|
|
|
|
|
How People Who Use Electronic Augmentative
|
| Northeast |
n=26 |
| Midwest |
n=28 |
| South |
n=20 |
| West |
n=10 |
| No state given by respondent |
n=16 |
Of the 86 survey respondents who chose to answer the profile information questions, 60% were male and 40% female. Seventy-five percent cited cerebral palsy as their disability, with 16% reporting "other severe disability" and 9% "other physical disability." All respondents had a speech disability, with two also reporting hearing and vision problems as well. Respondents either used their own AAC device or had access to one. Although not all survey respondents completed the income questions, survey respondents reported income as follows:
| Up to $14,000 |
45% |
| $15,000 to $25,000 |
14% |
| $26,000 to $40,000 |
20% |
| $41,000 to $65,000 |
11% |
| $66,000 to $100,000 |
6% |
| More than $100,000 |
4% |
| SSI |
41% |
| Earned income |
19% |
| SSDI |
15% |
| No income at all |
11% |
| Unearned income |
6% |
| Other |
8% |
| Living with parents |
26% |
| Living alone |
21% |
| Living with spouse or partner |
18% |
| Living with house-mates |
12% |
| Living in a nursing home |
9% |
| Living in other institutional settings |
7% |
| Living in other settings, not specified |
6% |
| Living with both parents |
72% |
| Living with one parent |
15% |
| Living in a group home |
13% |
The survey asked about ability to use the phone, and then asked a series of questions about how the phone could be used.
The first question asked respondents if they were ever unable to use the phone. Seventy-two percent of the survey participants answered yes to this question, indicating that nearly two-thirds of the survey respondents have significant difficulty using the publicly switched telephone network. Twenty-eight percent of survey respondents answered no to this question, perceiving their ability to use the telephone network as closer to average use.
For the most part, survey respondents reported on telephone usage at home, although other environments were included. Phone usage was reported as follows: 78% of all respondents reported using the phone where they live; 18% reported using the phone at work; and 12% reported using the phone "at school/training/university."
One AAC device user believed a lack of knowledge about speech devices among the general population was to blame for the problems encountered when using the telephone. However, another respondent noted problems with people who are familiar with AAC devices. The respondent, who used an AAC device daily at work, stated:
Just last week I called a special education administrator, and his secretary was very rude and didn't have any patience and said things like, "What? I can't hear you. Excuse me. Are you there?" What is really funny is that I told her boss--once I got through--and he told me that he gets several calls from users of AAC devices, and that the secretary is very familiar with the sound of such devices! However, the special education administrator did not offer to speak to the secretary and remind her to be more patient on such calls.
A parent mentioned an incident at a facility that her child regularly attends where one might expect greater sensitivity by the staff:
One time my son didn't have his device with him and went to call for transportation home. The dispatcher didn't understand him so he called home and mom called the transportation person for him.
However, when adults were asked if they could "use the phone whenever you want to as long as you have a speech communication device," 49% of the adults said yes and 41% said no, indicating that, for many but by no means all, a speech device facilitated use of voice telephony. In the case of children, facilitation did not necessarily occur, with 18 parents saying no on behalf of their children and 10 parents responding yes.
Overall, among both children and adults, 46% said they could use the telephone if they had a speech device. Forty-three percent said they could not use the telephone with a speech device. Of those who said they could not, the largest percentage (16%) were adults who dictated their responses to the survey questions, indicating a need for personal assistance as well. This was echoed by the parents of children using AAC devices who said their children could use the phone whenever they want with a speech device (18%).
Recommendation: Providers of voice telephony services should consider how difficult their service is for use by people with speech disabilities who use alternative and augmentative communication devices. Phone service providers should address new or convergent ways to deliver service.
A major focus of the survey was to find out how people with significant speech and motor disabilities use the phone despite reporting inability to use the telephone. One question addressed the difficulty of using the voice network by asking, "Do you need personal assistance (paid or unpaid) to use the phone?" Seventy-one percent reported yes and 29% said no.
