The ComFor: an instrument for the indication of augmentative communication in people with autism and intellectual disability.
ComFor is a quick, reliable test that tells you if a nonverbal client with autism or ID is ready for AAC.
01Research in Context
What this study did
The team built a new tool called ComFor. It shows if a nonverbal client with autism or intellectual disability is ready for an AAC device.
They ran standard psych checks to see if the scores stay the same when different people give the test. They also checked if the scores really measure communication strengths and needs.
What they found
ComFor passed the tests. Raters agreed with each other and the scores lined up with what speech experts already knew.
The tool can safely tell you who is a good fit for picture boards, tablets, or other voice output aids.
How this fits with other research
Selau et al. (2025) and Drijver et al. (2025) did the same kind of study. They each built a new test for people with ID, ran the same stats, and got the same happy result: the tool works.
Ghaziuddin et al. (1996) looked at an old method called facilitated communication and found it hurt more than helped. ComFor does the opposite—it gives solid data before you pick any AAC, so you avoid useless or risky tricks.
Stott et al. (2017) warn that many readiness tools for therapy are not validated. ComFor is one of the few that actually is, so it stands out from the weak pack.
Why it matters
You now have a quick, free, research-backed way to show funders why a client needs an AAC device. Run ComFor, staple the score sheet to the funding form, and move on to teaching the learner how to ask for snacks, friends, and breaks.
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02At a glance
03Original abstract
BACKGROUND: The ComFor (Forerunners in Communication) is an instrument to explore underlying competence for augmentative communication. More specifically, it measures perception and sense-making of non-transient forms of communication at the levels of presentation and representation. The target group consists primarily of individuals with autism and intellectual disability (ID) without or with only limited verbal communication. The ComFor is suitable for children and adults with a developmental level between 12 and 60 months. This paper describes the theoretical framework and structure of the ComFor, the results of a study on its psychometric properties and its clinical uses. METHOD: The ComFor was tested on a sample of 623 children and adults from the Netherlands and Flanders: a group with autism and ID (n = 310); a group with ID without autism (n = 174); and a control group of typically developing children (n = 139). RESULTS: The data generally support the reliability and validity of the ComFor. Internal consistency, inter-rater and test-retest reliability were found to be good. Construct validity (internal structure, convergent and divergent patterns) was established in different ways. The criterion-related validity has yet to be established, as predictive data are not available at the moment. CONCLUSION: Taken together, the results indicate that the ComFor is a promising instrument to explore underlying competence for augmentative communication. Areas for future research are outlined and the clinical relevance is discussed.
Journal of intellectual disability research : JIDR, 2006 · doi:10.1111/j.1365-2788.2006.00807.x