The instinctive view of most people when thinking about a communication aid is likely a device that ‘replaces’ speech for someone who can not otherwise speak – i.e. something that provides _all_ of their communication.
This is a view that two recent papers published in the Augmentative and Alternative Communication (AAC) journal challenges. Smidt & Pebdani’s forum note contributes to AAC theory and proposes an AAC framework that incorporates the Capability Approach. In doing this Smidt and Pebdani challenge the concept of abandonment of (voice output) communication aids as being a binary concept of use or non-use and propose a more refined consideration that takes into account conversion factors, capability, possible ‘functionings’, choice/agency and achieved functioning.
(reproduced under Creative Commons Non Commercial Licence)
Considering AAC provision and use from the point of view of the Capability Approach the authors argue “might be viewed as a subtle difference, but it moves the choice away from being that of the clinician and places the opportunity for daily choice in the hands of the person using AAC.”
Zoë from our team was lead author on the second paper. This paper reports on a research study carried out by the team across Barnsley and Sheffield with people with partially intelligible speech (dysarthric speech) – part of the Vivoca project.
In this study we talked to people who used communication aids about when they chose to use different communication strategies. We found that even participants who were classified as having ‘unintelligible speech’ had a strong preference for using speech, particularly with close communication partners.
The research also suggested a model of communication for those with partially intelligible speech. This model consists of a communication loop – where experiences of prior communication attempts feed into decisions about whether to communicate and what method to use to communicate – each of which were influenced by considerations of the importance of the message, the time taken, who the communication partner was, the environment the communication is taking place in (physical and social) and the personal context and preferences of the individual.
(reproduced under Creative Commons Non Commercial Licence).
This work also highlights that the role of communication aids in an individuals’ communication is subtle and not a simple binary ‘used or not used’. We also suggest in this work that the design of communication aids does not necessarily reflect this – i.e. it is not clear that communication aids are designed with the assumption that they will be used alongside speech and other methods of communication to _support_ conversation.
The AAC and AT literature often focuses on implementation and ‘feature matching’ but this effectively implies a passive approach to the technology. Peter Fuzesli’s PhD identified that practitioners act as designers in the provision of communication aids and assistive technologies – although this may not be recognised as such in practice. I find it interesting that the model proposed by Smidt & Pebdani and the Participation Model does not seem to address design. It is clear that design is not the only reason why communication aids might be ‘abandoned’ but equally it should be clear that design does have an impact on use the daily choices about communication modes as Annalu Waller highlights in the 2018 IJLCD lecture. In this lecture Annalu highlights challenges of designing communication aids but also the exciting opportunity that design presents to provide to ‘unlock the potential of AAC’. Maybe it is time to rethink the role, and design, of communication aids.
Simon Judge on AT 