Sunday, March 30, 2014

The Best Communication/AAC App*

When it was time to pick an AAC (augmentative and alternative communication) system for Maya, I kind of didn't know where to begin. It was 2010, she was somewhere in the neighborhood of 2.5 years old, and I was already a little (ok, a lot) bitter that no one had suggested looking into AAC before I discovered it on my own. (We had been receiving therapies by the bucketload since she was around 10 months old.)

The iPad had been released several months earlier, and Maya was fortunate enough to receive one from relatives who knew that it could open communication doors for her. We quickly bought "the best communication app" around, downloaded it, and then thought "ok, now what?" (AAC experts are quick to point out that having a communication app doesn't make you a good communicator any more than having a piano makes you a good pianist . . . it's all about modeling, teaching, and practicing.) I fumbled around, making page-based digital boards (like, I made a folder for "food" and then a folder for "breakfast" and then a page with breakfast words). I didn't know what I was doing, but it worked . . . until it didn't. Maya could easily select what she wanted to eat for breakfast, but she couldn't talk about her day. She couldn't tell me what she was thinking. She wouldn't learn to use verbs or construct sentences (other than a very few simple ones). The system fell apart.

We moved on to plan B. I wanted her to have a dedicated communication device, or an SGD (speech generating device). The speech people that I consulted with (typically over the internet) who knew apps and knew SGDs clearly favored the SGDs, and I did too. They were designed linguistically, by SLPs or language experts (or both), and they were set up in ways that made sense . . . ways that lent themselves to appropriate, meaningful language growth. Everything had been considered---grammar, verb tenses, the things that I couldn't even think to anticipate because I have no linguistic background. I even wrote about how Maya wasn't going to be a long-term app user, that as soon as she was ready she would move to a dedicated SGD.

Until I had the representatives from the big communication companies come to my home, to show me their product lines (now we're in fall of 2011, a year past our initial app acquisition). As it turned out, the devices were (crushingly) not what I had hoped for. One company's entire line didn't make good linguistic sense to me (oddly enough, this is the company that seemed to provide most devices through the preschool assistive tech evaluations in NYC). There were pop-ups, there were (a bazillion) folders, sometimes when you wanted to exit a page you had to tap in one corner, other times that button was somewhere totally different. No good.

The other company had potential, and the wise words of a fellow AAC parent had led me to suspect that I would favor their devices . . . and I did . . . but they still weren't good enough. Their simpler device (geared toward younger users) was too simple, and Maya would have outgrown it too quickly. Their more advanced device (which serves people into adulthood) was too advanced for a 3 year old. There were still too many layers. Without drowning in specifics, there was a shifty top row that would have been initially tricky, and there were often times still too many screens to navigate through to find the desired word. The language system was brilliant and the consultant was lovely, but it wasn't a fit. And, at upwards of $8000.00, we couldn't gamble on the fact that she "would probably" grow into it.

So we had nothing. I begged online, hoping that somehow, somewhere, I was missing an app that would be a perfect fit---designed with linguistic development in mind, simple enough for a pre-literate 3 year old but designed in a way that would allow it to easily grow with her into and through adulthood (if she continued to need AAC support). Seven weeks later, that app (Speak for Yourself) came onto the market and changed everything for us.

These are the reasons that Speak for Yourself (SFY) is, in my (only sometimes) humble opinion, is the best communication app on the market:

1. Only Two Taps: In SFY it only takes two taps to say any word. ANY WORD. Eat? One or two taps, (depending on how you customize). Waffle? Two taps. (None of this "eat"-"food"-"breakfast"-"waffle" folder organization). Tyrannosaurus rex? Two taps. (Seriously.) There is no other app or device that allows you to program EVERY word as a two-tap word. This alone would have sold me, really. It lets the AAC user speak more quickly, it makes things easier to remember and find, it's fantastic. Two taps, any word. Awesome.

2. Motor Planning: One of the biggest frustrations with other apps (and some SGDs) is the fact that they don't take motor planning into account. Example: If your child is using a screen with four words, those four words fill the whole screen. If you want to change to six words, everything moves, and the child is left thinking "wait, yesterday "eat" was in the upper right corner . . . where the heck did it go?" I wrote an entire post on motor planning and why it's amazing, including a video clip of Maya unknowingly showing the power of motor planning. There are only two apps that incorporate motor planning (SFY and LAMP:Words for Life). Some other big communication apps can be creatively programmed in a way to try to mimic this principles, I think, but that level of programming is out of my realm of experience and seems kind of mind boggling.

Combine these first two reasons, and it's already a clear stand-out. (As mentioned, the LAMP app does the motor planning, which puts it in second place, but it takes more than two taps to say some words, and it doesn't do some of the stuff that I'm about to list, so it remains a firm second.)

