People who have complex communication needs (CCN) possess communication skills that do not meet their personal communication needs – it usually involves natural speech and writing difficulties. Difficulties for people with CCN may be associated with a wide variety of cognitive, sensory and environmental causes that limit their ability to communicate relatively independently in everyday contexts. Examples of speech and language disorders which may affect the communication abilities of people with CCN include autism spectrum disorder, traumatic brain injury and Down syndrome (to name a few).
Augmentative and alternative communication (AAC) involves a set of “tools” aimed at aiding (augmentative) or supplementing (alternative) natural speech and/or writing difficulties using aided (e.g. presented objects and symbols) and unaided (e.g. gestures) symbols.
High-tech AAC apps for people with CCN provide a working aided symbol system on a portable and mainstream device such as on iPads and other touchscreen devices. The advantage being that these devices are less expensive and not as stigmatising as their traditional high-tech counterparts, namely speech generating devices such as the Pathfinder. We will look at how AAC apps satisfy the basic principles of an effective AAC system within its emerging technological context:
With reference to the general framework proposed by Lloyd, Quist and Windsor (1990). People who have CCN need:
1. A means to represent symbols
Users need clear symbols that effectively represent objects, events and concepts to be chosen and used for expression. On AAC apps this is often through illustrations, pictures and words or a combination of modes.
Picture based symbols such as those used on the AAC app Proloquo2go involve illustrations that symbolise a plethora of concepts. The user and their communication partners can choose which symbols are relevant to their communication needs.
Alphabet systems capitalise on the user’s word use frequency. In the video below, we see the app Predictable makes predictions on words during sentence construction. Alongside being able to type out words using the touch keyboard, this allows the user to quickly choose from words that are relevant to them and allows them to save already-constructed responses.
2. A means to select symbols
Regardless of the nature of the symbols used in AAC apps, all AAC apps require an effectively organised interface to which the user can make her/his choice from. The touch-screen nature allows the user to quickly enact symbols without the need for secondary input devices. An emphasis for clarity of symbol representation within the interface alongside a capability for the user and their communication partner to configure the interface in a way that is most helpful and relevant for them can be realised with relative ease in this digital context.
3. A means to transmit symbols
Transmission relates to how the user can send their message across to their communication partner. Given that a large majority of users who have CCN have difficulty with natural speech, many AAC apps seek to aid their communication through digitised/synthesised speech of the chosen symbols. This minimises the need for the communication partner to “look over” at what the person is doing, or to visually pay attention to which symbols the person is selecting, thus allowing for a quicker understanding on the partner’s side of the conversation.
AAC apps provide people who have CCN the chance to express themselves when their communication skills are limited. It is important to highlight that these individuals have specific and complex communication needs relevant to their personal and social context and circumstance and not one AAC app (or even one mode of AAC) will suffice to aid everyone in the same way. A combination of further research in AAC app design, its use and effectiveness in therapy will help us to further understand the ways in which individuals with CCN can benefit from AAC technologies.