Forum Proceedings

Market Needs | Current Technology | Needed Technology | Barriers to Achieving Needed Technology | References

The following is the raw data collected during the T²RERC's Stakeholder Forum. It reflects the comments and needs as expressed by the Forum participants.

1. Needs (Unmet needs of consumers, clinicians, etc.)

GENERAL

• Alternative input systems are needed for individuals who are severely involved and cannot efficiently use direct selection methods.
• Advanced input systems are needed for individuals who do not have a method of communication because physical, cognitive, and/or sensory deficits prevent use of current input interfaces (e.g. individual has no reliable way to access AAC device).
• Advanced input is needed for individuals with hand or wrist issues such as carpal tunnel syndrome or arthritis who cannot use traditional keyboard access methods.
• Input systems are needed that create the highest performance (i.e. rate) of human machine interface.
• Input system performance should not prevent a user from communicating efficiently.
• Improved input systems are needed for persons with a wide range of physical, sensory, and cognitive abilities (e.g. persons now using scanning vs. direct selection).
• When assessing selection of an input system it is important to take into account the difference between an individual's input rate for typing dictation vs. typing for composition (i.e. typing for composition is usually slower).
• Input capabilities need to be customizable to end users physical, cognitive, sensory, and speech abilities.
• Input systems should be self-calibrating for changing abilities throughout the day (i.e. fatigue, cognitive, or other human factors).
• Input systems selection should be based upon several factors including etiology of disability (i.e. congenital or acquired), use of device (i.e. for verbal communication or writing), environment of use (i.e. home, work, school), level of functioning (i.e. physical, cognitive, and sensory abilities), and/or access needs (i.e. AAC device, computer, phone).

GESTURE RECOGNITION

• Individuals who have severe speech impairments such as apraxia or dysarthria may benefit from gesture recognition as an input system.
• Gesture recognition systems are needed for individuals who have limited movement, and the system should be able to recognize even small discreet movements.
• Non-traditional AAC users, such as, tracheotomy patients would benefit from gesture recognition.
• Gesture recognition systems should be highly transparent so as to allow users to communicate with "natural" gestures.

BIOSIGNAL BASED

• Biosignal based systems are needed for individuals with extremely limited or no physical control (e.g. High Quadriplegics, ALS, TBI, MS, BSS, Locked in syndrome).
• Biosignal based systems could have a large market including individuals without disability (e.g. hand free computer control, gaming) to individuals with severe disabilities (e.g. control of AAC systems).

EYEGAZE

• Eye gaze systems are needed for people who lack the capacity to generate or communicate using voice or gesture (e.g. ALS, high level quads, TBI, MS, BSS, Locked in syndrome).
• Eye gaze systems could benefit young children even before they were able to use head pointing devices such as a head stick or wand.
• Eye gaze systems could assist in reading development, especially for children with dyslexia and Attention Deficit Hyperactivity Disorder (ADHD).
• People with significant cognitive disabilities could benefit from eye gaze technology as an input system because the system relies on a person's innate tendency to look at what they want.
• Eye gaze systems could benefit individuals who maintain the ability to control eye movement (i.e. stroke and autism).
• Eye gaze systems may not benefit individuals with poor eye control (i.e. CP, TBI).
• Pilots unable to complete complex motions because of reacting G-forces, could utilize eye gaze systems as an alternative input interface.

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2. State-of-the-Practice (current technology, strengths, weaknesses, etc.)

GENERAL (Current input systems include the following)

