Augmentative Alternative Communication (AAC) AppsCommunication applications (apps), designed to be used on an iPhone, iTouch or iPad, fit different cognitive and learning profiles just like all programs and devices do. Today, most people use multiple devices to address their daily communication needs. The idea that ANY one device can (or should) “do the job” for individuals with communication needs no longer makes sense.The Rehabilitation Engineering Research Center on Communication Enhancement (AAC-R ERC)  shares, "Mobile technologies offer a broad spectrum of communication options as well as other functions. Not only have the devices themselves become smaller and multi-functional, but the number of communication Apps and tablet platforms is increasing more rapidly than AAC hardware or software ever did. At this writing there are easily a hundred or more Apps that can meet the needs of some individuals with Complex Communication Needs."So, what are some of the Pros of using a tablet or other mobile device, with the less expensive apps, as a communication system? Apps are low cost and easily acquired “Normalization”  has taken the mystique out of AAC AAC is likely to reach out to many more users, for example someone who has temporarily lost her ability to speak AAC may appeal to families of very young children, individuals with autism and others who may not traditionally have thought about AAC helping to make it more acceptable and common place They are multi-functional making their appeal enhanced because they offer ongoing access to information, social interactions, entertainment, music and gamesWhat are some of the Cons of less expensive AAC apps that should be considered? Loss of technical support Lack of quality control Less customization Support in choosing the correct system by matching the attributes of the program to the needs of the client not being used (individuals or family members are sometimes making decisions based solely on what they have seen, heard or read) Lacking the process and consideration of training, technical support and follow up There are challenges with mobile devices themselves, such as glare, ruggedness, sound, and system back-up Possible costs in monthly service agreements

Access remains unresolved for individuals with motor and sensory impairments who cannot use touch screen interfaces They are NOT dedicated devices meaning they are not approved for funding by private medical insurance, Medicaid or Medicare like dedicated devicesOne of the main concerns is that of abandonment of all AAC if the apps do not live up to the expectations.There is a growing need to evaluate what exists and compare features across mobile devices and communication Apps. With that said, here is a partial listing of communication apps. Please note that the apps available are growing at such a rapid rate, it is hard to keep up. It makes one really start to wonder about quality at the rate they are being developed. Also, sometimes you really get what you pay for. In other words, you cannot assume that a $10 program is going to be the same quality as a $100 program. Some have "hidden" costs. What you think is free you might really have to pay a monthly charge for in order to customize and personalize it. 

Please understand that this is in no means meant to be a thorough description or a recommendation of any of the programs. It is only meant to be an attempt to try to stay informed and to have a beginning place for locating what is available. As soon as this listing is updated, it is out of date as apps are expanding so quickly it is impossible to keep up. Jane Farrall from Spectronics is your go to person for a more thorough and most up-to-date AAC listing. This is where I go if I want to know what is really out there.As you explore, please remember, the goal of augmentative and alternative communication has always been about communication, not the device or technology.

Emergent and Entry Level Communication Systems Answers:YesNo  is a very simple straight forward app with two, large, color-coordinated buttons...one for yes, and one for no. Press either, and you will hear a voice read your selection. New in Answers:YesNo HD is the ability to create a custom button page which will allow the user to place custom text on two buttons, and record custom audio to play when the custom buttons are selected. ($2) iAssist Communicator  is focuses on the needs of young learners and individuals on the autism spectrum and others who are more cognitively challenged. It is a photograph based AAC app with 4 photos and related speech output per page over multiple pages and is customizable. ($37) GoTalk Now  is a customizable app for the beginner to experienced communicator featuring an easy to use, touch-based editor. Create one to 25