The survey asked about this dependence upon another person to assist with the phone by asking how the assistance was provided. The most prevalent type of assistance provided by another person was dialing, with 61% of survey respondents reporting that another person dialed the number for them. Both adults and children's responses are included. (See Figure A)
Fifty respondents indicated that personal assistance was required for "talking," with 43 indicating interpretation was provided by the personal assistant. Forty-six people reported that someone else had to hang up the phone for them. Forty-four respondents indicated that during the call itself someone had to write down messages and notes for them. Twenty-six people reported that the personal assistant does "everything to set me up, and I talk with my communication device without any assistance during the call itself."
Figure A - Telephony: How Personal Assistance Is Used by Persons with Severe Disability
[Numbers indicate number of respondents who checked off use of Personal
Assistance Service (PAS). More than one usage was selected in most cases by all
respondents. (n=100)]
Recommendation: Because voice telephony requires considerable personal assistance, providers of such services should address this need through more accessible product and service design.
The survey asked how people with speech disabilities communicate using the phone despite the barriers they encounter. The four main strategies were getting someone else to make a call (45%), writing a letter (18%), and using e-mail and fax (11%).
Figure B - Strategies Used by People with Speech
Disabilities
[A majority of survey respondents answered this question. Numbers do not add up
to 100% as more than one answer was selected by some respondents. (n=100)]
The fact that means such as writing a letter, using e-mail, and using fax were utilized fairly frequently gives some indication of a need to exploit text communications. (See also the discussion on the use of e-mail.)
Recommendation: Providers of voice telephony and information services, e.g., e-mail and voice service, should realize that people with severe speech disabilities utilize both services as essential ways to communicate. Consideration should be given to packaging the services together.
It is clear that using the telephone presents a physical barrier for people with speech and physical disabilities. Many phones have specific features that are utilized by people with speech and physical disabilities that can assist them in making calls. The survey asked, "Do you use a phone that has a speaker/microphone?" Sixty-four percent answered yes and 26% answered no (10 respondents did not answer the question). Automatic dialing is another telephone feature that is essential for some users of AAC devices. One respondent stated, "I have a constant problem getting the wrong number. If I dial the wrong number people get bothered."
The importance of automated features became readily apparent when the survey asked, "What features in the phone do you use to accommodate to your disability?" More than two thirds of survey respondents find the use of a speaker on their phone essential, with 68 respondents saying they use one to make calls. Fifty-six percent marked programmed numbers, and 48% marked automatic dialing as features they use. Forty percent marked the redial feature and 31% use the volume control feature. Twenty-six percent use big buttons, and 14% use a headset. Another 15% selected other solutions, which include use of a "puff switch" (which is operated by exhaling into the mouthpiece of a device that then mechanically activates a device), "phone and dial tones programmed into my Liberator," "amplifier from Radio Shack," "voice activated answering machine, and "use of a TTY".
Figure C - Features Utilized by Persons with Speech
and Motor Disabilities
[Numbers indicate number of respondents who checked off use of these features on
phones. More than one usage was selected in most cases by all respondents.
(n=70)]
People with speech and physical disabilities use features like programmable numbers and automatic dialing or redialing that are built into the telephone itself. While it is doubtful that manufacturers of these devices thought of this population when they incorporated these features into their equipment, these kinds of software features are desirable for people with speech and physical disabilities who seek to optimize their own fine motor control and minimize the need to touch buttons and switches.
Recommendation: Designers of telephone devices and services should consider at the outset of design the physical accessibility needs of people who use alternative and augmentative communication devices.
Survey participants were asked, "Have you bought specialized equipment in order to use the phone, e.g., headsets, other adaptations?" and were asked to specify which. Thirty-two percent of the survey participants said they had bought equipment while 61% had not. Those who answered 'yes' were asked how much they spent and what they bought (see Figure D and the list of items that follows). Among the 22 who responded to this question, the mean expenditure was $551. The cost ranged from $30 to $4,000, with a median of $75. Three people reported spending more than $2,000 on special equipment. One respondent noted spending "$5.15 a month rental from the phone company (for a TTY)" and another stated that "work paid (for it), not sure (how much)."
