Assessing Student's Needs for Assistive Technology (ASNAT)

Chapter 10 – Funding Assistive Technology
AUGMENTATIVE COMMUNICATION SYSTEM EVALUATION
for Wisconsin Medicaid
Name: D.O.B.: Address:
Medicaid ID #:
Diagnoses: Dates of Onset:
M.D. Order and Date:
Speech Pathologist: Evaluation Date:
History: brief social and clinical
Gross/Fine Motor:
Vision/Hearing:
Oral/Motor:
Cognition:
Assessing Students’ Needs for Assistive Technology (2004) 259