The Sett Framework. Student and the Environment

• The Sett Framework. Student and the Environment

  
  

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    This topic considers the SETT framework and how we address the STUDENT and ENVIRONMENT parts of the assessment framework.

    • Using the SETT framework helps us to consider the needs of the child and their environment
    • The usefulness of the International Classification of Functioning,Disability and Health (ICF) to consider things about the child and the environment you may to wish to consider in your assessment
    • Lots of free tools available to help you with these stages!

    
    

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    SETT overview

    This video provides a short overview of the framework. This will introduce you to SETT. A transcript is available.

    
    

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    SETT: The Student

    We need to always be considering a range of factors about a student's body, cognition and behaviour when preparing for an assessment, observing the student and trialing equipment, Questions regarding their attitudes towards AAC and communication in general, their ability to attend to tasks, the things that they are interested in, how they express that interest, are examples of important things to note.  

    It is also important to ensure the AAC assessment team and all stakeholders including the family agree on the best possible solutions when the child is not able to indicate preferences. 

    The child’s physical abilities such as the way they move their hands and arms are going to have a very significant impact on the solutions you can trial and recommend. 

    Consider a child you know who has a physical disability.  Then have a look at the International Classification of Functioning, Disability and Health (ICF) which provides a long list of  ‘student factors’ that you can consider when completing an AAC assessment. 

    As you complete more assessments you will notice that some are more relevant than others, but nonetheless the document provides a very useful checklist to help ensure you have covered everything. 

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    • Personal Contextual Factors
    • Functioning and Disability
    • Sensory and Mental Functions

    • Age, gender, lifestyle, habits, social background, education, religion, life events…

    • Body functions (Mental functions, sensory functions and pain, cardiovascular, neuro-musculoskeletal, movement-related…)
    • Body Structures (Joints, muscle power, tone, shoulder and upper limb, pelvis and lower limb, trunk, lips, tongue, pharynx, larynx, ears, eyes...)
    • Upper limb (Range of movement, joint stability, strength, endurance, tone, spasticity, flaccidity, bilateral integration, motor reflexes, tremors and perseveration.)

    • Sensory functions (Visual field, visual acuity, accommodation, oromotor movements, perception, visual neglect, control of pupil, pupil concentricity, strabismus, nystagmus, moisture of the eye... )
    • Mental Functions (Consciousness (arousal), orientation (times and place), intellectual (problem solving and learning), attention, memory, emotional functions, language, arithmetic, etc.)

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    Activity - Introducing Stefan

    Let's meet Stefan, a child with cerebral palsy, he needs an assessment so we will complete a SETT-style assessment using the scaffold documents provided by SETT’s author, Joy Zabala. 

    Read Stefan’s case study. Return to the ICF lists above. Which items in the lists could be seen as barriers for Stefan when using a communication aid?  Where are his strengths?  

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    SETT Scaffold Form - Consideration of Need

    The SETT Scaffold form helps you to consider the challenges that Stefan faces. When completing this do bear in mind that Stefan has a lot of strengths, too, and we'll be using those strengths to find the best communication solution.

    1. Print out the SETT Scaffold for Consideration of AT Need. 
    2. Thinking of Stefan, highlight any areas of concern in the list in Section 1 of the form as best you can (you may need to make up some details for this case study!)
    3. Now list these areas of concern in the first column of the table on page 2.
    4. When you have finished use the presentation slides to check some of your ideas and you can refer to the ICF to search for other information.

    
    

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    SETT: Environment

    When completing an AAC assessment the environment often gets forgotten about. This is one reason why following a model such as SETT can help make sure it is at the forefront of the assessment process.  The International Classification of Functioning, Disability and Health (ICF) provides examples as well.  Drag the words listed to the appropriate category on the left. 

     

    
    Picture Stefan as a student in the place where you work. 

    Think about which of these environmental considerations are going to help him and which might be barriers to his success with AAC?  
    

    There are a number of documents, written in English, available to support AAC practitioners in the following areas:

    • Interviewing children, families and school staff
    • Observing children
    • Clinical assessment checklists
    • Hands-on assessment tools

    Links and descriptions for these can be found in the further reading section.

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    Summary 

    • SETT makes it easier to step-through a process to consider AAC for children
    • The ICF provides a list of useful things to consider when deciding on the best AAC solutions for children
    • The AAC solution that you choose should be dependent on the child and the environment that they communicate in
    • There are lots of useful tools available to help you every step of the way

    
    

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    Further Reading 

    The ICF can be downloaded from the World Health Organisation website:

    • The ICF for children and young people

    Interview Tools: 

    • Home Talk: A Family Assessment of Children Who Are Deafblind 
    • Every Move Counts-3: Communication Assessment Section 
    • AAC In The Schools: Best Practices for Intervention 

    Observation Tools: 

    • Communication Sampling & Analysis 
    • Ace Centre Pragmatics Profile for AAC users

    Clinical Assessment Checklists- Partner Informed: 

    • Communication Matrix 
    • Dynamic AAC Goals Grid-2 (DAGG-2) 

    Hands-On AAC Assessment: 

    • AAC Evaluation Genie App 
    • Test of Aided-Communication Symbol Performance 
    • Empowering Voices: Involving Students in AAC Solution Choices 

    
    

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    Reflective Journal 

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    Journal

    Reflective Journal
  • Presentation slides and Case Study

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    URL

    Understanding the needs of the student The influence of environment on options URL
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    Page

    Stefan - our Level 2 case study Page
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    Page

    Example - partially completed SETT Consideration of Need for Stefan Page
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    File

    SETT Scaffold Consideration Form Template File