LONG PAPER

Jonathon Allen

Designing desirability in an augmentative and alternativecommunication device

Published online: 19 August 2005� Springer-Verlag 2005

Abstract This paper discusses work carried in the con-text of a study addressing the design and development ofa wearable communication aid for people who are illit-erate and cannot speak. People with such disabilitiesoften depend on electronic augmentative and alternativecommunication devices for interpersonal communica-tion. A central theme of the paper, however, is that suchproducts, and products intended for people with dis-abilities more generally, have characteristics that inade-quately attend to users’ needs—in particular manydevices pay insufficient regard to the psychological andsociological impact the devices have upon their users.The paper briefly discusses an empirical case study tar-geted to design and develop the Portland Communica-tion Aid (PCA). The process of establishing userrequirements, and in particular the notion of designer-facilitated participatory design, is discussed. The result-ing prototype of the PCA is briefly explained along witha discussion of the importance of product semantics inthe design of assistive technology.

Keywords Disability Æ Product semantics ÆAugmentative and alternative communication(AAC) ÆIndustrial design

1 Introduction

Products catering for people with disabilities have acrucial role in determining the quality of life of theirusers. These products must perform both functional andcommunicative goals [10] if they are to satisfy users’needs, wants, aspirations, abilities and capabilities. Thatis to say, the design of disability products must address

not only technical functions but, as Buchanan describes,the ‘‘more thorough and diverse interpretation of thephysical, psychological, social, and cultural relationshipsbetween products and human beings’’ [3].

Regarding disability products in general, Paul Ho-gan, then Chairman of the European Institute of Designand Disability (EIDD), states,

‘‘Most of the products on display are engineered andnot designed. No thought appears to have been given tothe psychological impact of the design on those whohave to use them. The majority of products ... are ugly,shiny and say in the most emphatic way to the pur-chaser, ’You are a cripple’.’’ [9].

This is a damning statement and highlights a pro-found problem. Technology is capable of granting peo-ple with disabilities greatly increased independence andquality of life, affording opportunities to perform tasksthat would otherwise be impossible. A product’s successis, however, often marred by a lack of consideration ofhow its technology is packaged. In many cases, the verydevices intended to assist people with disabilities in factdo damage: they compound people’s disabilities bydrawing attention to impairments.

As a consequence, the question arises of how thisproblem can be addressed. The work presented in thispaper aims to contribute to answering this question,through the design and development of the Portlandcommunication aid (PCA), a prototype product de-signed to empower its user by more sensitive and per-ceptive design. The design work, commenced in 1995,was carried out as part of a Ph.D. study [1] in theDepartment of Design and Technology, LoughboroughUniversity (UK), in conjunction with Portland College,an independent college for people with disabilities inMansfield, Nottinghamshire (UK). Portland Collegehad identified the need for an improved communicationaid suitable for their students.

Portland College catered for students with variousdisorders and disabilities affecting speech and hadexpertise in the area of augmentative and alternativecommunication (AAC). AAC simply refers to all types

J. AllenDepartment of Design Faculty of Art & Design,Monash University, Melbourne, AustraliaE-mail: jon.allen@artdes.monash.edu.auTel.: +61-3-99032070Fax: +61-3-99031440

Univ Access Inf Soc (2005) 4: 135–145DOI 10.1007/s10209-005-0117-2

of communication that supplement, increase or improvespeech for people who have articulation, voice, or lan-guage impairments. There are various disorders anddisabilities affecting speech—damage to the vocal tractcan result in a person not being able to speak effectively,as can damage to the region of the brain affecting musclecontrol. A severe speech disability is often the result ofpoor motor control affecting muscle co-ordination, sothat the larynx cannot function effectively. The loss ofmotor control can occur form birth, such as in the caseof cerebral palsy, or can be acquired due to a degener-ative disease, a cerebral vascular accident (a stroke), or aserious head injury.

For the case presented in this study, the mostprevalent AAC users at the college were individualswith cerebral palsy, but individuals with serious headinjury and degenerative diseases (e.g. motor neuronedisease) were also included. These students were non-vocal and illiterate, and many had additional impair-ments as a result of their disabilities. The electroniccommunication aids used by the students, althoughconsidered to be state-of-the-art, presented a numberof shortcomings.

The process of establishing user requirements and theresultant design work are discussed in the followingsections.

2 Establishing user requirements

There is a limited, but growing, body of literature ondesigning for people with disabilities. However, at thetime of the study there was little work available on theapplication of design techniques for disabled users inpractical situations. Whilst some authors present guidesto the selection of particular methods [22, 20] and somenote the problems and issues specific to selecting meth-ods of assessment for people with disabilities [7, 19, 20],little is discussed with regard to communication dis-abilities. The designer is therefore faced with a problem:how to uncover and thoroughly understand the per-spectives of people with disabilities, along with theirneeds, wants and aspirations for disability devices.

