The iPad as an Augmentative and Alternative Communication (AAC) Hardware Option

Various iDevices pushed together on a table, each displaying a different app. The center one
Various iDevices pushed together on a table, each displaying a different app. The center one displays a photo.

If the iPad had feelings, I’d be concerned about its self-esteem in the world of Augmentative and Alternative Communication (AAC). Its inferiority complex would be reinforced at conferences when speech-language pathologists who do AAC evaluations, pick it up with interest, but then put it down as they say, “Oh. It’s an app for the iPad? I only recommend devices.”

Well, the iPad is a tablet that deserves to sit at the AAC hardware lunch table with the popular devices. It seems to get snubbed as an AAC option because it wasn’t intended to be a “communication device.” Even though for many individuals with complex communication needs (CCN), it is exactly that.(I wrote about it here almost 3 years ago)

An engineer trying to make a circuit to record fast heart sounds invented the pacemaker. Scientists trying to make a wallpaper cleaner invented Play-doh, which brightens many of our days. Fortunately, someone looked past the intended function of those products and saw value in other areas.

Kleenex was invented to remove cold cream, but when people started using it as a disposable handkerchief, Kimberly-Clark Corporation (manufacturers of Kleenex) paid attention. Two years after Kleenex was first introduced, the company realized 60% of people using the product were using it to blow their nose, so they started marketing it for that purpose.

I can imagine people at that time clinging tightly to their used cloth handkerchiefs and saying, “the Kleenex is only a cold cream remover. I refuse to see it as anything else.”

The iPad was invented as a consumer tablet for work and entertainment purposes. When Steve Jobs revealed the iPad to the world, he said, “iPad creates and defines an entirely new category of devices that will connect users with their apps and content in a much more intimate, intuitive and fun way than ever before.”

Steve Jobs may not have been thinking about providing access to language through mobile device technology for individuals with complex communication needs (CCN). But why wouldn’t these individuals want to connect with their apps – ESPECIALLY their AAC apps – “in a much more intimate, intuitive and fun way than ever before?”

A child under 3, who’s not talking, can have an educated parent decide to put words in his hands. The iPad provides that opportunity.  That child would be fortunate to receive any early intervention services at all. Most likely he wouldn’t have the opportunity to receive an augmentative and alternative communication (AAC) evaluation. Toddlers have a lot to say.

Adults with CCN, who don’t have access to school support, often lose access to many of the therapies and services that had been beneficial to them. The iPad gives them the opportunity to explore and use AAC if they find it helpful.

The iPad wasn’t intended to allow family members and adults themselves to decide that AAC support allows them to communicate more completely, clearly and/or with more complex language…but it does.

Engineers at Apple may not have meant to provide a dependable, lightweight hardware device with a long battery life. They may not have known that they were creating a device with the ability to run the AAC language system of choice for an individual user. But that’s what they did.

Just as the Kleenex provided a solution for non-cold cream wearing individuals who wanted to blow their nose in a more sanitary and disposable way, the iPad provides a solution for many individuals with CCN to have access to AAC.

We were early adopters of new technology long before the iPad was introduced to the world. As soon as a company released a new device, we were immediately in touch with local representatives. We wanted to know it. We would try it and go through our mental inventory of kids and their needs. We’d ask ourselves, “Will this new device help anyone we know?” We tried eye gaze technology as soon as we could get it in front of us. We saw the life-changing potential of that technology immediately.

So when Steve Jobs stood on stage and gave the world the first look at that 10 inch, sleek, lightweight device, our eyes widened. It was big enough to provide access to a lot of language, but so portable that A LOT of people were going to be carrying them around in public. We were early adopters of the iPad as a way to provide AAC to people who needed access to language and were able to touch a screen (use direct access). It also had something else that AAC systems previously lacked…affordability.

At the end of July, I had the honor of attending the AAC institute/I Can Talk camp in Pittsburgh to train the nearly 50 volunteers on the Speak for Yourself app. These volunteers were then paired with each of the 23 campers. Some were running various activities and offering a helping hand to campers, families and fellow volunteers when needed. The camp is a wonderful opportunity for children and their families to be around other AAC users and families.

The local news did a story about the camp. The reporter starts by saying, “Those things they’re carrying are NOT iPads.” I initially bristled at that statement because several of the campers were in fact using iPads locked into AAC apps.

AAC Institute campers looking at their devices, which are iPads with the Speak for Yourself app.
AAC Institute campers looking at their devices, which are iPads with the Speak for Yourself app.

However, when I thought about it, she’s seeing it as more than “just an iPad.” When individuals are using a tablet and app that gives them a voice, it is more than an iPad.

