A little while ago I interviewed, we interviewed David Niemeijer, who is the Founder and CEO of AssistiveWare, makers of the famous Proloquo2Go. I also interviewed Ian Thompson, Managing Director of Liberator. Today, we are going to continue that tradition of interviewing leaders of AAC companies by bringing in Wayne Whatford of aacorn (warning – link has autoplaying videos). The aacorn approach has been on my radar for a little while now and one of the more innovative approaches to AAC, and Wayne was kind enough to answer questions.
Me: Can you tell us a bit about the background and inspiration for aacorn?
Wayne: My eldest daughter Jessica was born with a rare condition called Metopic Craniocynostosis, that if left untreated would almost certainly have resulted in long-term developmental issues. Thankfully where we live we have access to a fantastic children’s hospitals and her condition was able to be addressed via a (not insignificant) surgical procedure. It was through this experience and meeting some tremendous families with children many of whom were non or minimally verbal that we came to learn about the tools for assisted communication that were available to children – or what back then I rather naively described as large bulky and very expensive, robotic sounding apps and devices!
Fast forward a few years to 2010, I had established a successful business creating apps for mobile devices, Jessica was doing better than fine (and would actually later provide one of the voices available in aacorn), but despite the iPad having recently been launched it was kind of alarming to see that rather than it opening the floodgates to new and better forms of AAC, what we were actually seeing (with very few exceptions) were either copies of the PECS style flashcard systems that already existed, or variations on the fixed ‘grid and folder’ based communication systems popularized by Dynavox – and LOTS of them. A continuation of the AAC designs that by this stage had been with us for more than 30 years!
As a developer it seemed to me that merely porting existing software onto a modern touchscreen device wasn’t really changing or improving anything for our children. Sure it was more affordable but it’s not unreasonable to ask ourselves how come assistive speech apps for children with autism, apraxia, down syndrome or developmentally delayed speech were still so time-consuming to set-up, difficult to use, and still asked users to hunt and peck for words by searching through tables and folders of hard to identify stick figure drawings? Compared to the software advances in any other aspect of our lives, it wasn’t difficult to conclude that children deserved a lot better! So we decided to see what we could do to improve things for children and their families by creating what some speech professionals have called the first ‘intelligent’ assistive communications solution, one we designed especially for children- taking into account their individual needs and abilities, as well as the first to make full and proper use of the unique features of the iPad.
Me: As one of the first in what I’m hopefully be a new generation of AAC apps aacorn certainly does look different from the more traditional approaches to assistive communication technology. How does it differ from the hundreds of other AAC apps and devices available?
Wayne: If I cast my mind back to those visits to the children’s hospital before we started this journey, I was struck not only by the cost of the AAC options available and the use of rather dated technology by todays standards, but some concerns I had arising from the fact that the majority of assisted communications devices were originally designed for higher functioning adults, yet as they became more affordable were increasingly being given to children. With a keen interest in early childhood development and as a parent myself it seemed odd that there was very little difference between the tools provided to adults and those offered to children. AAC companies and developers are very fond of saying ‘there’s no one size fits all approach’ – and yet by virtue of the fact that every available AAC option is so similar, that’s exactly what children are being provided. A choice between apps with a handful of words (the digital equivalent of flashcards) – too few to be useful long term, or apps with a larger grid plus folders with more word choices in the hope of fuller communication.
That’s not to say these apps and devices are without merit, quite the opposite as they are very effective for plenty of adults and if you have a higher functioning child that can type and spell then they remain some of the best options to consider today. But our suspicion was that for many many children – particularly those who are younger and pre-literate, or have more serious cognitive issues – using systems that require some serious mental gymnastics to hunt and peck through grids and folders is very far from the ideal solution for most children. In many ways it’s a bit like the card games ‘Memory’ or ‘Concentration’, where you turn all the tiles upside down on a table and you have to remember where certain word pictures are. What may be easy for adults presents a major challenge for a three year old, let alone a child with significant challenges; and yet with AAC that’s the expectation – except with the added challenge that because all the words don’t fit on the table (or in this case the screen) we’re going to also literally ’hide’ the words you need in folders. Add in the fact that most young children don’t even know which words they should be looking for, and well you begin to see the extent of the problem!
After researching the AAC experiences of families with non-verbal or speech impaired/delayed children with the help of the Murdoch Children’s Research Institute, the feedback we received from countless parents, educators and speech therapists was that assistive communications technology was extremely time consuming to set-up, difficult to learn, and too often led to a frustrating and discouraging experience for the child and everyone involved. Buried among the highly publicized stories of non-verbal children making great strides, are far far more stories of children in danger of slipping through the cracks because the tools available were either far too simplistic and limiting, or too complex with little to no support available, or just ill suited to their purpose and the specific needs of children, and that’s why we wanted to get involved.
