Adolescent Preferences and Priorities For The Design Of Current Augmentative And Alternative Communication Devices

First author Name: Erika Jane Dowling
Affiliation: Trinity College Dublin, Ireland

Second author name: Dr. Martine M Smith, PhD
Affiliation: Trinity College Dublin, Ireland

ABSTRACT

Purpose: This study investigates what adolescents consider important in determining whether a communication device is attractive and socially acceptable with peers. Features of the DynaVox V™, Tango™ and Pathfinder Plus™ were explored.

Method: A questionnaire addressing; appearance of communication devices; telecommunications; voice output, rate enhancement and vocabulary selection was used to investigate the attitudes of 97 adolescents without communication impairments. Data were analysed quantitatively using chi-square analysis, total & percentage scores and qualitatively using four themes.

Results: Overall, participants were willing to sacrifice appearance for communication efficiency. Features such as durability, portability, voice intelligibility and vocabulary to support social interaction were prioritised. Chi Square scores indicate that boys are significantly more likely to select a DynaVox V™.

Conclusion: Future communication devices should be reliable, capable of interconnectivity and support the development of social networks. As adolescents have unique preferences, opportunities must be provided to ensure involvement when selecting a device.

Keywords

Augmentative and Alternative Communication (AAC); communication device; adolescence; appearance, social participation.

BACKGROUND

Adolescence

During adolescence the approval of friends becomes critical [1]. Dissatisfaction with body image can become a key source of emotional turmoil [2], leading to feelings of self consciousness and a fear of being labelled ‘different’ [3]. The expression of personal and group identity becomes critical [4]. Adolescents crave acceptance and dread isolation, and social interaction is both the means for and the measure of such acceptance.

Adolescents spend a lot of time chatting, iteratively re-living past events with friends. Features of adolescent interaction include the use of slang [5], and a fast rate of communication [6]. Advancements in mainstream technology have also led to changes in adolescent interaction. Text messaging and email now play an important role in the maintenance of social networks [7, 8].

Adolescents With Complex Communication Needs

Adolescent AAC users experience the need for a positive self image and to participate in conversation [9]. Considering the pre-occupation with appearance at this age, the stigma of a disability can be difficult. Adolescents who feel self conscious may abandon their communication device as it looks ‘embarrassing’ [10], or due to a fear of being rejected by peers [11].

Peer acceptance is important for the development of social competence [12]. An AAC system is designed to supplement spoken communication, creating opportunities for participation [13]. However, negative attitudes may pose barriers to the inclusion of adolescents requiring AAC [14].

Augmentative and Alternative Communication

AAC is a ‘tool’ that supports communication and provides opportunities for social interaction [15]. However, some AAC users may reject their communication device due to inappropriate vocabulary, unreliability [16], if the device is not socially reinforcing or is rejected by peers [(17), (18)]. Therefore, there is a need to design a communication device that supports social participation, creates a positive self image and positive attitudes by peers.

Current Voice Output Communication Aids (VOCA’s)

If AAC systems are attractive, adolescent AAC users may be motivated to use their device, serving to enhance self esteem and facilitate interaction [19]. Current VOCA’s are products of great innovation, but are not without disadvantages [20]. They have limited aesthetic appeal. Complex device navigation strategies can decrease communication rate, while long pauses may result in a negative impression of the user’s communicative competence [9]. The absence of age appropriate vocabulary can distance the AAC user from peers. Poor voice intelligibility and naturalness can have negative implications for self expression [14]. A limited range of voice choices raises questions about the role of voice in reflecting the user’s communication identity [3].

Justification And Aims Of This Research Study

There is a paucity of information relating to the features of AAC technology that might be considered desirable by adolescents and thus influence selection. These issues prompted the research questions:

What design features of AAC technology would typically developing adolescents identify as desirable? The reviewed devices are (a) DynaVox V™ (b) Tango™ (c) Pathfinder Plus™
What aspects of adolescent daily life might influence the design of AAC technology?
What design modifications might increase the appeal of future communication devices?

