CA Dept. of Education


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Assistive Technology/AAC Archive 2010


Betsy A. Caporale, M.S. CCC-SLP-.
Speech-Language Pathologist
AAC/AT Specialist

Betsy has been working in the field of speech-language pathology for over 18 years, specializing in autism, augmentative communication and assistive technology. She has worked in a variety of settings, including public schools, private clinics, and hospitals. She received her certification as an Assistive Technology Specialist, Communication Services, from the University of South Florida, and earned a Certificate of Competency in Communication Assistive Technology Applications from the National Association of State Directors of Special Education.

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  • What can you suggest for educational interventions and assistive technology resources for a child with a rare congenital diagnosis?



My son is 6 years old and is in first grade, has Macrocephaly-Capillary Malformation Syndrome (M-CM) used to be called Macrocephaly-Cutis Marmorata Telangiectatica Congenita (M-CMTC) and he has hydrocephalus with a VP shunt and has had decompression surgery for Chiari I malformation and has had multiple shunt revisions. Anyway he has fine and gross motor delay and is treated at the CCS MTU here for ataxia although he is able to walk independently but has some balance issues with steps and some lower quadrant vision issues with depth perception and uses peripheral vision for many tasks. He is highly distractible and requires redirecting often. He was evaluated in April 2009 by our county AT person and she recommended a trial of the Intellikeys keyboard and software. We just got the Intellikeys this month but the school staff does not know how to use the software, the district does not pay for the AT person to do trial and training (too expensive) and one vision therapist from the district knows how to use it but they are too busy covering the whole county. My son does see one of the vision therapists 2 times per month. He also receives OT, speech, APE in school. He is in a general ed class most of the day with a one on one aide. Up to this point most of his academic work is done with hand over hand writing with the aide. I think the special ed staff is a bit perplexed as to the right types of educational interventions and assistive technology to use with him and since this is such a rare diagnosis there is not a lot of information on techniques and potential learning success. Any information or suggestions you may have would be appreciated. 




Thank you for writing and sharing about your son. I am unfamiliar with the exact nature and characteristics of your son’s syndrome, but will do my best to advise you regarding assistive technology tools and strategies, based on the information you have provided. First of all, I want to stress the importance of an AT (Assistive Technology) assessment being a comprehensive, collaborative and ongoing process, involving your son’s teacher, service providers, and of course you, the parent. I understand this is often difficult given everyone’s busy schedules, but it can be done with careful planning and organization.   Here are some suggested next steps for you to share with your son’s IEP team:

  • Staff should make time to read the training manual that accompanies the adapted software, and/or investigate on-line training opportunities.   A training class might not be necessary.
  • Try to enlist a “tech-savvy” teacher or staff member to help with installation and programming of the software.
  • Contact the vision specialist to see if he or she would be willing to utilize therapy time to provide “Intellikeys” training to staff.
  • Use a “roles and responsibilities “ chart to designate who will be doing what in terms of training, programming and maintaining the AT equipment. I like the one designed by the Bridge School. You can download a copy from their website:
  • Develop an Implementation Plan that clearly defines how, when, and where the technology will be used , and who will be facilitating its use for specific activities (i.e., identifying colors, matching shapes, labeling pictures). Your son’s service providers  (speech therapist, occupational therapist, vision specialist) should be able to incorporate the use of the technology into their therapy sessions. The classroom teacher and aide can use it for individual instruction.

An adapted keyboard, such as Intellikeys, is often a good solution for students with fine motor issues , like your son.   When implemented appropriately, adapted hardware and software can be valuable learning tools that help students access the curriculum while increasing independence. As your son’s computer skills develop, he will be less reliant on an aide for academic tasks.   Once he is able to do more for himself, you may find that he is more focused and less distractible. You should also see a boost in his confidence and self-esteem!   

I hope these recommendations are helpful. Please keep me posted as to your son’s progress with assistive technology!


  • Can you give me names of some good assessment tools for AAC as well as information about the iPod Touch and iPad?



