Augmentative Communication Program

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”.

Our Goal:

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).

The Chart:

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.

Case Study:

Nancy, a 69-year-old woman with Bulbar ALS was seen in August 2010 (Table 1.1 & 1.2)

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.