The Augmentative Communication Program has a rich history in the design, development and research of assistive technology in issues related to augmentative communication. Clinicians and researchers in the Augmentative Communication Program are continually exploring solutions for persons diagnosed with multiple communication impairments.
Current Research Projects
- Dysarthric speech recognition
- AAC in the Intensive Care Unit
- AAC to enhance patient-nurse communication
- AAC and End of Life communication
- Feature Matching AAC apps and iDevice selection
- Message Banking
- Eye gaze communication systems
- Software design for individuals with anomia and those on the autism spectrum
- Visual supports for persons on the autism spectrum
- Two way video modeling for persons on the autism spectrum
- Virtual sound environments for the deaf and hard of hearing. In conjunction with the Habilitative Audiology Program and the Deaf and Hard of Hearing Program, we are developing a computer software program that introduces a visual prompt, such as a flash on the screen, for children with hearing disorders. Such a program will make the thousands of educational software programs that are available for the general public, finally accessible to the hearing-impaired.
RERC on Communication Enhancement
The Augmentative Communication Program is a partner in the RERC on Communication Enhancement. This research project involves visual interest of persons with autism spectrum disorders including visual scene displays. Learn more about the Center for Communication Enhancement.
What Apps Do We Use?
Clinical Considerations in Feature Matching: When your thorough assessment of all options and strategies leads you to consider an iDevice platform:
Many speech-language pathologists are now faced with iDevices suddenly showing up in the office of their assessment center or in their school with the question: “what apps do we use?” followed by “make this work”.
View Related Handouts here.
It is not our intent to review every app or media device that has been or will soon be released. Rather our goal is to provide a framework, based upon well established clinical considerations for feature matching a person's strengths and needs to available tools and strategies (Shane and Costello, 1994), and apply that to comparing and selecting an iDevice platform and apps (refer to Table). Only through an informed clinically based selection, can we minimize the emerging trend toward selecting communication apps based on the robustness of media coverage, public testimonials or recommendations from well meaning friends and family.
To this end, a chart was created to detail the features known to be vital considerations for a broad profile of people with complex communication needs. Not all of these features currently exist in apps thus highlighting the need to match a person’s needs to the right tools and strategies and NOT try to fit a person to a specific platform or app. In addition, this chart should be considered as dynamic ( the number of communication apps is constantly growing as is the scope of available features).
Feature Matching Communication Applications Chart (PDF)
To better understand the application of the chart, a case study will illustrate application of the assessment process and use of the app feature matching process/chart.
Nancy, a 69-year-old woman with Bulbar ALS was seen in August 2010 (Table 1.1 & 1.2)
Table 1.1: Key Needs/Features Based on Assessment Outcomes
Information gathered during assessment
Key App Features based on information gathered during the assessment
| Rate Enhancement
- Doesn’t not want to “write every letter out”
- Word Prediction
- Abbreviation Expansion
- Logical Letter Encoding
- Ability to store Phases/Retain Codes
| Display Settings
- Was able to navigate dynamic displays
- Wants something with “little set up”
- Able to use QWERTY keyboard
- Increase font size
- QWERTY Keyboard
- Increase font size
- Able to type on iPad and other devices
- No current motor issues (yet could potentially have motor issues in the future)
- Adjust dwell
- Edit icon size and spacing
- Direct Selection
| Purpose of Use and Patients “requests”
- Communication in multiple contexts
- Wants voice output and a female’s voice
- Synthesized Speech (voice output)
- Female Voice
- Adjust rate
- Speak after selection
In Nancy’s case, the iPad is a tool that meets most of her communication needs, serving as her primary communication system. Recommendations in addition to the iPad during the AAC consultation included use of pen and paper (for written messages) and a low-tech alphabet board. Yet the iPad will be used as her primary tool due to the voice output features, ability to pre-store messages, and word prediction (thus enhancing the rate of communicative interactions). Assistive Chat was selected as the primary communication app, matching key features that Nancy needs within her price range (Table 1.2).
In Nancy’s case, both Prolqou2go and Easy Speak had just as many “matched” features to the final app choice. Yet in trialing them in the assessment with Nancy, she voiced a clear preference for Assistive Chat (due to quality of voice and what she described as “the best prediction”); thus stressing the importance of step four in Table 1.2.
ASHA Perspectives, July, 2011
Using a Clinical Approach To Answer “What Communication Apps Should We Use?” (PDF)
Gosnell, Costello & Shane
ASHA Leader, October 11, 2011
Apps: An Emerging Tool for SLP's
Video demonstration of the Feature Matching Process for Nancy.
The Boston Children's Hospital service delivery model for patients who are Communication Vulnerable was recently highlighted in the AAC-RERC spotlight on Supporting Effective Patient-Provider Communication Across Health Care Setting
Hospital-based Picture Communication Board
For nearly 20 years, Boston Children's Hospital has provided Augmentative Communication Services using high and low technology solution for inpatients who are unable to speak.
Through this unique service, the Augmentative Communication Program has focused on meeting the needs of communication-vulnerable patients throughout the medical center by creating custom communication boards either at bedside or through it's world renowned model of Preoperative Augmentative Communication Intervention.
In 2002 the Boston Children's Hospital Medical Symbol Set was created to better support the communication needs of patients by representing unique vocabulary related to hospitalization. Because the dedicated augmentative communication service Children's offers is extremely unique, in 2008 the creator of the Vidatak EZ Board teamed with Children's to create the Vidatak Picture Communication Board.
Through this collaboration, the Boston Children's Hospital Medical Symbol Set is available to patients whose medical provider does not have the ability or dedicated staff available to create custom communication boards.
For more information, visit www.vidatak.com.