What is assistive technology?

Assistive technology is any kind of technology and/or tool that can be used to enhance the functional independence of a person with a disability. Often, for people with disabilities, accomplishing daily tasks such as communicating with others, going to school or work, or participating in activities can be a challenge. Assistive Technology (AT) devices are tools to help overcome those challenges and enable people living with disabilities to enhance and have access to a quality of life, that may otherwise not be known, and lead more independent lives.

The mission of this blog is to serve as a voice of a constant researcher in the field of educational and assistive technologies so that the best products, strategies and services may be located easily, in hopes that they will then be delivered, taught and used to better the lives of people with disabilities.


Augmentative Alternative Communication (AAC) iDevice Apps and Visual Supports

Communication applications (apps), designed to be used on an iPhone, iTouch or iPad (iDevices), fit different cognitive and learning profiles just like all programs and devices do. Today, most people use multiple devices to address their daily communication needs. The idea that ANY one device can (or should) “do the job” for individuals with communication needs no longer makes sense.

The Rehabilitation Engineering Research Center on Communication Enhancement (AAC-RERC) shares, "Mobile technologies offer a broad spectrum of communication options as well as other functions. Not only have the devices themselves become smaller and multi-functional, but the number of communication Apps and tablet platforms is increasing more rapidly than AAC hardware or software ever did. At this posting, there are easily a hundred or more Apps that can meet the needs of some individuals with Complex Communication Needs."

So, what are some of the Pros of using a tablet or other mobile device, with the less expensive apps, as a communication system?
  • Apps are low cost and easily acquired comparatively speaking.
  • There is a “Normalization” factor that has taken the mystique out of AAC.
  • AAC is likely to reach out to many more users, for example someone who has temporarily lost her ability to speak.
  • AAC may appeal to families of very young children, individuals with autism and others who may not traditionally have thought about AAC helping to make it more acceptable and common place.
  • They are multi-functional making their appeal enhanced because they offer ongoing access to information, social interactions, entertainment, music and games.
  • More people are talking about AAC and accepting it. It is becoming normalized.

What are some of the Cons of less expensive AAC apps that should be considered (when compared to dedicated AAC devices)?
  • At least 75% of AAC Apps are developed by individuals/teams with little-to-NO background in communication.
  • Most Apps are simply a picture with a speech component or text that talk. For a developing child/emerging communicator – there is no language development in having just a talking picture.
  • Technical support is often lacking as are updates.
  • A company rep does not come out to you to help you assess the best tool, the best access method, or provide a trial, etc. (Unless it is from one of the major AAC companies and you are using their hardware.)
  • There is a lack of quality control so the buyer needs to be careful.
  • Less customization opportunities are available. You pretty much get what you see and what you see is not individualized. You must provide this part and know what you are doing or know someone who can help you.
  • Support in choosing the correct system by matching the attributes of the program to the needs of the client is usually not being used (individuals or family members are sometimes making decisions based solely on what they have seen, heard or read).
  • Lacking the process and consideration of training, technical support and follow up.
  • There are challenges with mobile devices themselves, such as glare, ruggedness, sound, and system back-up.
  • Distracting- many options at your fingertip may cause client to venture away from communication purpose.
  • Possible hidden costs in monthly service agreements often sneak up.
  • They are NOT dedicated devices meaning they are not approved for funding by private medical insurance, Medicaid or Medicare in most states like dedicated devices.

One of the main concerns is that of abandonment of all AAC if the apps do not live up to the expectations or fit the specific student. This is why it is important to have a specialist in the field help you in the decision-making process.

As mentioned above, I recently heard a number thrown out that stated at least 75% of the AAC apps available are developed by individuals with little-to-no background in communication. There is good and bad in this. The good is that the quantity and exposure of apps is bringing more people to the field which is expanding the field and use of AAC. The bad however is that most AAC apps are simply pictures that talk, which is not what AAC is really all about- it is only the beginning. Because of this, there is a growing need to evaluate what exists and compare features across mobile devices and communication apps. The apps available are growing at such a rapid rate, it is hard to keep up. It makes one really start to wonder about quality at the rate they are being developed.