• Optical Head Pointer (e.g. used to establish mouse position on display)
• Direct access technology (e.g. touch screen on AAC system with dynamic display).
• Morse code with single switch
• Jouse (e.g. joystick mouse) [Note: Jouse is a rate proportional joystick that is controlled with your mouth. Moving the joystick moves the cursor. The further you move the joystick, the faster the cursor moves. Mouse button activations can be made with the sip, puff, and bite switches built into the JOUSE. Typing and other keyboard functions can be achieved through an on-screen keyboard such as WiViK or through Morse code.][1,2]
• Intraoral dental form (e.g. tongue touch keypad)
• Virtual Reality Technology [Note: Virtual Reality technology is currently found in a variety of areas, including gaming, animation, and web design. Software is available for areas such as automotive, aviation, defense, industrial, medical, visualization, etc. Hardware for virtual technology includes data gloves (i.e. Cyberglove [3], 5DT Data Glove [4]), virtual reality glasses (i.e. 3D-MAX [5], EyeFX VRS), etc.
• Voice Recognition [Note: Voice recognition is currently being used in a variety of industries, including automated phone answering services, automatic dialing on cell phones, TV remote control access via the voice, computer access including typing, and Internet Voice Portals, etc.
• Neural Implant [Note: Neural Implant includes a variety of technologies such as cochlear implants, neural prosthesis, implants for animals, etc.]
• Neural Implant [Note: Cochlear implants are hearing prosthesis designed to help severe to profoundly deaf individuals who gain little to no benefit from hearing aids. The cochlear implant system converts acoustic sound waves into weak electric currents, which are delivered to the immediate vicinity of the auditory nerve in the inner ear or cochlea. The auditory nerve is stimulated by these electric currents and transmits nerve impulses to the brain, where they are understood as acoustic sensations.][6]
• Neural Implant [Note: Neural implants in animals are currently being done. University at Washington is conducting research with the aim of developing the techniques and tools for intracellular recording in live, freely behaving animals. The goal is to develop surgically implantable silicon microchips that record from, and communicate with, nervous tissue in intact behaving animals, to develop neurophysiological preparations and techniques to implant and utilize computers in neuronal investigations, and to develop the physical interface between silicon and nervous tissue. ] [7]
• Neural Implant [Note: Neural prosthesis is being researched and developed to restore function in neurologically impaired individuals through functional neuromuscular stimulation. National Institute of Neurological Disorders and Stroke is developing an initiative to research a system for people afflicted with paraplegia that would allow them to independently rise and remain standing so that they can do activities that they cannot accomplish in a wheelchair. ][8]
• Two-dimensional controls (e.g. PC, Mouse, rate proportional joystick, isometric joystick).
• Force feedback joysticks and mice (i.e. used in gaming, personal computers, industrial design, aircraft flight control).

GESTURE RECOGNITION

• Gesture recognition can be defined as the recognition and interpretation of voluntary movements (i.e. head, shoulders, etc.) for the purpose of controlling and providing input to the AAC device.
• A gesture can be defined as any movement of the body whether idiosyncratic or iconic that is used to convey some sort of meaning to an interactant or input interface.
• Universal gestures are defined as gestures that can be understood by the general population, usually consisting of iconic representations of actions or ideas (e.g. a person pretending to lift a glass to there mouth meaning to drink).
• Idiosyncratic gestures are defined as gestures that represent an idea but are not transparent to the general population (e.g. a child may shake fist to indicate hunger, which only the mother understands).
• Gestures have also been used to create whole languages (i.e. American Indian Sign, ASL).
• Gesture recognition can employ universal or idiosyncratic gestures.
• Gestures are part of a natural form of communication, they are more likely to be socially accepted as a communication attempt, thereby increasing social interactions and enhancing the quality of communication. · Gestures are a part of the natural communication system (e.g. allows you to pay more attention to your communication partner through eye contact).
• Gesture recognition systems employ video cameras to record gestures. These gestures are interpreted through signal processing techniques.
• Gesture recognition systems require a lot of concentration and vigilance (the process of paying close and continuous attention).
• Gesture recognition systems are subject to environmental factors (e.g. movement, distance to video, head angle, involuntary reflexes, body posture).
• Gesture recognition systems involve no physical contact (e.g. the person is not tethered to the device eliminating possible skin breakdown with systems requiring continuous contact).
• Gesture recognition systems can increase potential for employment, by facilitating verbal communication.
• Gesture recognition systems could augment and improve current telecommunication systems (i.e. video conferencing, telephones).
• Gesture recognition systems can utilize (respond to) a variety of different gestures thereby eliminating repetitive motion injuries (i.e. carpal tunnel ) that sometimes accompany some input systems.
• Gesture recognition system performance can be affected by proximity (e.g. the distance of the user to the device).
• Gesture recognition systems require the user to remain still in order to record and translate more discrete movements.
• Video capture of gestures is dependent upon available lighting (i.e. environmental, ambient). · Gesture recognition systems can create privacy issues (e.g. people in the environment may be able to interpret gestures that are being used for input).
• Individuals may access the AAC system video field which might disrupt the device's ability to read the AAC users gestures. "Background gestures" may result in the wrong message being input.
• Gesture recognition systems need to distinguish between "input gestures" and continuous movement. · Gestures used as input to gesture recognition systems must be precise - a point of activation and a point of termination.
• Gesture recognition systems need to select and abstract gestures suitable for each individual. · Gesture recognition systems need to custom adapt to each individual.
• The gesture recognition system should have automatic/smart adaptation, which do not require assistance for customization.
• Artificial Intelligence research is incorporating gesture recognition in projects (i.e. MIT Media Lab) [Note: OPERA is technology that is being developed by the MIT Media Lab, which focuses on creating music. Systems have been developed for people of all abilities, ranging from professional composers to children. The user provides input to the system by touching sensors found in a variety of forms from balls to bowls. The system interprets the information and translates it into music.][9].
• Gaming technology is incorporating gesture recognition technology [Note: Immersion TouchSenseT used with Black & White game play supplements visual and audio feedback by providing tactile feedback through the mouse. This capability adds realism to the game experience while the player explores the virtual world and interacts with objects].[10]
• Handwriting recognition systems are closely related to gesture recognition systems.

