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Talk about why communication matters

AAC_TomAAC_Tom Member Posts: 3 Listener
edited April 9 in Guest blogs
Hi, I’m Tom and I have been working as an Assistive Technologist at Great Ormond Street Hospital for the past eight years. My primary role is assessing children with communication difficulties, with the view to providing them with techniques, strategies and devices to improve their expressive communication. I’m also studying for a PhD involving the use of eye-tracking technology in the assessment of children with cerebral palsy. I will be on the community all this week, representing Communication Matters. I will try and answer any questions you may have about how voice output communication devices work, how they are assessed for and selected, and what current arrangements exist for funding and provision of these devices. Whilst my background is paediatric, I will try to answer questions related to all ages as best I can. Please bear with me if I am not able to respond straight away, as I will have to check this forum around my daily work commitments. Looking forward to speaking to you all! ask away!


  • marionstantonmarionstanton Member Posts: 4 Listener
    I'm Marion and I will be joining Tom in answering your AAC (Augmentative and Alternative Communication) questions. I am a qualified special needs teacher and AAC practitioner so I can answer questions about the use of AAC in mainstream and educational settings and also about low tech (sometimes referred to as paper based) as well as high tech solutions to support students in learning and communicating. I will be happy to answer questions about literacy development for AAC users which is one of my passions.
  • EllaBEllaB Member Posts: 35 Listener
    Do either of you get involved with finding solutions for people who's communication has deteriorated through age? My brother is nearly 60, and he has Down's Syndrome. He has always suffered from a severe stutter, which has impaired his speech and made it frustrating for him to try. In recent years, he has almost entirely given up trying to speak and attempts to communicate through a series of grunts, nods, points and meaningful looks (eyebrows raised, pointed stares, slight smiles, as if he's sure you know what he's talking about). Now he has gone completely deaf, so communicating with him is even harder. It's very frustrating for everyone - but especially him. He has recently gone into a residential home and I worry that he is not making his needs known to staff. But I also find it upsetting as his sister, because it has impacted on our relationship.
  • marionstantonmarionstanton Member Posts: 4 Listener
    Hi Ella,
    What is are your brother's literacy skills like? This can have a bearing on what you decide to use.
  • AAC_TomAAC_Tom Member Posts: 3 Listener
    Hi EllaB,

    Thanks for your question. Firstly, I should say that my background is only in paediatrics, but I will see if I can add anything to this discussion, others may follow...

    To start with, I would advise asking the staff in the home if they are using any other communication support solutions for other residents: they may use communication books or boards, or perhaps have some knowledge of signing that might be able to help with supporting your brother so he can better understand and articulate his needs. It would also be worth inquiring whether a Speech and Language Therapist is (or can be) involved - they would be your route into thinking about any other support that could be put in place.

    A communication board might be a good place to start. This could be as simple as a set of pictures of things your brother regularly needs or wants (or places he likes to go, things he likes to do...) that he can point to in order to indicate to less familiar communication partners what his needs are. This sort of system could be presented on a single board, across a couple of pages or even on a tablet such as an iPad using the built-in camera and photos app.

    You can see some examples here: (again, apologies if it looks a bit childish, but should give you an idea).

    A free resource for making these sorts of things is Picto4Me, which you can access here: (requires Google Chrome).

    A system such as this may well help to relieve some of the stress he experiences when talking to less familiar people.

    It would be difficult to discuss specific solutions without a better understanding of your brother's communication and the environment, but there are a number of solutions out there that might help. These would include the use of symbols or photographs for him to select things he wants or choose topics of conversation, but may also include the use of "high-tech" devices. Many solutions are available for mainstream tablets such as the iPad, some of which offer free trials. Again, though, the choice of these would depend on your brother's exact communication needs.

    I hope that makes some sense, I am sure others on the forum may have things to add as well.
  • joden1joden1 Member Posts: 22 Listener
    HI, my son Dennis has severe cp, but is very aware on whats going on around him etc. We have had eyegaze tech for nearly a year now and we find he just gets very frustrated with it after 5 mins , throws arms back moans unless we put on his fav programmes in video walls option then he will happily focus on what he wants to watch. But i dont feel he is learning to communicate ( we would be over moon if he could show us yes or no ) he is just watching fav things on different device!
    Any advice would be good!
  • AAC_TomAAC_Tom Member Posts: 3 Listener
    Hi joden1,

    Thanks for your question. I'll try and answer it as generally as possible, since it wouldn't be possible to go into specifics without knowing more about the young man in question.

    I would recommend starting with a "no tech" method for indicating yes and no, rather than trying to move straight to using eye-gaze. Accurate selection for choice-making or giving responses through eye-gaze technology is a different set of skills from looking at a preferred or attention-grabbing video and requires a lot of different components (cause and effect, understanding the use and purpose of the device for selection, understanding of the question posed and the options on the screen, working memory...).

    My advice would be to talk to your local Speech and Language Therapist about how to develop a reliable and consistent yes and no response. They will be able to advise you on the sorts of questions you could work on and the sorts of choices you could give that would be understandable and relevant. Above all, though, you'd want to keep it fun and motivating, in order to minimise the frustration and allow your son to experience success and reward - perhaps through indicating the choice of a favourite toy.

    The idea of minimising frustration leads me onto the technology side of things: I'd want to make sure that your son wasn't being asked to use a skill that might be difficult (using eye-gaze for controlled selection) to complete a task that might also be difficult, or require some learning or development (purposeful use of yes and no). Using something like this that is difficult for him would leave questions about whether he "doesn't know" or "can't show" the answer, if the technology is difficult for him to control purposefully. Being able to signal yes and no is itself a complex set of skills and the eye-gaze might just be adding an extra challenge at this point.

    Hope that helps
  • SobiaKSobiaK Member Posts: 2 Listener
    Hi, my daughter is just over 13 months and has agenesis of the corpus callosum. She has some developmental delays, speech included. She can make most sounds now and understands and responds to words. My worry is she is not saying any words with intention. No Mama yet :(
    She does sing in her own way and tries to mimic my sounds when we read her favourite books.
    I was thinking it may be a good idea to take her to baby signing. Just so she has another aid to communicate, although she makes her wishes quite clear! What do you think?
  • marionstantonmarionstanton Member Posts: 4 Listener
    I think that would be great from a point of view of mixing with other little ones as well as the potential usefulness of using sign to support communication. Is she vocalising recognisable words yet?
  • SobiaKSobiaK Member Posts: 2 Listener
    Thanks for the response Marion. No recognisable words apart from daddy (she is singing fingers song so she continue to babble after the word daddy) and she says this , that as it's is from the title of one of her books "this rabbit, that rabbit".
  • tarunsarwaltarunsarwal Member Posts: 3
    I'm not sure I am in the right place but trying to see if anyone is interested in helping in the development of new assistive devices for people with locomotor and upper limb disability. To see what I mean you could go to I'd be grateful if someone could direct me to the right place if I am on the wrong community.
  • Tim WoodmanTim Woodman Member Posts: 4
    Apropos of nothing, eye tracking software does exist for Linux operating systems, the ppa for Debian/Ubuntu is ppa:cesar-crea-si/eviacam And there are a lot more disabilty programs on Launchpad. I hope I am not telling my granny how to suck eggs here, but thought I would mention this.
This discussion has been closed.