Contextual Adaptive Communication Aid: Supporting Individuals with Neurological Disease in Communication
Lula Albar · 2020 · Proceedings of the 17th International Web for All Conference (W4A) · doi:10.1145/3371300.3383355
Summary
This doctoral consortium paper proposes a context-aware Augmentative and Alternative Communication (AAC) system designed to support people with communication impairments (CI) caused by neurological disease or acquired brain injury, such as aphasia and dysarthria. The research is motivated by the high abandonment rates of existing AAC devices — a survey of 275 people with CI found that 67% abandoned AAC because the vocabulary did not match their daily life needs, and 66% abandoned due to high maintenance and materials preparation. Current AAC systems like Cyrano Communicator and Lingraphica support only basic, predetermined communication through icons and images, failing to handle complex interactions like telling stories or participating in casual conversations. The author argues that AAC should go beyond pre-set interaction scenarios to support self-expression in unplanned, unfamiliar conversational settings by leveraging contextual information such as location, activity, and time. The paper reviews existing context-aware AAC systems (MyVoice, TalkAbout, and others) and identifies gaps: most use contextual cues linearly rather than combining multiple context domains, and many were not tested with actual CI users.
Key findings
The review of existing context-aware AAC systems revealed that few research projects address communication for people with acquired CI after stroke or brain injury, and those that exist use contextual information in limited ways — typically combining only location with activity, or location with time, rather than leveraging all available contextual signals. Only one identified system supported users in unplanned activities. Several existing prototypes were never evaluated with their target user population. The paper proposes a three-study research plan: (1) qualitative interviews and observations to understand how CI individuals communicate in familiar vs. unfamiliar environments using existing AAC, (2) a co-design study adapting user co-creation approaches for this target group to design contextual adaptive software, and (3) an iterative design and evaluation of the proposed communication aid using functionally-based applications. The methodology emphasizes working in collaboration with speech therapists and people with CI throughout the design process.
Relevance
This paper highlights a critical gap in AAC technology: most systems are designed for structured, predictable communication scenarios but fail in the spontaneous, unplanned interactions that constitute much of daily social life. The 67% abandonment rate due to vocabulary mismatch is a stark reminder that assistive technology must adapt to users' actual lives rather than imposing predetermined communication patterns. For accessibility practitioners, the emphasis on co-design with CI users and speech therapists offers a model for developing assistive technology that genuinely meets user needs. The context-aware approach — using location, activity, time, and conversation partner information to suggest relevant vocabulary and topics — represents a promising direction for making AAC more adaptive and less burdensome. As a doctoral consortium paper, this presents a research plan rather than completed findings.
Tags: AAC · communication impairment · aphasia · context-aware computing · co-design · neurological disease · speech therapy