Individuals who rely on augmentative and alternative communication (AAC) devices to support their communication often have physical movement challenges that require alternative methods of access. Technology that supports access, particularly for those with the most severe movement deficits, have expanded substantially over the years. The purposes of this article are to review the state of the science of access technologies that interface with augmentative and alternative communication devices and to propose a future research and development agenda that will enhance access options for people with limited movement capability due to developmental and acquired conditions.

Individuals with complex communication needs often use alternative access technologies to control their augmentative and alternative communication (AAC) devices, their computers, and mobile technologies. While a range of access devices is available, many challenges continue to exist, particularly for those with severe motor-control limitations. For some, access options may not be readily available or access itself may be inaccurate and frustrating. For others, access may be available but only under optimal conditions and support. There is an urgent need to develop new options for individuals with severe motor impairments and to leverage existing technology to improve efficiency, increase accuracy, and decrease fatigue of access. This paper describes personcentered research and development activities related to new and emerging access technologies, with a particular focus on adults with acquired neurological conditions.

This study described preliminary work with the Supplemented Speech Recognition (SSR) system for speakers with dysarthria. SSR incorporated automatic speech recognition optimized for dysarthric speech, alphabet supplementation, and word prediction. Participants included seven individuals with a range of dysarthria severity. Keystroke savings using SSR averaged 68.2% for typical sentences and 67.5% for atypical phrases. This was significantly different to using word prediction alone. The SSR correctly identified an average of 80.7% of target stimulus words for typical sentences and 82.8% for atypical phrases. Statistical significance could not be claimed for the relations between sentence intelligibility and keystroke savings or sentence intelligibility and system performance. The results suggest that individuals with dysarthria using SSR could achieve comparable keystroke savings regardless of speech severity.

The purpose of this article is to describe the impact of an intervention involving safe-laser pointing technology on six persons with locked-in syndrome. When these individuals were invited to participate in this project (4 weeks to 18 years post onset), none were able to speak and none were able to access an augmentative and alternative communication (AAC) device. All communicated using eye movements (e.g., looking up or down), eye blinks, dependent scanning strategies with eye movement signals, or eye linking. Following intervention with the Safe-Laser Access System, three of the six participants developed head movement sufficient to control AAC technology. Two participants continue to develop head control; however, their progress has been slowed by repeated illnesses. One participant has discontinued his involvement with the project because of medical and psychological concerns. These six participants represent consecutive referrals to the project.

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