buttons per page, use own images or library, record your own speech or use text to speech, auditory scanning. ($80) iTake Turns  is a simple app that allows the user to say, "my turn" and "your turn" in a male or female voice. Great introduction to AAC and just might have its place in your environment. ($2) Look2Learn  addresses communication needs through the use of real pictures categorized and integrating vocal output so individuals may be able to express wants and needs. This is a PECS type of system in that it is based on “I want”. The images are nicely organized. You can manage the categories, use your own pictures, enlarge or reduce the size of the images and pretty much make it your own. The default voices consist of a boy, girl, man, or woman. You can record your own voices. This is for the individual who is not needing a full system but more of a support system. ($15)(Look for Stories to Learn and Social Skills by the same producers.) TapSpeak Button  is a simple cause and effect button that records and speaks messages just like a One-Step communication switch that allows you to manipulate the visual surface. You can record unlimited messages, then play them back by tapping a big (red) circle. You can also edit the phrase image, including the PCS icon library (4500 images) or the ability to use your own photos. You can adjust the screen response to allow for a variable finger drift/dwell on the  surface. ($15) TapSpeak Sequential  turns your iPad into a sequenced single message communication device/switch. Allows the user to record a number of sequences and store them – which can then be pulled up again later. Can change how long the “switch” needs to be pressed before it activates...recording and playback of songs, stories, nursery rhymes, and other messages. Includes starter set of songs with others sets available through iTunes. ($30) TapSpeak Picture Choice  for iPad is an extension program by the same company as the TapSpeak Button, Conley Solutions. It uses Mayer-Johnson Pictures Symbols, allowing 1-56 buttons per page and has drag 'n' drop editing. For those whose motor skill abilities make it necessary to use a switch, TapSpeak Choice support using the iPad screen as a switch for scanning and is the first app to use RJ Cooper’s iPad Cordless Super-Switch and iPad Switch Interface for external switches. You can use one or two switches for auto scanning and step scan and choose among a complete array of scanning options.($100) Yes/No Bilingual  is very simple and straight forward. It allows the communicator to say yes or no in English or Spanish and in a male of female voice.($2)Intermediate Level Communication Systems Expressive by Smarty Ears  uses non-standardized clip art images and offers both male and female voices.  There are over 19 apps available at SmartyEars, all created by speech/language pathologist, which includes

fluency, wh questions, articulation, turn taking and others skills. They have 3 AAC apps with Expressive as their most complex AAC app. Expressive comes with a built in library of over 400 pictures, ability to create folders and organize the images based on categories. Users can also enter images from the library as child’s vocabulary increases. ($35) iConverse  displays 6 different icons that represent a person’s most basic needs. When activated by touch, the icons give both an auditory and visual representation of the specific want or need. It is an educational tool designed for young children and individuals with communicative disabilities, and also toddler-aged children who have yet to master language. ($10) Lingraphica's SmallTalk  is a variety of small programs worth exploring. Simple yet powerful if they fit your needs. These are not able to be adjusted, you get what you get, but they are a possible option to supplement verbalization, other devices or for someone who has had a injury.  SmallTalk Common Phrases contains greetings, conversational phrases, and aphasia-oriented phrase SmallTalk Conversation Phrases provides words and phrases commonly used in conversations, such as greetings, responses, requests, and statements about well-being. There is one for the pain threshold, Hospital communication, ADLs, etc. (All are free.) Locabulary  Lite is an app with possibilities for use as a communication tool. Words are made available based on your GPS location. You can create a fast sentence using Locabulary's noun-verb-object structuring.This would be used with someone who is a reader as there are not any picture symbols built into the program. Vocabulary is offered in list view, with text only. A keyboard is also available to type into for text-to-speech.(iPhone app, not available for iPad yet. Free but must have WiFi available to use!) MyTalk  allows you to create personal communication boards for both education and everyday use. It was created for children, teens and adults with developmental and acquired expressive language challenges. MyTalk doesn’t come with a symbol system – just some clip art and photos and mostly you need to import your own pictures.  It doesn’t have a message window or sentence bar – so the user can’t create their own sentences.  You can pull up the keyboard to type but you can’t combine symbols and text into the one utterance.  You need to make a page set yourself from scratch.  It is reported to be very easy to use but hard to make pages which can produce generative language for the end user. ($40 for the main program. To be able to develop your own, you will need the "Workspace" also.It comes free for 30 days then plans are available for $9 per month (cancel at any time), $75 yearly or $175 every 3 years. Workspace is free for SLPs and Professionals with an ASHA member number. Worth working with your child's SLP.)