**Table 1.1; This table describes the three communication aids that were reviewed in this research study**
Device	*DynaVox V™*	*Tango™*	*Pathfinder Plus™*
Manufacturer	DynaVox Systems	Blink-twice	Prentke- Romich Co.
Dedicated options	Choice of both¹	Dedicated	Dedicated
Display	Dynamic	Fixed	Fixed
Size	23cm x 20 cm x 7cm	4.5cm x 31.8 cm x 11.2	30.5 cm x 24.77 cm x 7.62
Weight	4 lbs 11oz	2.5 lbs	2.02kg
Selection method	Direct selection, auditory scanning, joystick, Morse code,	Direct selection and scanning method	Direct selection via keyboard and switch activated scanning
Design	Choice of 5 colours, square shape with two front mounted speakers. Touch screen	White/ grey with green buttons, cylinder shape, touch screen and 6 control buttons	Blue/ Grey square shape with 128 static keys; each button has a symbol with a word/ phrase stored.
Voice output	Synthesised & digitised option inc. DECtalk and AT & T natural voices	Digitised, Synthesised & voice morphing (expression and prosody)	Synthesised -choice of ten voices RealSpeak™ natural voice
Telecommunication features ²	A Bluetooth adaptor to send/ receive texts	Compact flash expansion slot – for future use of mobile & Bluetooth	Air card – enables device to operate as cell phone (send/ receive call/ texts)
Entertainment features	calculator, address book, MP3 player, games	Digital camera	calculator, play MP3 files, notebook journal
Rate enhancement features	Word, character and phrase prediction Slots³, Quickfires⁴	Phrase bank and pop up keyboard to allow for efficient communication	Spelling, word prediction and icon prediction
Vocabulary	InterAACT	Language streams; quick access to topics and relevant vocabulary	Semantic compaction (Unity 32/128); meaning is assigned to graphical icons
¹The DynaVox V™ also comes in an open format where it operates as a fully functioning XP computer ² all devices provide computer connectivity allowing for internet activity – this requires the use of wires/ cables or in the case of the Pathfinder Plus™ infrared is available. ³Slots – provide easy access to related words that can be used to complete a message ⁴quickfires – short conversational interjections that are available on the main page

METHODOLOGY

Research Design

This is a non experimental questionnaire - based study. The questionnaire consisted of 29 items and focused on three themes: (a) physical appearance (b) functions and features (c) components related to communication. The Communication Aid Protocol [21] served as a guide for developing the questionnaire, and themes are based on those described by Light [22]. To ensure face validity, Senior Speech and Language Therapists reviewed the questionnaire and agreed the items were applicable to the project. A preliminary form of the questionnaire was field tested and subsequently modified for use in the study. Modifications included changes to the structure and changes to five questions.

Table 2.1; This tables provides examples of the items contained in the questionnaire used in this research study

Section

Sample Question

A - Physical appearance of the communication device

Which communication device do you think is the most attractive to look at? Circle which one and why
Based on how the communication device looks, if you were at the cinema and had to order tickets using one of the communication devices, circle which one you feel most comfortable using?

Tick which communication device you think has the most appealing colour, shape or size:

	Device 1	Device 2	Device 3
Colour
Shape
Size

How important is it that the design of a communication device would not embarrass you or make you feel isolated from friends?
Would you consider it important that the external design of device is tailor made to the individuals needs and interests i.e. customize the device?
If you needed to use a communication device, what would you prioritise when choosing your device?
- How the communication device looks
Or
- The amount of information the device can hold that will allow you to communication

B – Functions and Features of Communication Devices

**Telecommunications**
How important is it that the communication device	1	2	3	4	5
Ability to text friends and family
Ability to phone friends and family
Games to entertain you
Ability to access the internet
Ability to email friends/ family
Ability to browse the web (e.g. connect to bebo/ google)
Ability to take pictures with a built in camera
Ability to take video recordings with a built in camera
Ability to listen to and download music
Communication device has Bluetooth

C – Parts of the communication device related to communication

How communication devices sound (voice output)
When designing a communication device for a teenager, what features of the voice that speaks would be important for the person who uses the device and the listener.