For the study it was imperative to involve AAC usersin the process of designing. However, there were par-ticular difficulties in achieving this in practice. Tradi-tional techniques for assessing user needs and wantsusually rely on the user providing some form of feed-back. AAC users cannot talk but instead typically relyon a communication aid to convey their thoughts. Thevery fact that an AAC aid is used in the communicationprocess in assessing user needs can also detract from thequality and efficacy of the results. Furthermore, manyAAC users lack coordinated motor control, and so thepossibility of representing and exploring their ideasthrough non-verbal media such as sketches and models(techniques commonly used by industrial designers) waslimited.

A number of techniques were used towards estab-lishing user requirements, including literature reviews,observation, participant interviews (formal, informal,video recorded), expert interviews, questionnaires, ‘days-in-the-life-of’ participants, photographic studies,sketching, modelling and prototyping, to name a few.This paper focuses upon interviews and the role of de-sign work (sketching, modelling and prototyping) inthose interviews to establish user requirements.

Informal but semi-structured, one-to-one interviewswere carried out with AAC users at Portland College.The interviews were conducted under the guise of chatsso as not to intimidate the interviewees, and to allow theinterview to be participant-led. An interview protocolwas followed when conducting the interviews. Open-ended questions were first offered in order to encouragethe AAC users to respond as freely as possible. If therewas a limited response (and as the AAC users’ com-municative abilities varied) questions requiring a simpleone-word answer were then posed to prompt andencourage responses. Often the order of questions wouldchange to ensure that the interview sounded more con-versational than scripted. Where possible, the questionswere adapted to focus upon issues raised by the inter-viewees. A set of questions was posed to determine:

– needs of a communication device;– wants and desires for a communication device; and,– perceptions of their devices, the relationship between

themselves and their devices, and their perceptions ofhow others saw them and their devices based on theirown experiences.

Over fifty interviews and discussions were conducted atthe College over the period of the study, providing theopportunity to review findings in relation to the partic-ipants’ circumstances and experiences at the time. Sea-sonal changes revealed different physical requirements ofboth the user and the AAC device (for example, insummer fingers may slip on keyboards due to sweating,whilst in winter hands operating a keyboard get cold andnumb). Such findings may not have been apparent ifonly one ‘snap shot’ interview had been conducted.Interviewing the same participants periodically provideda more comprehensive account of their needs at differenttimes.

A strong rapport developed between the author andthe participants, permitting more open communication.This allowed, when necessary, sensitive and difficultquestions to be asked with comfort, compassion andconsideration, as mutual trust and respect had alreadybeen established. Thus, issues raised by the participantscould be penetrated at depth (something more difficultand time consuming to establish with a greater numberof participants). The interviews also provided the par-ticipants the opportunity to spend time talking withsomeone who was keenly interested in their ideas andconcerns, and hence they felt valued. The interviews alsoprovided the participants with a form of symposium by

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which issues central to their everyday lives could beexpressed and explained.

Building a rapport with these students throughout theduration of the study provided the opportunity toexperience in an intimate way their frustration, hopesand everyday interactions. Being accepted into theirsocial activities gave the author an opportunity to see, atclose hand, different sides to these students when com-pared to their behaviour in a classroom setting. Inaddition, over the year key events took place in theirlives: birthdays, parties, achievements, relationships,illnesses and injuries, and so on. These events provided amore complete picture of what the users required.

2.1 Designer-facilitated participatory design

The design activities of ideation, sketching andmodelling had a significant role in establishing userrequirements. In this instance, the author engaged indesigner-facilitated participatory design whereby theauthor stimulated, interpreted and synthesised partici-pants’ ideas in the form of sketches and models in orderto more accurately articulate their needs.

Sketches of concepts were shown in the interviews tosolicit interviewees’ thoughts and preferences. The au-thor’s ideas were deliberately left until last to ensure thatthe interviewees’ perspectives and ideas were not shapedor manipulated by poor interviewing technique. Inaddition, it was important to reassure the intervieweesthat they were involved in the design of the device, andthat their comments were valued. Sketching the studentsand placing design ideas upon the same drawing helpedto put the concepts in context. (Fig. 1 shows an exampleof one such sketch.) The sketches were then used, inpart, to help focus the participants upon particularpoints being discussed in the interviews, and to solicitinterviewees’ thoughts and preferences. Moreover, thesketch work was used to help the participants think

about alternative possibilities to their own preconceivedideas (there were often differences between participants’initial statements of what they wanted and those posedby the participants after exploring other options anddesign proposals).

