NDSC 2015 AAC Presentation. Katie Dames, MS CCC-SLP and Katie Maddox, OTR/L co-owners Fusion Therapy and Learning Center

1. iTalk: Using Technology as a
Transitional Communication Tool
Katie Dames, M.S. CCC-SLP
Katie Maddox, OTR/L

2. Session Objectives
 1. Why is it important to access tools that provide
voice output when verbal communication is limited
 2. Explore affordable communication technology
that can support the child during communication
breakdown
 3. How to use technology to enhance self advocacy
and social skills in early adolescence

3. Transition:
A movement,
development, or evolution
from one form, stage, or
style to another.

4. What is a
Transitional Communication Tool?
 A tool or method used by the child to support
delayed expression.
 Most children are using some basic sign language
and picture exchange as a transitional
communication tool.
 Fewer are using high tech speech generating
devices…..but let’s explore!

5. Children with Down syndrome
learn most effectively……
 Visual Support
 Social Inclusion
 Repetition

6. The research is IN……..
 The research supporting increased verbal language
using AAC is there and has been for 30+ years.
 With recent advances in affordable technology we
are now able to go beyond sign language to
implement a more visual multi-modal approach
including the use of more natural voice output.

7. How does AAC support increased verbal
language?
 Provides a visual (picture and/or words)
 Provides a perfect model of speech at the single word
level
 Provides a perfect model for sentence structure (pre-
programmed phrase based buttons or icons)
 Mimics the most widely used mode of communication
 Can replace negative physical gestures (stomping,
hitting, biting)

8. MYTHS ABOUT USING AAC:
 1. AAC is the last resort in speech intervention.
 2. AAC hinders or stops further speech development.
 3. Children must have a certain amount of skills to benefit from AAC.
 4. Children have to be a certain age to benefit from AAC.
 5. Once my child starts using AAC no one will ever work with their
speech again.
 6. My child will always have to use the AAC device. Or, my child has
already learned so many signs why we would we change now?
 7. AAC devices are extremely expensive.
 8. AAC makes a child look abnormal.
Supporting People Who Use AAC, Strategies: in Home, School & Community. SET, BC 4th ED.,
2/2008

9. MYTH BUSTERS!!
 AAC can increase independent speech production
 AAC can increase utterance length by way of modeling
and practice
 AAC can increase speech intelligibility
 AAC can facilitate long term memory storage of concepts
and scripts based on independent repetition
 AAC reinforces literacy concepts and sentence structure
 AAC can be used to aide in written expression

10. Types of Voice Output Technology
 Dedicated SGD’s
 iDevices (iPad, mini and iPod)
 Android tablets
 Recordable Device (single use
messages)

11. Android tablets with 4 Star Ratings
• Google Nexus 9 The Google Nexus 9's premium build, speedy performance
and consistent updates render it one of the best high-end Android tablets.
Price: $395.00 - $599.76 (check prices)
• Nvidia Shield Even if you don't take advantage of its gaming prowess, the
Nvidia Shield Tablet is one of the most versatile -- and affordable -- high-performance 8-inch
Android slates you can buy. Price: $299.99 - $375.99 (check prices)
• Dell Venue 87000 With its powerful 3D camera and strong image editing
features the Dell Venue 8 7000 makes the strongest case yet for tablet photography.
Price: $349.00 (check prices)
• Amazon Fire HDX 8.9 Impressive Amazon features and an outstanding
display make the Fire HDX 8.9 one of the best and most affordable media consumption
tablets. Price: $379.00 (check prices)
cnet.com June 2015

12. Communication Apps
NOT ALL APPS ARE CREATED EQUAL
 Free vs. Affordable
 Ads
 In App Purchases
 Reputation of Creator
 Technical Support

13. What’s Out There??
 As of right now, there are 265
AAC apps listed in total
 55 of which are free
 17 of which are above $115.00
 105 apps below $10.00

14. A Few of our App Picks
TouchChat - $149 - $299
Proloquo2Go - $249.99
Dynavox Compass -$179.99
GoTalk Now - $79.99
SonoFlex - $99.99

