do you have a VAssistX menu in the IDE? do you have a "Visual Assist X" toolbar? if you cannot see one is it listed when you right click on a toolbar to see the list of available toolbars? in tools -> options -> keyboard do you have any commands containing the string "VassistX"?
if all of these are no did VA create a directory when it installed? this is usually: C:\\Program Files\\Visual Assist X