	1	2	3	4	5
Voice is clear and easily understood
The voice is natural sounding (i.e. easy to listen to)
The voice does not sound computerised (sounds like human voice)
The voice is the same gender as you
The voice sounds similar to peers (same age group)
The voice is the same nationality/ has the same accent as you
You can change the voice on the communication device to reflect how you are feeling e.g. angry, sad, happy, afraid
You can change the voice to a whisper or shout
The voice can be heard in noisy situations e.g. restaurant
The voice is a similar speed/ rate to natural speakers

Rate enhancement features:
These are the strategies that increase the rate of communication output of the user and makes communication quicker and better.

	1	2	3	4	5
The communication device has features to speed up communication rate
The communication device can predict what you are typing to communicate (like predictive text on your mobile phone)
Rate of communication is similar to typical conversation
It would be important that the rate of communication does not stop me from talking with friends (e.g. if it’s too slow I can’t get my say)
It would be important that I am not embarrassed by slow rate of communication
It would be important that people do not think I am unintelligent (less smart) because of the slow rate of communication using a communication device.
Spell check features – if I’m typing a word for the device to say, it recognises that I have spelt it wrong
Word morphology features (e.g. change word from singular to plural)

Vocabulary Selection

If you had to use a communication device, what would be the three most important topics to be included on the device. Please tick three boxes only.

Personal information (age, where I live etc)
My family
My friends
School
My home
Music I like
Films and TV I like
What I like to eat/ drink
What annoys me
What I’m good at
Things I need help with
Things I’ve done in the past
Others (please specify)

If you had a communication device that could only store 5 words, what words would you choose that would allow you to communicate your basic needs (e.g. hungry, stop, yes)
If you needed a communication device and had to choose people to select messages/ words to put on your communication device, who would you prefer:
- People who know a lot about language
- People who know a lot about you – family
- People who know a lot about you – friends
If you needed a communication device, would you prefer to have words that allow you to:
- Interact and chat with people
- Learn the school curriculum

Participants

Ninety-seven typically developing adolescents participated in this study, and completed the questionnaire outlined above. Inclusion criteria for participants were; (a) between the ages of 15 years and 16:11 years; (b) fluent in English; (c) attending mainstream secondary school.

**Table 2.2; This table provides a breakdown of the participants in this research study according to their gender and age**
Gender	Age	Number of participants
Boys (n =52)	15 years 16 years	34 18
Girls (n=45)	15 years 16 years	32 13

Procedures

Ethical Approval for the project was given by Trinity College Dublin. A PowerPointpresentation about the field of AAC and purpose of the study was created. A loan of the communication devices was not possible; to compensate a DVD of each device in operation was made. This was based on a video demonstration of the Tango™. The same sentences were programmed into each device to ensure consistency and eliminate bias. Data collection took place in the participant’s school over a one hour period. First The PowerPoint presentation was shown and then the DVD. Participants then completed the questionnaire

Data Analysis

The coding system used to develop the questionnaire was used to qualitatively describe findings. The data was sorted into the themes of ‘the 21st century adolescent’, ‘physical appearance’, ‘functions’ and ‘components of the communication device’. Data was summarised for the 4 coding themes and 8 subthemes.

**Table 2.3 This table provides a summary of themes and subthemes identified from the data to be analysed**
Themes	subthemes	Examples
The Modern Adolescent
Physical appearance (Attributes of the external device)	Communication device features	Preferred and least preferred communication device Preferred/ least preferred communication device features Changes to reviewed communication devices and general AAC technology Features of communication devices identified as important
Physical appearance (Attributes of the external device)	Self image and psychosocial issues	Social acceptability of communication device Attitudes to communication devices
Functions (purpose and uses of the communication device)	Telecommunications (internet and phone use) Play and entertainment features	Email Phone Instant text message Bluetooth Digital camera Video recordings Listen to music Games
Functions (purpose and uses of the communication device)	Adolescent life	Importance of telecommunications and entertainment as part of adolescent life Frequency of telecommunication and entertainment use in adolescent daily life
Section C; Components of device related to communication	Voice output	Intelligibility Naturalness (emotion & prosody) Personal attributes & identity (age, gender, nationality)
	Rate enhancement features	Rate enhancement features (prediction, word morphology, spell check) Psychosocial factors – impact of rate enhancement on self perception
	Vocabulary selection	Communication topics, context & partners Core vocabulary Psychosocial issues – appropriate vocabulary for adolescents and who should select adolescent vocabulary

