech communication systems	NR	NR	General description in the article, referring to an unpublished dissertation.	14
Multi‐part instrument	29	Six stages: (1) 12 items. Closed questions (binary relevance), (2) rating line (difficulty of relevant activities), (3) rating line (importance of relevant activities), (4) choosing a single activity that was both ‘difficult’ and ‘important’ to discuss in greater detail. (5) Assessing the chosen activity by three themes and 14 items (binary agreement) presented in symbol form, (6) assessing a level of problem of the realized items on a scale (big to small problem). Interviewer and child worked together with the visual materials presented by the computer. Option to stop or repair the conversation by symbols.	Yes/No responses or Pointing at a line or symbol	NR	NR	In supporting material	6
Questionnaire II	12	Open‐ended questions and an interview	Using their own high‐tech communication systems	NR	NR	In appendix	2
Questionnaire III	24	Open‐ended questions and an interview	Using own AAC system	NR	NR	In appendix	12
SEAS‐PCS	22	7‐point scale (agreement), and both ends are presented by symbols. Items presented by text and symbols. Used independently or with help after the activity.	Pointing at the scale	NR	S	In appendix without symbols	3, 8
SEAS	22	7‐point scale (agreement). Used independently or with help after the activity.	Pointing at the scale	S	S	Original version in the original article	13
All ages
COPM	NR	Semi‐structured interview. Scales 1–10 (ability and satisfaction).	NR. Specific protocol for patients with verbal disabilities.	S	S	Purchased online	9
DDQAQ	5	‘Do you choose…?’ 3‐point scale (frequency)	Pointing at the scale	S	S	In article	11
Short STAI	4	‘I feel…’. 3‐point scale (quantity). Adaptation for applied version: Two statements less than in original. Widgit symbols representing feelings. Different sizes of circles representing scale. Adapted version of Talking Mats.	Putting pictures on a scale	App‐ InS/S b Or‐S	App‐InS Or‐S	In article	16

Abbreviations: #IA, sequence number of included article; App, applied instrument; InS, insufficient; NR, not reported; Or, original instrument; Rel, reliability; S, at least sufficient; Val, validity.

^a Reported in the original study.

^b Insufficient < 7 years; sufficient > 7 years.

3.4. Psychometric Properties and Availability

The psychometric properties were not reported at all in eight self‐assessment instruments, and neither reliability nor validity was reported in five instruments (Table 5). When psychometric properties were reported, they were assessed at least sufficiently, with one exception (short STAI). The reliability of self‐assessment instruments was generally examined either by measuring how well the different items of the instrument measure the same attribute (internal consistency) or by assessing the stability of the instrument over time by administering the same test to the same subjects at two different points in time (test–re‐test). The validity of the materials was evaluated by examining whether the tool truly measures the theoretical construct it is intended to measure (construct validity).

In three studies, researchers adapted the original version for the needs of PWUAAC, and they reported the psychometric properties of the original and the adapted versions (CETI, UCLA Loneliness and short STAI). There was also one instrument (SEAS‐PCS) that was an adapted version of the original instrument (SEAS) and had its own product name and copyright. In this study, this instrument was explored as an independent instrument.

Regarding the availability of the 22 instruments, seven can be accessed free online, albeit two without symbols. Three of them can be purchased online. Six instruments are included in the article or in the appendices or supporting material of the articles. In three articles, the original instrument is referenced to the original article.

4. Discussion

In this review, we identified 22 self‐assessment instruments for PWUAAC. The instruments were evenly distributed between those designed for children and those intended for adults. The most common format was a statement evaluated on a scale. We found a lack of instruments addressing the feelings and individual goals of PWUAAC, and only a few instruments were originally developed to meet the needs of PWUAAC. The results of the review can be beneficial in clinical intervention and in future research.

In comparison with the study by Broomfield et al. (2019), it is noticeable that the current study did not find more than two instruments that were the same. The reason for this may be that we used different search words or that Broomfield and colleagues focused on aided AAC use, and the current study had a broader focus.

