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August 5, 2014 — Alisa Konishi, Brooke Mickelsen and Ashley Fisher huddle around an iPad, punching various buttons. The three University of Wyoming speech-language pathology majors review and critique a software application called “ChatAble” that is designed to help people with communication difficulties communicate more easily.
The graduate students navigate to another app within ChatAble called “My House,” which pulls up a picture of a home, with the garage, window and door bordered in blue. They touch a finger on each bordered “hot spot,” and an electronic voice identifies the various parts of the home’s exterior.
“We’re using software that helps our clients,” says Konishi, from Denver, Colo. “This is learning technology for anyone who struggles with communication or is not verbal.”
These clients could include individuals with autism, cerebral palsy, ALS (Lou Gehrig’s disease), Down syndrome, a traumatic brain injury or someone recovering from a stroke.
The three students are part of Mary Jo Cooley Hidecker’s “Augmentative and Alternative Communication (AAC)” graduate-level course, which provides students hands-on experience with numerous and various technologies that persons -- who cannot speak or are difficult to understand -- would use to communicate.
“I want you all to create a visual scene application,” says Cooley Hidecker, a UW assistant professor in the Division of Communication Disorders within the College of Health Sciences.
Students pulled up another app, this one a hybrid type, that included different colors and pictures of persons working in various occupations, including an engineer, a farmer, a medical professional and a web designer. When students clicked on the hot spots for these occupations, a computer voice described the job.
“For any person who cannot use their own voice, for whatever reason, the software’s voice should be similar to their family/community,” says Fisher, originally from Bellflower, Calif.
Konishi adds that, when creating an app, one has to consider cultural diversity and dialects. A voice set up on an app may not sound familiar to someone of ethnicity, she says.
“My generation understands technology,” Konishi says. “But, we have to understand what our clients need.”
Intensive and hands-on
The course -- which included 15 hours of classroom and lab time for each of the past three weeks -- concluded Aug. 1 with student presentations.
“For three weeks, we’ve been introduced to one-to-three technology applications per day of lab devices and techniques that are out there for people who need a voice,” says Mickelsen, of Wheatland.
In one of the lab sessions during the last week of the course, Cooley Hidecker donned SCATIR (Self-Calibrating Auditory Tone Infrared Switch) glasses and explained their purpose to her class. The switch allows individuals who can’t use their hands or are unable to speak, such as those with advanced ALS, to communicate. The glasses work by emitting infrared light. For example, a person with a disability can wink or blink to control a computer or to use a speech-generating device.
“This keeps the person with a neurological disorder in the game longer,” Cooley Hidecker says of the device.
She adds the SCATIR glasses serve the same function as twitch switches, which are used by Stephen Hawking, the well-known English theoretical physicist, cosmologist and author of “A Brief History of Time.” A twitch switch detects when he moves his cheek muscles.
Some of the other technologies introduced during the class included:
-- Speech-generating devices that assist individuals who are unable to communicate reliably with their own voices due to cognitive, language and physical impairments. One software program includes icons and symbols that can be used to create comprehensive words, sentences and thought to communicate.
“It’s like a giant word tree in the computer,” says Darcy Regan, a speech language pathologist with Wyoming Assistive Technology Resources (WATR). WATR is within the Wyoming Institute for Disabilities.
-- Tobii device. The Tobii ATI 1-15 Eye Gaze high-tech device uses infrared light technology that persons with ALS or cerebral palsy can use to communicate by using their eyes. The persons’ cognitive functions may be intact, but they have an inability to express themselves.
“With this program, it takes time for a person to say what they want to say,” Mickelsen says. “Everything has to slow down for the client.”
-- EZ Keys is a text-to-speech keyboard. This program provides an on-screen keyboard, from which a person can create words by selecting each letter. EZ Keys allows someone with a motor neuron disease to give speeches and write papers. Hawking uses this type of program, says Cooley Hidecker.
-- iPads. While these devices are designed to use various apps, they are not durable or rigid for certain disabilities. For example, a person with cerebral palsy may hit the iPad too hard or drop it, causing it to break. It may be necessary to protect the iPad by placing it in a durable case before and during use, or use a different speech-generating device that is built specifically to be more durable, Cooley Hidecker says.
“You have to be multi-modal with this technology. There’s no one answer,” says Cooley Hidecker. “Speech-language pathologists learn to match the features of the AAC systems to the person’s needs.”
Some students expressed they will use what they learned in the classroom during upcoming work experiences.
Fisher says she has two “externships” set up, one with a regional medical center in Memphis, Tenn.; and another with a hospital in Trenton, N.J. For a future job, she says she is looking for a medical setting.
“I would like to work in an acute rehab facility with stroke survivors, or those with head, neck or throat trauma,” Fisher says.
Konishi desires an academic setting. Starting in January and running through May, she will work in Ethete with Eastern Shoshone and Northern Arapaho elementary school students on the Wind River Indian Reservation.
“It will be very culturally different,” she says.
Mary Jo Cooley Hidecker (second from left), a UW assistant professor in the Division of Communication Disorders, works with graduate students (from left) Ashley Fisher, Brooke Mickelsen and Alisa Konishi to create an iPad app that can be used by those who cannot speak or who have trouble communicating. (UW Photo)
Mary Jo Cooley Hidecker dons a pair of SCATIR glasses in front of students in her “Augmentative and Alternative Communication” graduate-level course. The glasses allow disabled persons, who can’t use their hands or are unable to speak, to blink or wink to communicate with a computer program or other speech-generating device. (UW Photo)