Quantitative analysis methods (Chi-Square analysis, and total and percentage rating scores) were used to compare and contrast preferences across gender, and to rank features according to level of importance.

RESULTS

The Modern Adolescent

Over 70% of participants spend time talking with ‘my best friends’, primarily in school. Adolescents talk about a variety of things; personal information, family and friends were considered most important. Texting, internet access and listening to music were identified as important features of adolescent life.

**Table 3.1; This table describes the influence of adolescent life and their preferences (listed from most to least important features) on the design of communication devices**
	Who would they talk to?	Where and when would they talk?	What topics would they talk about?	Are interested in doing what?
1.	My best friend	School	Family	All kinds of sports
2.	My mum	At home	Personal information	Watching television
3.	My brothers and sisters	Going out	Things I need help with	Listening to music
4.	My dad	At sports training	My friends	Talking/texting friends
5.	My boyfriend/ girlfriend	At friends house	What they like to eat and drink	Hanging out with friends

External Appearance of Communication Devices

Participants identified reliability and portability as most important, while colours and use of skins were not considered important. Over 96% of participants (% rating score) stated the design of a communication device should not embarrass the AAC user.

**Table 3.2; This table outlines the ranking of communication device design characteristics that are considered important by adolescents (listed from most to least important)**
Overall ranking (determined by total number of points)		Ranking as determined by percentage rating (number of students selecting important, very and critically important)
1. durability and reliability (won’t break easily)	351/ 388	1. light and portable	98.9%
2. light and portable	331	2. durability and reliability (won’t break easily)	97.9%
3. weight (not too heavy)	323	3. size (not too big)	97%
4. size (not too big)	298	4. weight (not too heavy)	94%
5. materials (comfortable to carry and touch)	284	5. materials (comfortable to carry and touch)	91.7%
6. themes – reflects what I like	244	6. themes – reflects what I like	80.4%
7. look cool to others	241	7. interesting shape (not just a box)	78.3%
8. interesting shape (not just a box)	218	7. look cool to others	78.3%
9. choice of different skins	211	8. choice of different skins	70%
10. colours (can be different colours)	172	9. colours (can be different colours)	57.5%

Recommended changes and modifications to communication devices included the use of a touch screen and a reduction in size.

**Table 3.3; This table outlines the ranking of communication device features that need to be modified and improved upon as determined by adolescents (listed from most to least important)**
Overall ranking (determined by total number of points)		Ranking as determined by percentage rating (number of students selecting important, very and critically important)
1.communication device should have a touch screen	303/388	1. communication device should have a touch screen	93.8%
2. reduce size of communication device	287	2. reduce size of communication device	90%
3. communication device should have less buttons	255	3. communication device should have less buttons	84.5%
4. communication device should look more like a mobile phone	252	4. communication devices should be different shapes	78.3%
5. communication devices should be different shapes	222	5. use gender specific features in the design of communication devices	73.1%
6. use gender specific features in the design of communication devices	210	6. communication devices should have a choice of more colours	65.9%
7. use of skins to change the appearance of communication devices	189	7. use of skins to change the appearance of communication devices	63.9%
8. communication devices should have a choice of more colours	184	8. communication devices should look more like a mobile phone	60.8%
9. communication device has pictures on the outside	136	9. communication device has pictures on the outside	39.1%
10. communication devices should have more buttons	81	10. communication devices should have more buttons	18.5%

Chart 3.1 % of participants who can/can’t imagine life without access to phone etc (Click for larger view)

Participants prioritised practical features over aesthetics. 82.5% considered memory capacity for communication more important than appearance. However, over 86% stated that further thought should be given to the aesthetic appeal of AAC technology.