3. Simple to complex, easily. When Maya started using the app she only had a handful of words open. Now she has hundreds (thousands? I really don't know). Opening new words is easy, and the programming is something that anyone can learn to do after a few minutes on youtube. My son started using this app at 17 months. You can start young (and should). (Video of opening/closing words)

4. The Search Feature: A little magnifying glass on the home page allows you to type in the word your looking for. The feature has text prediction, so if I am looking for "ball" when I type "b-a" words like baaah, baboom, baby, baby wipes are all popping up---along with the picture that accompanies them in the app (so a pre-literate child could scroll through and find the ball picture, even if all they know is that it starts with the letter B). When you tap the word, the boxes actually light up to walk you through the app to the word you're looking for. No other app has a search feature that is nearly as user-friendly and clear as this one, and I haven't seen any app that has a search feature that a pre-literate child could use. (Video of search feature)

4. Babble: I didn't understand the power of the babble feature right away, but Maya showed me quickly how important it is, and my 18 month old son is now a fan of it as well. The babble button allows the user to turn on all of the words in the app with one touch, and then have a grand old time exploring on their own and finding all sorts of fun words---without messing up your programming. Trust me, it's important. We would have had no idea how much Maya likes the weather (because I didn't have all of those words open) until she found "rainy" on her own and kept going back to it, over and over. (Video of Maya using Babble)

5. History Tracker: I don't even fully know how to analyze all of the data that you can collect with the history tracker (like rate of communication and number of words used) but what I do know is this: when I send Maya to school I cross my fingers that she's using her device. With the history tracker, I can actually see how long the app was active for, what was said, and what time those words were said. That's important to me. (Video of history feature)

6. The Basics: I guess I should mention that all of the basic things that I was hoping for are met with this app. Text-to-speech, a QWERTY keyboard, the ability to change the pictures that are in the tiles, the ability to use photos or internet pictures or whatever, the ability to change the pronunciation of a word if it sounds weird.

7. Bells and whistles: Maya is only 5, so we don't use the app to it's fullest potential. I like knowing that eventually she can send text messages from the app (if we make the switch to iPhones). The "Hold That Thought" feature is a unique way that a user can write a sentence (or paragraph) and "hold" it until they are ready to say it---great for answering questions aloud in class or giving a speech or even just talking with people and being able to say your whole thought at once instead of tapping it out slowly.

8. Support and community: The developers of SFY answer emails, respond to Facebook comments, and are tireless in supporting people with complex communication needs and their families. There is also a Speak for Yourself Users Group on Facebook, where ideas, questions, screenshots, video clips, and photos are shared and discussed.


Why am I writing all of this?

First, because I get a lot of "I'm starting to look at apps and I'm not really even sure what I'm looking for" emails. This is an easy way for me to lay out my thought process and why we chose SFY.

Second, because Speak For Yourself is half price on April 2, 2014 (sorry if you're reading this after April 2nd!). It's an amazing deal. I would hate to wake up to an email on April 3rd that says "can you tell me why you picked SFY?" . . . I'd be kicking myself for not laying it out for everyone to read.

Third, because I remember what it was like to spend all of my free time researching AAC, apps, devices, communication boards, PECs, etc. I was desperate for answers, hints, people to brainstorm with, anything. I hope this helps.


(in case you haven't seen it, this video shows Maya's AAC progression, from 2-4.5 years old, through signs, communication boards, PECs, and 2 apps)


*for most people, as far as I can figure out. While it is switch accessible it doesn't yet work with eye gaze, so there's that. 

Disclaimer 1: I am not affiliated with, nor do I represent, Speak for Yourself. I do not have a financial relationship with them and have nothing to gain by writing this. They were unaware that I was posting this until after it went up.

Disclaimer 2: If your child/client/parent/friend successfully uses a device or app that I seem to not be a fan of, then I am truly happy that they have a working system. This is not an attempt to badmouth other systems, but rather an attempt to reach families who want "something" but can't even figure out what features to compare and contrast while looking at a surprisingly crowded field of communication apps and devices.

Disclaimer 3: I'm not a professional, just a really educated mom. I'm going back to school to become a professional, but it's pretty early in that game.

11 comments:

Adelaide Dupont said...

Wow.

I think I really like the HOLD THAT THOUGHT feature, especially for longer and deeper talk.

And of course the motor planning.

Heather Lanier said...

