Assistive Technology to Enhance Communication Abilities

Communication is  an essential function necessary for “social survival”. Thus, Augmentative and Alternative Communication (AAC) is one of the seven AT  categories (See Module 3). Because of the importance of communication,  developing devices and strategies to enhance the communication skills or abilities of people with disabilities has been a priority of the AT community. The evolution from low-tech picture based communication boards to computer-based, dynamic display AAC devices with built-in environmental control has provided people with communication difficulties more options and greater access to “standard” communication.

Options across the AT continuum exist to benefit people with communication disabilities. Sheets of topic specific symbols or a sheet consisting of the the alphabet can be used as low tech options. These options are best used by people with an ability to point to a symbol or letter either with a finger or an eye gaze. Some downsides to this communication option include  that user does not have a "voice" and the user's communication partner typically has to interpret what each symbol means for successful communication. Other effective low tech communication options include dry erase boards or using a pen and paper.

Mid tech AAC options are typically devices that allow users to activate one to twenty prerecorded messages by direct selection or scanning. These are simple to program and usually provide a user with limited options. Because of their limited options, these types of devices are usually used by individuals with cognitive impairments as well as communication disabilities. Standard messages often include simple greetings, important information, or messages related to daily needs or wants (ex. I'm hungry or I need to use the bathroom). Another benefit of these devices is that they give users a voice although the voice technically belongs to someone else. The user can use this device to get others attention or  "speak" to others. The downside is that options are often limited, so users can only speak about topics prerecorded on their devices.

High tech AAC devices are computer-based devices with dynamic touch screens that use synthesized voices to allow users to "vocalize" communication. To use one of these devices, an individuals will have to be able to choose options on a screen via touching options on a touch screen, scanning, or utilizing a mouse emulator (ex. Headmouse). The dynamic nature of the onscreen display allows numerous preprogrammed communication options to be accessed. Typically, these devices connect preprogrammed words or phrases to symbols. When a symbol is selected, the message associated with that symbol is played. Because entire phrases can be associated with one symbol, communicating in this manner is faster than typing. These devices are typically the size of laptop computer. There are, however, more portable options in the form of PDAs. These devices are expensive and although the give the user a voice, it is a computerized voice. Despite these issues, high tech AAC devices give the user unlimited communication options, allowing them to converse about any topic in a normal fashion. 

Communication is not just an issue for people with disabilities that affect their ability to speak. AT solutions or strategies to daily communication must also be considered for people with hearing impairments. Many people with hearing impairments can communicate face-to-face with others by developing an ability to read lips. Issues arrive, however, when using the telephone. Many technologies such as email, instant messaging, and text messaging have unintentionally made communication easier for people with hearing impairments by creating a widely used communication mode free of audio components. Even with this new technology, telephone communication is important. This can pose problems for people with hearing impairments. To combat this issue,  telecommunication devices for the deaf (TTD or TTY machines) can be used in combination with a relay service. TTY machines are telephones equipped with a keyboard and small screen. People can communicate from TTY to TTY simply using the keyboard, much like text messaging. When someone with a hearing impairment wants to use a TTY to talk with someone without a TTY machine, a relay service must be used. A relay service consists of a person at the relay center who listens to the speaking person and types it to be read by the TTY user. This person also reads what the TTY user types and speaks it to the non-TTY user. Through the use of TTY machines, relay services, and modern text-based communication modes, people with hearing impairments are able to communicate at a level necessary for independent living.

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