Would Your Loved One or Client Benefit from AAC? Find Out with Our Assistive Technology Compatibility Checklist

If you have a loved one or client who has challenges trying to communicate, you’ve probably been wondering whether it’s time to look for some help in the form of an augmentative and alternative communication (AAC) device or app.

If so, your first move should be to seek professional assistance from a speech pathologist or AAC specialist. But if the physician won’t provide a referral to a speech pathologist, or if your insurance does not cover such services, you may need to take the initiative to seek assistance for the individual on your own.

In such situations, we know that you probably have a lot of questions. Here are just a few of the common questions we hear at APP2Speak:

• “What if the person can understand language well but can’t speak themselves?”
• “What if the person has limited fine motor abilities?”
• “What if they’re technology averse?”

There are just so many variables, and the specific situation will determine what the best course of action will be.

That’s why we decided to put together a simple “AAC Compatibility Checklist” to point you in the right direction so you can start getting your loved one or patient the help they need.

Simply work through the checklist and follow the suggestions. Here you go:

AAC Compatibility Checklist

Would your loved one or client benefit from AAC? Use the following checklist to assess their compatibility and decide if an AAC trial is a good idea.

Goals for AAC Use

The overall goal of AAC trial is to address the following questions:

• Would the person be receptive to the use of AAC and willing to learn how to use it?
• Would the person understand the purpose of the specific app or AAC you’re introducing?
• Would the person be capable of using the device or app successfully?
• Would the person have the necessary support system in place (family or other caregivers) to help them use the AAC for its maximum benefit?

Answer each of the questions above either “yes” or “no.”

If you find yourself answering any of these questions with a “no,” ask yourself why you answered in the negative. It might be that an AAC device or app isn’t a good fit for this situation. Or perhaps it would be possible to change the situation in some way before running a trial.

If you answered “yes” to all of the questions above, consider that a green light to continue working through this checklist.

Daily and Emergency Communication Needs

Next, consider the person’s current ability to communicate with others such as family members, the doctor’s office, etc. to get their needs met. For example, how capable and successful is the person of:

• Communicating with others in emergency situations?
• Directing the behavior of their caregivers?
• Advocating for their self?
• Communicating with family, friends, or clergy in person and/or using the telephone?

If your answers to these questions indicate that the person is capable of communicating successfully in all of these situations, they may not be in need of help from an AAC device or app at this point.

If, on the other hand, they would have difficulty in one or more of these situations, you should probably investigate further. If that’s the case, move on to the next section to assess the physical factors that might impact your choice of AAC device or app.

Physical Factors:

Awareness and Focus

One important step in assessing whether someone might be a good candidate for an AAC device or app is their ability to focus and direct their attention in order to follow verbal and written communications. Answer the following questions about the person:

• Does the person read? Can they follow written instructions or use written reminders if they’re posted where they can see them?
• How well does the person follow conversations?
• How well do they understand questions?
• Does the person pay attention well?
• Do they have trouble with memory?

If they encounter difficulties with any or all of the above aspects, they may require a simplified AAC device or application.

Mobility and Dexterity

Certain AAC devices and apps are more physically demanding to use than others. Answer the following questions about the person:

• How well do they walk? Do they have any other gross motor physical limitations?
• Can they hold an iPad or iPhone? How well can they use their fingers when using such a device? Can they transport the device?

If they have trouble with mobility and dexterity, they would likely need additional technology assistance like switches, eye gaze, and other types of accessibility technologies.

Vision

Obviously, many devices must be seen in order for the person to use them effectively. Answer the following questions to determine if the person will be able to use such devices “right out of the box,” with modifications, or not at all:

• Can the person see? If so, how well can they see? Do they need help with the size of words and photos to make them more visible?
• Has the person ever attempted to use the accessibility features that iOS provides to help with vision difficulties?

If they experience visual impairment, they may require additional technological support like braille keyboards, backlit keyboards, magnifiers, and other types of low vision aids.

Hearing

Many AAC devices and apps can provide audio help—for example, text-to-speech functionality. Ask yourself:

• Does the person possess the hearing abilities to effectively use an AAC app or device?

If they face challenges with hearing, they may require additional supports such as assistive listening devices, personal amplifiers, TTY (teletypewriter), and other forms of accessibility technologies.

If the person has serious challenges in any of the areas above, you should seek a consultation with a speech pathologist or assistive technology specialist.

Every state has an assistive technology agency. For example, in my state, the Missouri Assistive Technology organization has a lending demo library of such technology.

Long-Term Considerations

One final consideration to think about: Technology is going to change and improve over time. That’s why you can’t afford to just think about how the device or app you choose will work today. You need to make sure that it will work for your loved one or patient for the long-term.

That’s why it’s crucial to make sure the company you’re working with explains how they’ll assist you in the long-term maintenance of the chosen device or app.

If they can explain to you how they continually improve/update their product and how they communicate those improvements to people who are already using the product and ask for help, that’s a positive sign.

If they can’t or won’t explain, that’s a red flag. Likely, they don’t have a plan for communicating improvements to users—meaning, once you buy their product, you’re on your own. In that case, you should probably keep looking for a better solution.

I hope that this checklist helps you to think through the various considerations you should think about when exploring AAC options. Every AAC device or app out there has strengths and weaknesses. None are perfect.

For example, our APP2Speak app is a perfect option for someone who:

• Is an adult or young adult who has language (can read and understand people when they speak) but who for one reason or another has lost their ability to communicate through speech, completely or in part
• Can use a device like an iPad or iPhone as an interface for our app by touching preset or customized photos to communicate their needs, and/or…
• Can use the app’s text-to-speech feature by typing in and saving words, phrases, or even complete sentences to be voiced by the app at the touch of a button or can use the text-to-speech feature by typing in what they want to say in real time

On the other hand, APP2Speak may not be the best choice for someone who:

• Is a younger child who is still developing their understanding of language
• Is incapable of using a tablet or smartphone as an interface
• Has very low vision (though APP2Speak does have two display options for low vision)

The point is, there are many options for AAC out there. All it takes is some research to find the choice that’s perfect for your loved one or client. I hope the checklist provided here is helpful to you in your search.