4.1. Procedure of the Instruments

Generally, it seems that the self‐assessment instruments used were not highly adapted to meet the needs of PWUAAC. Conducting self‐assessment requires both language comprehension and expression skills. Regarding language comprehension, it is noteworthy that plain language was not discussed in developing the instruments (see Finlay and Lyons ²⁰⁰¹). The non‐use of plain language in the instruments implicitly takes for granted that the PWUAAC has good language skills, although PWUAAC may have language comprehension difficulties (Binger and Light 2008). There were, however, eight instruments in which graphic symbols were used alongside the items to ensure understanding.

Several different question formats were employed in the instruments. Most of them used close‐ended questions where the responses are more controllable and possible to quantify, but also more restricted. Thus, close‐ended questions require less linguistic skills to respond but are more limited when it comes to expressing an opinion. Open‐ended questions, in turn, are more demanding to answer but are less restricted when expressing views. Thus, open‐ended questions require that the responder has an advanced AAC system with a large vocabulary and the possibility to generate many nuanced utterances.

Most of the instruments utilized different scales that were easy to point at, even if a responder had severe motor disabilities. In one instrument (Lund and Light 2006), if the PWUAAC could not point to the scale, the researcher used partner‐assisted scanning. The reason for utilizing scales is probably that scales provide quantitative data. Moreover, scales are considered to be easy to use and understand, although this can be debated. In some instruments, graphic symbols were used to supplement the scales. There were no instruments that utilized alternative methods of expression during self‐assessment, such as playing, photography or video observations (see Nilsson et al. ²⁰¹⁵; Vänskä et al. ²⁰²⁰; Best et al. ²⁰¹⁶). Self‐assessment appeared to be treated like a traditional survey, with creative methods to gauge the PWUAAC ’s opinions being rare.

Researchers often seemed to choose participants who could participate fluently and express themselves in a nuanced way. Based on participants’ profiles in the studies, we conclude that most participants belonged to the expressive language group (Martinsen and von Tetzchner ¹⁹⁹⁶). Thus, there is a potential risk that if the materials are not adapted sufficiently to individuals communicating with AAC (e.g., plain language, supplement with graphic symbols, creative methods), some PWUAAC may be excluded from self‐assessment, and consequently, excluded from the right to make choices and important decisions. It is important to note that our review did not include studies involving Talking Mats. Talking Mats is a widely used tool that supports expressing and understanding, and it is used with individuals in the alternative language groups. The exclusion of such studies may have limited the scope of the review in terms of understanding the full range of self‐assessment instruments available for people who use AAC.

It is also worth reflecting on the amount of multimodal co‐construction between communication partners, a prevailing feature in everyday interaction involving PWUAAC (Savolainen et ²⁰²⁰). The communication partner commonly plays a crucial role when the PWUAAC constructs their contribution. The communication partner frequently takes on several tasks, such as, for example, voicing, adding prosody and adding grammar (Sigurd Pilesjö and Rasmussen ²⁰¹¹). The feature of co‐construction may be expected also to occur when conducting self‐assessment, and in that way, the support person/communication partner may potentially unconsciously also affect the response. In their review, Broomfield et al. (2019) also explored the authorship involved in completing the PROM and noticed how poorly it was reported. They found that in some cases, it was a researcher who completed the questionnaires. This risk has not been highlighted in the self‐assessment instruments identified here, but it should be noted.

4.2. Purpose of the Instruments

Since self‐assessment instruments focus on the person's own evaluation of different aspects of their life, we wanted to characterize the instruments within the component of personal factors in ICF. For this purpose, we utilized Geyh et al. (2019) categorization and found that the area of subjective experiences with the different groups (feelings, thoughts and beliefs and motives) was well‐suited to the aim of the analysis. The categorization and coding were effortless. A majority of the instruments focused on group Thoughts and beliefs and were related to participation in different contexts. The focus on participation seems understandable due to the fact that participation is considered the most important outcome measure. All other components of functional ability affect participation (Eadie et al. 2006), and severity of the disorder does not necessarily predict the level of challenge it causes in everyday participation (Dattilo et al. 2008; Hartelius et al. ²⁰⁰⁸).