I am a Speech-Language Pathologist specializing in AAC. I was wondering if you could give me the names of some good assessment tools for AAC. Also, our district recently acquired funding to purchase iPod Touches to use as AAC devices. Can you provide me with information regarding AAC applications for the iPod Touch and iPad.


Greta Tan, M.A., CCC-SLP
Speech Language Pathologist
Cupertino Unified School District


Hi Greta,

In answer to your question about AAC assessment tools, I first want to stress that an AAC assessment is an ongoing, collaborative consideration process which involves the entire IEP team, family members, and most importantly, the student. The assessment process should always begin with a review of reports, records and previous assessments, followed by interviews with family and school staff, and observations of the student in a variety of settings.   A helpful tool for gathering this information is the Wisconsin Assistive Technology Initiative (WATI)  Assessment. It can be downloaded for free from their website:    You can use this tool to create a “feature match” which will help determine appropriate technology solutions  for a particular student. Below is a list of other AAC assessment tools you may find helpful:

  • Augmentative & Alternative Communication Profile (Tracy M. Kovach, Ph.D.)
  • Functional Communication Profile (Larry I. Kleiman)
  • Interactive Checklist for Augmentative Communication (Susan Oakander Bolton and Sallie E. Dashiel)
  • Social Networks Communication Inventory (Sarah Blackstone, Ph.D. and Mary Hunt Berg, Ph.D.)
  • Test of Aided Symbol Performance (Mayer-Johnson)


Regarding the iPod Touch and iPad , here is a list of  AAC apps with which I am familiar:

  • Assistive Chat
  • AutoVerbal
  • iCommunicate
  • iConverse
  • Look2Learn
  • MyTalk
  • NeoSpeech
  • Proloquo2Go
  • SpeakIt
  • TaptoTalk

All of these apps are available at the iTunes Store.  The price point and features of these apps vary significantly.   At the most basic level, there’s NeoSpeech, which is a free app offering text to speech using either a male or female voice (both are very realistic sounding). At the other end of the spectrum is Proloquo2Go,  a robust dynamic screen application with an extensive vocabulary and a wide range of customizable features. It runs $189.99. I would highly recommend visiting their websites to determine which apps may be appropriate for the students with whom you work.  You may also want to visit the ScribD website (  for a comprehensive,  up-to-date list of  other special education and communication apps.

I hope this information is helpful.   Once you have the iPods and apps, I would love to hear how you are implementing them with your students.    Please keep me posted!


  • Will there be a way for a text-to-speech software to sound more natural?


Dear Ms. Betsy Caporale:

One of the limitations to text-to-speech literacy software is having to hear artificial speech. Will there be a way for a text-to-speech literacy software (e.g., WYNN, Kurzweil) to recognize a user's voice and be trained to mimic his or her voice, so that the speech sounds more natural? Please let me know at your earliest convenience.


Maria Pham
Psychology, B.A.
University of California, Berkeley


I agree with you about the artificial speech which is inherent to most text-to-speech software.   The robotic nature of the voices makes it very unpleasant to listen to!  The good news is that the technology is improving rapidly, and there are now many realistic voices available to choose from in text to speech software. The software you mentioned, Kurzweil 3000 and Wynn, are both document reader programs, but if you are looking just for text- to- speech software (TTS), you have quite a few options.  Windows Vista has TTS available in its Ease of Access Center.   You can find out about other TTS applications by doing a web search of “text to speech software”.    Many of these are free downloads. Most commercially sold programs offer free trials so you can compare features and voice quality before you purchase.

I think you might also be interested in learning about the innovative work being done at CereProc (, a company based in Edinburgh, Scotland which creates text-to-speech solutions for any type of application.   One of their recent projects involved the creation of a synthesized voice for film critic Roger Ebert, who lost his ability to speak after several surgeries for jaw cancer. Using audio recordings from his past TV shows, they were able to produce a proto-type of his voice that sounds very much like the speaking voice he once used. Pretty amazing! 

So, it seems the technology you’re inquiring about is already here, and my guess is it may not be long before it’s readily available to the average consumer!


  • Assistive technology at home.



