Eight-year-old Nico is hunched in his wheelchair carefully working out what he is going to say with his communicator. His shaky fingers pick through the array of icons, and words appear on the communicator screen. Other children are assembling in their walkers and wheelchairs for a morning meeting. When his teacher arrives, Nico presses the speak/display button, and the machine in the boy's hands begins to talk. "Good morning Mrs. Henneberry. I want a red bike."
Mrs. Henneberry smiles. She takes a minute to chat with Nico. They discuss whether it would be appropriate for him to have a bike like the highly modified one another disabled student rides around campus. Nico, who retains limited use of his arms and upper torso as a result of a car accident, pleads his case. "I want one. I need it." A few words come out as his own halting, whispery voice, but most of what he says is produced by his Pathfinder communication aide, a powerful 40MB laptop device with a 128 location static keyboard capable of producing a 4,000 word vocabulary. Mrs. Heneberry assures Nico she'll help him make his pitch to the physical therapist.
The children then begin the calendar lesson. Every student in the second- through fourth-grade class for alternative and augmentative communication (AAC) users at Valecito School in Marin County, Calif. has a severe communication disorder. Each of them uses some kind of communication device, from VOCAs (Voice Output Communication Aid) that produce simple digitized, pre-recorded speech, to complex communicators running Unity semantic compaction software. It is not a silent classroom. It is, in fact, a happy classroom, with what seems to be the usual amount of chatting and vocalizing going on during the learning.
In the past, children like the ones at Valecito were often hopelessly trapped inside bodies that could not produce communication. Ruth Sienkiewicz-Mercer, a writer who suffered from cerebral palsy, remarked, "As long as . . . people considered my brain useless and my facial expressions and sounds meaningless, I was doomed to remain 'voiceless.'"1 There is still frustration, as these children struggle to shape voices from circuitry and switches and muscles that won't obey. But with the help of new assessment and teaching techniques and an array of modern assistive technologies, the defeat educators once saw so often in the eyes of disabled children has been replaced, in many cases, by the sparkle of excitement. Many AAC children now have the opportunity to go on to become eloquent speakers and productive members of society and the work force.
Student Alessandra Lituanio is working on language arts with the help of her Pathfinder Communicator and AbleNetBookworm software. There are many extra steps in learning to read for AAC users.
It is estimated that approximately 2,000,000 Americans suffer from severe communication disorders. A variety of congenital or acquired physical, mental, and health impairments can cause communication disorders, including cerebral palsy, autism, developmental apraxia, multiple sclerosis, traumatic brain or spinal cord injury, stroke, and mental retardation. More than 50 percent of AAC systems are currently low-tech systems, such as communication boards, sign language, and voice and gesture systems. Low-tech systems are important because they support users of all abilities in a wide range of environments. A growing cadre of AAC users, however, is using both low-tech and high-tech systems to communicate in increasingly sophisticated ways.
Alessandra selects the pronoun "he" during the morning meeting as she speaks with her teacher and peers using her communicator. In conjunction with other keys, the pronoun "he" can have hundreds of meanings in the Unity language.
Marc Bainbridge lives in San Francisco and is a former principal and teacher in the San Francisco Bay Area. He is currently a graduate student in Special Education, Health, and Physical Impairments at San Francisco State University and an editor at Treasure Bay Children's Books in San Anselmo, California. marc@webothread.com
1. Ruth Sienkiewicz-Mercer & Kaplan, A.B., I Raise My Eyes to Say Yes (Hartford, CT: Whole Health Books, 1989).
Technology and the IDEA
The Individuals with Disabilities Education Act (IDEA-PL 101-478) of 1990 assures the right to assistive technology for individuals with disabilities. Later versions of the law increased spending, support, and consumer decision making and encouraged research and development for a range of assistive instructional technologies. As a result, the number of technological products and solutions for communication-impaired clients has grown exponentially.
Technological devices are not necessarily a panacea, however. The number one complaint about them is that they often go on the shelf and never come down after being prescribed in a student's IEP. It is essential that the device be supported by solid instruction.
New AAC Resources
Here is a guide to the latest and best classroom resources for communication-impaired students.
The two largest and most influential makers of AAC devices are Prentke Romich Company and Dynavox Systems. Both of these companies produce a range of systems, software, hardware, and accessories. On the high end, the communicators produced by both companies are essentially laptop computers with radically modified keyboards, speaker systems, and other accessories. A wide variety of switches are available from both companies so that users can cursor to a symbol and select it. For students who can't use their fingers, there are infrared head pointers. Both companies produce lighter, smaller communicators and models with a variety of capacities. Lower-tech or less complicated models are necessary for clients with severe limitations.
Prente Romich also authors the AAC language program, Unity. Unity is a sophisticated language that uses "semantic compaction." Icons on the keyboard have multiple meanings depending on the combinations in which they are used. The language has virtually unlimited symbolic and semantic complexity, but like ordinary speech, it can be used in a fairly simple and intuitive fashion by new users and children.
Dynavox's software is designed more on the premise that one size will not fit all. Their software tends to be both list and semantic driven. On many of the systems, the language stored in the devices is generated by the user and recalled when it is needed. For both companies, the intended clients are AAC users with a wide range of semantic and intellectual capacities, from beginners to competent users.
Alternative and Augmentative Communication Products and Support Services
Major Players
Prentke Romich Company
www.prentrom.com
Sells the Unity semantic compaction language and a whole line of machines based on the language. Unity was developed from MinSpeak, a system of encoding organized messages using icons that are capable of multiple meanings.
Dynavox Systems
www.dynavoxtech.com
Sells a variety of communicators and "semantic compaction like" systems including Word Power, which provides word-based communications.
Additional Resources
Assistive Technology, Inc.
www.assistivetech.com
Intellitools
www.intellitools.com
Lingraphica
www.aphasia.com
Solutions for Humans
www.sforh.com
Zygo Industries
www.zygo-usa.com
