Thinking outside the box(es) for older beginning communicators

Unfortunate but true: Despite the advances our field has seen in AAC awareness, knowledge, and technologies, too many children with complex communication needs remain “emergent” or “pre-symbolic” communicators into adolescence and beyond. Older beginning communicators encounter huge restrictions to their participation across environments. There are lots of reasons for this, and many individual factors at play, but it’s definitely a problem.

The authors of this study argue that some part of this skill gap—and one reason that gains from AAC interventions with this population have been modest—is that the available high-tech AAC options have just been too cumbersome: difficult and slow to program, with high cognitive, linguistic, and motoric demands for the user. They suggest a different approach, now possible thanks to evolving technology: visual scene displays (VSDs), based on photographs snapped by device’s onboard cameras, programmed “just-in-time” with voice-output hotspots. And yes, “just-in-time” means “you’re programming hotspots right then and there during the interaction.” Remember that the next level up from “emergent” communicator is “context-dependent.” These technologies are intended to help learners make that leap, by giving them quick and easy access to that context, right when it’s relevant.


The researchers used a tablet and mobile app* with these features during high-interest leisure activities with 9–18 year-old beginning communicators. During the activity, a communication partner snapped a picture and programmed in a couple of relevant hotspots. (By the way, they say they needed only 25 SECONDS to program a VSD with two hotspots.) The article has some great descriptions of how the interactions were structured and how the partners chose what to program. Compared to a baseline condition (using the participants’ current AAC systems), the beginning communicators averaged over 20 additional conversational turns within 15 minutes using the just-in-time approach.

What was the magic ingredient here? There are a number of possibilities, but the authors highlight a few:

  • Access to the immediate context of the activity
  • Potential advantages of using photographs vs. symbols
  • Contextualized vocabulary, for a reduced cognitive demand
  • Use of mainstream technology (tablets)

*The specific mobile app they used, EasyVSD, is not commercially available, but Snap Scene is based on the same technology.

Holyfield, C., Caron, J. G., Drager, K., & Light, J. (2018). Effect of mobile technology featuring visual scene displays and just-in-time programming on communication turns by preadolescent and adolescent beginning communicators. International Journal of Speech-Language Pathology. Advance online publication.