I was just looking around this website and saw your question. I currently teach a Special Education Life Skills class in South Texas. I have 15 years experience. The last 8 years I have had experience with a wide range of disabilities. We use PECs or picture symbol communication with most of the students. Voice output devices are used for students when in the community &the classroom as needed.
These range from High-Tech Pathfinders & Vanguards to Low-Tech recordable picture frames and other low cost voice out put devices. For example: When we take them out to a restaurant all students are expected to order their meal. They may use their voice, picture menu or a voice out put device. No one orders for them.
As far as the Alternative Testing, well that is more complicated. We have a State Developed Alternative Assessment (SDAA) we give our students. They take an off grade level test. We test the students that function Kinder and up. Right now the state of Texas is developing another Assessment that will make the NCLB administrator happy. When that happens I am not sure how it will effect my students. The students that function below Kinder take a Locally Developed Alternative Asessment (LDAA) This varies from Teacher to Teacher. I use a portfolio that includes scored rubrics from tasks that require transfering skills from the classroom to the community an any Brigance test that are appropriate, student work samples are also included.
I know this was long, hope it was helpful.