Talking Pictures: Visual Scene Displays
AAC (alternative and augmentative communication) for aphasia is a challenging area of practice for many Speech-Language Pathologists. Whereas most AAC devices and apps help those who have difficulty physically speaking, people with aphasia need help overcoming the underlying language disorder on top of any speech difficulties. Traditional grid displays organized by part of speech are usually unhelpful given the demands they place on grammar, working memory, and categorization.
One AAC format that is aphasia-friendly is Visual Scene Display (VSD). The concept behind VSD is to show a picture of a detailed scene and either surround the picture with messages related to it, or designate hotspots in the picture that express a message. Here are four apps that offer VSD functionality, popular for users with autism as well as aphasia:
Scene Speak (iPad only, $9.99) allows you to build books of visual scenes, adding recorded audio, text to speech, and text to each hotspot. Scenes can also be linked together by hotspots. Unique features include a built-in Internet photo search and word highlighting as scene labels are read aloud.
Scene & Heard (universal iOS app, $49.99, free Lite version) offers similar functionality with over 10,000 built-in symbols to augment the scenes as well as the ability to add video to hotspots.
Autismate (iPad only, $149.99) adds to the previous features with grid-based AAC options, a shared content library, social stories, and GPS functionality.
Touch Chat (separate iPhone & iPad versions, $149.99, Lite version for $9.99) offers more traditional grid-based AAC with the option to add scenes with printed messages around the edges that produce phrases or link to grids. You'll find the VSD options as part of the MultiChat 15 Student vocab set.
Some ideas for creating visual scenes for people with aphasia include:
- Rooms from their house to express needs related to each area
- Picture menus from favorite restaurants to help with ordering
- Family photos with each person's face made into a hotspot explaining who they are
- Vacation photos that tell a story about a trip or experience
- Add hotspots to screenshots from other apps to make them speak: symbol grids made with Custom Boards, family trees made with Popplet, a medication schedule made with Pillboxie, a typical daily schedule from Calendar, a satellite map of the neighborhood taken from Maps
For more information on Visual Scene Displays, there is a free webcast you can watch along with several low-tech VSD resources from University of Nebraska. For general AAC assessment tools for people with aphasia, Garrett and Lasker have provided amazing resources. The blog PrAACtical AAC has also recently published several posts on using AAC with people with aphasia, including written choices, communication books and questions to ask when making them, and AAC assessment.