Instruments focusing on feelings and motives, comprising goals related to functional ability, were lacking. This is a surprising finding considering that affective dimensions, such as feelings and the motivation to undertake change, greatly impact the outcome of an intervention in general (Riger 2001). Self‐assessed goals have been found to increase motivation and enhance attainment of goals (Sakzewski et al. 2014). Thus, there is a need for more instruments dealing with feelings and motives.

The current review differs in a few aspects from the review by Broomfield et al. (2019), and the two studies can be seen as complementing each other. The analyses differ; in this review, a more deductive approach was taken at least at the end of the process. Broomfield has a focus on outcome measures of therapy; our study has a broader focus on different aspects of life in general. Their review covers aided AAC use, but our review addresses all AAC modalities. The nine domains, the Broomfield et al. (2019) study generated, were communication, cognition, role, health, quality of life, physical, social, spirituality and AAC equipment. The majority of these were also captured in the instruments found in our review, except for cognition, role and spirituality.

4.3. The Gap in Self‐Assessment Instruments

Due to current principles and recommendations to involve clients in their rehabilitation process (Staniszewska 2009), there are now several self‐assessment instruments available (e.g., PROMIS). However, as our study confirms, these instruments are rarely designed specifically for PWUAAC. More often, the instruments are developed for certain diagnoses, with PWUAAC users representing a minority within these groups. The results show that the development of self‐assessment instruments for PWUAAC has been generally steady but slow. Many of the instruments date back to the 1990s or even earlier, although there has been some increased activity in creating instruments for children who use AAC in the 2010s. The slow change in assessment practices may be partly explained by the lack of instruments, but it remains unclear why the development of such tools has been scarce.

PWUAAC users may have varying cognitive disabilities and difficulties in expressing themselves, which present challenges in constructing workable self‐assessment instruments (Finlay and Lyons 2001; Martinsen and von Tetzchner ¹⁹⁹⁶). When implementing new tools, their validity must be tested with a sufficient number of PrAAC users. Recruiting these participants takes time, and it can be difficult to find suitable individuals. Even though previous studies have shown that clients and professionals or proxies may represent distinct perspectives (e.g., Clarke et al. ²⁰⁰¹; Gray et al. ²⁰¹²), there might still be lingering attitudes from the past suggesting that PrAAC users do not have many opinions about their functionality. Consequently, it may be considered acceptable for professionals and significant others to decide the course of interventions.

There is a need to develop more self‐assessment instruments with sufficient psychometric properties that are suitable for PWUAAC users. The instruments in our data were either informal or used exclusively in specific research contexts. The purpose of 16 studies was not to develop a self‐assessment instrument, and some researchers used their own instruments tailored to specific research questions. This affected the reporting of psychometric properties, with eight instruments lacking any psychometric data and five instruments reporting neither reliability nor validity. One reason for the lack of psychometric properties may be that the area of self‐assessment tools has just started to develop in AAC, that is, it is at a pioneer stage. In this study, however, we found six applied instruments for PWUAAC, whose psychometric properties were measured, unlike Broomfield et al. (2019), who did not find any. The heterogeneity of the AAC population and low prevalence of PWUAAC may also make it difficult to ensure the reliability and validity of self‐assessment instruments. There is a clear need for validation studies of these self‐assessment instruments and for the development of new, robust instruments.

Despite the lack of measured psychometric properties, many of the introduced instruments could still be utilized in clinical practice to assess changes in individuals' functionality over different time points. The questionnaires on communication access in retail contexts, communication and friendships and the use of digital technology and social media included open questions, and PWUAAC responded using their own high‐tech communication devices. These questionnaires could be generally used with PWUAAC who are competent in responding to open questions using symbols or written text. Additionally, the other instruments in our data, which do not have measured psychometric properties, could also be used with individual clients at different time points to compare results over time.