Key differences in quality AAC Apps:p
  • Core Vocabulary Set
  • Organization Structure to Vocabulary Set
  • Symbol Set being used
  • Programming Ease
  • Underlying Support to Development of Language

Tools to Use In Making Decisions:
Sometimes you really get what you pay for. In other words, you cannot assume that a $10 program is going to be the same quality as a $100 program. Some have "hidden" costs. What you think is free you might really have to pay a monthly charge for in order to customize and personalize it. Some companies are providing lite versions so you can try it before you buy it, then the full price version allows you more options. Explore and research before you buy.
Some of the attributes that should be considered when exploring your need for an AAC app are listed below. You will want to know, does it have and/or use, do you have a need for or desire:
  • Symbol support
  • Text support
  • Text-to-speech
  • Phrase/Thought-based
  • Word-based
  • Allows customizable pages
  • Allows photographs to be imported
  • Digitized speech
  • Synthesized speech
  • Direct Select
  • Auto-scanning
  • Two-switch step scanning
  • Auditory scanning
  • Copy/Paste messages into other apps
  • Simple Navigation/Operation
  • Research-based
  • Allows backup of pages/layouts

I began to find it impossible to keep up with the apps and their quality, so my approach is- leave it to those who are providing us with their amazing talents:
Aubrey Taylor Klingensmith has a blog worth reading: “What Is the Best AAC App Out There?” In this section, she provides a section on how she reviews AAC apps including a feature matching chart that Jessica Gosnell of Children’s Hospital Boston designed. She has great suggestions for how to approach this often overwhelming task.

Visual supports are different than communication systems. Spectronics, again, is a great resource for information on Visual Support Apps. To help out, Charlene Cullen put a selection of Apps together into the categories of visual schedules, taking books and photo albums, rewards, shopping lists and visual timers.

After choosing an app, the choice of peripherals is equally important.

When choosing a case, some needs  to consider:
  1. How rugged/robust do you need the case to be?
  2. Do you need it to be waterproof, drop proof, bounce proof?
  3. Does the person remove the device from cases easily?
  4. Do you need a screen protector? How heavy-duty does it need to be?
  5. Does the person tend to pick at rubber/silicone edging?
  6. Does the person tend to chew on their cases?

We prefer that the person carry their own device and take on this responsibility, if possible. With this in mind, do they need it mounted or do they need a carrying strap? Consider:
  1. Is the iPad to be worn by a child, teen, or adult AAC user or is the strap just to enable the iPad to be carried by staff members?
  2. If it's used as AAC, do you require Bluetooth speaker?
  3. Do your clients cope with across the body straps okay or do they need a sturdy and well-fitted chest harness?

When choosing peripherals, I need to put my eyes on them. Here are some links to my Pinterest Boards for this purpose:
  1. Sound Options (Speakers)
  2. Bluetooth Keyboards

Research!! I recommend going on YouTube and doing a little research on the program first to get a good visual of the program you are considering. Then check out what kind of supports are out there:
  • Are there tutorials?
  • Read the reviews.
  • Talk to people you know who might have it.
  • Decide if you want to be able to customize it or not- is that important to you?
  • Can you use personal photos?

Consider that you might want to use more than one program as one may not offer you all of the options you are looking for. These apps can nickel and dime you to death if you just start purchasing - so, be an educated buyer.

Need pictures to use on your iTouch or iPad? Of course you can use your digital camera then transfer them or consider the use of Internet resources such as Do2Learn then transfer them to your photo library. You might also try ARASAAC which has pictures available and are nicely organized in both English and Spanish. (I am waiting for a Boardmaker app!)

Mobile Devices and Communication Apps - is an AAC‐RERC White Paper worth exploring -  
In order to gather information in a timely manner, more than 25 AAC “thought leaders” were interviewed between January and March, 2011, representing multiple stakeholder groups. "At this writing there are easily a hundred or more Apps that can meet the needs of some individuals with CCN (Complex Communication Needs)."
Many questions have come up as we are deluged with this media. AAC‐RERC raises the following: "There is limited evidence that demonstrates the efficacy of mobile technologies and AAC Apps on the functional communication and quality of life of people with Complex Communication Needs (CNN). Who uses mobile devices? Which ones? For what purposes? Where? Why? How often? How does the availability of low‐cost, highly portable, multiuse devices change the traditional AAC intervention process? What clinical and technical supports need to be in place; who needs to be involved; what, if any, standards are needed; and how does all this impact clinicians, end users and AAC manufacturers? Finally, what design specifications should be incorporated in Apps for people with CCN whose communication needs are poorly meet by current AAC technology and applications? These are some of the questions, among others, we need to explore.

We have our first "research" survey and it's findings available, Posted April 17, 2012, " Taking the Pulse of Augmentative and Alternative Communication on iOS". It is introduced with, "During Autism Awareness Month, an exploratory survey on Augmentative and Alternative Communication (AAC) and iPads, iPod touches and iPhones was distributed as part of research collaboration between AssistiveWare and professors from the University of San Diego and the California State University at San Marcos."

Happy Apping but, as always, do your research!