People who use iPads for augmentative and alternative communication often know that it is possible to hook up switches to the iPad. This way, it can be used by someone with complex physical needs. This can be done either by pairing the iPad to the switch via a Bluetooth interface , or with a wired interface. Switches can be added, allowing for different types of scanning (single switch auto scan, two switches to move forward and select, etc..). One positive about Bluetooth interface use is that the switch doesn’t have to be right next to the iPad. This can allow for it to be mounted on a headrest, or by an elbow. We want that switch placed where the individual user has the most reliable (and least fatigue-generating) point of access.
A minus can be when you have to “re-pair” the interface and the iPad because the Bluetooth connection has dropped off. I once thought I had correctly paired someone’s iPad, only to hear their voice coming out of a Bluetooth speaker across the room!
External switches can be a great option. However, some may not be aware that it is actually possible to use the iPad screen itself as a switch. I once met a young woman who used the screen of her iPhone as a switch to send text messages to her friends. She did not have the fine motor control to use the keyboard, but was a very proficient communicator.
How does this work? First, we have to go into settings on the iPad.
General → Accessibility → Switch Control → Switches → Full Screen
Tap the Full Screen option to make sure the function is set as “Select Item”. I have my Scanning Style set to Auto Scanning. I also made sure that I had toggled on switch control on in my Accessibility Shortcuts (at the bottom of the first screen of Accessibility options).
Once my Settings are configured, I open the app I want to use. I then triple click the home button to activate switch control. At this point, one tap, anywhere on the screen, will activate the scanning pattern.
I have tried this with TouchChat HD with WordPower, Speak For Yourself (SFY), and Proloquo2Go, and using the screen as a switch has worked with all three. With Proloquo2Go, I gave this a try with the iPad settings, not the built in scanning settings within the app.
What does this look like in the different apps? In all three, the scanning pattern activated lots of the ‘little’ buttons that provide options other than selecting words to speak. This can slow down the process to some extent. In TouchChat and SFY, the scanning pattern operates as row column scanning. When you reach the row you want, you tap the screen. The scanning pattern then highlights individual icons. You tap twice the activate the word you are trying to say. In Proloquo2Go, the scan first highlights the entire field of icons. Once you select this, it then highlights the individual rows.
Will this work for everyone? Of course not. It still requires the ability to use some part of the body to tap the screen. Depending on your scanning rate, this tap may have to be pretty rapid. Choosing a scanning speed is a delicate balance between speed and accuracy. If the scanning rate is fast, you need to be able to respond rapidly to accurately select the word you want. If the rate is slow, you may be more accurate, but communication will be slower.
Another consideration: Can you position the individual so that they can both see and access the screen? Don’t forget, you can use a capacitive stylus or a head pointer. Without good visual access to the icons, however, you might need to use auditory scanning. This feature is not available in all apps. Auditory scanning functions so that a voice speaks each word as you scan through the individual rows. The word is then spoken (again) when it is selected. You can then go to the message window to speak your entire utterance. Within the apps Proloquo2Go and Go Talk Now, you can configure “in app” settings to choose a scanning pattern and to set up auditory scanning.
So, who will this work for? As with every AT decision, you need to match the features of the device/app with the needs of that individual.
I can imagine using the screen as a switch might be a good match for some individuals with spinal cord injuries, or cerebral palsy. Perhaps for someone with a degenerative disorder that has robbed them of their voice, but not all of their movement.
Of course, using the full screen to scan can be used to access other apps as well, not just AAC. If you are a Pennsylvania resident, you can borrow an iPad from PIAT’s AT Lending Library: https://disabilities.temple.edu/programs/assistive/atlend/
Try out the Switch Control settings on the iPad. See how this works with different apps and let us know what you think!