Often the AAC users’ statements of their needs andwants changed when presented with alternative ideas. Itcould be argued that these changes were the result of animposition by the author. Rather than supplant theAAC users’ ideas with those of the author, however, theauthor’s ideas, typically presented through discussion orin the form of sketch work, provided an opportunity tofurther explore ideas coming directly from AAC users.Whilst there can be dangers of this approach, mostnotably that the designer is at risk of usurping the role ofthe participants, in this case there were distinct advan-tages. The ideas of the participants were often bound bytheir knowledge of what they believed to be possible or,counter to this, participants would propose possibilitiesoutside the practical constraints of the project.

In some cases, AAC users only became aware of anissue or problem affecting them once it was revealedthrough this process. For instance one participant, afterdiscussing the idea of having a separate speaker for thecommunication device, identified a number of scenarioswhere such a feature would be useful. One of thesescenarios was to provide some privacy when using thetoilet. Whilst he knew that he needed assistance from hiscarer when using the toilet, he now realised that he didnot need help for the entire duration of toileting—hecould leave the speaker unit with his carer so that whenhe had finished he could inform the carer to come andget him (rather than have the carer wait with him). Thiswould thus grant him some privacy in the toilet. Thisparticular benefit of having a remote speaker wouldhave been difficult to predict if it were not for the authorintervening and exploring scenarios with the participant.

After each interview, further sketching and ideationwere conducted, with many of the ideas that partici-

Fig. 1 An example of earlysketch work

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pants suggested being incorporated into product pro-posals. The drawings would then be shown to theparticipants on later occasions for further evaluation.In turn, drawings would help in the articulation ofuser requirements by transforming users’ own mentalmodels into recognisable and feasible sketched designideas.

It was found from the interviews that drawings couldhold inherent bias—one drawing might be drawn orrendered better than another, thus influencing the situ-ation. A solution was to do black-and-white line draw-ings, but these were open to interpretation. Isometricdrawings often needed explaining to those unfamiliarwith this drawing convention. Three-quarter views andperspective drawings were again open to interpretation.AAC users tend not to draw, as most do not have thedexterity or muscle control to produce drawings. Lack-ing such experience of the activity of drawing may per-haps hinder the understanding and interpretation ofdrawings. Whether this is the case or not, it was foundthat physical (3D) models allowed the AAC users tomore fluently comprehend design ideas.

Physical models allowed the AAC users to compre-hend more fluently design ideas, and proved to be muchmore powerful tools for evaluating and discerning userrequirements than verbal presentations and sketchesalone. The hard medium density fibreboard (MDF)models accurately approximated the weight and feel ofthe intended designs, and although they were more timeconsuming to produce than softer foam models, theruggedness they provided was necessary in this instance,as foam models were not durable enough to last theduration of the interview session. There is a great dif-ference in how someone with cerebral palsy interactswith a hard or a soft material—typically the hardermaterial can be used to help support the hand whenperforming a task. Hence, the MDF models were moreuseful in establishing whether certain tasks (such asreaching for a button) could be performed by AACusers.

In addition to physical models, other representationsof design ideas included the use of sound samples (rep-resenting different voices available at the time), tactilematerial swatches, colour swatches, examples of featurestaken from other products, and the use of metaphorsand analogies.

Developing ideas through working prototypes addedan important sense of realness to design concepts. Owingto their interactive properties, the prototypes provedimportant tools for eliciting user feedback: an action onthe user’s part resulted in a reaction from the product.Visual models rely on interpretation and imagination tocomprehend the final item, whilst working prototypesare easier to perceive and relate to as final productionitems. Presenting prototyped parts of the PCA to AACusers at the College, and allowing them to try them outand comment upon them, provided more detailed andempirical feedback on design details than either draw-ings or solid models could provide.

Presenting and re-interpreting users’ ideas in the formof sketches and models whilst designing had manybenefits. Working with AAC users in this way permittedthem to learn about design, and so in time the partici-pants developed a greater awareness of, and ability toarticulate their needs and conceptualise their ideas (al-beit through the hand of the author). Often the AACusers’ statements of their needs and wants became morecomprehensive after consultation with the author.Intervention and co-operation led to a comprehensiveproduct design specification—without it, the specifica-tion would have been patchy. The designer has theability to articulate and ‘‘specify,’’ in functional terms,what is required. In this sense, the designer, knowl-edgeable in many areas, has a vital part in articulatinguser needs. Further, the designer can facilitate partici-pants in the design process by helping to:

– generate and develop more creative ideas (byprompting questions and visualising the participant’sideas)

– broaden options (an idea can be extrapolated to coverother, unthought of, areas, and the designer’sknowledge of contemporary and emerging technologycan expand options and possibilities)

– rationalise ideas (the designer’s technical acumenconcerning for example manufacturability, availabil-ity of technology, predicted costs, etc., can help focusa participant’s ideas into practicable concepts)

– articulate and define user needs.