While the up-front cost of assistive technology has come down dramatically in recent years the real barrier to entry is that the software requires a high level of cognitive ability to be able to use it. That bar is set pretty high and excludes the youngest or most developmentally delayed – those who could benefit most! Our response was to try to create an alternative that instead focused on uncovering the true cognitive abilities of each individual child, and based on their actions actually ’learns’ and adapts to meet their particular needs! That meant retiring the old filing system of words in folders all arranged in a grid, and instead thinking about a different much more naturalistic approach based around how we all learn language, and really taking advantage of the flexible nature of the iPad.
We still have a system based on core vocabulary and word pictures, but that’s really the only similarity. In fact we had a long list of areas we thought could and should be improved based upon the above issues and the feedback from our research. Our first thought was AAC should be an experience that is welcoming and engaging so that children (and adults) will want to use it. As any parent or teacher knows we’re competing for children’s attention amid all the games and fun things you can do on the iPad and it can be a real challenge to get children to use their AAC. So when you first look at aacorn it doesn’t even look like an AAC app in the usual sense. That’s not just to be different for the sake of being different, we spent a lot of time looking closely at the way children interact with the iPad, as well as giving careful thought to the shapes and position of buttons to make things very clear and accessible for little hands with developing motor skills, and we compliment this with an extensive series of fully interactive lessons for children and their carers, so yes they’ll be more interested initially, but ultimately it’s about lowering the barrier to entry to make AAC much easier to learn and use, so that it is more accessible to children of all ages and cognitive abilities.
Next we looked at the voices that were available. Certainly computer generated speech has come along way in recent years but very often we’re still hearing the voice of generic middle-aged american or british male/female, and where you do hear simulated children’s voices what they don’t do especially well is capture the personality or inflection you’d want for a child to be able to express their thoughts and feelings. So we worked with real children with the help of families in the US, UK and Australia, recording many hundreds of words in a way that they can be played back in aacorn and give an almost limitless combination of very expressive phrases or sentences.
But perhaps the biggest break-through can be found in the way we use words to build sentences. Rather than each word picture being an island on its own, what happens is that just by using aacorn you teach it about the relationship between words. So we’re basically making daisy chains linking words together. If you model “I want Apple” then aacorn knows next time that these words potentially make a sentence YOUR child might want to say and brings them to him or her automatically! That saves a lot of time and reduces the cognitive hoops that child needs to jump through, it’s easier to navigate and so often less frustrating, but maybe more exciting we are finding that by making these connections and showing words via branching pathways we’re able to introduce all the little words that otherwise people may say oh my child could never say or understand.
All they do is follow the path laid out for them, so that real sentences such as “Can I have an apple please?” are no more work, and through repetition of seeing and hearing all these words in context hopefully over time things start to click for them.
Me: I understand that you’ve put a lot of your design effort into this predictive aspect, can you give us some details on what you mean by the ’word tree’ and how the predictive aspect works?
Wayne: Sure. Out of the box aacorn is like a new-born, big on potential but something of a blank canvas waiting for you to imprint your child’s communication style on it. So if you launch it for the first time and try to say ‘I love Mom’ (or Mum in the UK) for example and it isn’t immediately offering you Mom as an option, you click the ’+’ symbol to add it and you have basically taught the app hey “love and Mom” go together. The very next time a child (with or without help depending on their needs) starts a sentence or phrase using “I” the word ‘love’ will appear as an option (along with any others you’ve taught it). These ‘word tree’ branches can be tapped and will be spoken aloud or if not tapped are removed until needed (eliminating the tendency of some children to fixate on particular buttons). What your child chooses takes them down different paths – but and this is very important- they aren’t random groupings of words that we think they should be saying, they appear based on what aacorn has learnt about the words your child uses or what you wish to teach them to be able to say. Working in this fashion – without needing to worry about where you place words in a grid or folder or spending hours making pre-canned phrases – with practice we’ve seen kids who previously struggled to build and speak 2-3 word phrases using other devices and software communicate the same thing in a third of the time. Similarly others are able to expand their vocab to 8+ word sentences almost overnight. In short we’re substituting the time you’d perhaps otherwise spend setting up an AAC app (before you even get to making sentences) and using that time to model desired behaviors and teach language! It truly is a case of the more you use aacorn the smarter it becomes and so the more useful, which is incredibly exciting when you think about it because we’re moving the conversation beyond maybe being able to express a few simple phrases and with the same or less effort providing a platform upon which to empower children to become communicators by building an understanding of language, grammar and meaning.
I’ve seen approaches from very well known AAC companies where the first thing their apps do is have parents complete a questionnaire about what a child’s ability is and depending on the answers you input as an adult they then get access to a small, medium or large pool of words. That just boggles my mind! No-one can know what children are really capable of because the tools we have available don’t encourage them to be able to show us. We’re much more interested in what children can do given the opportunity and the right tools, than what they can’t, and passionately against putting artificial limits on what might be possible, so felt if we went with a very open ended approach that could adjust on the fly to each child’s abilities – and knowing they wouldn’t be doing this in isolation, that success is always dependent on a good family support structure – then we could arrive at a place where it’ll be as easy for children to build and speak complex sentences like ‘Dad I fell and hurt my arm’ as it is a two word phrase like ‘me sad’. With the unique concepts we’ve imbedded in aacorn and in particular the ‘word tree’ it’s proving to be the case. Model the sentence structure one time for a child and it’s added to the knowledge base in the app! In a very real sense it is about moving our definition of AAC beyond apps with buttons that speak when pressed to providing solutions that empower children, expand vocabulary and actually help to teach language!
