The iPad phenomenon is a big topic. When it comes to AAC, in a nutshell, here's what ATPN has learned...
PROS:
- iPad+app=affordable accessible AAC. Schools are providing communication devices where before they weren't, families are buying it themselves (without waiting on schools or insurance). Simply put, iPad makes it easier for many more people to acquire AAC technology.
- apps are easily customized, often by users and families (a huge relief to those who have felt dependent on professionals for programming devices).
- the "cool factor," especially for teens, means better device adoption by users and better social integration (many report iPad functions as a conversation starter rather than stigmatizer).
- multi purpose advantages. There are lots of reasons for "device adoption" by the iPad user (i.e. reasons to love it). For individuals with autism, this may be especially powerful. iPad is admired as an engaging learning tool beyond AAC.
- ease of demonstration for professionals. iPad can hold multiple AAC apps, making demonstrating a range of options portable and efficient.
CONS:
Lack of...
- insurance coverage. Medicaid/Medicare and private insurance are not commonly covering these devices as they are not "dedicated" for AAC.
- training and support for implementing, learning, and using AAC apps (and most families admit that acquiring a system is often only half the battle).
- time-limited trials for apps (Apple won't allow them), so no try-before-you-buy options (only "lite" options which are not full-featured).
- durability and adequate volume for all environments (requiring purchasing accessories that can negatively impact the iPad "cool factor").
- options for alternative access. Limited ways to adapt iPad for alternative access (switch scanning, yes). Also no infra red ECU functions.
- touch screen sensitivity control is another reason iPad does not work for everyone.
- hardware support and warranty (your iPad/Pod may get replaced, but you have to reinstall and reprogram apps if there's a problem).
- research on apps (evidence of effectiveness just isn't there yet).
- support for language development or solid AAC practice with some apps (which offer, instead, a "quick cheap fix" without growth potential for users to have spontaneous conversations).
- LAM--software that tracks usage, monitoring progress to engage/learn the AAC method (which can prove to be critical for successful adoption).
Too much...
- media hype (including social media). Many professionals report the hype has raised expectations beyond what is reasonable. iPads are sometimes seen as a veritable "miracle cure," particularly for autism. Can lead to after-purchase hangover.
- acquiring without a proper assessment (to see if iPad can work for an individual).
- pressure on SLPs and special educators to provide iPads or to make them work for children (by parents who have gone out and purchased them or by schools that have them already).
- choice and distraction. An overwhelming number of apps exist to consider for AAC. Also, apps for gaming and social media and everything else can be distracting for the user learning an AAC method.
iPhenomenon FEARS:
- Medicaid will approve iPads/apps for AAC and make approval for expensive dedicated devices harder and harder to acquire by those who need them.
- dedicated device companies will lose too much of their market to survive, and their decades of research, commitment, and know-how will be put at risk.
- loss of availability of dedicated devices will make access to effective AAC harder for individuals who cannot use mainstream devices.
iPhenomenon HOPES:
- mainstream awareness of AAC is going up, which is also raising awareness of and demand for AT in general.
- expectations that technology is for everyone is becoming the new norm, putting new and positive pressure on hardware and software developers.
- evidence of a cool-factor wrap-around effect? Thanks to the popularity of high-tech everything, even dedicated AAC devices are a little "cooler" now. (For example, in a recent conference presentation video, 3rd graders were engaging a mainstreamed classmate about her Tobii Eye-Gaze system: "You have your own computer?! Can you get on the internet with that?")
For a good read on some of these issues, check out the white paper "Mobile Devices and Communication Apps" from the AAC-RERC (Rehabilitation Engineering Research Center).
*Note: many of these points are true for other tablet devices and their apps as well.
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