BIOSIGNAL BASED

• Biosignal based technologies are currently used with AAC systems to provide single switch access.
• MCTOS technology uses biosignals to access AAC devices using a switch system that is activated by biosignals. [Note: Mind Controlled Tool Operating System is a switch that is controlled by bioelectrical impulses measured at the forehead. These include: brainwaves, electrical impulses from eye movement and muscle activity.][11]
• Biosignal based technologies are currently used in myoelectric prosthetics and EMG testing for heart problems.
• Biosignal based technologies utilize Electroencephalogram (EEG), Electrooculogram (EOG), and Electromyogram (EMG) signals.
• Perspiration can affect biosignal system reliability (e.g. sensor sensitivity is affected by skin conditions). · Biosignal-based technologies can respond to a signal within 10 milliseconds. This is much faster than an individual can volitionally move their hand, thereby saving 100-150 milliseconds (the time it takes for volitional muscle movement to be produced by the brain). · Biosignal controlled synthesizers could benefit musicians and composers.
• Game developers could incorporate biosignals as a way of controlling gaming systems (e.g. creating games that require concentration such as Jedi Mind tricks).
• Emotions produce non-communicative biosignals that may decrease the reliability of biosignal-based technologies (i.e. interface, false inputs, etc.).
• Biosignal based systems may not require direct contact with the body (e.g. wires, headband, worn sensors). However, use of remote sensing makes the device more susceptible to external interference.
• Future biosignal based systems may support multi-tasking (allowing other activities to occur simultaneously). · Biosignals could provide multi-channel input. Separate channels could provide signal redundancy, help reduce noise, make a biosignal interface more applicable for users with differing needs, and make access more reliable.
• Biosignal based systems may be difficult to control by people lacking a high level of control over volitional movement due to degeneration, tremoring, or involuntary spasticity.
• Depending upon sensor placement, persons with some disabilities (i.e. MS) may be unable to reliably generate some biosignals (e.g. EMG for voluntary muscle).
• Lack of voluntary muscle control (e.g. ALS, MS) may be an advantage for some biosignal systems (e.g. EOG, EEG based) because it reduces interference.
• Biosignal-based access currently requires certain skills such as attention, cognition, and muscle control. · Improved signal processing algorithms are needed for biosignal-based systems.
• Algorithms currently to reduce noise also throw out a large part of the signal that could be used to provide additional information.
• Algorithm processing for biosignals is dependent on the computational capabilities and memory of the AAC device. Signal extraction currently takes a lot of processing time.
• Individuals using biosignal-based technologies currently must be tethered to the device (e.g. a sensor array commonly in a headband and wires).
• Continuous body contact of the sensors can cause skin breakdown, discomfort, sores, and/or a rash.
• Biosignal-based systems have the ability to interpret multiple input signals (i.e. EEG, EOG, EMG).
• Biosignal-based systems may not be dependent on voluntary muscle control.
• Biosignal based systems based on sensing voluntary muscle movement may be movement dependent.
• Uncontrolled muscle movement can interfere with the biosignal-based system (e.g. CP tremors, spasticity).
• Biosignal based technologies could be used in diverse environments (i.e. inside, outside, work, school, day/night, etc.) and would not be restricted due to lighting issues.
• The performance, reliability, and precision of a biosignal-based system may not be as good as an eye gaze system.
• Biosignal based systems may invade privacy. Person may not be able to stop input to the system. Ideas may be conveyed by the AAC device without the users intent.
• Biosignal based systems may misinterpret signals from the user and incorrectly access the AAC device.
• Biosignal system sensitivity can be increased and customized to each user to improve overall reliability. Increasing sensitivity might also increase the likelihood of misinterpreting signals.
• Biosignal systems currently cannot prevent or halt signal transmission. The user is always providing input to the device even when they don't intend to.
• EMG based biosignal systems don't have the ability to distinguish between purposeful/intentional or non-intentional movement.
• The military is currently working in the field of Biosignal based technology