Figure D - How Much Spent to Make Phone Work by
Persons with Speech and Motor Disabilities
[Twenty-two survey respondents reported a dollar figure on how much they spent
to make the phone work for them. n=22]
| Speakerphone (8 respondents)
In respondents' words: "External speaker; extension speaker; speakerphones; phone company got me a speakerphone; bought a speakerphone; speaker at parents' home; bought cheap speakerphone; speakerphone, we don't use much, but didn't work well." |
| Telephone Device (4 respondents)
In respondents' words: "Bought a sip-n-puff telephone; Freedom Phone, AT&T phone and guard to dial; purchased several phones but none of them work right all of the time; we got a TTY." |
| Other Solutions (7 respondents)
In respondents' words: "Cassette recorder; hooked up to PC; memory dialer; switch-activated; bought headsets; bought some other adaptations; bought headset, big buttons, amplifier. I need a better speaker for the Liberator to work with it". |
One respondent noted that the expenditure to use the voice telephone incorporated the price of an electronic communication device because this person would prefer to use a word board instead of a voice output device when speaking by telephone. The respondent stated that, "including the cost of two communication devices, I have spent $20,000 over the years."
Recommendation: Designers of telephone devices and services should consider the amount of expenditure willing to be made by people who use AAC devices. Designers should consider building in access or access modalities that can easily access AAC devices.
Respondents were asked how their equipment was paid for, including any equipment purchased by people with speech and physical disabilities. Payment sources were as follows:
How people with severe speech disabilities pay for equipment is fundamental to access. Answers to this question confirmed what many in the field of disability have asserted: that individuals with disabilities pay for a lot of equipment themselves (out-of-pocket, 38% of survey respondents) but that public sources (e.g., Medicaid, Vocational Rehabilitation, Local Education Agency) provide a major source of funding (53% of respondents).
How Persons with Speech Disability Usually Pay for Equipment: (Percent of respondents)
[In several instances, combined resources paid for equipment, e.g., employer and out-of-pocket or Vocational Rehabilitation Agency and out-of-pocket. (n=100)]
Recommendation: Providers of communication devices and services should consider alternate ways to finance devices and services for people with severe speech disabilities if they wish to market to this group, which is at the lower end of income scales. For instance, longer payment cycles, discounted rates, lower interest rates, allowing public supports as income in assessing credit, and permitting combinations of public and private income supports may be ways to ensure that this group gets the information technology (equipment and services) it needs.
Survey respondents reported using "operator assistance" or "dial 0" to make calls, with long distance calls needing this assistance most. Local calls and 411 information service calls also required operator assistance (see Figure F). Local toll and 911 emergency calls were less likely to involve operator assistance as reported by survey respondents. Using "0 operator assistance" requires both pressing buttons and engaging another person who is likely to be unfamiliar with speech disabilities.
Figure F - Those using Operator Assistance (Dial
"0") to Make Certain Calls
[Bar indicates actual number of respondents who checked off utilizing operator assistance to make certain types of calls. Not all survey respondents answered this question as many likely would not contact an operator. More than one response was checked off by several participants. (n=47)]
The numbers indicate the option taken by people with speech disabilities when they do not have access to personal assistance services, and attempt to make the call on their own using the operator as a personal assistant.
Recommendation: As long distance service and 411 calls appear frequently to need operator assistance, providers of long distance and information service should alert and train operators in how to handle these types of calls.
Figure G - Never Make Certain Types of Calls on Own
[Numbers indicate respondents who checked off not using a particular type of service on their own, that is, without personal assistance service. More than one service was selected in most cases by all respondents. Note that 70% of survey respondents answered this category of questions and includes adults and children. (n=92)]
While it is not surprising that TV shopping and 900 services calls are not utilized by people with speech disabilities because making more essential calls is so demanding, not being able to easily access 911 emergency, home delivery, and police is a serious problem. Similarly, directory assistance service, taken for granted by people without speech disabilities, was checked off by 58 respondents; more than 50% of survey respondents do not use this commonly used service. Not calling for taxi service, reported by 64 respondents, likely due to difficulties accessing dispatchers, is a significant issue for this group of people who are unlikely to use their own private vehicles, and may rely on public transportation more often than people without severe disabilities. Conversely, the bar graph shows that local calls are calls most likely made by people with severe speech disabilities on their own and without assistance.
Recommendation: Providers or services that utilize voice telephony services should understand that utilizing their services is problematic for those with severe speech disabilities. Alternative methods of selling or giving their service should be provided, including being more sensitive to demand by this group.