Before more self‐assessment instruments become available, we should consider other possibilities for flexibly using existing instruments. In our search, we found approximately the same number of self‐assessment instruments for adults as for children. It may be feasible to use instruments originally developed, for example, for developmentally disabled adults, for children who use AAC. While we do not suggest that all instruments are suitable for any age group, it could be possible to select self‐assessment instruments based on the client's functionality. Of course, it is crucial to carefully consider the psychometric properties of the instruments (if they have been measured in the original version) and to evaluate the need for adaptations.

The biggest challenges in the availability of instruments are the scarce number of informal tools and the dominance of English‐language materials, which affects the possibility of using them in non‐English‐speaking populations. Developing assessment instruments could initially be based more on international cooperation to ensure linguistic diversity. English‐speaking developers could also be more proactive in communication and marketing, offering the possibility of official translations to researchers from other language groups. However, researchers must ensure that the psychometric properties are retained in the translated versions.

4.4. Limitations

The following restrictions should be considered when assessing the implications introduced in the previous section. Our search statement included both AAC and communication, which might have narrowed the scope, potentially leaving out studies that did not explicitly mention AAC, even though the users of the instruments could utilize AAC. As our results indicate, many general self‐assessment instruments could be used with PWUAAC, albeit with some adaptations. It is important to note that this paper did not aim to identify all potentially useful instruments but rather focused on those that have been used or those that mention potential for use in the AAC population.

The results may also have been influenced by the inclusion criteria used in this review. Most of the self‐assessment instruments were in English, and we included only articles published in English. This approach did not consider possible linguistic diversity in self‐assessment instruments. Including articles that used self‐assessment instruments for different purposes posed challenges in extracting comparable data. For instance, when some researchers focused on designing and assessing the instrument, while others utilized the instrument to study specific phenomena, it affected how they reported the psychometric properties of the instruments. Additionally, there might be a lack of information in the extracted data because we relied solely on the data from the articles found. This potential limitation is particularly relevant when researchers use an instrument originally introduced in another article.

The results of this review may also be influenced by the quantity and quality of the studies included. We conducted the procedure of the scoping review according to the PRISMA protocol (Tricco et al. 2018) and did not assess the quality of the studies. The scarcity of studies and the diversity of participants and their communication modes pose challenges in generalizing about the data. The results of this study should therefore be viewed as preliminary data on the self‐assessment tools used with PWUAAC.

5. Conclusion

Self‐assessment is emphasized as an integral part of the change process in rehabilitation, but there is a lack of a systematic culture to conduct self‐assessment and limited access to appropriate assessment materials in the AAC field. This study sought to begin to address these issues. The scoping review summarizes and characterizes the existing self‐assessment materials and tools for persons with severe speech impairment who use AAC. The study found 22 instruments for self‐assessment for PWUAAC of different ages. The instruments either explored a research question or aimed at developing a self‐assessment instrument. The majority of the instruments were in English, and most of the studies were conducted in English‐speaking countries. The instruments had varying numbers of items, ranging from 1 to 150 items (questions or statements). Most of the instruments used scales as a response method. The psychometric properties were relatively poor overall. The main purpose of the instruments was to explore thoughts and beliefs related to activities and participation. The paper reveals that there is a limited number of instruments focusing on feelings and motives. Moreover, there is a lack of available instruments in languages other than English and a need for improved psychometry.

By gathering information about the current self‐assessment instruments available internationally, this study has identified and described existing assessment instruments that may be used in clinical practice and in research. It may inspire the improvement of existing self‐assessment instruments as well as the development of new instruments. In addition, the paper may encourage professionals and researchers to develop self‐assessment practices tailored to the needs of PWUAAC.

Funding

The authors have nothing to report.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Supporting Table S1: Data of search.

Savolainen, I. , and Pilesjö M. S.. 2026. “Self‐Assessment Instruments Related to Functional Ability for People Who Use Augmentative and Alternative Communication—A Scoping Review.” International Journal of Language & Communication Disorders 61, no. 1: e70171. 10.1111/1460-6984.70171

Data Availability Statement

All data and materials discussed in this review are derived from previously published studies.