EYEGAZE

• Infrared sensors used in some eye gaze systems can be affected by the infrared component of ambient lighting (i.e. sunlight).
• Eye gaze systems can benefit a range of individuals from non disabled to severely disabled.
• Some eye gaze systems are not affected by fluorescent lighting and can therefore be used in the workplace or at home.
• Eye gaze systems are compatible with other electronic devices (e.g. do not produce RF interference).
• Eye gaze systems can be used to control a wide array of devices (i.e. AAC device, PC, environmental controls).
• Eye gaze systems have been used to type at 20 words a minute using single selection.
• Individuals using eye gaze systems are positioned 2-4 feet from the display.
• Eye gaze system can be customized and calibrated to suit individual's posture and/or orientation. Positioning is limited in that the person must be "in front of" the display.
• Users of eye gaze systems need to stay within the parameters of customization (for position and orientation) for optimal use.
• Eye gaze systems can be calibrated so that eyeglasses do not interfere with the IR beam.
• Eye gaze systems generally cannot be calibrated for use with contact lenses (contacts interfere with the infrared beam).
• Mascara and long eyelashes can interfere with the infrared beam, thereby decreasing system reliability.
• May be able to utilize eye gaze system to control (speed, direction) power wheelchairs. [Note: It would not be practical to try to compose messages on AAC devices while maneuvering a wheelchair].
• Eye gaze system size and cost is expected to decrease in the future, making them more affordable and accessible to potential users.
• Many persons with CP cannot use eye gaze systems due to postural and movement difficulties, which make eye movement an inconsistent and uncontrolled movement. In addition, persons with CP may not be able to stay within positional parameters because of involuntary spasms.
• Eye gaze systems require a high degree of concentration and can be fatiguing to use, especially when first training to use the system.
• Eye gaze systems can be used to track a person's tendencies to look at certain areas of a web page and determine what draws the users attention the most. (For example, if the right upper corner of the page has an advertisement located there, does the user look at the advertisement or do they avoid looking at it? Some approaches may be used to track vocabulary hits on AAC devices.)
• Eye blinks and/or head nods are tracked in automobile applications to detect if the person is drowsy and provide alarm.
• Many persons who would benefit from an eye gaze system cannot use it because of fatigue and concentration required.
• Aesthetics may be a concern for eye gaze systems that employ sensors and wires around the eye. · Currently eye gaze systems are very expensive (cost is $15-17,000).
• Eye gaze systems require a high level of vigilance, which may preclude looking at the communication partner.
• As displays become more complex (small targets, or icons) it is more difficult to select any given target.
• Smooth continuous control of eye gaze systems is initially difficult but improves with practice.
• Eye gaze systems are currently employed with individuals having severe disabilities. Other input methods such as direct input have failed for these individuals.
• Eye gaze systems can augment single switch scanning by adding a few more channels (e.g. find, select, highlight item).
• Eye gaze technology originated in military applications.
• The Campus School/Eagle Eye project at Boston College develops computer access technology for people who are non-verbal with limited voluntary muscle control; and children with multiple disabilities. Two technologies developed under this project are the Camera Mouse and Eagle Eyes. The Camera Mouse allows a person to control the computer with slight movements of the head or thumb or toe. Eagle Eyes allows a person to control the computer through electrodes by moving his or her eyes. [12]