Me: What has the response been like from parents and the different sectors of the assistive speech community, and what kind of results are you seeing?
Wayne: In the nine months since we launched aacorn we’ve been blown away by the level of interest from parents, speech and language professionals, and educators from around the world, and the support we’ve received has been kind of overwhelming, especially as we’re relative newcomers to the industry. It’s extremely humbling, but I suspect in part it is probably less about aacorn and more about the special kind of people you meet if you work in this space – individuals who are honestly passionate about helping others and readily embrace change if it can lead to improved outcomes for the children and families they work with.
We get a lot of enquiries about aacorn’s new approach. These range from those families investigating their first AAC, to those who’ve bought app X,Y or Z and for many reasons are either making very little progress or feel their child has plateaued. The sheer volume of the latter suggests to me there is a clear need for better access to support for families but at the same time a need for more transparency on the part of the big AAC companies regarding the suitability of their product for children – which children and how does it help? – so that people can make an educated decision before they spend the kind of time and money people can ill afford to waste.
Doing what we can to ensure aacorn meets the needs of children with very specific requirements is a responsibility we take very seriously! It’s why we spent three years working with some of the most respected speech and language professionals to create solutions to a wide range of issues rather than just making yet another copy of what’s out there, and we work extremely closely with those considering aacorn to ensure they know what to expect. aacorn has great potential to help many children and in particular those who are pre-literate and who until now have had limited options, but we’re quite upfront in saying it’s not for everyone, and the success we’re seeing is in large part dependent on a child having a supportive environment with a parent, caretaker or therapist who can work with them using the software as part of an overall language development strategy.
So it’s extremely rewarding when we check back with our customers and very often within days of purchasing aacorn hear how well they are doing. You can read some of their stories on our website or facebook page, but we’ve seen completely non-verbal children who are developmentally believed to be as young as 2-3 years old surprise everyone by becoming self-motivated and expressive communicators, 6 year olds who not only build their own sentences but can use the built-in tools to create their own custom words with pictures, and even users in their 20’s who after many years of struggling to make 2-3 word phrases with the better known AAC apps, improve to the point they can make 8 word sentences almost overnight! This may sound implausible, and in fact in these examples the families were initially extremely skeptical their child would be able to use aacorn, and yet the results speak for themselves.
Me: What does the future hold for aacorn and what are your hopes for the AAC industry and trends we might see moving forward?
Wayne: Our initial goal was to to prove aacorns unique design and concepts like the word tree could be effective and we’re definitely seeing that, so now the focus is all about educating people to the possibilities. In the short term that means getting out of our small office here in Australia and bringing aacorn to the US, Canada and the UK or wherever there’s a need in a way that people can learn about it and get hands-on and experience the difference it can often make for themselves, and at the same time working with speech and language professionals so that they have access to copies of aacorn that they can use in their work with families where it’s most appropriate.
In the medium term we have a lot of ideas and plans for improvements and new features. Making aacorn accessible in multiple languages for children in Europe, Africa and Asia is a top priority, and I think there’s plenty we can do around also empowering parents and professionals by making it easier for them to connect with each other; sharing data via the cloud to further reduce the work involved in things like adding new words and maybe providing opportunities to discuss their experiences and help each other. While longer term we’ll continue to look at how we can make AAC more accessible with a potential version for adults, by incorporating new technologies like eye-tracking, and looking at ways to make aacorn even more affordable for families.
With regards to the AAC industry today and where I see things headed, you could say it is the best of times and the worst of times. On the one hand you can’t work with children and not be excited about devices like the iPad and their potential, especially when applications like aacorn just wouldn’t have been possible a few short years ago. But on the other hand the sheer volume of generic AAC apps or those masquerading as apps for children with special needs make it very hard for families and educators to discover the options that can actually make a positive difference. When you encounter families who’ve spent not just a few hundred but many thousands of dollars in their search and along with that countless months and even years struggling to get results, it’s a problem for all of us, because it contributes to the perception some people have of AAC as something you need to be of a certain age or ability level to use, or the belief that because the prices of the most popular AAC apps are so much cheaper than the dedicated devices of a few years back that things have never been better and don’t need to be improved.
So while I think we’re on the right track and am excited for the future I do believe the industry is at a crossroads and my personal hope for the future of AAC is that as users become more familiar with the capabilities of todays modern devices including but not limited to the iPad, their expectations for what they’ll accept will be higher so that over time we’ll see the demand for more and better forms of assistive technology outstrip supply and the balance shift to where we have more developers investing in making a wide range of comprehensive solutions that support and empower the next generation of children with a whole lot to say themselves.
aacorn is available for iPad and iPad mini via iTunes and the AppStore.
Pricing: $190 (USD) less any educational discount where applicable.
Wayne can be contacted via the aacorn website or directly at firstname.lastname@example.org