Adaptive & Individualized AAC

Nearly 5 million Americans require augmentative and alternative communication (AAC) methods to meet their daily communication needs. Some of these high-need individuals have motor impairments so severe (due to conditions such as brainstem stroke, traumatic brain injury, Guillain Barré syndrome, and cerebral palsy, among other disabilities) that they do not have the manual dexterity to control AAC technology and require alternative access methods (such as eye-tracking, head-tracking, or switch-scanning). Existing solutions, however, require extensive maintenance, frequent re-calibrations, and manual interface modifications that must be carried out with continued assistance from a caregiver or by compensating via their own residual motor activity. The excessive workload of adapting to these alternative communication methods are among the leading causes of AAC abandonment, ultimately depriving this population of their fundamental right to communication. To meet the critical communication needs of individuals with severe motor impairments, we propose the first AAC device comprising a versatile access method that automatically learns and customizes a keyboard interface to the residual motor function of the individual. In Phase I, we established the feasibility of developing a personalized keyboard interface (limited to A–Z, space) based on an individual’s cursor movement and target selection abilities using a combined surface electromyographic (sEMG) and inertial (IMU) access method placed on their forehead. When evaluated amongst individuals with and without severe motor impairments, our AAC solution achieved greater information transfer rates (ITRs) over the standard QWERTY keyboard. Having successfully demonstrated this proof-of-concept, we are collaborating with speech researchers and clinicians at Boston University, MA (STEPP Lab for Sensorimotor Rehabilitation Engineering) and Madonna Rehabilitation Hospital, NE (Institute for Rehabilitation Science and Engineering) to advance our Phase I system into a pre- commercial MyAACTM system comprising versatile access method and personalized, comprehensive communication software. We will achieve this by developing hardware to support streamlined access across multiple points on the body (Aim 1), designing automated algorithms to rapidly create an expanded AAC interface, inclusive of letters, numbers, symbols, emojis, and word completion options, that is personalized based on the residual motor function of user-specific access points (Aim 2), creating software for point-of-care use of the access technology and interface, and evaluating the resulting MyAACTM system for communication efficacy in individuals with severe motor impairments (Aim 3). Our milestone will be to demonstrate that MyAACTM improves ITR and user experience over conventional AAC devices. The final MyAACTM deliverable will be easily integrated with existing AAC tablets and mobile devices to provide those in need of alternative communication methods with an automatically customized, efficient, and intuitive solution to restore communication access in their daily lives.