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About the FIATS-AAC

The Family Impact of Assistive Technology Scale for Augmentative and Alternative Communication (FIATS-AAC) is a parent-report questionnaire designed to detect functional change associated with augmentative and alternative communication (AAC) interventions for children and youth, ages 3 to 18 years, and their families.  

The FIATS-AAC has 13 dimensions to measure overall and domain-specific functioning associated with AAC system use. The domains include seven child-related factors (behaviour, communication, contentment, doing activities, education, self-reliance, social versatility) and six parent- and family-related factors (caregiver relief, energy, family roles, finances, security, supervision). 

Why do we need the FIATS-AAC?

Children with communication-related disabilities have more unmet needs for assistive devices compared to children with other disabilities. These unmet communication needs may hinder a child’s ability to participate meaningfully in everyday activities. To best meet the needs of children with complex communication needs and their families, it is important for clinicians and service providers to have the tools to measure how effective existing programs and interventions are. Currently there is a lack of valid and reliable parent-report measures that detect the functional effects of AAC interventions in young people with complex communication needs. We developed the FIATS-AAC to give researchers and service providers a questionnaire designed to detect the functional impact of AAC interventions on the lives of children and youth and their families.

How was the FIATS-AAC developed?

The FIATS-AAC was developed by researchers and clinicians at Holland Bloorview with the assistance of graduate students from the Department of Occupational Science & Occupational Therapy and Rehabilitation Sciences Institute at the University of Toronto. Research support was provided by the Canadian Institutes of Health Research, Holland Bloorview Kids Rehabilitation Hospital, and Thames Valley Children`s Centre.

The FIATS-AAC is based on the framework of the International Classification of Functioning, Disability and Health for Children and Youth promoted by the World Health Organization.  The framework conceptualizes child functioning as the relationship with and dynamic interaction between a child’s health condition and contextual factors including AAC interventions. 

Our team completed a series of research studies to select items and domains that may be affected by the introduction of new AAC interventions. More than 200 parents of children with complex communication needs helped to develop and test the measurement properties of the FIATS-AAC.

What do FIATS-AAC items look like?

The FIATS-AAC is a 6-page questionnaire with 89 statements. Parents rate their level of agreement with each statement using a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree) for each FIATS-AAC item. The FIATS-AAC takes approximately 15 minutes for a parent to complete, and an additional 15 minutes to score using a scoring workbook (Excel).

The workbook automates calculations for total scale and subscale scores and pre-post change scores. Change scores that exceed minimum detectable change (MDC) thresholds are flagged automatically based upon a level of confidence selected by the clinician. The workbook also generates a printable outcomes report for clinical applications.

The following table provides a sample item for each of the 13 domains of the FIATS-AAC:


Sample Item

Behaviour"My child behaves well around me."
Caregiver Relief"I can manage my child on my own."
Contentment "My child can be happy when left alone to play."
Doing Activities"My child can play games."
Education"My child is performing well in school."
Energy"My child needs a lot of help to be understood."
Face-to-Face Communication"My child knows how to keep a conversation going."
Family Role"All family members take turns supporting my child when going out into the neighbourhood."
Finances"My child's communication disability affects family finances."
Security"My child can phone for help in an emergency."
Self-Reliance"My child's independence is increasing."
Social Versatility"My child is very sociable."
Supervision "I am concerned about my child's safety when he/she is left alone."