OnVoice  is a simple, easy to understand, and easy to begin program. It is straight forward in that the categories are all always available rather

than having to dig through one page to get to the next to the next. Pages can't be linked but for some, this is a plus as you don't get lost in the pages but just exit out.You can decide whether to play each word as the icon is pressed or wait until the person presses "speak" to read the whole sentence. This app has two modes: a more advanced mode that allows you to build a full sentence before having the app speak it and one for beginners that speaks the word as soon as it's touched. You can also pull up a keyboard and type sentences. ($200) Phrase Board  allows people to communicate when they are unable to speak for medical purposes. It was designed by a Registered Nurse experienced with clients who were unable to speak or for whom speaking was too taxing. - Large “Yes” and “No” buttons allow for simple usage.  This does not have text-to-speech however. Messages must be read. (Free.) SoundingBoard  by AbleNet lets you create custom boards using their picture symbols and add speech to the buttons by recording messages of pretty much any length.It includes the most frequently used 100 to 120 words used in communication devices and grids to make overlays with various amounts of pictures. Comes pre-loaded with 14 communication boards, ready for immediate use. Those boards highlight communication outcomes which include: Expressions, Emergency information, Reading, Daily Living, Social Situations, Shopping, and more. You can always customize the pre-loaded boards also or leave them as they are. ($60) Tap to Talk  allows you to program 6 choices in the display, with a category picture above it. A subscription needed to edit and add. With extra app, adds text and albums. Pre-made grids. TapToTalk Designer has a library of over 2,500 pictures that you use to organize your albums. You can add your own pictures and either record your voice or use text-to-speech. You are the designer so be prepared. In TapToTalk Designer, you choose what word or phrase is associated with a picture. You decide the appropriate caption and description that your child sees for a particular image. With TapToTalk Designer, you also choose a word, phrase or sentence that will be "spoken" when the child taps on a picture. Then choose the comfort of recording a real voice or the convenience of text-to-speech You are in total control of the vocabulary, accent and language. (Free then pay for programming ability at $100 a year.) Voice4U  is an AAC application that has its own unique little character used throughout its graphics. A cute little alien, it is designed for the young user. To find what you want to say there are several ways you can go about. You can browse alphabetically, type in a search, view the 'popular' list, view the 'recent' list, or browse by category.You can import your own pictures and record your own voice or use one of the about 150 pictures included along with the built in unisex voice. ($30)Advanced Level Communication Systems

EZ Speech  by Gus Communications is a text-to-speech system with NeoSpeech voices and a system of folders to organize and speed things up. No pictures symbols. ($180) PredictAble   is a new solution brought to you by Therapy Box. This solution offers 3 access methods, a phrase bank, and word prediction. It is based on typing, therefore having some ability to spell is important. By including Word Prediction as well as Switch Access this solution will meet the requirements of many AAC users. (RJ's iPad Switch Interface and Super-Switch work with the Predictable app for iPad.) It gives you a choice of 9 different voices plus the ability to adjust the speech rate, pitch, and pronunciation and 3 keyboard set-ups. ($160) Proloquo2Go  is a “natural sounding text to speech” app. It provides the ability to individualize and program to fit personal needs, including symbols and a vocabulary of over 7000 items. It is highly customizable from the words and pictures to the colors of the interface and the voice you relate to the most.  The layout makes it easy to find what you are looking for. Although this was one of the first programs developed, it continues to be up-dated and improved. ($190) Tobii Sono Flex  was developed for users with limited or no literacy skills, it combines structure, flexibility and a clear growth path, which promotes interaction and long-term language and communication development. It combines the benefits of structure and flexibility, providing a framework for language development, quickly matching individual and situational communication needs. ($100) TouchChat  by Silver Kite and the Saltillo Corporation is a full featured communication application.This program offers a robust communication system with various ways to set it up depending on the age and cognitive ability. Words, phrases and messages are spoken with a built-in voice synthesizer or by playing back a recorded message. Five voices are available, allowing you to choose a voice that meets your own personality. In order to communicate silently in noisy environments, TouchChat also has a unique feature whereby one can simply tilt the device to make the message expand to fill the entire screen in large letters.TouchChat comes with SymbolStix providing a range of symbols built in to choose from.  It has a message window and the user can combine symbols and typing to construct sentences or use the whole phrases stored under buttons.  It comes with a range of pre-programmed page sets which suit different users and there are more page sets available as in-app purchases.  You can make a page sets yourself also. ($150 however be careful to know what you need as there are add-on supports available for additional costs.)  Verbally   (for iPad only)  is designed for a literate user. It is a very simple program providing text. Core Words Grid offers over 60 essential words, which can save you over 50% of the taps required to input your sentences. 16 Core Phrases Grid offers a dozen common phrases to enable faster but without the ability to design your own, and text prediction that