SPEECH RECOGNITION

• Speech recognition systems are already incorporated into many products and applications (e.g. ViaVoice for Macintosh [13], Speech Works 6.5 [14] for telephony use).
• Speech recognition systems are most applicable for individuals with high-level spinal cord injuries whose speech quality (i.e. able to produce consistent speech sound) is not affected but who may have problems with loudness.
• Persons with apraxia (motor speech disorder associated with inconsistent speech production caused by neural misfiring in the speech processing centers of the brain) may not be able to use speech recognition because of inconsistencies in their speech.
• Speech recognition systems have a narrow tolerance for speech pattern variability. This limits the applicability and performance of speech recognition systems.
• Background noise can reduce speech recognition reliability and increase recognition errors.
• Speech recognition technology currently being used won't allow for editing (e.g. once the device records your speech you can't go back and make changes).
• May not be applicable in certain environments and settings (i.e. work and school) because of the noise level (i.e. student couldn't silently compose work causing a distraction for other students).
• Comprehensibility (overall understanding of a message) versus intelligibility (understanding of the speech sounds) is an issue when discussing dysarthric speech recognition. A human interlocutor uses a variety of methods to understand or comprehend a speaker's message (i.e. context, body language), whereas a speech recognition system functions only on the intelligibility of the message (records sound patterns, and speech sounds). Therefore speech recognition systems cannot interpret speech as well as humans.
• Provides good access for people who have perfect speech (articulation).
• Speech recognition systems are transparent in that they are easy to learn, are natural to the individual, and are widely accepted by society.
• Systems are relatively inexpensive.
• For a non-disabled individual with regular speech and volume, speech recognition systems are easy to set up and use.

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3. Needed Technology (refinements, innovations, etc.)