Chart 3.2 % participants who spend time on the internet everyday (Click for larger view)

The DynaVox V™ was identified as the most popular communication device, participants liked its colour and flat screen. Over 60% selected it as the most attractive, and the device they would feel most comfortable using in public. Chi square analysis revealed a significant gender effect. Boys showed a significant preference for the DynaVox V™. Boys selected the DynaVox V™ as the most attractive communication device (p = 5.96, at p<0.5) and the device they would feel most comfortable using at the cinema (p = 7.57, at p<0.1).

Chart 3.3; % of participants who spend time texting everyday (Click for larger view)

The Tango™ was second favourite due to its small size and interesting shape. The Pathfinder Plus™ was the least popular communication device, 98.97% of participants selected it as the least attractive due to its bulky appearance and large number of selection keys.

**Table 3.4; This table provides a summary of adolescents most and least preferred communication devices that were reviewed in this research study**
	DynaVox V (N)	Tango (N)	Pathfinder Plus (N)
Most attractive communication device	62 (39 boys & 23 girls)	35 (13 boys & 22 girls)	0
Least attractive communication device	1	0	96
Device you would feel most comfortable using at the cinema	60 (39 boys & 21 girls)	36 (13 boys & 23 girls)	1
Device which best reflects technology	59 (34 boys & 25 girls)	38 (18 boys & 20 girls)	0

Functions (Purpose And Use Of The Communication Device)

Chart 3.4 % of participants that think features that should be integrated into communication devices (Click for larger view)

Results emphasise the importance of distance communication, more than 90% of participant’s text every day. The integration of text messaging, email and music were of paramount importance. For some participants communicative function was more important than telecommunications, and should only be integrated ‘if not going to take away from communication potential’.

Table 3.5; This table outlines the telecommunications and entertainment functions to be included in the design of a communication device according to adolescent preferences (listed from most to least important)
Overall ranking (determined by total number of points)		Ranking as determined by percentage rating (number of students selecting important, very and critically important)
1. the ability to text friends and family	316/388	1. ability to text friends and family	97%
2. ability to phone friends and family	261	2. ability to listen to, and download music	84.5%
3. ability to listen to, and download music	255	3. ability to phone friends and family	80%
4. ability to access the internet	243	4. ability to access the internet	78.3%
5. ability to browse the web (e.g. connect to Bebo™)	241	5. ability to browse the web (e.g. connect to Bebo™)	77.3%
6. ability to email friends and family	239	6. ability to email friends and family	76.2%
7. communication device has Bluetooth	202	7. communication device has Bluetooth	64.9%
8. ability to take pictures with a built in digital camera	193	8. ability to take pictures with a built in digital camera	59.7%
9. games to entertain you	163	9. games to entertain you	56.7%
10. ability to take video recordings	161	10. ability to take video recordings	51.5%

Components Of The Device Related To Communication

Adolescents expressed the need for a voice that is not only intelligible, but that also sounds natural with qualities reflecting characteristics of the user e.g. gender.

**Table 3.6; This table outlines the voice output features that are considered important by adolescents (listed from most to least important)**
Overall ranking (determined by total number of points)		Ranking as determined by percentage rating (number of students selecting important, very and critically important)
1. voice is clear and easily understood	384/388	1. voice is clear and easily understood	100%
2. voice is natural sounding	351	2. voice is natural sounding 2. voice is similar speed/ rate to natural speaker	98.9% 98.9%
3. voice is similar speed/ rate to natural speaker	346	3. voice does not sound computerised 3. you can be heard in noisy situations	97.9%97.9%
4. voice does not sound computerised 4. You can be heard in noisy situations	340340	4. voice is the same gender as you 4. you can change the voice to reflect how you feel 4. voice is the same nationality/ accent as you	92.7%92.7% 92.7%
5. voice is the same gender as you	329	5. you can change the voice to whisper and shout	89.6%
6. voice is the same nationality/ accent as you	301	6. voice sounds similar to peers	87.6%
7. you can change the voice to reflect how you are feeling	300
8. you can change the voice to whisper and shout	286
9. voice sounds similar to peers	262

Participants felt that communication rate should not hinder social interaction with peers. Almost 58% of participants stated they would react to slow rate of communication by abandoning the communication device.