learns the words and names you use which makes entering your thoughts significantly faster than typing. There are 3 keyboard layouts for you to find the one that's best for your purposes and comfort. The keyboard also includes buttons for repeat, speak each word and play a chime (which has a peasant sound) as a call button. The text entry field clears when the text is spoken. This is a great program for a real niche that is needed however the voices, a choice of male or female, are not good quality voices. (Free) Assistive Chat is very similar but for $25 you get the addition of being able to program in commonly used and personalized phrases and list for quick access to previously spoken sentences. Worth exploring and comparing. 

Verbally up-Grade  gives you voices that are much improved in the premium version. In a new release that will be released by Apple soon, you will be able to adjust the voices to suit your own taste.  The voices can be customized in both speed and pitch.  There is also a slider control for volume as an alternative to the iPad volume buttons that some users said were difficult to control.The upgrade also includes the ability to create, save and organize your own favorite phrases.  You or your clients can create a unique category such as 'Greetings' or 'Classroom' and save highly used phrases.  You can create an unlimited number of categories and the phrases can be as long or short as you'd like.  The upgrade also saves all of the user's history, so you can scan through it and either delete it from the list or tap to edit it, say it again or save to your favorites. There is an improved word prediction feature in the upgrade that learns from the user.  So, if your user often says "How are you today, Glenda?", after they tap in today, "Glenda" will be in the predictions and after that.  This just makes conversation quicker as do the above.  Users can also send their current text to their own email account.  This feature is very helpful for those with limited motor skills that can take advantage of the low number of taps it takes to say something using Verbally. 

WordPower for TouchChat   is a special version word-based vocabulary, designed specifically for the small iPod screen. It is a word-based page set that is used to create sentences "on the fly." Exclusive to the TouchChat software, WordPower contains two page sets. As a sentence is being built, you often find that the next word you want to say can be spoken with one or two button presses. "Grammar" keys are used to provide morphological endings to verbs, nouns and adjectives. A spelling/word prediction page is used to spell words that are not included as separate buttons on the pages. WordPower uses a 24-location keyboard layout. A second page set is included with the WordPower add-on. 'WordPower 24 with Phrases' is designed for individuals who are unable to use a word-based vocabulary design, but are able to generate novel thoughts using carrier

phrases and semantic categories. ($149 in-App purchase bundled with TouchChat.) Visual supports are different than communication systems. Below are various visual supports provided for the iTools that are worth exploring.