If a student is using assistive technology for reading, writing and math to demonstrate his or her knowledge in the classroom, how does that transfer to homework assignments and parent inclusion, as an effort to close the gap between home and classroom support? I guess what I am asking is how does one make sure school and home are connected if your child's best way to perform is through technology?

Thanks for your help.




Thank you for writing and inquiring about this important issue. It’s always tricky determining how, when and where assistive technology (AT) will be used to help a student with special needs. With appropriate implementation, assistive technology allows students to access the curriculum, and perform curriculum related activities independently. It is important to remember, however; that AT is just one component of a student’s comprehensive educational program. Successful AT implementation requires a collaborative effort on the part the IEP team, and specific implementation strategies should be reflected in the IEP, based on an individual student’s unique needs and abilities.

In terms of using assistive technology for homework; if the IEP team determines that district-owned equipment is necessary in order for a student to complete homework, the school must allow the equipment to go home. [34 C.F.R. Sec. 300.308 and Part 300, App. A. Q. 36.] For example, if a student needs a computer and adapted software to complete written work, the IEP team might consider a lap top computer that can be transported easily between school and home. Or, if the student has a computer at home, the team might decide to purchase multiple licenses of the adapted software, and install it on the home computer. A flash drive can then be used to store and transport assignments.

Keep in mind that homework assignments should provide an opportunity to practice what a student has already learned in the classroom. Homework should never be used as a means of instruction to teach material with which the student is unfamiliar. If the student is unable to complete homework independently, or with minimal assistance, it should not be assigned. Guidelines regarding technology use and homework will need to be clearly defined by the IEP team, and ongoing communication between home and school will be crucial in assuring that appropriate homework is assigned.

I hope this helps answer your questions, Sherrell. Thank you again for writing!

  • When to impelement a device?


Dear Betsy,

I have two students who are currently using Proloquo2Go on an iPod Touch. I’m wondering how best to implement the device. Should they be using it the whole day? Or, can we begin using the SGD just in Morning Circle, for instance, and then implement it during other structured tasks over time, as we develop them? 

Anne in Martinez


Hi Anne,

Good questions about implementation!  You are smart to start slowly with the iPod, or any other aac device. I usually recommend that aac devices be used initially only during very structured tasks. For most students, there is a huge learning curve involved in using a device. Several skill sets must first be established including symbol recognition, discrimination, vocabulary knowledge, categorization, and page navigation. The student must also learn how to operate the device itself. Activating buttons and scrolling up and down on the iPod screen can be tricky for some students, especially those with fine motor issues.

Once you have established the skills sets of a student, you can begin to design appropriate pages on the aac device. For beginning users with limited skills, you will want to start with a very small field of icons (2, 4 or 6) on a static page (one that does not link to other pages). For more advanced students, you may be able to start with a dynamic screen home page that links to several other pages. Once the student is using the device independently in a very structured setting, you can slowly expand its use to additional, less structured settings. As skill sets are developed, you can increase the complexity of the page design. The important thing is to make an aac device as user-friendly as possible, and avoid frustration!

Keep in mind that a speech generating device is just one mode of communication. Augmentative communication users rely on a variety of strategies to ensure quick and efficient communication across all environments, including signs, gestures, and low-tech communication boards.


  • Can iPods help students focus?


What do the studies really show about ipods and that they 'help' students focus? I have asked this question to many teachers and no one seems to agree. Of course, the students say it helps them focus, but who is to say with some of the music they like to listen to! Would love to see some study or something concrete on this!




Hi Gwen,

Your inquiry about using iPods to help students focus is an interesting one. Actually, I see your question as being two-fold: “Does listening to music help students focus?”, and “Can an iPod be used to help students focus?”

If you are interested in knowing whether listening to music helps with attention and focusing, that question is best answered by a neurologist or neuroscientist. One study that addresses this topic, published in Science Daily, August 2007 reported that music “engages the areas of the brain involved with paying attention, making predictions and updating the event in memory”.