She spent hours at the camp. This reporter interviewed camp directors, parents and adults using AAC. She watched the campers interacting, playing and socializing. She saw “communication devices.” When she said that the campers aren’t carrying iPads, it’s likely that her view of the iPad is that it’s a tablet used for entertainment and business purposes. “Those things they’re carrying” are so much more.

When we see someone using a traditional device, we don’t refer to it as a Windows or Android tablet with specialized software, even though it is. When someone says they are using Traditional Device X, it’s rare to hear or see anyone say, “Well, that’s not the solution for everyone.” I think the reason is pretty simple…We know that already. It’s common sense. Nothing is the solution for everyone.

Imagine telling a colleague you’re considering buying a Toyota, and she says, “Well, that’s not the solution for everyone.”  It would be odd to have that response before you even discussed whether you were considering a Prius or Sequoia."<yoastmark

Yet, when someone mentions the iPad as an AAC option in an online group or in an in-person discussion, it is inevitable that someone says, “The iPad is not the solution for everyone.”  Maybe they say, “AAC is not one size fits all.” That’s obviously true, but there are hundreds of apps and the availability of various robust language systems. There are case options to address portability and durability and 3 different screen sizes. The iPad IS absolutely an AAC device solution for many.

It may be a residual response from those early days of the iPad. School districts and parents were buying iPads and saying, “Make it work.” Maybe some of the professionals in the field are still recovering from that trauma. At the time, there were very few AAC language app options. “Making an iPad work” meant reprogramming entire apps and undoing (at times) years of language building and AAC implementation work.

The iPad is still not the a viable choice for some AAC users. It’s generally not an option for individuals who face extremely complex physical access challenges…yet. The iPad does not support eye gaze technology or incorporate environmental controls.

However, for many children and adults who are able to physically touch a screen (direct access), even with fine motor and visual issues, an iPad is a viable hardware option to consider for AAC use.

The field of AAC acknowledges bias in software systems pretty readily. Practitioners are often bias based on their knowledge and familiarity. They have seen someone/a lot of people communicate successfully using XYZ language system. It makes sense. Of course people are going to think the AAC system that gives their child or students a voice is awesome. We are all bias.

Bias becomes a problem when it causes close-mindedness. It’s an issue when it interferes with the decision that would work best for the child/client.

If you are an AAC evaluator who doesn’t consider the iPad as an AAC hardware option for direct access AAC users, you are bias. Your personal preferences are interfering with an option that may be best for your clients.

If you are a parent or a professional, and your child can access a touch screen, an iPad is a valid consideration. If the evaluator didn’t consider it as an option, ask for their reasons. Here are some explanations they may give, and some responses to those reasons.

iPadAACflierpic

When I’ve presented or spoken with professionals, their objections to an iPad for direct access users are often outdated. It’s as if they made a list of iPad “negatives” six years ago, saved them to copy and paste into reports and never looked back. If you’re one of those professionals, it’s time to take another look. A lot has changed in the last six years.

We are not bias to the iPad as a hardware device for AAC BECAUSE we created the Speak for Yourself app for the iPad. In the classic chicken-egg conundrum, it was the other way around. We accepted that the iPad was a dependable, portable, affordable, long battery life, capacitated touch (which many of the traditional devices at that time lacked) option. SO we created an AAC software app that provided a strong language system to run on the iPad.

If you’re working with individuals who are trusting your professional opinion about their communication, that’s an immense responsibility. Those individuals are depending on you to be open-minded about the hardware and software options that exist. You’re trusted to consider the option that will provide the long-term best solution for that individual.

If you’re a parent, a professional or someone who uses AAC, and you feel like an evaluator is making a recommendation based on their own bias, ask questions.

As a field that embraces technology, it’s time to acknowledge that the iPad is not an inferior or temporary AAC option.

It’s time to realize that mobile, direct access AAC users benefit from the availability of Apple Stores when there is a hardware issue that can be corrected immediately.

Students often lose valuable time waiting for insurance companies to approve a dedicated device. In many school districts, these same students walk past “spare” iPads sitting on carts each day.

If you’re someone who would have been clinging to a handkerchief and talking about these newfangled Kleenex being a passing fad, it’s time to look again.  Regardless of the hardware or software selected, the AAC implementation is crucial. It’s going to take time. Our students and children who are waiting to communicate don’t have time to lose.


Comments

One response to “The iPad as an Augmentative and Alternative Communication (AAC) Hardware Option”

  1. the iPad made having a voice affordable. The SFY app with the IPad is like chocolate and peanut butter, fantastic together. How fortunate we are to have a voice because of this technology. The only reason to discriminate that I can think of is they just don’t get how an app can replace a stand-alone device. At least the parents understand this.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.