3 Findings

A number of problematic issues facing AAC users wererevealed through the study and were broadly categorizedunder six main headings:

– Physical issues of devices (e.g., batteries running outof charge, or the aid being prone to knocks)

– Perception of the devices– Interface issues (e.g., fingers slipping on keys)– System issues (ability to be programmed by users)– Situational issues (problems of use outdoors, or in the

dark)– Voice issues (in particular the intelligibility of the

voice synthesiser, and lack of intonation and expres-sion)

The range of methods used in the solicitation of userneeds also revealed much about users’ wants and aspi-rations for a new communication device. Moving be-yond the problems of devices to the possibilities fordevices was an exciting and liberating step in the designof the PCA, and one in which the students at the collegekeenly participated. Indeed, whilst the functional limi-tations and problems of the students’ AAC devices werean extremely important concern, many of these issues

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could be relatively easily addressed in the product de-sign. In order to develop a truly useable and successfuldesign of an assistive technology device, it was impor-tant to consider the wider sociological and psychologicaleffects of the use of such disability devices upon theirusers.

3.1 Sociological and psychological considerations

When it comes to an encounter with someone with adisability, it is clear that first impressions are made‘‘based on the most obvious and superficial data,’’ and‘‘the most obvious datum they [people with disabilities]communicate is their disability’’ [23].

Society’s perspectives of disability are varied, butunderlying public attitudes towards people with dis-abilities often set them apart from the rest of society.People’s social programming can lead to prejudice.Physical, social and psychological barriers are put upbetween different groups. The ‘disabled’ are placed indifferent schools, or streamed into sets catering for‘special needs’: our language and definitions segregate.This results in insufficient social intercourse with peoplewith disabilities to the extent that they are perceived,by and large, to be greatly different. The majority ofthe public does not know how to interact comfortablywith people with disabilities, all too often focusing onthe disability and not the person. Louis Batty puts itwell:

‘‘The cripple is an object of Christian charity, a socio-medical problem, a stumbling nuisance, and an embar-rassment to the girls he falls in love with. He is avocation for saints, a livelihood for the manufacturers ofwheelchairs, a target for busy-bodies, and a means bywhich prosperous citizens assuage their consciences ...He is pitied and ignored, helped and patronized,understood and stared at. But he is hardly ever takenseriously as a man.’’ [15].

Ignorance often handicaps people with disabilities.Stereotypes, attitudes, entrenched prejudice in societyand even the language we use to describe people withdisabilities reinforces the notion that people with dis-abilities are social outcasts—they do not fit society’sperception of ‘normal’ and desirable.

People need to feel that they are accepted by soci-ety—that is, that they are a part of society, not apartfrom it.

Society’s perceptions and labelling of people withdisabilities can have a profound effect upon their per-sonal worth—their personal image of themselves. Manypeople with disabilities experience feelings of rejection,inferiority, loneliness, depression and frustration.

Many people with disabilities are reliant on others forassistance. Although this is much appreciated by thosebeing helped, some experience frustration at the resul-tant lack of control, autonomy and independence. Beinghelped can be viewed as synonymous with being help-less. The use of disability aids, to a certain degree, offers

some form of independence for their users, as theopportunity to become more socially integrated.

When examining the wider consequences of disabil-ity, it is important to consider both society’s views andthe views of people with disabilities themselves.Csikszentmihalyi and Rochberg-Halton [5] discuss avery insightful sociological study presenting a compel-ling examination of mankind’s relationship with mate-rial objects. They argue that material culture is not just apassive reflection of society, but has an active rolehelping to create its identity. This happens not only atthe level of society, but also at the level of the individual.They argue that the way we interact and transact withthe material world ‘‘will determine, to a great extent, thekind of person that emerges. Thus the things that sur-round us are inseparable from who we are. The materialobjects we use are not just tools we can pick up anddiscard at our convenience; they constitute the frame-work of experience that gives order to our otherwiseshapeless selves’’ [5].

This statement mirrors similar discussion by Deweywho argues that we live in a series of situations andtransactions between people and the environment thatshape and influence us [6]. The term transaction is par-ticularly poignant—the relationship between object andindividual is interactive in that objects are not only areflection of who a person is, but are in themselves partof an individual’s identity.

Material artefacts not only convey aspects of our-selves, but also create them. A beautiful piece of clothingmay make people look beautiful when they wear it, but italso has a significant role in making people feel beautiful,and can affect how they act. Moreover, like actors, weoften will dress or use material artefacts as props tocommunicate a different persona. People will often dressup, or put on ‘airs and graces’, to change their perceivedsocial status. Attire can be used to establish or impartsocial standing, or to express an individual’s tastes,interests, aspirations and attitudes. Dressing up ordressing down is also a very obvious way in which anindividual can attempt to change his or her perceivedsocial identity. Whether it is the clothes we wear, the carwe drive, the brand of fragrance we use, or the materialpossessions we deem precious or significant to us—allcommunicate to others aspects of our identities.