I am not familiar with any studies that specifically address using iPods to help students focus, but several iPod/iPhone applications are designed to help with attention and organization. Here are just a few:

  • VoiceNotes- a voice recording application that allows you to make recordings and play them back later. Students may find this useful for remembering homework assignments, due dates, directions given by teachers, lecture notes, etc.
  • Dobto Todos – this application allows you to create categories, and then add tasks within each category. It provides options to sort by “Due Date”, “Priority” or “Date of Creation”, and also includes a “Hide Finished Tasks” feature.
  • Audiobooks – allows audio access to thousands of books, with convenient options such as automatic bookmarking, and a sleep timer.
  • Stanza - allows you to read a wide variety of e- book formats from your iPhone or iPod Touch. Books can be stored and categorized using the built-in organizer.
  • NeoSpeech- high quality text to speech software (male and female voices), available in several languages.
  • iFlashcards- allows you to build databases of questions and create your own flashcards.

All of these applications are either free, or very inexpensive, and are available through the iTunes AppStore ( I highly recommend visiting this website and doing your own search of the hundreds of educational applications now available for the iPhone and iPod Touch.

I hope this information is helpful!


  • Can you recommend adapted software for touch screens?


Dear Betsy,

I am an SDC teacher with preschool-aged children who present with a variety of physical and cognitive challenges. An HP TouchSmart computer was recently purchased for my classroom, and I have been asked to put together a “wish-list” of software for my students to use with the new computer. Can you recommend adapted software that would be appropriate for a variety of cognitive levels (from basic cause/effect to pre-academic) and can be accessed via the touch screen? I would also need the software to be switch-adaptable, as a few of my students have physical limitations that prevent them from using the touch screen. Any advice you can give me would be greatly appreciated!


Outi from San Jose


Hi Outi,

I am so thrilled to hear that you have a computer with a touch screen monitor for your classroom; this will be an invaluable tool for your students!

The wonderful thing about a touch screen is that it allows complete navigation of a computer screen without the hassle of a mouse, making it extremely user-friendly for individuals with cognitive and physical challenges. You should be able to use any of the educational software you already own using the touch screen, however, you will want to double check that the software is compatible with the TouchSmart operating system (which I assume is Windows 7). You will also want to inquire about compatibility when purchasing new software for the TouchSmart.

I know you and your students will thoroughly enjoy using touch screen technology in the classroom. Please let me know how things are going once you have your library of new software up and running!


  • Dragon Naturally Speaking.



I have heard recent radio advertisements for Dragon Naturally Speaking, which apparently is speech recognition software that may benefit students with writing difficulties. It sounds like this might be a valuable tool for my son who frequently has trouble completing lengthy writing assignments. Is it difficult to install and use? Can it reliably transfer speech to text?




I’m glad you asked about this! Voice recognition software has been available for awhile now, but the technology is constantly changing and improving, and becoming more affordable. In fact, most computers have speech recognition built right into the operating system. It is important to realize, however, that there are two types of speech recognition software; one type allows you to command and control your computer, the other type (usually referred to as “dictation” software) lets you create written documents using your voice. If you are using Vista or Windows 7, you can find Speech Recognition (with dictation) in the Control Panel. Mac OS X users can find it in System Preferences. Currently, the Mac version only allows you to speak commands, not dictate.

You also have the option of purchasing voice recognition software, such as Dragon Naturally Speaking, which you mentioned. There are a few different versions with various options (visit for details about pricing and features). If you are a Vista or Windows 7 user, I would recommend trying the built-in program out first as it may be all you need. If you are a Mac user, you will want to look at MacSpeech Dictate ( All of these programs claim to have an accuracy rate of 97-99% in transferring speech to text.

Speech recognition software is not difficult to install, however, there is some training involved before the software can be used for dictation. Users must “teach” the computer to recognize their voice. During this process, the user needs to speak clearly into a microphone, with background noise being kept to a minimum. It’s also important to use a “natural” voice, and speak at a normal pace. This requires some patience, and can be challenging for young children, or anyone who has a speech disorder.

As a writing tool, speech recognition software is often a good option for students with learning disabilities, such as dyslexia or dysgraphia, or for students who have difficulty operating a mouse and keyboard. I hope your son can benefit from this wonderful technology!