**Table 3.7; This table outlines the rate enhancement features of communication devices that are considered important by adolescents (listed from most to least important)**
Overall ranking (determined by total number of points)		Ranking as determined by percentage rating (number of students selecting important, very and critically important)
1. the rate of communication does not stop me from talking with friends	338/388	1. the rate of communication does not stop me talking with friends	97.9%
2. I am not embarrassed by the slow rate of communication	324	2. rate of communication is similar to typical communication	95.8%
3. important that people do not think I am unintelligent because of the slow rate of communication	313	3. I am not embarrassed by the slow rate of communication 3. communication device has features to speed up the rate of communication	93.8% 93.8%
4. rate of communication is similar to typical communication	304	4. important that people do not think I am unintelligent because of the slow rate of communication	91.7%
5. communication device has features to speed up the rate of communication	296	5. communication device can predict what you are typing 5. communication device has word morphology features	89.6% 89.6%
6. communication device can predict what you are typing	285	6. communication device has spell check features	87.6%
7. communication device has spell check features	275
8. communication device has word morphology features	274

Figure 3.5: This figure presents participants reaction (in terms of percentages) to slow rate of communication (Click for larger view)

Adolescents prioritised the programming of vocabulary to express basic human needs More than 96% of participants prioritised vocabulary to support social relationships over academic learning. Two thirds of participants would want these words to be selected by a friend, with only 8.2% wanting input from a professional speech and language therapist.

Table 3.8; This table provides a summary of the core words provided by adolescents in this study. These are the words that are considered most important to be programmed into a communication device for an adolescent AAC user.
Basic needs	Social phrases	Verbs	Feelings/ emotions	Commands	Other
Toilet	Hi / hello	Sleep	Tired/ sleepy	Stop	Feck
food	Bye	Play	Hungary	Piss off	Curse words
drink	Please	wash	Thirsty	Shut up	Fuck
	Thanks		Lonely	Leave me alone	Injury
People	Yes	Questions	Pain	I need	Itch
Family	No	What	Bored	Come here	So it is
Friends	Ok	Why?	Happy	Go away	I’ll see
parents	Adios	How?	Love you		Ha ha
	Going out, back at ten	Can I?	Sad	Hobbies
Places	Oh no	How come?	Sick/ Ill	Music
Bedroom			Cold	Television
Bathroom			Too warm/ hot	Texting
Home				movies

DISCUSSION

Effect Of Device Type

Figure 3.6; This figure presents the percentage of participants who choose different people to select vocabulary for communication device (Click for larger view)

Adolescents rated the DynaVox V™ and Tango™ as most popular. Their design does not look conspicuous and may be easily integrated into adolescent life, thus reducing self consciousness. The sophisticated design and choice of colours of the DynaVox V™ was favoured, reflecting the choice adolescents have when selecting an i-POD. The Tango™ was favoured for its small size, indicating adolescents require a device they can carry and use in all environments. Keys and buttons were considered undesirable, contributing to the unpopularity of the Pathfinder Plus™. As Semantic Compaction is a feature of the Pathfinder Plus™, the static keyboard is essential for effective communication. Attitudes may be less negative if participants were given the opportunity to operate the device. When selecting a communication device for adolescents, the use of learning trials to demonstrate the communication potential of the Pathfinder Plus™ may help to ensure that it is not disregarded due to its appearance.

The unique preferences demonstrated by participants emphasises the importance of ensuring adolescents participate in the selection of a communication device. Similar procedures described by Sigafoos et al [23] could be adopted to ensure active involvement of adolescents during the selection process.