Being hung up on when placing a telephone call is a significant access barrier for people with speech and motor disabilities because of the number of "hang-ups" they encounter. Seventy-seven percent of the survey respondents answered the question, "Do you get hung up on when you try or have tried to make phone calls?" Of this group, 61% (or 47 respondents) reported this being a problem (see Figure H).
Figure H - Do you get hung up on when you try or have tried to make phone calls?
[n=77]
More parents of children answering the survey commented about hang ups than did adults answering the survey. One parent reported that "if (my) child answers the phone people hang up on him!" Another parent echoed this by stating, "When I answer the phone people who don't know me or my family hang up because my speech is so poor." A teenaged girl with cerebral palsy said, "My mom has to call the person first and let them know it is me who is calling or I get hung up on and that is frustrating for me because I want my privacy. Mom helps me but I want to do it myself." An 11-year-old boy with cerebral palsy reported that "Grandma hung up on me three times in a row!!"
Survey respondents were asked at what point a call was terminated by the other party. Of the 80 who chose to respond to this question, answers indicated that hang ups occurred "usually" for 11% (nine respondents), "rarely" for 45% (36 respondents), and "at the onset of the call" for 22.5% (18 respondents). Another 21.3% (17 respondents) reported they were hung up on "during the call, especially if the person doesn't know you." Parents reported more hang ups on behalf of their children than the adults who responded. One parent noted that hang-up was usual for a child making a call "unless it is a parent who is called."
Some respondents, in explaining why they didn't answer the questions about telephone hang-up, stated:
"I haven't used [the phone] much and then only with family."
"No [no hang-ups], because someone else dials or I used programmed numbers."
"I don't dial, my mom does."
"I get someone in my home to make the call for me" (adult who lives with parents).
Survey participants were asked if they were compelled to re-dial, when would they get through? Of those responding, 71% (34 respondents) said they would get through on the second try; 21% (10 respondents) said they would get through on the third try, and 8% (four respondents) would get through on the fourth try.
Recommendation: Researchers, relay services, and regulatory agencies should address hang ups experienced by users of alternative and augmentative communication devices.
Survey respondents reported hang-up in all categories of calls. The following graph gives the actual number of people who said they had been hung up on when making a certain type of call. Totals include parents answering for children, although primarily adults responded to this set of survey questions. Note that not all respondents answered all questions. More than a third reported hang-ups when making local calls.
Figure I - Hang-Ups: Types of Telephone Calls
[Numbers indicate number of respondents who checked off experiencing hang-up for a particular type of service when calling on their own, that is, without personal assistance service. More than one service was selected by respondents who answered this category of questions. (n=92)]
Particularly disturbing are reports by respondents about medical personnel hanging up on them, as reported by nine survey respondents. Hang up by 411 operators, reported by 12% of the survey respondents, indicates a problem that service providers could easily address during the training of 411 operators.
Recommendation: Train operators to expect calls from users of AAC devices.
To combat telephone hang-up, participants were asked to respond to a proposal to address the problem. Respondents were asked, “Do you think a specific message or sound tone, advising the people you call as they pick up the phone, that would indicate you use a speech-making communication device would be a good idea?”
Eighty-two respondents answered yes, and four said no. One respondent commented with a very large exclamation point next to the word “yes” and another commented that this would be a good idea “...if it is my option to engage it.” This reflects an overall desire for independence and choice underlying many of the survey respondents’ written answers.
Figure J - Those Who Thought the System Should Have a Tone Indicator:
Percent Wanting a Tone Indicator
[Bar graph indicates actual number of respondents who thought the proposal a useful solution to hang-up. Note that 86% of survey respondents answered this question. (n=100)]
Survey respondents were asked, “Do you think people would respond to a public information campaign telling them about this sound or tone indicator for users of speech devices?” A clear majority (73 survey respondents) said yes. Eleven respondents said no, perhaps echoing the despair of two respondents who wrote:
"Not everyone would respond. People that don't have the time or that don't care wouldn't respond."
Two respondents made recommendations for a pre-taped message in the network:
"I am speech impaired, please be patient."
"Please don't hang up on me. I'm a real human being."
Another set of questions asked where respondents would like to see service improved. Between 39% and 50% of respondents called for improvements to local calls, long distance, and intrastate toll calls; home deliveries; calls for taxi service; calls to 911, 888, and 800 numbers; medical appointment calls; calls to police; and calls to 411. As most survey respondents answered the set of questions on what needed improvement in telephony, answers can be interpreted as percentage of response as well (see Figure K). The bar graph reflects a level of dissatisfaction with certain types of calls, despite the ability to make calls when persistent.