• Need communication to be sustainable for at least 30 minutes without the person fatiguing.
• Need AAC systems to increase time until user fatigue sets in (e.g. double time to fatigue at some predefined communication rate).
• Need to significantly improve the selection rate (Communication rate is dependent upon selection rate. All other things being equal, doubling selection rate also doubles communication rate).
• Interlocutor's ability to follow communication diminishes at very high and very low communication rates.
• Some AAC users will output word by word in order to not be interrupted, and then complete the phrase at the end.
• The ideal AAC product should be able to use different input systems (i.e. gesture recognition, switch, head pointer, infrared, etc.) at different times during the day depending on the needs of the user (i.e. fatigue, environment, time of day factors).
• An individual using AAC should not be dedicated to one device (i.e. AAC device, PC, cell phone) at a time.
• Need AAC systems to support multiple input channels (e.g. two multilevel switches one for the right hand, one for the left).
• Combining input modalities can increase selection rate for the AAC device (e.g. if you use one channel for scanning and one for switch).
• Need redundant input modalities that allow a user to maintain communication across environments and activities (e.g. if you were using voice input and you went into a loud room you could switch to direct selection).
• Multi channel systems should reduce the need for calibration over time especially for disorders that are progressive in nature such as MS or ALS (i.e. as person's abilities change over time they can migrate to other input modalities, or adapt the amount of time spent with each modality).
• Multiple-channel input systems could benefit individual's who have improving skills. The amount of time spent with one input modality or another will vary as their skills improve. When a person completely outgrows an input device they should not need to be refit for another input device.
• Smart interface for AAC devices should automatically recognize the input system (e.g. head pointer, eye gaze, single switch, etc.).
• Input systems should produce the necessary controls and signals without calibration or modifications to the AAC system (i.e. should not have to install or customize software, shouldn't have to tell the device which input system is being used).
• Input system should be wireless (i.e. no physical tethering between input device and AAC system).
• Input system should be portable.
• Input system should have no positioning requirements (i.e. no line of sight, head to be maintained in a certain position or orientation, use in any position when ambulatory).
• The input system should not be in continuous contact with the body (i.e. head wands). · Input system should change as the user's abilities change.
• Input system should be robust and accommodate a large range of user abilities (e.g. degenerative diseases or fatigue variance).
• Input systems should be used compatibly with other systems (i.e. cellphone, ECU, PC) through wireless means.
• Input systems (i.e. Infrared headpointer, gesture recognition, eye gaze, etc.) should be able to be set-up, taken-down, and/or calibrated to other electronic devices (i.e. cellphone, PC) without the intervention of a third party.
• Each input system should be independent of other input systems. If one input system goes down, it should be easy to switch over or substitute another input system.
• Input devices should support multi-level switch access. (e.g. data glove with finger and thumb switch to access five levels).
• Multiple input channels, with multilevel input devices would support rapid 2-dimensional access (e.g. two finger presses to access an item in a five by five grid).
• Depending on the person's abilities you could support different numbers of channels for each input system (i.e. Data glove with 5 channels and voice input with 8 channels can matrix to a display of 40 items. With two inputs you could select one item out of 40 using the glove as access for the rows and the voice input as access for the columns).
• Direct selection could be one input channel that can be used in combination with other input channels or an alternative input channel.
• Input system should take advantage of the person's residual physical abilities.
• AAC systems should have a universal interface that is both multi-channel and multi-modal.
• User should access personal computers through their AAC system (AAC system capabilities for communication, composition, and control are adapted to the user).
• AAC system should have a reliable wireless link to the PC system.
• User should be able to independently access (connect, disconnect) and control (on/off, run software) a PC through their AAC system.
• Input systems should communicate wirelessly with the "HUB".
• The "HUB" should serve as a universal input interface.
• The "HUB" should interface with an AAC system through the USB port.
• Input systems (ideally) should have their own power supply.
• Input systems powered from the HUB are less ideal.
• When AAC system is used on power wheelchairs, should be able to power it off the power wheelchair battery using USB protocol.
• When AAC system is used on power chair, wheelchair battery may be used to power the HUB.
• Input devices should have their own power source (especially if they draw a lot of power).
• Systems that don't have their own power supply should be powered through the HUB (generally can't power input devices through the HUB if they have a wireless connection).
• Input devices (or HUB) should have automatic power saver capability (i.e. save power when input device not in use).
• Multi-modal systems should turn off one input device when another is being used or activated to help prevent power/battery drainage. This applies to both wired and wireless systems.
• The HUB should be compatible with a broad range of input systems (i.e. eye gaze, biosignal based, voice recognition, keyboard (VT), and gesture recognition technologies.)
• The HUB should increase the effective selection rate (e.g. if the HUB supports multichannel/multi-input systems two-dimensional item selection is possible rather than standard scanning).
• The HUB should recognize the input devices and how to interpret the signals produced by these devices without external calibration.

The HUB should translate input signals into the language recognized by the AAC system, without external calibration.

• The HUB and input devices should adapt to the abilities of any user without external calibration (e.g. as user tires, selection dwell time might increase).
• The HUB should accommodate simultaneous input channels (i.e. gesture recognition input signals, virtual reality control glove, and a camera).
• A gesture recognition system should be able to interpret American Sign Language (ASL).
• The input system should be able to operate continuously for eight hours on its own power supply.
• The input system (HUB and input devices with a particular AAC device) should require minimal attention demands for the user.
• Input system (HUB and input devices) should provide the user with a real time communication rate.

AAC systems should have setup capabilities (installation or use of new input devices through the HUB) that are easily understood by both the user and the clinician.

• The installation and use of the HUB and input devices should require little training for both the consumer and the clinician.
• Input devices powered through the HUB should be reliable.
• User should control transfer between input modality (e.g. select input system when entering different environments).
• The input system should reduce fatigue.
• The input system should not cause the user any pain or discomfort.
• The use of the input devices through the HUB for AAC system access should be transparent (user should be able to access the input systems unconsciously).
• Virtual glove technology (perhaps a simplified version, hand or foot model) might be a good candidate input system.
• Biosignal-based sensors might be a good candidate input system.
• The HUB should communicate with each input device with a standard protocol (e.g. Bluetooth).
• Participants reported that input technology would be advanced enough in the next 5-7 years to provide the user with real time communication abilities.
• Consumers sometimes prefer to use their own voice rather than an AAC device because they can achieve a higher communication rate. They use the device as a backup (e.g. if they have a soft voice in loud environments).
• When developing needed technology it is important to differentiate between what measure of communication rate is being used: words/min, person's ability to follow and participate in dialogue, etc.
• Communication rate might better be measured as the rate at which ideas are exchanged.
• Communication rate is dependent on selection rate and the language processing abilities of the device (e.g. 2 selections produce a phrase which gives you a high communication rate, selecting 2 letters on the other hand would give you a slow communication rate.)
• Non-disabled persons compose at about 20 words per minute. This may be the (typical) upper band for composition rate for disabled individuals using an AAC device.
• Using current technology, high-end AAC users compose at 25 words per minute (using such things as word prediction, phrase storage, and semantic compaction).

