Every person needs some method of communication in order to interact with others and have healthy social relationships. People with cerebral palsy who are nonverbal or whose speech is not understandable enough to communicate effectively can benefit from using some type of communication device. Augmentative communication devices are tools and methods that help individuals communicate more easily and effectively. They can include things as communication boards (a board with pictures representing a students daily needs), symbol systems, programmable switches, electronic communication devices, speech synthesizers, recorded speech devices, communication enhancement software, and voiced word processing. This technology can help a person with cerebral palsy and difficulty speaking feel more independent and take part in activities with others.

Communication Boards
Communication boards are an inexpensive and practical mode by which an individual can communicate. This system does not involve any mechanical parts. A picture of an object (a hairbrush, a toy, food, or printed words) can represent what the person is attempting to say. The trouble with manual Communication boards is that there is only so many symbols which can fit on a board. The board must be portable and so cannot be too bulky or difficult to carry. Changing the symbols on the board can also be a tedious process. Computer technology has made the simple communications board much more versatile and usefull. One example is the ability for computer programs to easily store symbols, and then print a custom communications board every day to reflect the person's changing needs. On the other end, there are electronic communication boards which can use a hierarchy to display hundreds of times as many symbols than a conventional board. A person with cerebral palsy could drill down through a hierarchy to express their feelings, needs, or to construct sentences by combining small phrases. To create a message, the person would select a menu with a specific category. The categories on the screen are similar to folders on a computer. When you select a category, subcategories are listed. Categories for a young boy with cerebral palsy might be school, home. The category home might be broken down into eating, having fun, family, friends, etc.... Those subcategories are then broken down even further.

In the past, it would have been impractical to carry around a large personal computer and monitor in order to communicate via such electronic boards. Now that technology has allowed for the physical shrinking of computer componants and light weight LCD screens, it is possible for people with cerebral palsy to carry with them small, portable communications boards.

Giving Voice
Furthermore, these devices can do much more to facilitate effective communication. They can speak the phrase or sentence through a speaker so that the person with cerebral palsy can have conversations with others. Stephen Hawking, the renown physicist who happens to have ALS, uses such a device on his motorized wheelchair. He is able to hold lectures and answer questions from students by crafting his responses with his device. It then speaks his words aloud for him. There is a delay involved in this communication, but that seems a small price to pay to be able to tell the world just what you are thinking.

These devices, also known as augmentative and alternative communication (AAC) devices, can be used in a variety of ways. Some people with cerebral palsy have good control of their upper extremities. If such a person requires the use of an AAC, they can simply touch the screen or use a computer mouse to choose the words and phrases they wish to speak. If that person has poor control over their arms, they can utilize switches. A switch works in tandem with scanning to form the sentences for the AAC. The computer will scan through the possible choices and the person hits their switch when the desired word or phrase is highlighted. This can in turn display new options to build upon the initial idea. Once the person is satisfied with their message, it is spoken by the computer. The switch can take the form of a button, foot pedal, or a mouth operated switch. Exciting new technology has made it possible for a camera to translate eye movements and blinks into computer input. The camera mounts just below the computer screen, and uses infrared light to track a person's eye movement and estimate with great accuracy what portion of the screen they are looking at. So a person would be able to simply look at the phrase they wanted to say on the computer screen and blink twice (for example) to select it. Not only do these devices make it easier for people with cerebral palsy to communicate, but it also give that person much more freedom and independence.

Growth and Evolution
Often times young children with cerebral palsy who are learning to use these communication devices start out by playing games. A device may have a game which teaches the child to use their switch by rewarding a correctly timed click with an animation, sound, or video. The communication board would be very simple to start, with large pictures of various objects (a toilet, food, a blanket, etc..). As the child grew and their vocabulary and needs became greater, they would move to more complicated symbol systems which would have more nested categories. Eventually they may move on to using only written words with no symbols. Environtmental controls may even be integrated with their communication device, so that the person can influence their surroundings (turning off/on lights, appliances, televisions, etc...) via their all-in-one device.

The encouraging thing about the evolution of computer added communications devices is that they can be endlessly customized to fit a person's specific needs. If some with cerebral palsy cannot speak clearly, and also is visually impaired, the device can speak the the phrases to them through a headset or speaker (known as audio scanning). The person would then use their switch to select the proper phrase when it is heard. The device's external speaker will then say this outloud to the other party.

People with cerebral palsy and other disabilities want to have fun and interact socially with their peers just as much as anyone else. Assistive technology can help them to participate in all sorts of recreational activities which can be interactive with friends. It can help them gain friends and develop more relationships with people. Augmentative Communication Devices are making enormous strides, and as computer technology allows more powerful and easier to use designs, a person's ability to communicate with others will increase to the benefit of everyone involved.