There are many benefits to be drawn from the psycheof material objects, but the counter-side is also true:products can detract from the self. This is a trend ofdisability products. In the case of a communication aidthat provides an audible voice for its user, the expecta-tions and aspirations for that product are especiallyimportant since the device becomes an extension of itsuser [14]. If a voice communicates to the outside worldeverything that a person is, it should represent him/heraccordingly.

Material possessions, therefore, have an importantrole in establishing social identity as well as in the con-struction of selfhood [5, 6, 8]. It is, therefore, importantto consider the effects of the use of disability devices by

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people with disabilities, and their relationship with thosedevices. The study revealed that AAC devices, and dis-ability devices more generally, are seen as extensions oftheir users, and therefore the aesthetics and productsemantics of these devices reflect upon their users andhave a significant impact upon users’ self-image. Self-image is very important, and often the very devices de-signed to help people in fact compound their problemsby drawing unwanted attention to their impairments.‘‘The main disadvantage mentioned by users of high-tech [AAC devices] was that their devices drew attentionto them that they did not want’’ [16]; indeed, one usersaid, ‘‘people focus their attention on the machine, notme’’ [16]. This gives rise to a situation where manypeople are reluctant to use aids as the devices maycontribute to their problems, compounding a psycho-logical stigma of inferiority. Other authors have citedthat many products within the disability sector are re-jected by their users [11, 18, 21], due to their unreliability[17], their appearance [4, 9], and the handicapping as-pects of the product [9, 17, 21]. One could argue there isa paradox: disability products often disable their users,not necessarily in a physical sense, but on a psycholog-ical and sociological level.

3.2 AAC users’ perceptions and experiences of howothers saw them and their devices

Augumentative and alternative communication users’perceptions and experiences of how others saw themwere particularly noteworthy. Most students had expe-rienced some form of unwanted attention: usually staresor else avoidance and patronising comments or actions.Most of the participants noted that the public typicallydid not know how to react towards people with dis-abilities. Although the public tended to be polite, theparticipants noted that few people wanted to enter into,or else maintain, a conversation.

When asked about how other people tended to reacttowards the communication aids, the comments varied.Most of the participants acknowledged that peopleseemed curious about the AAC devices. Some peoplewanted to know what the AAC devices were and howthey worked. One participant had been requested to givea demonstration of his communication aid, whilst an-other participant had been asked by a member of thepublic whether he would let her child have a go with theAAC user’s communication aid. This latter statementwas echoed by another participant, noting that peoplethought his communication aid was a toy. When askedwhy they may have thought this he replied, because ‘‘itlooks like a toy.’’ He went on to discuss his experience ofpeople interfering with his communication aid. On oneoccasion someone erased the memory of his machine bypushing the buttons on it; ‘‘I couldn’t stop them,’’ he said.

The participant said that the public most commonlyreferred to the communication aids as ‘‘ machines.’’ Theparticipants noted that the public tended to not

acknowledge that the communication aids were a vitalpart of the AAC users—that is, their voices.

An interview with one participant raised some inter-esting issues. The initial intention of the interview was todiscuss some of the concepts that had been generatedand to get the participant’s feedback on what ap-proaches should be taken with regard to the develop-ment of the PCA. Three options had been identified—toeither design from scratch, adapt a current product, orto collaborate with a manufacturer of electronic goods.The conversation that followed was far more significantthan the selection of a particular approach. The partic-ipant was very much in favour of the idea of adaptingmainstream consumer products because he felt that ifthe public used the same product as people with dis-abilities, then people would not be frightened off by thesight of him using a machine to talk. The participant feltstrongly that if the public were more familiar with AACusers and their devices, then both parties would benefit.If the public used the same device as he did, he wouldfeel more equal, and then possibly fewer people wouldlook at him and his AAC device with curiosity. Whilstadapting current devices was seen positively by theparticipant, the reasons for doing so were less related tothe manufacturing virtues of this approach but, moresaliently, with a product’s role in integrating people withdisabilities into society. Another way of attempting toachieve such integration is to design an AAC device thatpeople without disabilities would want to use.

4 The Portland communication aid

The design approach was to modularise the PCA and todesign each part as a socially acceptable and desirableitem. The PCA consists of three physical parts, namely

– Book– Waist-pack– Mobile speaker unit.

4.1 The Book

The principle idea for the Book was to camouflage thetechnology and to attach to the product an associationof intelligence, whereby those using it would be per-ceived to be literate and, hopefully, intelligent. A bookcarries more than just the association of intelligence,however. The information or stories contained withinbooks, rather than the physicality of them, stimulatesemotive or reactionary responses. In this way, theintention of the Book was to draw the public’s attentionaway from the ‘machine’ and to focus upon the contentof what was generated upon it and spoken by the PCA(in other words, what the user was saying). The associ-ation of books with story telling was also apt for thePCA, in that a story-teller can captivate an audience by

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reading from a book. The correlation between learningand books was also intended to be explicit, as the PCAwas intended to be used as an aid for learning.

