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Ella's Story



Ella is a 5 year old girl who communicates using a combination of vocalisation, gesture, pointing to symbols, and her own gestures / signs. However, it is very difficult to understand her communication out of context.

She has trialled a medium tech paper overlay recorded speech device with 15 button locations and is currently trialling a dynamic screen recorded speech device, using 32 locations.  She responds well to having a ‘voice output’ and is also able to cope with a ‘dynamic screen’ interface and the navigation required for this. She is also able to physically access up to 32 buttons without using a key guard, so she is doing well operationally.

Ella also makes good use of her low tech Picture Communication Symbol (Boardmaker PCS) communication book and always returns to it when her high tech option cannot help her.

The challenge

Although she was making some progress with the communication device she had, Ella’s SLT and mum were particularly interested in whether an iPad with a suitable AAC App could be an alternative way forward for her communication.  They also thought that she would be very interested in multimedia approaches to communication such as using visual scenes and photo based resources, which are not easy to set up on her existing AAC device or on other high tech communication aids available.

Ella’s parents are familiar with iPad technology and would be keen to support use of this type of device for communication. Being a mainstream device, it is also considerably cheaper than other high tech options. However, this is only a bonus if it’s found to be appropriate for Ella’s needs. The fact that her direct access skills were so good also made the iPad an attractive option.

Our approach

As the first stage of the CALL assessment, taking these factors into account, we decided to try out some appropriate communication and photo based Apps on an iPad with her. Firstly we tried GoTalk Now, which is designed like a talking communication book, that you need to make up from scratch, containing pages of symbols (GoTalk symbols are supplied, Widgit symbols or SymbolStix have to be purchased as extras) and recorded or synthesised speech. Ella already made good use of her existing low tech (PCS) communication book and so it was decided that this App would not give her enough access to language structures and sentence building as required ‘long term’ for her communication. Staff also felt it would be more helpful to have a starter ‘vocabulary structure’ to expand within the communication app rather than having to build the system up themselves.

However, a feature of the Go Talk Now App that was particularly attractive was the ‘visual scene’ capability. This enables you to use your own personal photos and make areas of the photo, called ‘hotspots’ speak out appropriate messages giving the speaker and listener a shared context for communication. This can make communication more meaningful and fun. Mum particularly liked this feature and thought she could make use of it with photos from special occasions, family events and holidays.

Scene Speak is a separate ‘Visual Scene’ App that enables you to make these talking photos of family events, occasions and situations. Once I had demonstrated this app, we all agreed it would be useful for Ella to try it out, in addition to an AAC app.

We then tried Ella with the Proloquo2Go communication App.   This is a more comprehensive language based App, which usesSymbolStix symbols. Although Ella was already familiar with Boardmaker PCS, it was thought she would be able to learn these new symbols in the same way as she would learn new PCS. You can also use your own photos within the App, as symbols on buttons.

She responded very well to this App and enjoyed pressing the buttons to speak appropriate messages. She showed the ability to start to build sentences. Ella was able to scroll and select buttons easily and the clear and bright symbols and layout on the screen were very attractive to her. Once we had gone over how the App would be programmed and managed, it was agreed that Proloquo2Go would be the most suitable App for Ella to trial, as it provided more scope for language development and also provided a starter ‘vocabulary structure’ to build on.

Impact

Ella was loaned an iPad 2 from CALL Scotland for 3 months with Proloquo2GoScene Speak and some other suitable apps installed, as well as an iAdapter speaker case to protect the device and amplify the voice output.

She has been making good progress over the loan period and it has been now been recommended by CALL Scotland that her Local Authority fund this AAC system for her so that she can return the loan device to us and continue to develop her communication skills both in school and out in her local community and with family. CALL will continue to monitor the situation and be an advisory contact for school, SLT and Ella’s family.