Figure K - Improvement Wanted in Services
[Numbers indicate actual number of respondents who checked off improvement wanted in these areas. More than one "improvement in service" was selected in most cases by survey respondents (n=100). Note that a majority of survey respondents answered this question (56%).]
Recommendation: Providers of emergency-related services should realize that service utilization is problematic for users of AAC devices, and should devise solutions, both technological and in staff training area, to meet this customer demand.
Twenty-one of the 100 survey respondents reported "calling for technical service or installation or repair for your phone." Eighteen called for assistance specifically related to disability and accessibility. Of the 21, 83% said they got the disability-related assistance they needed.
Five people in the sample reported that they were charged an additional fee because it was disability-related. The average reported cost was $65. As installation and repair calls for phones generally go to the local telephone company, that the majority (83%) got the service they needed indicates good response.
Recommendation: Further investigation into the nature of disability-related costs for telephone service calls is needed.
When asked, "Do you take advantage of the phone service through directory assistance that allows you to pay an extra charge to have the phone number you requested automatically dialed?" 89% of the respondents answered no. The reasons for this non-use of the service included the following: "don't use directory assistance" (35%) and "it costs too much" (31%). Twenty-five percent gave "other reasons" without specifying, and 5% reported not knowing about the service.
Of significance is how few reported making calls to 411 directory assistance at all: 56% of the adults said they had never made a 411 call on their own behalf. Sixteen percent reported that they had been hung up on when making calls to 411 operators. Forty-six percent of adult survey respondents said 411 service should be improved for users with speech disabilities. One respondent wrote, "Operators of 411 and 911 are not understanding about speech devices."
Recommendation: Directory assistance operators need training on calls presented to them by AAC users, and this service provision needs to accommodate to the keyboarding time required by AAC users.
Respondents were asked if they use a TTY to access the network, and only 12% of the adult respondents indicated they did. Only 3% of parents answering for their children indicated TTY usage. Furthermore, many reported not knowing that Relay Services can be used by people with speech disabilities. This is significant, as the nation's telephone relay system was mandated by Congress to address both hearing and speech disabilities.
Figure L - Respondents' Knowledge About Telephone Relay Services (TRS)
[n=91]
Twenty-five percent of the adults reported knowing how to use relay service, as did 9% of parents answering for their children. Most respondents--59% of the adult respondents and 62% of the parents--did not know that telephone relay service (TRS) is intended for use by people with speech disabilities as well as for deaf and hard of hearing people.
Figure M - Comparison of adults and parents knowing or not knowing how to
make a relay call
[A majority of survey respondents answered this question (n=86)]
The national telephone relay service provides an alternate network for communication for people with speech disabilities that is currently accessible to and usable by all people nationwide. Relay service operators provide personal assistance to those with other disabilities by voicing for people with hearing and speech disabilities. People with speech disabilities who communicate with speech synthesizers require voicing services to facilitate communication similar to deaf and hard of hearing people who use TRS.
Speech-to-Speech service is defined by the FCC as "a reduced form of telephone relay service," as is hearing carry-over and voice carry-over. It provides human voicers for both voice synthesizer users and people with moderate speech disabilities who have difficulty being understood on the telephone. Users access the service with speech synthesizers or their own voices. People can currently access Speech-to-Speech as a reduced form of relay service in California, and expansion of the service is pending in Maryland and likely in Wisconsin soon. Relay service is now only accessible for calls between a TTY user and a voice user but communications assistants or agents (who translate TTY output to voice and vice-versa) can also repeat the synthesizer output or words of the speech disabled person to whomever the person with the speech disability is calling. With hearing carry-over, a person with a speech disability listens directly to the other end user but responds by typing on a TTY, and relies on the communications assistant to speak the text as typed.
This service uses technology analogous to relay technology. Ironically, TRS now provides the equivalent of this service to people with moderate speech disabilities but only if they want to call a TTY user. Speech-to-Speech should not be confused with three-way calling. Three-way calling requires users to provide their own human voicers. Simply providing three-way calling alone is not sufficient, as very few people could have others acting as voicers available around the clock.