The Book’s resemblance to a personal organiser or adiary was by no means coincidental. Both objects areused to store personal information, and have significantvalue to their owners. Likewise, the Book sought tofoster such an association. The design of the Book hadadditional virtues as discovered through concurrentevaluations with AAC users at the college:

– avoidance of unwanted attention drawn to the user (toall intents and purposes the user is reading);

– a full-sized keyboard that can be housed in half thearea required conventionally (the Book can fold up)

– a means of keeping private material private (the Bookcan be closed by users);

– the act of closing the Book allows a very demonstra-tive statement to be made: ‘‘I don’t want to talk toyou’’ (this was discovered when demonstrating thePCA to one participant).

The Book, leather bound or clad in whatever finishgrabs the owner’s imagination, accommodates the key-board and graphics-capable liquid crystal display. Asingle-chip micro-controller integrates the input andoutput functions of the Book to an external, serial link.

The keyboard and display are both back-lit andadditionally each key has a light emitting diode (LED)associated with it. These low power, super-bright LEDsare used to guide the user to keystrokes that naturallyfollow, within the adopted just-made AAC language.This key prediction feature provides the PCA with the

potential to become a device from which its user learnsnew words and phrases. The Book also contains a solarpanel both to assist in maintaining battery charge levelsand to provide the system with information regardingthe ambient light conditions, so that back-lighting maybe controlled in the most-energy efficient manner. Thesolar panel trickle-charges the battery in daylight anddetects when ambient light levels drop, automaticallyswitching on back-lighting of the screen and keyboard.Back-lighting permits the AAC user to operate the PCAin the dark or in poor lighting.

4.2 The Waist-pack

The Waist-pack (or ‘‘Bum-bag’’ as it is more commonlyknown in the UK) was devised as a convenient housingfor the main PCA computer hardware. The unit pro-vides a secure repository for the more expensive parts ofthe system, as well as being a conveniently worn orcarried item. A ‘chassis’ containing the computer hard-ware can simply be fitted into an off-the-shelf bum-bag.This allows users to select bum-bags according to theirfashion tastes (and, in time, changes in fashion tastes),and each PCA can be easily and inexpensively custo-mised. Figure 4 shows the Waist-pack and the computerit houses.

The Waist-pack contains the main power source byway of a cam-corder battery, an embedded PC-com-patible computer system, a speech output device con-trolled by sophisticated speech synthesiser software anda radio transceiver. The main computing element, the

Fig. 2 The use of physical models in a series of interview sessionswith one participant

Fig. 3 The Book in open andclosed states

Fig. 4 The Waist pack prototype

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embedded PC, links to the Book’s micro-controller andcommands it to perform various operations on the dis-play and LED array to convey the keyboard’s status.The radio transceiver in the Waist-pack provides a linkto the Remote speaker unit. In order to constraindevelopment time and costs, standard units were utilisedwherever possible. It was decided to make use of com-mercially available batteries so that additional batteriescould be quickly and relatively inexpensively sourcedfrom high-street shops. The main processing power inthe PCA is derived from PC technology. The selection ofa PC-compatible computer afforded access to the hugesoftware base produced for the desktop market, easierand faster development of application software andhence faster time to the market. The implementation isbased on standard, off-the-shelf PC/104 technologyoffering substantial computing power in a very smallpackage. The PC/104 format is an accepted industrystandard and echoes and enhances the system modu-larity that is part of the design basis of the PCA. Thespeech synthesiser, offering programmable changes inmood and inflection, runs on the embedded PC andoutputs via a PCMCIA version of the standardSoundBlaster product.

With present battery technology the major contri-bution to the weight of the PCA comes from the powersource. The decision to place the battery in the Waist-pack results in this concentration of weight being in anarea that does not upset the balance of a semi-ambulantuser. Indeed, the wearing of a strap around the waistmay increase the user’s stability. Further, placing themore delicate and expensive parts of the PCA in theWaist-pack affords them greater security and protectionfrom damage.

4.3 The Mobile

The Mobile speaker facilitates the speech output for thePCA. This self-powered unit contains a transceivermatching the one in the Waist-pack. Having a separateunit producing the final audio output offers a number ofalternative ways of using that output. The user may wearthe unit in such a position that the voice sounds asthough it is coming from the user, or the user may pass

the unit to the conversation partner so that a moreintimate conversation may ensue. In either event theintegral digital volume control is close at hand allowingthe unit to produce anything from a respectable shout toa whisper. The Mobile speaker unit is shown in Fig. 5.