Influence Of Adolescent Life On The Design Of AAC Technology

Adolescents, who are described as being pre-occupied with body image [6], were prepared to sacrifice cosmetic appeal for communication efficiency. Memory capacity for communication was considered more important than appearance. As participants communicate in a variety of environments, characteristics such as portability and size were of prime interest.

Adolescents identified ‘best friends’ as their main social network, where they chat about life experiences. Communication devices must then allow AAC users to share personal narratives with peers [3]. As most participants would want swear words programmed on a communication device, AAC users should then have access to age appropriate vocabulary, to promote group inclusion [3]. Unfortunately, inclusion and acceptance can be compromised by negative societal attitudes. Participants stated that “friends might not like you anymore and think you’re stupid” and “people would recognise you as the person with the huge device and bullying would be a problem”. These findings highlight the need to challenge negative societal attitudes towards AAC users.

Suggestions For The Design Of Future AAC Technology

Although individual differences are to be expected among adolescents, table 4.1 provides a summary of the recommendations that may be considered in the design of future communication devices. However, advances in technology will be of little use unless barriers to participation are overcome and strategies to support participation are implemented.

**Table 4.1 Suggested design features to increase the appeal of AAC technologies for adolescents**
Type of Feature	Design Suggestion
Physical appearance and Design Characteristics	Durability and reliability – communication devices are critical medical devices but they can and do break easily. There is a need to develop AAC systems that are robust and do not easily breakdown or crash. Colour and Shape – use a single bright colour & develop AAC systems that vary in shape (not only square/ rectangular) Size and weight – develop lightweight devices that are easy to carry and integrate into adolescent daily life without vocabulary or storage limitations. Display and access – use a dynamic display that is accessed through a touch screen. Personalisation of devices – incorporate the adolescent’s interests into the external design of communication devices to allow for self expression. The design should support self esteem and the user’s social image among peers.
Interconnectivity and Tele-communications	Interconnectivity – develop AAC systems that easily connect to other mainstream technologies without messy wires and cables. Computer and internet access are fundamental activities that allow adolescents to fully participate in school and social settings. Telecommunication features – incorporate instant text messaging, email and telephone to allow AAC users communicate with peers via multiple communication modalities Music – AAC systems should be able to download and play music files Entertainment Features – incorporate entertainment features such as video, camera and games, only if they do not decrease the communication efficiency of AAC technology
Features related to communication	Voice output – develop synthetic voices that are intelligible and reflect the intonation and pitch patterns of natural human speech. Communication output – develop AAC systems that allow for a faster rate of output to enable AAC users contribute to conversation with friends. Vocabulary – program a wide range of vocabulary to indicate needs and wants and to allow the user interact with their same age peers. Vocabulary selection should include input from friends, family and professionals.

Limitations Of The Current Investigation And Future Research

Participants were from a single school and represented a narrow socio-economic group. Results can be only generalised to similar individuals. Identifying the priorities of people who use AAC should be the focus of future research.
This research could be replicated with different communication devices to determine if similar findings would be achieved.
Studies [(2), (6)] suggest there is a greater emphasis on physical appearance during the ages of 10-16years. Replicating this study with younger adolescents would determine if more importance would be place on appearance.
Research must focus on identifying factors that promote the development of social networks for adolescents that use AAC. For example, “The Social Networks Model” [24] considers AAC within the context of the individual, family and peers.

Conclusion

Investigating the preferences of adolescents provides valuable insights into how the design of future devices may be improved. Future AAC technology should be reliable, robust, capable of interconnectivity and support the development of social networks. As independence is important for adolescents, opportunities must be provided to ensure they are involved in selecting their device.

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Contact author

Erika Jane Dowling, Clinical Speech & Language Studies, 184 Pearse Street, Trinity College, Dublin 2, Ireland.

Phone: +353 87 9587174

Email: edowling@tcd.ie

RESNA Annual Conference - 2009