15. Apps available on Android
http://www.friendshipcircle.org/blog/2011/03/09/7-special-needs-apps-in-the-google-android-market/
Voice4u
Price: $29.99
Link: https://market.android.com/details?id=com.voice4uaac.android.voice4u
Voice4u, is a revolutionary picture based AAC (augmentative and alternative communication)
application that helps individuals express their feeling, thought, actions and things they need.
It is a perfect solution for learning and communication for individuals with autism. Voice4u
includes over 150 Pre-loaded icons and lets you create your own icons and categories.
Link: https://market.android.com/details?id=com.jabstone.jabtalk
JABtalk is an android application that provides a fresh new approach to speech and communication
technology. Speech therapists commonly refer to JABtalk as an easy to use and effective AAC device. By
combining personalized voice and images with an extremely simple user interface, JABtalk delivers a speech
solution that is both fun to use and easy to learn.
JABtalk
Price: $9.99
TapToTalk
Price: Subscription based- $99.95 per child/yr
Link: https://market.android.com/details?id=com.Assistyx.TapToTalk
TapToTalk turns an Android device into an affordable AAC device. TapToTalk displays a set of pictures
on the screen. When you tap a picture, TapToTalk plays a word or sentence and displays another
screen of pictures. Each of those pictures can lead to another screen, and so on. For example, a
picture representing Food can lead to a screen with pictures of Fruit, Vegetables, Sandwiches, Snacks
and other foods.

16. AAC Speech Buddy
Link:www.market.android.com/details?id=com.codedimensions.android.aacspeech
Price: $27.99
AAC Speech Buddy create custom PECS Speech Sets. AAC Speech Buddy was created to
quickly & easily create custom Speech Sets Online (aacspeech.com) which could be loaded on
one or many AAC Speech Buddy Apps. AACSpeechBuddy allows users to quickly and easily
create customized Speech Sets using their own photos or collected images, or using images from
the AACSpeech.com image repository.
iAugComm
Price: $4.99
Link: https://market.android.com/details?id=com.ideal.iaugcomm
Created by Apps4Android, an Android software development company dedicated to developing
Android applications that enhance the quality-of-life, independence and educational success of
individuals with disabilities. iAugComm turns your Android into a powerful, high-quality, low-cost
AAC device, which can enable individuals who are non-verbal or whose speech is difficult to
understand to communicate easily and effectively using a simple, icon-based interface.
http://www.friendshipcircle.org/blog/2011/03/09/7-special-needs-apps-in-the-google-android-market/

17. Assessment
It is a process, not a single time event.
Assess to meet today’s needs, then
tomorrow’s, and tomorrow’s and
tomorrow’s…
Beukelman and Mirenda

18. Where to Start
 Consider Screen Size
 Fine motor coordination
 Vision Impairment
 Visual Perceptual and Visual Motor Skill Level
 Size and number of available icons
 Grid Set-up (standard vs. customized)
 Larger screen size adds to weight

19. Where to Start (con’t)
 Consider Motor Skills
 Set-up Grid Size
 Icons Permanence
 Hidden Icons
 Motor planning, coordination, motor memory
 Hand strength, muscle tone and finger isolation
 Appropriate use of a tools
 Sensory Processing
 Ease of Transport

20. Determining a Vocabulary
Most communication software comes with
3 types of vocabulary:
 Core
 A set of words that are used frequently and can be used
across contexts to express meaning and intent. These words
tend to be verbs, pronouns and demonstratives.
 Eighty percent of our vocabulary is made up of these 250
core words.
 Basic
 Tends to be more noun and phrase based.
 Blank

21. Single Finger Isolation - Tricks Of The Trade
Give all those “other fingers” something else to do.

22. Tricks of the Trade
Start teaching this skill early, give support if needed.
The touch screen will not respond
To the gloved finders.
Elliegrip commercially available
on amazon.com (Abilitations).
Sold individually; red for right
blue for left ($7.59).