The Mobile speaker concept was very popularamongst staff and students at Portland College for anumber of reasons. The facility to talk privately was amajor virtue of this proposal, as was the option ofwearing the unit (say, in a shirt pocket) so that the voicesounds as if it emanates from the wearer (as opposed tothe machine). The proposal to make the audio outputdevice resemble a mobile phone was favoured by thestudents, as mobile phones were perceived to be desir-able items by the students and, from a practical per-spective, the size also provided sufficient space to housethe components. The association with mobile phoneshad an additional advantage in that if a conversationpartner held the Mobile to his/her ear, people assumedthat the conversation partner was on the phone. Hence,conversation partners drew little attention when con-ducting conversations with AAC users, even though theywere holding something to their ears.

4.4 Generalisable principles of the PCA

Breaking the system up into discreet components is adistinct departure from the status-quo. It is tempting tosuggest that advances in circuit packaging density, bat-tery technology and power management will ultimatelyallow all the electronics to be housed within the PCA’sBook. The separation of the various parts of the system,however, is an integral part of the design concept. TheWaist-pack is seen as assisting the semi-ambulant user inmaintaining a better posture and provides a securerepository for the more expensive parts of the system.The Mobile speaker concept allows the user’s voice toemanate from the correct part of his or her body or tofacilitate a private conversation. The advances men-tioned will, though, allow the unit to be thinner andlighter and will certainly offer extended endurance.

More generally, the PCA has inherent design featuresand has incorporated key principles that are equallyapplicable to other projects in the disability sector.These include:

– modularity of components;– separation of interface, processor and output devices;– camouflaging technology;– affording meaning through semantics and metaphor

(e.g., association of intelligence);– using remote links to other components;– using noble materials (metal and leather) for their

longevity and patina;– making use of standard parts (such as batteries) to

minimise costs and provide greater availability ofreplacements;

– utilising standard hardware (upgrading is simple);Fig. 5 The Mobile speaker

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– push towards software over hardware solutions (e.g.,using a software-based voice synthesiser).

The evaluation of the PCA was limited, given time andfinancial constraints. However, concurrent evaluations,heuristic evaluations, a questionnaire with new studentsat the college and an evaluation interview with one ofthe primary participants revealed encouraging and po-sitive responses towards the device. More extensiveevaluations and user trials are desirable.

4.5 From AAC to mainstream

Although the PCA is intended for use by people withsevere communication disabilities, its use is not limitedto that population. Many of the attributes of the finaldesign have equal application in mainstream products.There is no reason why the PCA should not cater for awider audience, as the same device could potentiallycater for anyone having a form of communication dis-ability. Taking this one stage further, there is the pos-sibility for the PCA to be useful also to those withoutrecognised disabilities. Considering that a powerful andup-gradable computer is housed in the PCA Waist-pack,the system could be used in a number of situations toperform the personal computing of, for instance, busi-ness people, students and travellers. There are situationswhen the ‘able-bodied’ become disabled by their physi-cal environment. For example, using a lap-top computerwhen travelling in an aircraft can be precarious. Thelimited space, vibration and turbulence, people gettingin and out of neighbouring seats, and being serveddrinks and foodstuffs present hazards that lap-tops arenot always capable of surviving. Such a situation is notdissimilar to someone with cerebral palsy trying to use acommunication aid. The cultural environment can alsodisable people: not being able to speak the language ofthe country one is travelling in can be a handicap. As thePCA has the facility to output speech, by the inclusionof appropriate software, one could write or use icons togenerate words in English, and the PCA could translateand speak out in another language. One view to take,then, is that the needs of AAC users are not dissimilar tothose of able-bodied peers, but tend to be extreme.

5 Conclusions

Augumentative and alternative communication devicesare an extremely important conversation tool for peoplewho would otherwise be left out of conversations. Theseaids are, in effect, electronic replacements for what able-bodied people so often take for granted. People withcommunication disabilities rely heavily on these devicesto communicate. For those who have additionaldisabilities that seriously affect motor control, thedependence upon the aid is increased as they are limitedin their ability to communicate by other means (such as

using gesture). More than merely a tool, however, thesedevices are the voices of their users. An AAC devicebecomes a vital part of a user’s identity, yet currentdevices appear to have neglected this important aspect,presenting only technological solutions to the problemsof not having a voice and not solutions that take intoaccount the users’ identities.

Through reading, observation, social intercourse,discussion and interviews, a comprehensive understand-ing of the needs, wants, abilities, capabilities and expe-riences of AAC users was established. Over time, arapport was developed with the students of PortlandCollege. The nature of this informal and unobtrusiveapproach to requirements capture provided a muchneeded sympathetic comprehension of the nature of theproblems faced by AAC users. The observational studieshelped to foster an understanding and appreciation of thelives of the participant AAC users, and of how to conductinterviews with people with severe communication dis-abilities. The processes of designing and the 2-D and 3-Dmodels thereby produced were important in the explo-ration and articulation of user requirements. Throughconsolidation of these user requirements, a prototype ofthe PCA was created that both embodied AAC users’ideas, and addressed their needs, wants and desires for anAAC device. In this study both the process of designing(primarily by involving AAC users) and the subsequentoutcomes of industrial design (the sketch work, models,and the prototype of the PCA), had a valuable role in theempowerment and rehabilitation of AAC users.