Visual SchedulesVisual schedules display planned activities in symbols (words, pictures, photograph, icons, actucal objects) that are provided in the order in which they will occur. First Then Visual Schedule  is a customizable app which allows for schedules to be created as needed with audio and visual prompting. You record your own voice and add your own image.  You can add as many different picture schedules as you like, and choose from three different ways to present your schedules. It is completely customizable. You can record their own voice, add your own images or simply use images from the application’s library to create a schedule. This customization allows the application to be unique to the user and their needs. This also allows for schedules to be created “on-the-go” to help transition through unexpected changes in a routine. ($10) iCommunicate  is an app that develops a storyboard, which is provides a collection of pictures that convey a concept. Storyboards are collections of pictures that convey a concept. Many children are visual learners. They may be more likely to understand what they see rather than what they hear. Can record your own voice. Has many pictures. ($50) iPrompts  lets you create multiple picture schedules, including a visual countdown timer, choice prompts and an image library. ($50) Time Timer  provides a time management solution by providing a disappearing red disk which allows viewers to actually see the time elapse.Social StoriesSocial Stories are a tool for teaching social skills to children. They provide information about situations that may be found difficult or confusing. The situation is described in detail and focus is given to a few key points. The goal of the story is to increase the ichild’s understanding of, make him more comfortable in, and possibly suggest some appropriate responses for the situation in question. Model Me Going Places  is a visual teaching tool for helping your child learn to navigate challenging locations in the community. Each location contains a photo slide show of children modeling appropriate behavior. (Free) Pictello , developed by AssistiveWare, is a universal app for social stories. Each page in a Pictello Story can contain a picture, up to five lines of text, and a recorded sound or text-to-speech using high-quality voices. Stories can be shared using iTunes File Sharing or via WiFi with other Pictello users through a free account on the Pictello Sharing Server. ($15)

QuickCues  is a social script app designed for iPods and iPhones that helps teens and young adults on the autism spectrum handle new situations and learn new skills. QuickCues makes social scripts more mobile and practical in everyday situations.($5)The following programs offer various visual supports: Expressionist  by Adastrasoft was designed with autistic students in mind. It is very graphic in nature, divided up into 7 categories along the top. Expressionist uses a black and white characters along with photographs to create composite images. It is not real intuitive in nature and is strongly suggested you watch the instructional video before purchasing to see if this fits your needs. I see it as being great software for learning about names of objects along with facial and gestural expressions although it was designed as an AAC app. Very unique. ($10) Grace  is an electronic picture exchange program by building sentences from relevant images. It can be customized by the individual using their picture and photo vocabulary with the user taking and saving pictures independently to the app. Can install pictures, move pictures to make a sentence. Unique programing. ($38)Research!! I recommend going on YouTube and doing a little research on the program first to get a good visual of the program you are considering. Then check out what kind of supports are out there (Are there tutorials? Read the reviews. Talk to people you know who might have it. Decide if you want to be able to customize it or not- is that important to you? Can you use personal photos?) Consider that you might want to use more than one program as one may not offer you all of the options you are looking for. These apps can nickel and dime you to death if you just start purchasing - so, be an educated buyer. Again, take a look at: Spectronics. Jane Farrall breaks all of this down a little differently and has apps that I have not included or stayed on top of. You may appreciate her format and in-depth approach much better. 

Need pictures to use on your iTouch or iPad? Of course you can use your digital camera then transfer them or consider the use of Internet resources such as Do2Learn then transfer them to your photo library.

MOBILE DEVICES and COMMUNICATION APPS - An AAC‐RERC White Paper -In order to gather information in a timely manner, more than 25 AAC “thought leaders” were interviewed between January and March, 2011, representing multiple stakeholder groups. "At this writing there are easily a hundred or more Apps that can meet the needs of some individuals with CCN (Complex Communication Needs)." 

Many questions have come up as we are deluged with this media. AAC‐RERCraises the following: "There is limited evidence that demonstrates the

efficacy of mobile technologies and AAC Apps on the functional communication and quality of life of people with CCN. Who uses mobile devices? Which ones? For what purposes? Where? Why? How often? How does the availability of low‐cost, highly portable, multiuse devices change the traditional AAC intervention process? What clinical and technical supports need to be in place; who needs to be involved; what, if any, standards are needed; and how does all this impact clinicians, end users and AAC manufacturers? Finally, what design specifications should be incorporated in Apps for people with CCN whose communication needs are poorly meet by current AAC technology and applications? These are some of the questions, among others, we need to explore.