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The Use of Text-to-Speech Devices by Adults with Developmental Disabilities

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Adults with developmental disabilities (DD) may have limited speech for a variety of complex reasons. For many, the use of AAC can enrich participation at home, in day programs and in the community. The Augmentative and Writing Aids Program at Surrey Place Centre prescribed text-to-speech devices to six persons in the last few years: 3 Dynawrites, 1 Lightwriter and 2 iPads running Predictable. In each case, 6 - 8 two-hour therapy sessions were provided for the person and the mediator, focusing on technical and communication skills. Since each person presented with limited ability to interact appropriately, pragmatic language skills were also worked on. Four of the six persons were successful at using their devices. The other two returned their devices after two years - one due to his mother being uneasy with her sometimes-aggressive son using the device in the community, and the other for lack of a mediator support. For the other four, the “cool factor” was a consideration in choosing their device. Our experience led us to conclude that several factors determine if an adult with DD will successfully use a text-to-speech device: literacy skills, interaction style, pragmatic skills, user acceptance (including “cool factor”), caregiver acceptance and mediator support. While word predication can help with spelling and programmable messages can help with social commenting, users should continue to work on literacy and pragmatic skills. As with other forms of therapy, the person may find it daunting to communicate in this new way in their everyday life.


Paul Harbridge    
Surrey Place Centre


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