Image: Communication device for a cerebral palsy patient
2019 Jun 28
Some people with cerebral palsy have speech problems. They are not able to speak due to muscle spasms in the throat, mouth and tongue.
For them, there are in the market a number of solutions in the form of communication devices that can help them communicate. Or improve their communication skills. These devices allow the users to communicate in different ways, specialized to their needs.
In this article we make a summary of the main types of communication devices for cerebral palsy patients that can be found and used today.
What are communication devices for cerebral palsy patients?
When there are limitations in the ability to communicate, it is really challenging and frustrating to try and express emotions and needs, to learn in school or to otherwise participate actively in the individual’s social environment.
This is mainly due to cerebral palsy producing muscle spasms in the throat, mouth and tongue. These limitations make it difficult to form words or sentences and, therefore, communicate pain, symptoms, hunger, difficulty breathing or thirst.
Improving communication increases self-confidence, independence, opportunities, social skills, and so much more.
Better communication means better physical and mental health, and communication aids are essential for many of these people to maintain good physical and mental health.
People with cerebral palsy can work with speech and language therapists to improve communication skills, and these professionals often use assistive technology in the form of communication devices. They are also known as AAC (augmentative and alternative communication) devices, referring to any way of communicating other than verbally speaking, in this case by means of a device specifically designed for the purpose of communication.
Communication devices for cerebral palsy were originally only low-tech, including sign language or the use of pictures, but newer technologies are making these communication devices more practical, faster and easier to use for people with cerebral palsy. They allow them to ask questions, express emotions and actively engage in the world around them.
Assistive communication devices empower people with cerebral palsy to meaningfully contribute to conversations and form friendships and relationships, so that they have become an important part of the lives of nearly all people with cerebral palsy, both children and adults.
Communication devices today can be grouped in several categories. From very low-tech to very high-tech, we make a list below. Keep on reading.
Writing and typing aids
Writing and typing aids may be used to help an individual with cerebral palsy communicate through written content. Although holding a pen or typing on a normal keyboard may be out of reach for many of them, some aids exist that help them better control these instruments and write by their own hand or type in special keyboards.
For pencils, there are special grips available in various shapes. These allow to position the fingers in the proper position to keep some kind of movement control and to minimize hand fatigue. There are also different devices that increase or improve the graspable area of an object such as silverware, writing utensils, toothbrushes, etc. that can give the user greater independence while doing everyday tasks, such as, in this case, writing something down or making a picture.
Handcuffs, or clips, are assistive devices to hold utensils that can be adjusted to meet each user’s particular condition, hand size and the shape of the utensil. They help the user to hold things like eating utensils, toothbrushes or pencils. They are easy to use and very useful for people that struggle with hand control.
Wrist support are assistive devices that hold the hand in extension to support a weak wrist. Writing instruments are then fixed to this wrist support. Some of the wrist support designs are full braces while others are similar to splints.
Regarding the use of a computer, keyboards contain keys that are usually small and can, therefore, be difficult to press. Typing in these conditions can also be a challenge for people with cerebral palsy and reduced motor skills. In this case, there are keyboards designed so that each key is larger and therefore easier to press. They also provide an ‘assist mode’ which is helpful for those unable to press more than one key at a time.
For people with cerebral palsy that can talk but have difficulties with motor skills, talk-to-text technology can process spoken letter, words, sentences, and paragraphs, and convert them into text. Voice commands allow the user to do things like inserting an image into a document or indenting a paragraph without resorting to the program menus.
Low-tech communication boards
The low-technology communication boards may be something as basic as a sheet of paper that allows children to point to letters or words to display what they want to communicate or a picture book or board that communicates tasks and needs.
There are many in the market with contents of different levels of difficulty and abstraction. They can therefore match the user’s abilities and needs in almost all situations.
Electronic communication boards
Electronic communication boards and tablets help children with limited fine motor skills or speech use pictures, letters, and words on a screen to communicate.
These communication devices can be either dedicated devices or mainstream generic tablets (iOS or Android, for example) with special apps or programs. The way they work is by providing the users with a choice of letters, words, numbers, symbols and pictures. They can select any of them to communicate thoughts, emotions, needs or ideas.
Images and phrases are organized into categories such as people, food, activities and objects so that the users can easily search and select the words or phrases they want.
Speech-generating communication devices
A more advanced version of an electronic communication board actually generates speech for the people impaired by cerebral palsy. They type or tap words, sentences, pictures or symbols and they are then converted into texts that are read out loud for others.
Speech-generating devices use the same types of cues as communication boards but they additionally translate them into verbal speech so that others can easily and quickly understand.
Alternative inputs to generic communication devices
Some people with cerebral palsy are unable to use their arms, wrists, hands or fingers. This makes selecting images or symbols on a communication board very difficult. In these cases there is the possibility to use alternative input devices like special keyboards or joysticks.
Also there are special switches that can be activated by pushing them with the head, mouth or shoulder. These can work with specialized software like ours, Mouse4all, Easeapps, Sesame Enable and Tecla that build apps and assistive technology devices to improve the off-the-shelf switch support of Android and iOS.
With them, the user can move a pointer on the screen of their communication devices and select whatever object she desires.
This is a very cheap and easy to use option to those people with cerebral palsy who have communication needs and motor skill impairments.
Eye-tracking devices
Another option for people with cerebral palsy that are unable to use their arms, wrists, hands or fingers to select images or symbols on a communication board is to use an eye-tracking communication device. Using just eye movements, they can select images, letters, and words to speak with others.
These devices are very good and easy to use, but are a more expensive option than the ones related before.