23. Tricks of the Trade
Try a stylus, actually, try a few stylus’.
The smaller they are, the less
“real estate” available for all
the other fingers. Bonus plug
fits into the earphone jack for
safe keeping (Amazon.com
$1.22 for a bundle of 10).
Metal tip stylus, for the kiddos
who just can’t help themselves…..
the tip can not be picked or peeled
Off. THANK YOU ASHLEE WILSON!
Don’t for get to use the above “tricks” that facilitate the functional tripod grasp.

24. Single Words vs. Quick Phrases
 Combining single words for a meaningful message
 Takes time
 Teaches phrase structure
 Quick Phrases for efficient communication
 Time saving
 Models increased utterance length
 Models correct sentence/phrase structure
 Provides more information during communication breakdown
A complete and functional communication system should
have both single words and quick chat phrases.

25. Individualizing the Device
 Take a quick assessment of when, where and with
who communication breakdown occurs.
 Use quick chat phrases for times of frustration
 Determine some highly motivating items
 Allow your child to become good at using the device by
requesting highly motivating items/activities or places.
 Become familiar with programming
 Visual attention (color coding)
 Button/Folder creation

26. External Speakers
 The trouble with the built in speaker
- It’s not always loud enough
 External Bluetooth speakers available in all shapes,
sizes and price ranges.
 Portable
 Wearable
 Affordable
 Facilitate self confidence with increase volume

27. Self-Advocacy
 Communication is a basic human right not a long or short term goal
on an IEP.
 Once a functional communication system has been identified as an
effective means, it should be made available at all times.
 Verbal communication is powerful in our society. Adults are more
likely to honor a self-advocates “voice” no matter its origin.
 Pre-programed chat phrases provide communicators with more
opportunity for communication exchange vs. labeling.

28. Facilitating Social Exchange
 Creates opportunities for verbal social exchange with
unfamiliar listeners (let’s say….at McDonalds)
 Pre-teaching at home what you will order, practicing
ordering, and using device to order for themselves at the
counter.
 Texting, Tweeting and FB posting for teens and
adults using AAC.
 Using word and symbol based apps
like Proloquo4Text
 Offers word and sentence prediction
for increased speed of social exchange

29. Our Go To Accessories
The retractable key reel + a sturdy case with added detachable keyrings
We have used the retractable key reel with iPad mini and iPods only.
During the initial assessment and use during therapy sessions.

30. Off-the-Shelf Cases
Chatbag.net
Strotter.com
ibackflip.com
iCAT
(online. Target
& Staples)
Google search: hands free iPad case

31. 1. I wish my teacher would joke with me.
2. I wish my teacher would learn how to work my communication device.
3. I wish my teacher would stop shouting at me like I can’t hear.
4. I wish my teacher would remember that I don’t always spell very well.
5. I wish my teacher wouldn’t have a heart attack when my device
doesn’t work.
6. I wish my teacher would have more patience with me.
7. I wish my teacher wouldn’t hit my machine when it doesn’t work………
that’s my mouth she’s hitting!
8. I wish my teacher would call on me for Share Day.
9. I wish my teacher would give me enough time to say what I’m thinking.
10. I wish I could walk and talk like my sister and brother.
ASHA and Callier Center, Dallas
10 things I wish my teacher knew about AAC

32. Don’t be afraid to search for
equipment and strategy ideas on the
web (Google, Pintrest, Instructables,
etc.). Look for what “makes sense”
to you and your family, share with
family/friends, therapists, teachers
and doctors IF you feel it needs “fine
tuning”.

33. Additional Resources
Family Center on Technology and Disability
http://www.fctd.info/
National Dissemination Center for Children with Disabilities
http://www.nichcy.org
Center for Implementing Technology in Education
http://www.cited.org/index.aspx
Assistive Technology in the Classroom
http://atto.buffalo.edu/registered/ATBasics/Foundation/intro/index.php
/
Wisconsin Assistive Technology Initiative
http://www.wati.org/
Office of Special Education Programs
http://www.ed.gov/about/offices/list/osers/osep/index.html
www.fctd.info