Which physical factor should be evaluated first when assessing a student with cerebral palsy for AAC device access?

Trunk stability and control is a fundamental physical factor that should be assessed first in students with cerebral palsy when evaluating for AAC device access. This is primarily because adequate trunk stability is crucial for overall posture and positioning, which directly impacts the individual's ability to effectively use an AAC device. Without sufficient trunk stability, a student's overall balance may be compromised, making it difficult for them to engage with the device, whether through direct selection, eye gaze, or switch access.

Trunk control supports not only sitting posture but also has implications for the functioning of the upper extremities. If the trunk is not stable, the arms may be unable to reach or interact with the AAC device effectively, regardless of their range of motion or fine motor skills. A strong foundation in trunk stability also influences the assessment of other factors such as upper extremity range of motion or fine motor dexterity, since these aspects rely on the stability and control of the torso.

Evaluating trunk stability first allows clinicians to establish a base from which to assess other physical capabilities, ensuring that any AAC device recommendations can be tailored to the student's unique needs in a way that promotes successful communication.