The Xpress, which costs about $7,500 and begins shipping at the end of this month, features a 12.7-centimeter touch screen, weighs in at less than one kilogram, and offers Internet access via Wi-Fi. To help make the Xpress more rugged, it has an eight-gigabyte flash memory drive (rather than a hard drive with moving parts that could break if the device is dropped) and a magnesium outer case.
Different needs, different devices
Makers of assistive communication devices, in order to be responsive to the range of abilities among potential users, provide different devices that cover a range of patient capabilities, Shea says, adding, "A person who is nonverbal would see a licensed speech and language pathologist who would make determination which technology is a fit for them."
"We first look at whether someone is at a disadvantage because they can't communicate effectively," says John Costello, a speech language pathologist at Children's Hospital Boston and director of the hospital's Augmentative Communication Program. A doctor will then consider the person's motor capabilities, hearing, vision, education and social environment, along with their desire to communicate, and attempt to match these with available technology. The technology is advancing at such a pace, he adds, "that even next year we'll look back…and say, 'I can't believe they didn't have that feature.'"
Costello, who has been given a demo of the Xpress, says DynaVox appears to have succeeded in making "something that looks cool and incorporates as many features as possible in one device." Although he wants more time to fully evaluate the Xpress, Costello says the new device might be appropriate for patients (like Birch) who have difficulty speaking but are ambulatory and like to move around. Other patients, particularly those just starting therapy, however, don't need a device as sophisticated as the Xpress. "They don't need the Ferrari yet, they need to learn how to drive first," he adds. "This is not an entry-level tool for a person who's not used to using technology."
Some of the more commonly used augmentative communication devices made by DynaVox, Prentke Romich Co. in Wooster, Ohio, Words+, Inc., in Lancaster, Calif., and others are essentially Windows XP computers with a variety of input interfaces, including touch screens, keypads or eye scanners. There are at least dozen other companies that make a variety of augmentative communication devices.
Learning to live with a synthesized voice
Birch has been using digital speech devices since 2006, when his speech therapist, Lucinda Diggs, introduced him to DynaVox. Birch became so adept at using DynaVox's devices that the company asked him to test its Windows XP–based V before it was introduced in January 2007.