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Optimizing the interface of Augmentative and Alternative Communication devices in children with dyskinetic cerebral palsy

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Excess involuntary movements (hyperkinesia) and slowness (bradykinesia) in children with dyskinetic cerebral palsy (CP) often result with the inability to properly interact with Augmentative and Alternative Communication (AAC) devices, and eventually their information rate results significantly limited. The aim of the study was twofold: first, to develop a mathematical model to estimate the information rate in children with CP and second, to extract the optimal AAC interface using iPad® for each child with CP that results with enhanced speed of communication. The model was fitted based on the number and size of buttons on the iPad® screen underlying the Fitts’ and Hick’s Laws during a pointing task with the finger. The estimation of the information rate confirmed our hypothesis of lower channel capacity of using AAC devices in children with CP compared to age-matched healthy children. Eventually, we tested the optimal interface estimated compared to a standard interface during a 1-minute dictation task. The dictation performance with the optimal interface showed higher information rate when the subjects knew the location of the button on the screen, and this was more noticeable in primary hyperkinetic subjects when compare with the standard interface. This study quantity for the first time the effect of motor impairments on communication with AAC devices using iPad® and shows that communication performance can be improved by maximizing the transmission between the child and the AAC devices.


Matteo Bertucco    
University of Southern California
United States

Juliet Henderson    
Stanford Children's Health
United States

Terence D. Sanger    
University of Southern California
United States


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