Quadriplegics and Alternative and Augmentative Communication (AAC) Devices
Alternative and augmentative communication (AAC) or Speech Generating Devices (SGD) devices have traditionally been standalone hardware that people with speech impairments use to communicate verbally. Stephen Hawkings is probably the best known example of someone using dedicated AAC equipment to communicate verbally. While effective, these hardware based devices tend to be cumbersome and very expensive (up to $10,000+).
With mobile devices like the iPad, iPhone and Android devices becoming commonplace, AAC technology is now inexpensively available through a variety of apps (Proloquo2Go, TalkRocket Go, Verbally, Grid Player). However, for users with speech AND mobility impairments (MS, ALS, CP, MD, brain injury, stroke etc.) these apps are difficult or impossible to utilize due to the touchscreen-only interface of mobile devices.
Mobility Impaired Switch Access to AAC Apps on the Ipad
Users with mobility impairments now have a convenient option for accessing iOS and Android smartphones and tablets using the same assistive switches they would utilize for other functions, like wheelchair control. For instance, Apple has recently implemented a switch access framework in iOS 7, which, when paired with a wireless switch interface called the “Tecla Shield”, from Komodo OpenLab, allows users with mobility impairments to elegantly turn iPads, iPhones or iPods into cost effective AACs. The Tecla Shield couples the iPhone/iPad to the same input devices that individuals with mobility impairments are familiar using (simple switches, Sip/Puff, Wheelchair Joystick).
Operation of an AAC on an iPhone/iPad with a single switch using the Tecla Shield is quite simple. iOS has a “switch control” setting that, when turned on, allows cycling through the icons on the screen in “groups”. In the AAC app, the device would scan from the top of the screen to the bottom through groups of icons. When a group is selected, the device then scans through the icons in that group until the user clicks again. In this way, the different words on the screen can be selected and sentences can be built to then be spoken by the device. The rate of the “scanning” can be adjusted in the iOS settings, which allows user to speed up scanning (as they get comfortable with the interface) or slow it down (to accommodate change in function).
The Tecla Shield is powerful and can accommodate inputs that allow faster browsing and selection of icons. Pairing of a 4-way joystick with the Tecla (including wheelchair controls when an ECU is present). Once set-up, the 4-way control takes the place of scanning and allows fast navigation of the AAC options.
Advanced Switch Control Options for Users with Mobility Impairements:
In certain cases, some users prefer to operate the system with the “Switch Control” feature in iOS turned off. In this case, the Tecla Shield can be used as a bluetooth switch interface for apps that have built-in scanning (usually called "switch-accessible"). Used this way, iOS does not automatically perform “row scanning” where icons are grouped for faster interface, and the Tecla Shield turns a switch signal into a simple keyboard “space” or “enter” input that the app will use in its own settings. Jane Farrall has put together a very comprehensive list of these apps. This mode is particularly useful for these cases:
1) Older Apps – Some older apps do not play nicely with iOS switch control auto scanning and may nor provide the require visual feedback
2) Custom Scanning – For apps with built in scanning, some used may prefer to customize the scanning function for faster operation (like in Proloquo2Go)
3) Device as Dedicated AAC – If you want the device to act as a dedicated AAC device, operating in this mode will prevent the user from exiting the app. This is sometimes used with therapists working with kids where they want the kids to practice app function rather than playing “Angry Birds”. (Note: this can also be done in iOS without this mode using “Guided Access”)
- iPad, iPhone or iPod Touch (iOS 7 or higher strongly recommended)
- Tecla Shield DOS
- Input Device (Buddy Button, Sip Puff, Dedicated 4-way Joystick, Wheelchair Joystick)
- Input Device Mount (Optional)
- iPad or iPhone Mount (Optional)