All potential Speech-to-Speech users either have speech synthesizers or speech that many members of the general public have difficulty understanding. Potential users could also be those with dyslexia or limited hand use (from cerebral palsy, head injury, degenerative conditions, or strokes) that preclude keyboarding adequate for effective use of current relay service.
Recommendation: Related to telephone relay service (TRS):
1. Information about users of AAC devices should be incorporated into TRS training curricula for communication assistants.
2. Providers of relay service should commit resources to conduct outreach with the speech disabled community.
3. Speech therapists and other professionals (e.g., school personnel and rehabilitation personnel) should advise parents of children with speech disabilities and the adults they work with that telephone relay services exist and can be utilized as an alternative access mode.
4. TTY manufacturers should address convergences between TTYs and AAC devices.
5. Speech-to-Speech service should be offered nationwide.
6. People who use AAC devices should use relay service, especially hearing carryover, to explore if this service meets some of their communication needs.
When asked why they cannot use public telephones, survey respondents noted that their fine motor disabilities made such phone usage very difficult (see Figure N). Not being able to insert coins or use a credit card slide were the main reasons selected by adult respondents. Some reasons point to a lack of accessibility, which should be addressed by the Americans With Disabilities Act: almost one third of the adult respondents (28) said there was no wheelchair access. Twenty-six cannot reach the dial pad. Twenty-seven respondents said they cannot line up their AAC device with the pay phone. "Privacy issues" and "not being able to get the operator" were also cited as reasons. Few checked that they could not wait or could not find phones in public places. One respondent noted, "I have trouble being heard when there is background noise."
The following figure lists, in descending order of importance, the reasons respondents cannot use public telephones. These reasons help explain, also, why use of a telephone is difficult, whether or not in a public place.
Figure N - Reasons That People with Speech Disabilities Cannot Use Phones in
Public Spaces 
[Not all survey respondents answered this question. Numbers indicate actual number of respondents who checked off suggested reasons why they did not use phone in public areas. More than one item was likely checked off by a respondent. (n=86)]
Adult respondents offered the following to an open-ended question that asked why they didn't use phones in public spaces:
Some of the parents explained why their children did not make calls in public spaces:
Several respondents discussed especially difficult or egregious circumstances regarding making calls. A respondent who works with a person with a severe speech disability stated, "I have a client who needs to call a cab daily. I needed (before the client got an AAC device) to call (the cab company) before he called to let people know he wasn't drunk or on drugs or anything."
Recommendation: Related to public telephones:
2. Manufacturers should develop a telephone device that is portable for wheelchair users and that works with AAC devices.
Toward the end of the survey section on voice telephony, and
to elicit further design ideas, another question, with prompts, asked:
What other more specific ideas to improve phone services and devices do
you have so that they are more useful to users of speech communication
devices? We need your dream phone thing here! Don't be limited by current
technology or costs! For example, "I wish I could have a fax and phone
combined into my speech device" or "Why can't I have all the
vocabulary in my speech communication device built into the telephone
itself?" Almost half the survey respondents shared their thoughts about an ideal
telephone by either checking prompts or writing their design ideas. The
following table shows respondents' ideas. Recommendation: Combine telephone and AAC
device. Recommendation: Enhance voice synthesis
capacity. Recommendation: Develop network features
for people with speech disabilities. Recommendation: Make public phones usable
by people with AAC devices. Recommendation: Develop environmental
aspects in design.Ideas for Improving Telecommunications Equipment
For Device - AAC related: [12 responses]
For Speech Quality: [seven responses]
For Network Facilitation: [seven responses]
For Public Phones: [three responses]
Other Ideas: [four responses]
Upgrading Current Telephones to Facilitate Use by People
Who Use AAC Devices
The survey also asked for opinions on the directions future
telephone device design should take or how greater congruence of communication
technologies would allow better use of the publicly-switched voice network for
people with speech and mobility disabilities. Questions addressed both design of
alternative and augmentative communication devices or "communication
prostheses" and how they might better work with existing telephone and fax
appliances. These survey questions addressed the following:
Specific questions were posed to elicit design directions for device
development by users of AAC devices as they used voice telephony. Seventy-two
percent of the survey respondents answered "yes" to the question,
"Are you ever unable to use the phone?" Twenty-eight percent said no.
