Choosing an App for AAC - by Dr. Carole Zangari
FAAST Access Online 3rd Winter Edition

Buying a car is an experience familiar to most of us. We head to the dealer with a rough idea of what we’re looking for. You might want a sporty convertible, while your neighbor may be interested in an SUV. Your family might be in the market for a car with good gas mileage and have a preference toward one built in the US. Someone else might make their decision based on style or safety records or resale value. Whatever the particulars, people go car shopping knowing what sorts of factors or features are important to them. We do some research, compare models and brands, and test drive our favorite options before making a final selection.

Believe it or not, professionals recommend the same sort of process when it comes to selecting assistive technology for communication, like speech generating devices (SGDs) and iPads with apps for augmentative and alternative communication (AAC). A research consortium on communication enhancement explored the complex issues regarding mobile technologies for individuals with complex communication needs in a white paper. If you are considering an iDevice, like and iPad or Android tablet, to help someone with significant communication difficulties, here are some things to consider.
There are dozens of AAC apps ranging in price from free to over $200.00.

Each of the apps has different characteristics and features. Some of them are geared more for functional communication (like asking for things or making choices) and others were designed to develop true language skills. Some are terrific for people who have good literacy skills and others are well-suited to individuals who use pictures to communicate. There are many great apps out there, but not all of them may be a good fit. Choosing an app because it was featured on TV or because someone else likes it is not likely to lead to the best solution for your particular situation. After all, individuals with disabilities are individuals and their needs are quite unique.

Steps to Take When Considering an AAC App
1. Get an evaluation from a qualified speech-language pathologist (SLP) who has a background in AAC. He or she will help you figure out what features are best in your particular situation through a process called feature matching. You don’t want to end up with a gas guzzler if fuel economy is high on your list of priorities.

2. Educate yourself about the apps so you can make informed decisions. Sites like Spectronics and OCALI (see text box) have comprehensive listings of AAC apps. Spend some time browsing those.

3. With the help of the SLP, compare and contrast the apps that meet your criteria. Don’t rule out traditional SGDs, which have features that are unavailable in iDevices.

4. See it in action. Search for videos on YouTube or the developer’s website.

5. Take a test drive. The SLP should be able to arrange for you to try out the app or at least a trial version of it.

6. Ask yourself: Why is this the best AAC app for my situation?

While it is tempting to go to the app store and download an AAC app without going through these steps, this rarely ends up being the best approach. Helping people with significant communication impairments maximize their ability to learn and use language is a huge challenge and having the right tools can make a big difference. There is no doubt that there are many wonderful apps, but there are some poorly designed ones as well. AAC apps come in all shapes, sizes, and flavors. Picking one for someone to use for communication should be a thoughtful, informed process. After all, if someone needs an app to allow them to communicate, doesn’t it make sense to get one that is the right fit?

Helpful links for AAC and mobile technologies
OCALI
PrAACtical AAC Blog
Spectronics
SNEAK Outside the Box Blog

5 Things To Do Before You Choose an AAC App: Take A GULP
(Reprinted with permission from PrAACtical AAC)

Thinking about using an AAC app for someone you know with significant communication difficulties? There are some exciting options out there and more are released all the time. It’s easy to get caught up in the possibilities and click on the harmless little ‘buy’ button. We know. We’ve done it, too. And learned from it. So, next time you are thinking about buying an AAC app, stop for a second and take A GULP:

Ask: What do I want the person to be able to do with this app? An app for generative language has very different specs than and app for choicemaking.

Get a comprehensive list of AAC apps, like this one from Spectronics, or using a product like AAC Apps Assistant . Explore the product videos on iTunes, YouTube or at the vendor’s website.

Use a feature match approach to assessment to ensure a good fit between the app and the communicator.

Look at app reviews to get a sense of what others think and narrow down your options. Check out the growing list of options from places like The App Academy.

Play: See if you can get a lite version to explore before you decide. Ask around. Maybe a colleague or someone at your school has the app and will let you take a look at it.

Take A GULP. You’ll be glad you did.

Dr. Zangari is co-author of the blog, PrAACtical AAC.

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Focusing on the young and young at heart - by Safee Broxton
FAAST Access Online 1st Winter Edition

Laura Gatlin, a speech language pathologist (SLP) from Deltona, knew she wanted to become a therapist when she realized that the career path would allow her to work with people of all ages. Originally planning to go into childhood education, Laura looked forward to working with children. However, she wanted to expand her professional reach beyond grades K through five. Four years into working in her chosen field, Laura enjoys the challenges and benefits of treating a diverse population. 

“I currently work full time at a nursing home. I see children on the side for speech therapy. My youngest patient was eight months old and my oldest was in their 100s. I love it,” said Laura.

Most of the patients Laura treats have dysphasia, a condition that makes swallowing difficult. She also works with stroke patients who have difficulty with their speech and/or language, clients who are experiencing early onset dementia, Alzheimer’s and traumatic brain injuries.

“What I use the most in terms of assistive technology would be the Dynavox, for patients that are cognitively aware,” said Laura. Dynavox makes an augmentative communication device. It usually features a touchscreen with images that correspond to basic phrases indicating needs, preferences or conversation starters. The number of images on each screen can be customized based on the user’s abilities.

One of Laura’s current patients has Parkinson’s Disease. She is unable to speak and has difficulty swallowing. However, Laura explains, “She is very much aware and knows what she wants. She cannot even nod her head. She has so much difficulty communicating. We got her a Dynavox, and it takes her a while, but she is able to [use] the screen. We've really narrowed it down to her basic needs and wants. She is able to let staff know if she needs to go to the restroom. Before, she was not able to communicate those needs. It's helping her tremendously and increasing her quality of life.”

While having an assistive device greatly increases her client’s independence, having caregivers that engage with the device is an integral part of making the most of a patient’s AT.

“Right now, the biggest challenge is training the caregivers,” Laura said. She encourages caregivers to take some time and help the patient get to the right screen so she can communicate her needs.

Especially within nursing homes that have had to downsize, the staff doesn't have as much time as they used to.
“The staff is a lot busier. So that's what I'm working on right now. She's been trained, and she knows how to use the device, but how effective is that if the caregiver is not going to be an active participant? I can only be with her so long,” said Laura.
The community’s attitude toward aging and technology can also be a barrier to integrating a device into a patient’s routine. In Laura’s line of work, she has observed that there is an emphasis on helping children grow and develop with technology. “I can’t speak for everyone, but my sense is that when patients get to the nursing home they sometimes get forgotten.”

Although her educational preparation for becoming an SLP was intense- Laura was a stellar student in addition to working long hours as an emergency dispatcher- she gained the most knowledge from her hands-on experience in the work setting.
“It's a wonderful career if you want to help people because there is so much you can do. So much of what you will do impacts the quality of these patients’ lives.” Laura encourages prospective SLPs, “Just remember that [patients] are people first and we are here to help them. Most of them we can get back on their feet but sometimes you're working with patients who are at the end of their life. Every day you can impact a patient’s life. They're all people that need love.”