iPad and AAC (Augmentative and Alternative Communication)

A few years ago high tech AAC devices with dynamic displays involved heavy, cumbersome apparatuses that cost thousands of dollars. With the advent of tablets and iPads, it seemed inevitable that technology would pave the way for augmentative and alternative communication systems to now be accessible to all.

I have several clients that are diagnosed with severe apraxia of speech that are predominantly non-verbal. While speech production is the focus for most of these families, the reality is that communication must come before speech. (See one of my favorite blogs: http://niederfamily.blogspot.com/p/hi-if-youre-here-i-likely-crossed-paths.html). Dana, the author of the blog, “Uncommon Sense” explains perfectly how important it is to establish a communication system while working on speech production. As a PROMPT and oral motor trained therapist, I couldn’t agree more.

With a wide array of options that are now available, it is often confusing for a new therapist to pick the right app for their client. The truth is that there really isn’t a “one size fits all” app. The two more popular apps are “Proloquo2Go” and “Speak for Yourself.” I have tried both apps on a few of my clients. I made a “pros” and “cons” list for both the apps, which, I hope, will help parents and other therapists make a choice when selecting a suitable AAC system for their little ones.

Proloquo2Go

Pros:

  • The button sizes can be customized so you can potentially start with larger buttons and therefore bigger images. However, as you add buttons the size will decrease to accommodate the additional buttons.
  • It is fairly easy to customize the background colors and the colors of the buttons to make them stand out.
  • There are 2 vocabulary sets (core and basic). The core vocabulary is for students who are combining words to form utterances. Most frequently used words are on the home page and other words are in folders on additional pages. Basic Vocabulary is for students using the device mostly to request and can’t yet navigate through pages.
  • You can customize the number of buttons per page. For basic vocabulary, the grid can be as small as 3 X 3 buttons. In addition, you can remove buttons so you could potentially have as little as 1 button on the screen at a time for beginning users.
  • The Core Vocabulary contains academic vocabulary (e.g. calendar, numbers, colors, shapes, etc.) that is pre-programmed. I can see how teachers, especially preschool and kindergarten teachers would find this helpful.

Cons:

  • The biggest con for me is that it does not really use motor planning. You can potentially move the placement of the buttons around so the users aren’t really using motor planning or muscle memory while using the device. If you add new vocabulary to the page or change the grid size, the buttons automatically get shifted. To understand how important this is, consider a task such as typing. If the keys were moved to new locations, it would make a relatively simple task of typing incredibly tedious. Our fingers use the muscle memory and motor planning to locate the keys. If AAC users could use the same skills to access vocabulary and language for communication, it would indeed be a huge asset.
  • Words can be duplicated and be placed in different folders, making it very confusing for the user.
  • While the core vocabulary is a good start for users combining words to formulate utterances. However, locating words to formulate sentences can sometimes be cumbersome and requires opening several pages and folders to access the vocabulary.

Speak For Yourself

Pros:

  • It uses motor planning. The position of a button never changes. It will always stay at the same location. The users can therefore rely on muscle memory to access frequently used vocabulary.
  • It has the “hide and open” feature so you can hide as many of the icons as you want. You could potentially have just one button open at a time. This is a good level to use to introduce the app to new users.
  • It has the “babble” feature so users can explore the language and words on the app without changing any of the programming.
  • It only takes a maximum of two buttons to access a word.
  • It won’t let you record a word twice. So each word can only be programmed in one place, making it easier for children to remember where the symbol is located.

Cons:

  • The buttons are small so some of my younger clients had trouble accessing the buttons. This can be very frustrating sometimes. However using a key guard could potentially be helpful.
  • You can’t really change or customize the size of the buttons.
  • You can’t over ride the function, which only allows you to program a word once. For example, one of my clients loves to play with a top. I tried to program “top” in the page with the other toys, but it wouldn’t let me since “top” (the preposition) was already programed in another location. This is usually easy to get around by using a different label for the object. For example, I used “spin top” and used a photograph of the top my client likes.

Both the apps are similarly priced at approximately $200. Overall, while the motor planning element makes me lean slightly in favor of the SfY app, several of my clients prefer and do better with Proloquo2Go. I think it truly reinforces something we’ve always known: AAC systems are highly personal and something that works for one child need not work for another.