I'm still trying to decide if we'll spend the $100 and try out SFY. I don't think my daughter (Fiona, who we've talked about on the phone) is quite ready for SFY, but I wonder if having it will help her become ready. Right now, we have Lamp: Words for Life on loan, and the targets are just much too small. So... I'd love to know what you think about SFY for a kid who can't yet isolate a finger, and might not for awhile. When I see videos of Maya using SFY for the first time, she clearly has a pointer finger to use. Fiona is still tackling targets with a splayed hand, and usually rakes the objects on the screen. I think in a year SFY would be much more usable for her. We have Touch Chat right now, also on loan, and I think it's something she can use immediately (because of the larger targets. I'm thinking I could adapt Touch Chat into a core vocab system, with choice boards to boot). So I'm seriously debating: SFY now, or maybe wait a year? Again, what do you think about SFY for a kid who doesn't have a pointer finger, and maybe won't for a year, or more? (Or, of course, less if she surprises us, which is always possible).

Elizabeth said...

I want to take the plunge! We tried out SFY lite and while it is very limited my son had no problems using it. We asked him where fruit was and he touched it, same for snack. He is an iPad whiz as it is so while my concern is that he loves to play on it, I think we can get beyond that as he plays on my iPhone just as much if not more. Any tips, suggestions, advice, for taking the plunge? Also he is in ABA and they have been using signs and his ABA coordinator gave me a list of reasons why signing is better. Problem is they are almost all modified signs, he doesn't use them outside of therapy, and he is limited in fine motor. I have thought about it for as long as you have been blogging about it. For his birthday in November he was given a very generous iTunes gift card that would cover the cost of the sale price of SFY. If there is a post you wrote or a video you took that might help me please let me know. I appreciate any help you can give.

Dana said...

Heather, a few things:

1. I hate to be the bearer of bad(ish) news, but the target buttons on SFY are smaller than LAMP. LAMP, I believe, operates on an 84-square screen, SFY is 120. So, they are little. However, since you could have most of the screen go black and only have a small number of open buttons, you can grow into fine tuning the targets.

2. Regarding finger isolation, is she completely unable to isolate a finger, or does she only not isolate for communication? (My wise AAC friends always ask "can she pick her nose? If so, she can isolate a finger)

3. Have you seen the blog post about using a glove to that only one fingertip activates the screen? We did that and also used a keyguard for a while.

http://niederfamily.blogspot.com/2012/03/necessity-is-mother-of-invention.html

I wish there was a clear answer, but I have no idea.

Dana said...

Elizabeth,

1. If possible, using one iPad for AAC and one for games is the way to go (I know it's tough to gather funds for 2 iPads). Maya had a mini that only runs SFY and is locked in, and then we have a separate one for other apps.

2. SFY wrote a blog post about ABA and AAC that you might be interested in: http://www.speakforyourself.org/2014/02/22/accept-behavior-towards-non-autistic-child/

3. Some of the reasons that I feel sign is limiting are listed in #4 of this post: http://niederfamily.blogspot.com/p/hi-if-youre-here-i-likely-crossed-paths.html

Also, the "I'm not a mindreader" post might ring true---if he only has a small number of signs can he really make small talk and tell you everything on his mind, or are his thoughts limited to a few words and a lot of guessing: http://niederfamily.blogspot.com/2013/07/i-am-not-mind-reader-and-neither-are-you.html

Hope that's helpful!

Heather Lanier said...

HI, Dana, Thanks so much for your note.

No, Fiona can absolutely not pick her nose. Oddly, I would rejoice something fierce if she could! :) She just can't isolate a finger like that.

It sounds like maybe SFY targets are just too small for her right now. Lamp was already stretch. We're trying a modified sock (her hands are the size of a 6 month old or smaller) and I'm not sure it's really helping her. She'll be 3 in June. I think she'll get there in a year or two, but the Touch Chat targets are much more doable for her right now. ...Thanks again!

Elizabeth said...

Thank you for responding and so quickly! I will definitely take a look at those links you included. Right now it is not in the budget to purchase another iPad. He plays on my phone more than the iPad right now anyway so I am not really worried about that. Thanks again!

Kelley said...

Stupid question but what about non traditional foods? How does one add specialty vocab of any sort (just thinking food bc of their sample screen shots)

Dana said...

Kelley, you can add words to almost any screen. We actually filled up our EAT screen (where foods are) and now have moved into the TRY screen for new foods.

Antti said...

@Heather; your problems sound familiar. We used a cut glove just to give our son a different sensory feedback, but it was not very efficient. The best result so far has been with a bandage roll. We bend the fingers III-V around it and secure the hold with some adhesive bandage. That leaves him the pinch grab and possibility to point and it improves his iPad handling significantly, although we still have to do most of his nose picking for him. Naturally, we don't have it on all day.

Heather Lanier said...

An update: We're taking advantage of the discount today! Just yesterday, Fiona started scrolling through pictures on my phone with one finger. So I'm thinking this budding skill will evolve into SFY-style communicating. Besides, I've reasoned that $100 is incredibly cheap to give someone a voice! After all, we just ordered a 2,000 wheelchair, and mobility isn't nearly as important as speaking. Now on to key guard purchasing. Thanks for all you do!!