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A personnel framework designed to support people who rely on augmentative and alternative communication (AAC) because of acquired medical conditions and those who assist them is described. The roles of AAC finders, general practice clinicians, AAC intervention specialists, AAC facilitators, and AAC experts are summarized. These roles are described in detail for people with amyotrophic lateral sclerosis, brainstem impairment, and severe chronic aphasia. The personnel preparation needs for each of these support personnel groups are identified.

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In an effort to quantify communication efficiency, speaking rates and intelligibility scores were obtained from a normal speaking adult and 13 dysarthric speakers representing a wide range of severity. Speakers were audio recorded as they read words and sentences. A panel of judges transcribed all recordings and subjectively ranked a randomly selected sample from each speaker according to "communication efficiency." The following measures were obtained for each speaker: word and sentence intelligibility, speaking rate, rates of intelligible and unintelligible speech and a numerical ranking of communication efficiency. Results indicated that speaking rate and speech intelligibility are not closely correlated. By plotting measures that incorporate intelligibility and rate, one can rank speakers similarly to subjective rankings of communication efficiency, and distinguish mildly dysarthric from normal speakers. The addition of intelligibility and rate measures to supplement other assessment procedures in the evaluation of dysarthric speakers is discussed.