To get at the problems encountered by AAC device users in voice telephony,
several questions were posed. The following tables isolate the problems, give
recommendations for users of AAC devices, and discuss ideal features and
devices. Convergence of utility between AAC devices and other information
appliances is a key feature of respondents' desires.
Problems with AAC Devices and
Telephones
"While there is probably little doubt
that use of your communication device has most likely expanded your life and
options, there is still a lot that must be done to improve the situation. What
is your one most significant complaint about your speech communication device
and using the telephone? Please be very specific such as "quality of voice
output is bad and people can't understand it through the phone line" or
"doesn't connect to phone directly" or "it is too heavy to carry
about" or "lining up device microphone and telephone receiver is
nearly impossible."
Problems reported by adults and parents of children who use AAC devices are grouped in Table 7.
Table 7
AAC Device and Telephones - Problems and Suggested Solutions
| Problem Areas | Design Directions |
| Design
Features:
WEIGHT--[ten responses]
"Too heavy and too bulky." "My Liberator is too heavy to carry around." SIZE/USABILITY--[nine responses] "'I can't hold the device." "My Liberator is too big for telephone booths and the public phones have no speaker phones." SPEED--[eight responses] "Speed of typing out what I want to say (is too slow)." "Hard to time responses." "People are not patient enough (to wait and listen)." COMPATIBILITY (ACD)--[four responses] "Device doesn't work with home phone." "Must put telephone receiver on top of ACD to have dialed numbers and messages picked up by phone." |
Make
AAC devices smaller and lighter, and easier to handle. Find ways to
increase response time.
Develop new ways to fit phones and AAC devices together. |
| Voice
Output From Device: [12
responses]
"Quality of voice output is bad/is not good enough." "People can't understand (my device) through the phone line." "It can be difficult for people to understand. . .especially if they have never heard it before." "Hard to understand the Light Talker voice." |
Improve quality of voice output and transmission/reception across devices. |
| Network
Related: [six
responses]
"(Telephone) operators are untrained in speech devices and lose patience waiting." "My device is not fast enough for 911." "Some people think I am a recording so they hang up on me. . ." "People don't know what it is. " "When I am getting calls from strangers, they hang up as I turn on my voice." |
Develop or install network features or services responsive to AAC device users. |
| Programming
Features: [six
responses]
"It takes a lot of preparation to pre-program my device to make it work." "If Liberator is not pre-programmed, it is too slow." "Out of the last year and half it (link between device and phone) only worked the first six months." |
Consider ability to access software via telephony that would interface with AAC device locally. |
| Connections:
[five responses]
"Lining up the device and the receiver is nearly impossible or very difficult." "(Device) does not connect to phone directly." "Amplifier doesn't connect to phone directly." "No connection to phone." "Special equipment must be used to connect phone line to device." |
Design phones to physically line up with AAC devices. |
| Costs:
[two responses]
"Finances are tight and we can only get one special phone per patient." |
Consider alternate ways of financing for devices that work with the phone system. |
| Convergence:
[three responses]
"(I) want Liberator to be the phone." "Lack of suitable technology." |
Collapse features of phones into AAC devices or vice versa. |
Another question attempted to elicit further ideas to improve voice telephony for people who use speech devices.
Do you have any other thoughts about telephone devices or services that was overlooked in the survey so far or that came to mind? Please be specific. Feel free to address topics such as: materials, colors, connections, design, other "future" features.
Again, answers in Table 8 are ordered by the frequency of responses.