4. Barriers (to obtaining technology, to developing technology, etc.)

• Input devices (i.e. eye gaze, dysarthric speech recognition, biosignal-based infrared headpointers, etc.) are still being perfected and are not able to function without error.
• Running multiple input devices through multiple channels may create some operating issues and logistical problems (e.g. may be too much processing for a system to handle efficiently without errors or significant time expenditures).
• Current input devices (i.e. gesture recognition systems, eye gaze systems, etc.) are not compatible with systems such as AAC devices and PC's. Standards need to be created so that any input device can work with any computer, phone, or AAC system.
• Complex programming of input devices being filtered through a HUB can cause increased processing time and/or the inability to have systems function together.
• System complexity may increase the likelihood of system breakdowns.
• System complexity may increase difficulty (and cost) to repair device (e.g. due to the various technologies merged into one device). Separate professionals might be required to fix individual input systems.
• Device complexity creates barriers that need to be simplified in order to improve performance, durability, and cost.
• High error rate for selection and control will prevent the input system from being accepted.
• The level of sophistication of the pattern recognition system is a barrier that covers several different systems (e.g. voice recognition, gesture recognition, biosignal).
• A major barrier in input system development is the cost of the research.
• There are relatively few AAC manufacturers. This creates a barrier for technology transfer (i.e. who do you transfer to?).
• Market size is not large enough to create drastic and immediate change in the field of AAC.
• There is little public and national recognition of the need for AAC research. Without this recognition, public funding is not readily available for this research (i.e. people are often unfamiliar with the technology, and the number of people who use it).
• The AAC industry has evolved incrementally rather than adopting radical new ideas and taking great leaps forward.

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References

1. Prentke Romich Company. "Jouseä". (2001) [Online: http://www.prentrom.com/access/jouse.html]
2. Bloorview MacMillan Centre. "Welcome to WiViK" (2001). [Online: http://www.wivik.com/html/home.htm]
3. Immersion "Cyberglove" (2001). [Online: http://www.immersion.com/products/3d/interaction/cyberglove.shtml]
4. Fifth Dimension Technologies "5DT data glove" (2001). [Online: http://www.5dt.com/products/pdataglove5.html]
5. Discreet "3DS Max" (2001). [Online: http://www.discreet.com/products/]
6. National Institute of Health (NIH). "Cochlear Implants in Adults and Children". (2001). [Online: http://text.nlm.nih.gov/nih/cdc/www/100txt.html]
7. Denton, Denise; Diorio, Chris, and Willows, Dennis (1999). "MEMS Probe Tips for Intracellular Neuronal Recording". [Online:http://www.ee.washington.edu/research/mems/Projects/NeuralProbe/]
8. National Intstitute of Neurological Disorders and Stroke. (2001). [Online: http://www.ninds.nih.gov/]
9. MIT Media Lab "OPERA" (2001). [Online: http://brainop.media.mit.edu/project-overview.html]
10. Immersion "Touchsense" (2001). [Online: http://www.immersion.com/products/ce/overview.shtml]
11. Technos America, LTD LLC. "MCTOS Mind Controlled Switch". (2001). [Online: http://www.mctos.com/htm/mctos.htm]
12. Boston College. "Eagle Eyes Project". (2001). [Online: http://www.cs.bc.edu/~eagleeye/]
13. IBM "ViaVoice" (2001). [Online: http://www-4.ibm.com/software/speech/mac/newmac/]
14. Speech Works "Speech Recognition" (2001). [Online: http://www.speechworks.com/products/speechrec/speechworks65se.cfm]

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