How would you communicate with the world if you couldn't speak? If a progressive disease like ALS left you without speech, what could you use to express yourself? In this Fireside Chat, we’ll explore alternatives to human speech through devices, such as tablets with Augmentative and Alternative Communication (AAC).

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Giving a voice to those without
speech
with Kelsey Hall, EdM, MS CCC-SLP

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Kelsey Hall
● Masters in Speech-Language
Pathology
● Teacher of the Deaf
● Dyslexia Practitioner
● Assistive Technology &
Accessibility Consultant
● Currently at McDonalds
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What if…
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You found out
that you’d lose
your speech…
…and some of your
motor function.

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How well
would you
adapt?

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What situations could cause someone
to lose their speech?
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Common
Causes

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What do you look for in a speech
evaluation?
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HETT
evaluation
framework
Assessing
the end user
holistically
Human
Tasks
Tools
Environment
Performance

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How do you assess an adult’s communication needs?
● Do they plan to return to work?
● How much physical mobility do they
have?
● What’s their cognitive status?
● Can they take care of themselves?
● Is support required?
● Can they program their own device?
● YES: they’re a badass
● NO: who will be managing the
device?
● Are they literate?
● Do they have other disabilities?

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What about an AAC assessment for a child?
● are they of school age?
● do they have family support?
● do they have an external caretaker?
● are they independent in self-care or
device use?
● physical mobility status
● cognitive status
● where will the device be located?
● are they literate or pre-literate?

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What are the different visual languages
or symbols?
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Historical
systems
The first known
AAC system

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Fast forward to today…

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Alphacore

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Verbally

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Icon-based systems

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Boardmaker
PCS

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PCS Thinline

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SymbolStix

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Minspeak

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What’s the state of the art when it
comes to research?
What sort of feedback do you get from
end users?
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Research rarely includes…
● first-hand accounts from users
 particularly K-12 students with
multiple disabilities
● UX/UI user-research on the symbol
systems (design/implementation)
● cultural implications
● self-esteem, self-worth, etc.

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“Lost Voice
Guy” on
finding his
voice

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What are some of the ableist
assumptions that providers often make?
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Ableism &
Providers
They don’t have
the intellectual
ability to use
high-tech.
I think I’ll just
hide most of the
words and leave
the ones we’ve
learned.
They’ll probably
just break the
device, so I’ll just
have their
caretaker hold
onto it
Let’s focus on self-
care skills instead of
communication
because they
probably won’t want
them back at work

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What are some situations when you
have to switch to a low-tech version?
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Low-tech
“backup”

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How does a paper-based AAC
application work?
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PECS book
using PCS
Symbols

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Low-tech
AAC on a
desk

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Paper-based
AAC

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What does an AAC software look and
function like?
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TouchChat

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How does the home screen work on a
typical device?
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Sonoflex

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What happens when someone needs to
switch devices?
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Navigating
Insurance

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What would you require if you had to
build a new interface?
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Requirements
● Frictionless data
entry
● Uses established UI
metaphors
● Responsive layout
● Uses mainstream
technology stack
● Data and settings
must be portable
● Interoperable with
other devices
● Expandable icon and
symbol library
● Support languages
and i18n
(internat’lization)
● Different regional or
cultural sets
● Rugged hardware
● Works on
mainstream devices

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What could the future look like?
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Eyegaze
Using your eyes as a
pointing device

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Head
tracking
Open source
libraries in
javascript

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Intracranial
electrodes
Tapping directly
into the brain

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Machine
learning
Predictive typing or
input

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Blush.design
Illustration by
components and
characters

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Font
Awesome
Use a similar
approach to specify
poses, persons, and
even illustration
styles

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The
outcome?
Creating a flexible
glyph system that
could be the next
generation of
emojis

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Open source
Develop a new AAC
framework and icon
library as an open
source project

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Thank you
khall.consultant@gmail.com
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Resources
Try out AAC Software:
● PASS Software
● Chat Editor
Voice Banking:
● Google’s Project Euphonia
● ALS Message Banking @ Boston
Children’s
Common Symbol Libraries:
● PCS Boardmaker
● Minspeak
● SymbolStix
Research:
● Key Principles for AAC Research &
Design
● Exploring the Design Space of AAC
Awareness Displays