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Augmentative and alternative communication (AAC) devices are used by many people around the world who experience difficulties in communicating verbally. One form of AAC device which is especially useful for minimally verbal autistic children in developing language and communication skills is the visual scene display (VSD). VSDs use images with interactive hotspots embedded in them to directly connect language to real-world contexts which are meaningful to the AAC user. While VSDs can effectively support emergent communicators (i.e., those who are beginning to learn how to use symbolic communication), their widespread adoption is impacted by how difficult these devices are to configure. We developed a prototype that uses generative AI to automatically suggest initial hotspots on an image to help non-experts efficiently create visual scene displays (VSDs). We conducted a within-subjects user study to understand how effective our prototype is in supporting non-expert users, specifically pre-service speech-language pathologists (SLPs) (N=16) who are not familiar with VSDs as an AAC intervention. Pre-service SLPs are actively studying to become clinically certified SLPs and have domain-specific knowledge about language and communication skill development. We evaluated the effectiveness of our prototype based on creation time, quality, and user confidence. We also analyzed the relevance and developmental appropriateness of the automatically generated hotspots and how often users interacted with (e.g., editing or deleting) the generated hotspots. Our results were mixed with SLPs becoming more efficient and confident. However, there were multiple negative impacts as well, including over-reliance and homogenization of communication options. The implications of these findings reach beyond the domain of AAC, especially as generative AI becomes more prevalent across domains, including assistive technology. Future work is needed to further identify and address these risks associated with integrating generative AI into assistive technology. 

Autistic children face significant challenges in vocal communication and social interaction, often leading to social isolation. There is evidence that Augmentative and Alternative Communication (AAC) offers support to mitigate these challenges, enabling them to communicate with non-vocal means through forms of AAC, such as speech-generation devices (SGDs). However, the adoption and use of SGDs are hindered by several factors, including the large amount of practice required to learn to use SGDs and the limited options for highly engaging social learning contexts. Our study introduces the novel approach of using SGDs as game controller for digital and interactive games. With three design goals guiding our work, we conducted a Wizard-of-Oz formative case study with five participants aged 3-5 years, who were learning to use their SGD. We simulated a digital coloring game, integrating the speech-generated output of the participant's SGD to function as the game's controller. From this case study, we observed that all participants engaged with the game using their SGD for at least one turn, and two participants also engaged in emerging joint attention responses with the game and game's facilitator. This paper discusses these findings and contributes directions for future research, with suggestions for the design of future SGD-controlled games and exploration of social connection and collaboration between autistic children who use AAC and their caregivers, siblings, and peers. 

Grid displays are the most common form of augmentative and alternative communication device recommended by speech-language pathologists for children. Grid displays present a large variety of vocabulary which can be beneficial for a users’ language development. However, the extensive navigation and cognitive overhead required of users of grid displays can negatively impact users’ ability to actively participate in social interactions, which is an important factor of their language development. We present a novel interaction technique for grid displays, Predictive Anchoring, based on user interaction theory and language development theory. Our design is informed by existing literature in AAC research, presented in the form of a set of design goals and a preliminary design sketch. Future work in user studies and interaction design are also discussed. 

Abstract Millions of individuals who have limited or no functional speech use augmentative and alternative communication (AAC) technology to participate in daily life and exercise the human right to communication. While advances in AAC technology lag significantly behind those in other technology sectors, mainstream technology innovations such as artificial intelligence (AI) present potential for the future of AAC. However, a new future of AAC will only be as effective as it is responsive to the needs and dreams of the people who rely upon it every day. AAC innovation must reflect an iterative, collaborative process with AAC users. To do this, we worked collaboratively with AAC users to complete participatory qualitative research about AAC innovation through AI. We interviewed 13 AAC users regarding (1) their current AAC engagement; (2) the barriers they experience in using AAC; (3) their dreams regarding future AAC development; and (4) reflections on potential AAC innovations. To analyze these data, a rapid research evaluation and appraisal was used. Within this article, the themes that emerged during interviews and their implications for future AAC development will be discussed. Strengths, barriers, and considerations for participatory design will also be described. 

Introduction: Social participation for emerging symbolic communicators on the autism spectrum is often restricted. This is due in part to the time and effort required for both children and partners to use traditional augmentative and alternative communication (AAC) technologies during fast-paced social routines. Innovations in artificial intelligence provide the potential for context-aware AAC technology that can provide just-in-time communication options based on linguistic input from partners to minimize the time and effort needed to use AAC technologies for social participation. Methods: This preliminary study used an alternating treatment design to compare the effects of a context-aware AAC prototype with automated cloze phrase response options to traditional AAC for supporting three young children who were emerging symbolic communicators on the autism spectrum in participating within a social routine. Results: Visual analysis and effect size estimates suggest the context-aware AAC condition resulted in increases in linguistic participation, vocal approximations, and visual attention for all three children. Conclusion: While this study was only an initial exploration and results are preliminary, context-aware AAC technologies have the potential to enhance participation and communication outcomes for young emerging symbolic communicators on the autism spectrum and more research is needed. 

Purpose:Augmentative and alternative communication (AAC) technology innovation is urgently needed to improve outcomes for children on the autism spectrum who are minimally verbal. One potential technology innovation is applying artificial intelligence (AI) to automate strategies such as augmented input to increase language learning opportunities while mitigating communication partner time and learning barriers. Innovation in AAC research and design methodology is also needed to empirically explore this and other applications of AI to AAC. The purpose of this report was to describe (a) the development of an AAC prototype using a design methodology new to AAC research and (b) a preliminary investigation of the efficacy of this potential new AAC capability. Method:The prototype was developed using a Wizard-of-Oz prototyping approach that allows for initial exploration of a new technology capability without the time and effort required for full-scale development. The preliminary investigation with three children on the autism spectrum who were minimally verbal used an adapted alternating treatment design to compare the effects of a Wizard-of-Oz prototype that provided automated augmented input (i.e., pairing color photos with speech) to a standard topic display (i.e., a grid display with line drawings) on visual attention, linguistic participation, and (for one participant) word learning during a circle activity. Results:Preliminary investigation results were variable, but overall participants increased visual attention and linguistic participation when using the prototype. Conclusions:Wizard-of-Oz prototyping could be a valuable approach to spur much needed innovation in AAC. Further research into efficacy, reliability, validity, and attitudes is required to more comprehensively evaluate the use of AI to automate augmented input in AAC.