Recently, there has been much attention on how apps loaded into mobile devices can be used for communication. In conjunction with the International Augmentative and Alternative Communication (AAC) Awareness month celebrated around the world every October, Ms Sarah Yong, head of clinical services at SPD’s Specialised Assistive Technology Centre, explores the pros and cons of using apps for AAC and highlights how it has made available many opportunities for communication for those who have difficulty in doing so. This article was first published in SPD UPDATES on 17 October 2014.
Imagine a world where you are unable to communicate. All thoughts, comments, jokes and requests remain unexpressed within you. Augmentative and Alternative Communication (AAC) devices empower individuals with complex communication needs, such as those with stroke, cerebral palsy, autism, and hearing loss who have difficulty expressing themselves, with the means to break that silence and to find their voice.
AAC refers to the supplementation or replacement of natural speech and/or writing using aided and/or unaided symbols. Individuals who are unable to communicate verbally use AAC systems to express themselves. There are a variety of methods of AAC that individuals use to say what they want to say. These include gestures, body language, communication books/charts or high-tech computerised devices.
The use of applications is one method. Apps, as it is known in short, is a software which can run on the Internet, your computer, phone or other electronic devices. The apps for communication are usually a series of overlays and symbol sets which can be downloaded onto a mobile device like an iPad, iPod Touch or an android phone.
These mobile devices have touch screens which individuals with communication impairments can touch to access respective apps contained in the device. In some apps, a digitised voice would read out messages keyed in by the user, thereby enhancing communication. Individuals with communication impairments can download and use such apps as their AAC system for communication.
There are about 100 different apps available for downloading in Apple’s iTunes store with different features and prices designed for individuals who have communication impairments.
One benefit of using a mobile device as an AAC instead of a dedicated device is the size and weight. Devices such as the iPhone or iPad are much lighter and smaller than most standard voice output high-tech AAC devices, making them more portable. Dedicated devices, with its rechargeable batteries, are generally heavier and therefore pose a challenge to carry around.
As apps are relatively affordable in price, options for using AAC can be made available to more individuals from different income brackets. By comparison, an app costs a fraction of what a dedicated device would. A high-tech computerised dedicated device may cost about S$20,000 whereas an app which may be downloaded onto a mobile device could cost under S$200.
Mobile devices such as iPhones, iPads or smartphones are also used by the mainstream consumers. Individuals with communication difficulties may be motivated to use them so as to be part of the crowd. Moreover, with the ‘cool’ factor, these mobile devices are also great conversation starters.
An individual could download a text-to-speech voice output app into his mobile phone and use that to communicate with his colleagues at work. He would be able to participate in both work-related and social activities such as contributing at meetings, chatting with colleagues and even making presentations.
There are, however, various considerations when using these mobile devices. These are typically accessed through a touch screen which would require a specific amount of precision and motor control. Individuals with disabilities who have access difficulties may be unable to access the touch screen. For example, an individual with cerebral palsy may have uncontrollable movements, making it difficult for them to use such mobile devices.
Another point of consideration is the availability of vocabulary options. There are a variety of dedicated devices, each with vocabulary sets which cater for clients of different language abilities. Often, AAC companies may work with AAC specialists to develop these vocabulary sets. With apps, however, choices of vocabulary sets are often limited. Furthermore, many do not follow principles of good practice and hence may not include symbols or do not let the user string together words to create novel sentences. Some also crash frequently or have poor quality speech.
Dedicated devices are usually prescribed by a speech therapist trained in the area of AAC. Often a detailed assessment is involved. However, with apps being easily accessible and downloadable, individuals may not undergo an assessment to check for suitability so there may be greater possibility of a mismatch between the individual’s communication skills and the device he/she is using.
There are many issues which one should consider when looking at an app as an option for AAC. Before any AAC is chosen, consideration of the different communication options and devices should be done to determine the best solution for the user. Individuals should seek the help of an AAC or assistive technology specialist or speech therapist if needed.
Apps for communication have created greater options for individuals who have communication impairments who may need AAC. It is undoubtedly an exciting development in the AAC world.
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