It is the author’s contention that traditionally manydisability products have addressed, at best, only func-tional goals in solving problems associated with dis-ability. Designers have shown insufficient regard forcommunicative goals that deal with how such productsare perceived. Such communicative goals include raisingstatus, prestige, desirability, self-esteem, and pleasure fortheir users. It is proposed that disability products can begreatly improved by paying greater attention to suchcommunicative goals. This is not just a case of re-styling,but an exercise in meshing needs, wants, aspirations,purposes, abilities and capabilities of potential users ofdisability products with technological and functionalrequirements.

The PCA was designed to empower its users by beingpredominantly inconspicuous (that is the product hasbeen camouflaged so as to not draw attention to itsuser), but when a conversation is initiated with or by thePCA’s user the product enhances the user’s perceivedstatus and intelligence. That is, the public may perceivethe AAC user to be of reasonable intelligence (to bereading what appears to be a book), to be able to talkand to also be sociable (to be carrying what appears tobe a mobile phone). Further work to evaluate to whatdegree the public perceives the status and intelligence ofPCA users, and to compare the conspicuousness of thePCA over current AAC devices is required to substan-tiate these issues. However, the evaluative comments ofthe participants indicate that they believe the PCA is less

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conspicuous, and one of the primary participants furtherstated that he believes the public would perceive him asmore intelligent if he were to use the PCA, and in thisregard the PCA has acheived an important goal ofraising self esteem of a potential user.

The PCA was also designed to facilitate communi-cation on a number of levels. The PCA not only pro-vides the facility to say something but expresses, throughproduct form and semantic association, qualities theAAC users at the College wanted to communicate aboutthemselves. Within each of the constituent parts of thePCA, communicative qualities have been afforded intothe design. The Book’s form and the choice of materialshad cues from consumer electronic products and alsohad strong visual associations with personal organisers,diaries and books—all of which provided much soughtafter appeal because of the implicit association ofintelligence and communicative ability. The Waist-packallowed for personalisation by providing the opportu-nity for AAC users to cheaply customise or adapt thebum-bag to suit their clothing tastes. The Mobile unitadopted forms and cues from mobile phones—productswith which the AAC users at the college wanted to beassociated, because of the status (at the time) of owningone, and for the implicit association that mobile phoneshave with communication.

The complex range and nature of the disabilities ofthose people who could benefit from AAC devices pre-sents perhaps one of the most complicated set of indi-viduals in any market. Designing for this group’sphysical ability is very challenging for the designer. It is,however, not just the physiological and anatomical as-pects of disability that challenge the designer and theperson with the disability. Sociological and psychologi-cal consequences of physical disability have majorimplications on designing for AAC users.

The size of the market for products within the dis-ability sector, and the scope and need for productswithin it, provide a tremendous opportunity for indus-trial designers to get involved and focus their attentionon resolving the issue of poor products within the dis-ability sector. There are opportunities to make money,produce better products, and ultimately direct problem-solving to the task of fulfilling human needs. Bydesigning products with the needs of people with dis-abilities in mind, the industrial designer can offer muchfor the benefit of everyone.

There are many advantages of taking this approach.By widening the market to encompass as many potentialcustomers as possible, whilst still meeting the require-ments of AAC users, greater product numbers can beproduced. In turn, production costs are reduced, andthus the price per unit can come down, and greaterprofits can be made. By having a wide selection of thepopulation using the PCA, with different needs butperforming the same task of communicating with oneanother, perceived barriers could be broken down. Inessence, widening the market for such a product meansthat the product is more widely known, accepted, and

taken for granted. Hence, referring back to Thomas’sobservations of how people with impairments are re-ceived by society, it is as if one of the ‘signals’ providing‘‘a visible cue to the public to anticipate an ‘atypical’person’’ [23] is lessened. Further, this approach couldprovide an opportunity for AAC users and the widerpublic to better integrate, socialise and grow and learntogether. One of the participants stated that he believesthis to be true, and that he would feel more ‘normal’ andaccepted as a result. An example of where the perceptionof a product has changed as the diversity of the popu-lation using it has increased is the use of mobile phones.When mobile phones were first introduced as a consumerproduct they were seen as a status item: only the affluentcould afford them. Now society’s attitude is somewhatdifferent; mobile phones are commonplace, and soattention is not drawn to people using them. In short,the transfer of technology and ideas from the disabilitysector to mainstream markets, and vice versa, helps all.Further, disability devices can be greatly improved bypaying greater attention to communicative goals, and inso doing create desirable disability products.

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