Assistive Communication Technology for Cerebral Palsy in 2023

Assistive Technology for Enhancing Communication in Cerebral Palsy

Cerebral palsy is a disorder impacting muscle tone, movement, and motor skills. It can also affect speech and communication abilities. Fortunately, various assistive technologies can help augment communication for those with cerebral palsy.

Communication devices for cerebral palsy range from simple, low-tech options to sophisticated augmentative and alternative communication (AAC) systems. With today’s technology, it’s possible to find solutions tailored to each individual’s needs and capabilities.

Let’s explore some of the most effective communication assistive technologies available for people with cerebral palsy.

Low-Tech Communication Aids

Simple, low-tech tools can be extremely helpful for enhancing communication abilities. Here are some easy-to-use options:

Communication Boards

Communication boards display pictures, symbols, letters, words, or objects attached to a board. Users indicate their desired message by pointing. For nonverbal individuals, communication boards are often the first step toward augmentative communication.

Boards can range from simple, with just a few choices, to complex with hundreds of options. They can be customized to meet each person's needs and can grow with the individual over time.

Eye Gaze Boards

Similar to communication boards, eye gaze boards have letters, words, pictures, and symbols arranged on a display. Users communicate by shifting their gaze to the desired item. This allows people with limited mobility to communicate through eye movement.

Eye gaze boards are a great starting point for those with physical limitations. Gaze can also be used to control some high-tech AAC devices.

Gestures and Sign Language

Simple gestures like pointing, waving, thumbs up/down, etc. can supplement speech. American Sign Language provides a manual communication system using hand shapes, positions, and movements.

While gestures and sign language do not work for all individuals, they provide a ready means of communication for those able to control at least some hand and arm motion.

Objects of Reference

Objects of reference utilize tangible items to represent specific messages, needs, or requests. For example, a spoon could represent that someone wants to eat. Objects of reference are easy, portable, and intuitive.

They work especially well for young children first developing communication skills. As verbal skills advance, objects of reference can provide supplemental communication support.

Speech Generating Devices

Dedicated speech generating devices allow individuals to communicate full messages by typing words, pointing to pictures/symbols, or using eye tracking technology. Messages are then verbalized aloud.

Speech generating devices range from simple, pre-programmed single message units to sophisticated devices with natural sounding voices, touchscreens, word prediction, internet access, and more.

Single Message SGDs

The most basic type of SGD is a single message device that plays a pre-recorded word or phrase when activated. Pressing a button plays the chosen message aloud.

Simple message units allow individuals with limited mobility to alert caregivers to basic needs like hunger, pain, bathroom, etc. They provide basic communication with little effort required.

Multiple Message SGDs

Slightly more advanced SGDs can record and playback multiple messages. These devices have several level-activated buttons, each corresponding to a different pre-recorded message.

Users can string together messages to have simple dialogs. Multiple message devices provide expanded capabilities beyond single message units.

Advanced SGDs

High-end SGDs use text-to-speech technology to provide limitless communication. Messages are typed on a keyboard or touchscreen. Users can create novel messages or choose from pre-programmed words and phrases.

Some advanced devices also integrate word prediction, internet access, phone capabilities, environmental control features, and more. Advanced SGDs provide the most flexible and natural communication.

AAC Apps

Augmentative and alternative communication apps turn tablets and smartphones into functional speech generating devices. Apps are cheaper and more readily available than dedicated devices.

AAC apps allow users to touch words and pictures on the screen to form messages that are voiced aloud. Apps are easily customizable and offer word prediction.

However, mobile devices are less durable and can be hard to access for some users. Still, AAC apps provide an excellent mobile communication solution.

Text-to-Speech Apps

The simplest AAC apps utilize device text-to-speech capabilities. Users type what they want to say and the app speaks the text aloud. Some apps also incorporate word banks for quicker message creation.

While limited for those unable to type easily, text-to-speech provides natural sounding communication at a very low cost. Apps can also integrate with switch scanning access.

Symbol-Based Apps

Symbol-based AAC apps feature images, icons, and pictograms that users select to form messages. Symbols areverbalized using text-to-speech. Most apps allow limitless customization of symbol pages.

Symbol-based apps are intuitive and easy to use. They work especially well for non-verbal children or adults with cognitive impairments impacting literacy skills.

Word Prediction Apps

Word prediction apps help speed up message creation. As the user types, the app provides word and phrase suggestions based on context, frequency, and other factors. Users can select predictions instead of typing full messages.

Word prediction significantly reduces the effort and time required to create messages. It allows for faster-paced communication and more novel sentence creation.

Computer Access Devices

Specialty input devices enable individuals to access computers, tablets, smartphones, and speech generating devices. This allows device operation and communication even with limited mobility.

Switches

Switches are buttons that users activate with simple movements. Nearly any muscle movement can activate a switch, including eyes, eyebrows, hands/fingers, legs, etc. Users can scan through choices and make selections.

Switches empower even those with very restricted mobility to independently access communication devices. Switches are often used alongside scanning software.

Eye Gaze Technology

Eye gaze systems use cameras to track eye movements, allowing hands-free device control. Users look at on-screen buttons or keyboard keys to make selections.

Eye gaze provides full access for those unable to use their hands. It allows fast communication rates close to natural speech. Eye gaze works very well alongside speech generating devices.

Alternative Keyboards

Custom keyboards make typing easier for those with limited dexterity. Options include reduced-size keyboards, keyboards with larger keys, and keyboards designed for typing with a fist or pointer.

Alternative keyboards accommodate users who have some ability to control hand and arm movements but struggle with standard keyboards. They provide access with easier typing.

Environmental Control Units (ECUs)

Environmental control units enable individuals to control lighting, appliances, doors, phones, alarms, and other devices by switch activation.

ECUs empower those with mobility limitations to control their environment independently. Units can be programmed to each person's specific capabilities and needs.

Choosing the Right Device

With the wide variety of assistive technology available, choosing the right communication solution for an individual with cerebral palsy requires careful consideration of several factors:

Physical Abilities

Consider the person's mobility and range of motion to identify accessible options. Can they use their hands or only certain fingers? Do they have head control for eye gaze? Assessing physical capabilities is key.

Cognitive Skills

Devices must match the individual's cognitive and language comprehension level. Simple communication boards work best for more basic language skills, while AAC apps provide more advanced communication.

Vision and Hearing

Ensure the device accommodates any visual, hearing or sensory impairments. Options like eye gaze computing require vision. Speakers or sign language are needed for hearing issues.

Environment

Determine which environments the device will be used in - home, school, work, outdoors, etc. Rugged, durable devices may work best for all-purpose use. But apps provide good portable options.

Support Needs

Factor in any extra supports the user requires, like seating or mounting. Also consider who will aid with programming and customization. Simpler is better if support is limited.

Funding

Explore funding options like insurance, grants, and assistance programs, as costs can add up. Low-tech aids or AAC apps provide lower budget options.

With the right assistive technology in place, people with cerebral palsy can have meaningful communication and interaction with greater independence.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.