Recently I had the pleasure of being involved in a session with a young woman who had some additional requirements not being met by her current AAC Systems. Sally is in her early forties and lives in a group home. The people at the meeting were Sally, her mother, staff from the group home, her primary Speech Pathologist and myself.
Sally has been using the Lightwriter SL40 with the deep keyguard fitted; accessing the device using facilitated communication. A simple membrane keyboard style device is also included in Sally’s AAC toolkit. She also uses some signing and gesture for specific messages such as “yes”. Issues with vision had been identified through previous assessment. During the meeting she appeared not to use her vision in a conventional way, making it difficult to know what visual material works best for her.
To start discussion I had prepared several devices and they were all ready for use, handling and demonstration on the table. This turned out to be an ideal way of together working out the goals for the session, as we discussed the specific requirements not being met by the current systems. It was a process of elimination and discussion of features that lead us to define the needs. Comments such as “That’s too big to carry”, “It needs to be wearable”, “Can we have just two items displayed with high visual contrast?”, or Sally not being able to activate a keyboard as it required too much force quickly narrowed down the required features in a very practical way.
The identified needs were:
- A means of communicating independently in her home, to gain staff attention or communication a quick and simple message for example, “Something’s wrong”, “I’m finished”, “I have something to tell you”.
- A means of independently communicating a message when out, or visiting for example, “Hello, it’s great to meet you”, “Hi, what have you been up to lately?”
The goal for the meeting was to evaluate various technology and AAC options to meet the identified needs. Through further exploration with the available devices, we were able to identify the features that would best suit Sally. It was found she would be best suited to a device or devices which:
- Required only a very light touch to activate, probably with her index finger as she seemed to prefer to isolate this for accessing.
- Did not require vision to discriminate between message labels or keys
- She could wear on her body to take with her when out
- Could refer a communication partner to her LightWRITER if she needed to communicate something more complex.
- She could use without assistance or facilitation
- Had loud speech output for staff to hear or to be heard when out with background noise
After more discussion and experimentation with the available equipment the following was decided as a starting point for trialling:
1. The Smooth Talker from Pretorian was presented as a useful device for use in the home. It would not be small enough to meet the ‘wearable’ requirement and maybe considered not particularly ‘adult’ in appearance for use out and about. The various modes available could be useful for Sally. She was able to press the large sensitive button easily. The Smooth Talker button requires 90 grams of force to activate and Sally could manage this easily. The RANDOM mode could be set with several greetings or conversation starters. The SEQUENCE mode could provide a number of turns in a conversation. The Smooth Talker is part of the SimplyWorks wireless range which also means it can be activated by a remote switch. This means that Sally could perhaps carry with her a smaller switch or place it in her shirt pocket. The compatible wireless switch would be the Wireless Switch 75 (75 mm diameter). The switch has a 10 metre range so may be useful around the house. It can be used between rooms and around corners, as it uses radio connectivity. Smooth Talker has a wide range of additional functions including providing use as a single switch for computer use in conjunction with the Receive:2. This was not a requirement nominated by Sally but may open up some options not previously considered.
Some of the Ablenet devices may also be useful for these functions. Talking Brix (43 grams of force), the Little Step-by-Step range (57 to 85 grams of force). Sally did not try these in the meeting so would need to be tested to ensure the activation is easy for Sally and to check that the voice is loud enough.
QuickTalker S may be useful as a single message device as it uses only proximity to activate the message and requires no force. This is smaller and lighter than the Smooth Talker and BigMack but not as small and light and the wireless switch option.
2. iTalker app for iPhone or iPod touch was discussed as a wearable option for out and about. This would be worn on Sally's wrist using the type of strap-on carry cases a runner might use. This App provides a single message activated by a large button on the screen. A playlist is established so that a series of messages can be used in sequence.
Next actions: Sally's Speech Pathologist has a BIGmack available which could be tried in the home for the purposes outlined. The BIGmack requires 56 to 85 grams of force to activate, so Sally should be able to operate the large button as easily as the Smooth Talker. The family will source an iPhone or iPod Touch for Sally to use with iTalker.
This session started as a general request which remained rather broad until we met. I am always reluctant to become involved until the goals of the meeting are clear but in this case the session was the opportunity to discuss and define the needs and goals. With the contributions from everyone involved it seemed a useful session with clear outcomes. Although the outcomes involved simple solutions, the feeling at the end of the meeting was that the assistive technology discussed would fill the identified gaps in Sally's current systems.
Click below to view video of Simply Works Smooth Talker and operation using wireless Switch 125
Tracey Bode
June 21 2014