Augmentative and Alternative Communication (AAC) is basically a catch-all term for any number of ways that people with speech or communication difficulties can use to communicate. This ranges from sign language, to picture exchange systems like PECS, to specialty talking devices.
Using AAC doesn't necessarily mean choosing only one thing. Like all of us, people with communication challenges may use a variety of ways to communicate. Moe, for example, uses a combination of ASL signs, gestures like pointing and nodding or shaking his head, and some word approximations.
But they key here is that Moe wants to communicate. Until now, we had never done any formal AAC programs with Moe because he never seemed to catch on. Maybe we didn't stick with it enough, or maybe we were still unsure how to proceed. But Moe is getting frustrated a lot lately. He is getting older and his needs are more complex. He needs a way to communicate with us consistently.
We decided we wanted to take a look at a "talker," a device that would allow Moe to have a voice to communicate with those of us who know Moe well, as well as others in the community who might not understand his signs or sounds.
Talkers come in two basic varieties: stand-alone devices and apps.
DevicesSeveral companies, including Saltillo and PRC make stand alone devices, although the state of this business is changing. In fact many devices, like the Springboard and Vantage, that were once staples in the AAC world just a year ago, have been discontinued. I suspect this is because it is much cheaper and easier to for a company to make an app for a tablet device than to manufacture and support custom hardware.
|Example of a "stand-alone" device.|
NOVA Chat 10 from Saltillo.
There are several benefits to this kind of device. They tend to come with more support and training from the device company, and often are available in several form factors. Most are made by companies that have been in the AAC business for a long time, and the new devices are their next generation solutions. Companies will often allow 30 or 60 day trials with loaner devices as well.
These stand alone devices are very expensive, costing $3,000-$5,000 or more. However, it tends to be easier to get insurance coverage for the stand-alone devices.
There are many apps that can be purchased and loaded on iPads or Android devices. This approach seems to be where most of the action is these days. Custom hardware is complicated to make and expensive to support. By creating an app for sale in the Apple or Google store, AAC companies can reach many more customers and lose the overhead of device manufacturing.
For a user, there are several benefits to getting an app instead of a stand alone device. There are lots of apps to choose from, since the barrier to entry is much lower. Because of this competition, as well as the cheaper production cycle, the apps are less expensive than the stand alone devices, and bugs can be fixed and turned around relatively quickly. In fact, if all you need is a simple app, you may be able to find something inexpensive or even free. Many of the apps also have free "lite" versions that will allow you to see what the app is about before purchasing.
|iPad loaded with LAMP Words for Life|
The downsides are significant, however. Because there are many to choose from, it is harder to know which ones are from reputable companies that will be around to support their app, make updates or fix bugs. It is also harder to know how the apps really work as the lite versions are often not fully featured. App creators don't support the hardware, of course, and may not provide customer care beyond an email address or web form. And although cheaper than a device, the more robust apps still cost between $200-300. Add the cost of an iPad and high quality case (like the iAdapter), you could be approaching $1,000, and it is harder - though not impossible - to get insurance coverage for iPads used as communication devices.
Stay tuned for Part 2: An overview of the devices and apps we saw during Moe's AAC evaluation and what we selected.
Can't wait to hear which you selected. Our 5-year-old son uses PECs and is ready for the next step too. So far I think that the LAMP Words for Life might be the best option for him- but I'm anxious to hear your thoughts, since our boys sound pretty similar! Good luck!ReplyDelete
I've never really understood why it wouldn't be preferable to use an iPad or other tablet to one of those standalone devices you talked about. It just seems like that functionality is already built into a less expensive device that does way more. I get the part about the reputable companies, but it seems like once you have that figured out it would be a slam dunk.ReplyDelete
Not sure how I missed this one! Actually, the Saltillo rep is correct; they have to do significant modifications on hardward, not just cases, to make them robust enough to make it through 8+ hours of intensive use on a daily basis. The batteries are often specially designed for extra long life. Plus, many of them have been modified in order to lock out the features which make the tablet-based devices just like an iPad. In many, may cases (varies by state), insurance will not cover a non-dedicated device.ReplyDelete
We have both an ipad and a Vantage Lite device. My complaint about the use of an ipad is that my son really needs a fully dedicated device for communication. There are so many great apps out there, but there are also some really crappy ones, too. (I could send you those names offline!) It's a crapshoot and, as you said, insurance is reluctant to pay for those things. I like that Nik can be doing somethign on his ipad and either ask for help, or tell me somethign completely unrelated, using his "talker."
I know PRC is replacing the Vantage Lite (and the Springboard) with their Accent series. I'll be eager to check out the Accent 1000 (10 inch tablet) once it's out. Nik already has such tremendous facility with the Unity language that it doesn't make sense to force him to learn another one unless we have to.
Can't wait to read more of your process. :-)
This is really timely! My youngest was just diagnosed with childhood apraxia of speech, so we're starting to research AACs for him to use while we work on verbal speech.ReplyDelete
Thanks for the great information and article. My son is going to be 8 next month and has Apraxia. He is verbal but is difficult to understand and gets VERY upset and frustrated when we can't understand him. We were supposed to have his IEP meeting today but thanks to the blizzard we had to reschedule. His teacher informed me of some things we will be discussing and AAC device is one of them. I have mixed feelings as I don't want him to use it instead of talking as I can see him doing but I also want him to be able to communicate effectively. I hope we can find a way to use it only when he can't get his thoughts across so we continue to work on speech. Anyone out there use it only for this purpose?? I'd appreciate any advise! (Side note- he does have many other delays- several diagnoses but not an umbrella diagnosis- Drs. think it's genetic but as of yet we can't find it.) juliemyappykidReplyDelete
Thanks for the great information and article. My son is going to be 8 next month and has Apraxia. He is verbal but is difficult to understand and gets VERY upset and frustrated when we can't understand him. We were supposed to have his IEP meeting today but thanks to the blizzard we had to reschedule. His teacher informed me of some things we will be discussing and AAC device is one of them. I have mixed feelings as I don't want him to use it instead of talking as I can see him doing but I also want him to be able to communicate effectively. I hope we can find a way to use it only when he can't get his thoughts across so we continue to work on speech. Anyone out there use it only for this purpose?? I'd appreciate any advise! (Side note- he does have many other delays- several diagnoses but not an umbrella diagnosis- Drs. think it's genetic but as of yet we can't find it.)ReplyDelete