If you’ve read even a few of the posts in this blog, you know that I’m a big proponent of communication apps for nonverbal adults. After all, as a Speech Language Pathologist, I regularly use speech assistance apps like the one I developed, APP2Speak, when working with my patients.

For adults who have lost the ability to speak due to a stroke, brain injury, ALS, Parkinson’s disease, laryngectomy, or some other medical condition, communication can become a daily challenge. For many of these people, Augmentative and Alternative Communication (AAC) apps offer a powerful solution, enabling them to express their thoughts, needs, and emotions using digital technology.

In previous posts, I’ve highlighted the success stories of a number of people who have used augmentative communication apps (and APP2Speak, specifically) to regain their ability to communicate with those around them. For example…

• Bob, who lost his ability to speak when he had a laryngectomy due to throat cancer and who was able to use APP2Speak to talk to his friend and the medical staff immediately after his surgery.
• Elaine, who lost her ability to speak due to a stroke and who used APP2Speak because it was so much more portable than the “big box” device the hospital provided for her. Elaine was able to return to full engagement with her social groups, church, and regular Mahjong games.
• Police officer Gary Glasby, who lost his ability to speak as a result of a traumatic brain injury suffered in a car crash and who regained his ability to communicate with those around him through his use of APP2Speak.

But I’ll be the first to admit that, while AAC apps can provide life-changing benefits, they also come with some challenges. These tools are highly effective for many, but they may not be the right fit for everyone.

For example, I was recently working with a patient in his 90s with aphasia and Alzheimer’s who had suffered a fall and following his hospital stay, he was admitted to a skilled nursing facility. His spouse said that he has difficulty speaking and wants speech therapy to work with him using AAC. Unfortunately, even though he reads well, and can identify pictures, using APP2Speak or a picture/word communication board was difficult for him. He has a very short attention span and memory problems, which often causes him to forget what he’s trying to say.

In this article, I’ll explore the advantages and limitations of AAC apps, with the goal of helping caregivers and loved ones make informed decisions about selecting the right communication solutions for their situation.

What Are Augmentative and Alternative Communication (AAC) Apps and How Do They Work?

AAC apps are software applications designed to help people who cannot speak by providing alternative ways to communicate. These apps typically run on smartphones, tablets, and/or dedicated speech-generating devices.

Common Features of AAC Apps:

• Text-to-Speech: Users type in a message, and the app converts the message into spoken words.
• Predictive Text and AI Assistance: Smart suggestions improve efficiency and ease of use when using text-to-speech functionality.
• Picture-to-Speech: Users select images or symbols (either by touching them or, in the case of someone using eye tracking technology, focusing on them with their eyes), which are then translated into speech.
• Customizable Vocabulary: Users can create personalized, frequently used word banks and phrases for quicker communication.
• Customizable Photos: Some apps allow the user to select personally meaningful photos (such as family members, items from around their house, etc.) to add to the app.
• Voice Banking: Some apps allow users to record their own voice before losing speech (which would work for someone scheduled for a laryngectomy or someone in the early stages of a progressive disease that will eventually lead to them losing their voice).

 Pros of AAC Apps

Like I said at the beginning, I’m obviously a big fan of speech assistance apps. Here are some of the biggest benefits they provide:

1. Restores Communication

Often, someone who loses their voice shrinks away from being social and becomes isolated. AAC apps give users a way to express their needs, thoughts, and emotions, fostering independence and improving their quality of life.

2. Increases Independence

With an AAC app, individuals can communicate without constant caregiver assistance, enhancing autonomy in their daily interactions. This independence keeps them from feeling like a burden to their families or caregivers.

3. Portable and Accessible

Unlike bulky communication devices, AAC apps work on widely available smartphones and tablets, making them easy to carry and use anywhere. My patient Elaine, who I mentioned earlier, loved to say (through her APP2Speak app, of course) that she loved it because she could just “throw it in her purse and go.”

4. Customizable and Adaptable

Users can personalize most AAC apps based on their unique needs. Whether they prefer text, symbols, or a combination of both, customization not only ensures effective communication, but it also allows the person to create messaging that uses their own memories and unique way of saying things. 

5. Supports Social Connection

By enabling conversation, AAC apps help users stay connected with family, friends, and their communities, reducing social isolation. One user of APP2Speak told me that he programmed his app to say, “Beer me!” whenever he went out to the bar with his friends.

6. Ongoing Advancements in Technology

AI-driven features such as predictive text, voice banking, and facial or eye-tracking technology continue to enhance the usability of AAC apps. As great as they are now, they’re only going to get better in the future!

Cons of AAC Apps

I mentioned at the beginning that apps that talk for you aren’t the perfect fit for everyone. Based on my experience with a variety of people over the years, here are some of the possible drawbacks:

1. Learning Curve

Some users, especially older adults or those unfamiliar with technology, may struggle to navigate AAC apps effectively. Training and practice are often necessary, and not all apps come with good up-front training and tech support.

2. Tech Issues & Accessibility Barriers

The tech itself can sometimes be a problem. For example…

• Device malfunctions or battery life issues can create communication barriers.
• Users with fine motor challenges may find touchscreens difficult to navigate.
• Screen visibility can be problematic for those with vision impairments.

3. Social Stigma & Frustration

Using an AAC app in public may make some individuals feel self-conscious, even embarrassed. Others may become frustrated if listeners are impatient with them as they try to use the app to communicate.

4. Cost Considerations

Some AAC apps require an upfront payment or subscription, which may be a financial challenge for some users. However, free and low-cost options are available. APP2Speak, for example, is very affordable, with a one-time cost of only $199 through the Apple App Store.

5. Not the Right Fit for Everyone

While AAC apps work well for many, they are most effective for adults who retain their cognitive abilities and vocabulary.

For example, those who could greatly benefit from the use of apps for nonverbal communication include:

• People whose receptive language and vocabulary are intact, but who have difficulty speaking due to a condition such as cerebral palsy, MS, or ALS
• People who have had a laryngectomy (due, for example, to throat cancer)
• People with dysarthria (slurred or inconsistent speech caused by impaired muscle control)
• People with nonverbal autism
• People who have had a brain tumor, brain injury, or stroke that affects their ability to speak, but whose cognitive abilities are still mostly intact

On the other hand, those with significant memory, attention, or processing difficulties may struggle to use AAC apps effectively. This group includes:

• People in the late stages of Alzheimer’s Disease or other types of dementia
• People with frontotemporal or other types of aphasia

 Take Action Today to Help Your Loved One Regain their Ability to Communicate

I’ve seen first-hand how AAC apps have transformed the way adults with speech loss communicate.

While they’re not a one-size-fits-all solution, their benefits far outweigh the challenges for many users. By restoring communication, increasing independence, and supporting social interactions, AAC apps like APP2Speak can literally be life changing.

For caregivers and families considering AAC options, I suggest that you:

• Explore trial versions of AAC apps to determine the best fit.
• Work with a Speech Language Pathologist to receive guidance on app selection and training.
• Consider the individual’s needs, abilities, and comfort level with technology.

Communication is a fundamental human right, and with the right AAC app, many people who have lost their ability to speak can reclaim their voice and their place in the conversation.

 

Looking for an AAC app designed specifically for adults?

Reach out to us here at APP2Speak to see how we can help your loved one regain their voice.