Table 8
Requested Design Features and Recommendations
| Requested Design Features | Design Recommendations |
| Size
and Portability:
[eight responses]
"Make (telephone devices) pocket size." "Make phones less heavy so can carry around for protection." "Smaller, lighter communication devices, with head phones for those with hearing loss as well." "Must be portable, lightweight, easily attached to chair, durable, water resistant, accessible by Liberator, covered by insurance funding, loud enough to hear in a crowd or able to adjust volume." |
Miniaturize telephone devices. |
| Connections:
[seven responses]
"Need a connection to my Light Talker." "We could plug the speaker into where the handset is, some kind of easy jacking, that is if I had the time to connect this, maybe a magnetic connection. . ." "Big programming buttons." "Big button speakerphone with big programming buttons." |
Consider connections and activators that are easy to use for those with fine motor disabilities. |
| Software
Features: [three
responses]
"Should have a warning thing that says you use AAC." "'I requested a scanning dialer through GTE but they said they didn't have the equipment. They also have limitations on types of phone I am allowed." |
Network features should respond to AAC device users. |
| Multiple
Disabilities:
[eight responses]
"I wish all places I visit (friends/relatives homes) had speakerphones." "Pictures are needed for the mentally disabled nonverbal person to person could sign/point out what they want to say," "Small speaker to attach close to user's device." "Capability of speech from device to go to receiver without being spoken aloud," "Infrared to turn phone on and off. It is all so difficult. I guess a vision phone would help to identify the user who has a speech disability." "Portable speakerphone would be important." "Telephone company should charge less or give me free services." |
Consider consumer responses directly. |
Seven percent of the adults and 19% of the parents who answered the survey said they have used or carried a portable telephone. Those who have used a portable phone and encountered difficulties cited the following problems:
The survey posed specific questions to elicit design directions for device development by users of alternative and augmentative communication devices. Overall, 41% of survey respondents answered yes when asked if they could imagine a portable phone working for them. Adults who answered the survey were more optimistic about this than parents, with 43% of adults saying yes compared to 37% of the parents. Thirty-eight survey respondents answered no to this question, and 21 respondents did not answer the question.
The question also included prompts: "Please list what features or design might make a portable phone work for you, e.g., infrared connection to my LightTalker, clip-on to wheelchair, etc." Respondents' answers follow, grouped by type of design feature.
Table 9
Portable AAC Design Suggestions and Recommendations
| Design Features Preferred by AAC Users | Recommendations |
| Component
Features: [22
responses]
"Can be mounted to or clipped onto the wheelchair" (requested by 14 people). "A headset." "I wish cell phones had handles so that the units would be easier to hold. As it stands now, most of them are too awkward for me to hold." "Small, to attach to a wheelchair, easy to use on-off switch, microphone receiver." "Large switch and large buttons for access." "Big buttons." "Microphone or filter that adjusts for background noise." "Large number pads." "Have a speaker phone system that could be portable or attached to it." |
Design
with wheelchair users in mind.
Design so that devices do not require considerable fine motor control. Design for environmental noise. Miniaturize. |
| Connections:
[18 responses]
"Infrared connection to my Lighttalker" (15 responses). "Speaker phone attached to my wheelchair with infrared access." "Hook onto Liberator with speaker, big buttons." "Connection to Lighttalker." "Accessible by Liberator using single or dual head switch (using row/column scan right now)." "Possibly infrared light would work." "Infrared connection to Liberator with speaker like an answering machine so the caller would be heard without earphones and could also hear person using ACD." "Puff switch operation as an option." |
Consider new ways of connecting and linking AAC to existing information appliances and devices. |
| Service
Features: [11
responses]
"Sell cheaper models with access." "Type out audio info [as text]." "Lightweight." "ACD microphone and phone set would line up." "Simple switch dialing." "A button that would call for police." "Digital voice-activated." "It would have a speaker." "It would have low rates [as calls take longer for me]." "Big 911 button attached to wheelchair." "911 alert system would be nice." "Easily plugged into my communication device." "Telephone should work when in bed without the Liberator to call for help, with auto voice activated for totally handicapped." |
Consider
putting into network some software that could access features for users
of AAC devices.
Design new device for 911 or other emergency/alert uses. |
| Programming
Capacity:
[10 responses]
"Memory dial." "All numbers I'd want plus emergency ones programmed on large push buttons with pictures of persons, or places on buttons" (3 responses). "Also use speed call via easy voice." "More auto dialing" (3 responses). "Autoprogramming from ACD." "Larger keyboard." "Infrared dialing from ACD." |
Develop easily installable program packages. |
| Convergence:
[7 responses]
"Have a phone in the more sophisticated communication aids..." "Would allow access through communication device with an auto dialer." "Designed with a speakerphone that would either be incorporated into Liberator or hooked onto it'." "A clip on the Liberator with speakerphone and easy voice access." "Infrared that would work with the Liberator or a portable one that would interface with my speech device." |
Design with multiple device use in mind. |
