1999 Conference Proceedings

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A Solution Bundle for Progressive Speech Loss

Marilyn Buzolich
Private Practice, San Francisco

Howard Shane
Children's Hospital, Boston

Brent Koeppel
Assistive Technology, Inc.

Iris Fishman
Communication Independence for the Neurologically Impaired

Marta Kazandjian
Communication Independence for the Neurologically Impaired

Short Description: This presentation will overview a multitasking strategy for persons experiencing progressive speech loss. Assistance in conversation, writing, telephony, Internet access, games and entertainment, and environmental control is offered using Companion (TM) as the organizer of additional software programs.


Persons with progressive speech loss (PSL,) such as found in persons with amyotrophic lateral sclerosis (ALS,) require computer technology in order to communicate and gain independence over their environment. Typically disparate programs are introduced to a person with progressive speech loss in an attempt to provide a functional - albeit non-integrated solution.

This presentation represents a collaborative effort between several manufacturers as well as organizations, service providers, and consumers who share a common interest in developing a solution bundle for persons with PSL.

This presentation will overview the results of this collaborative effort. It will describe a multitasking approach that brings together numerous software applications. The resulting strategy is a seamlessly linked set of programs serving several functions that maximize the independence of an individual with PSL (Progressive Speech Loss). Several popular commercial software applications were integrated into the overall approach. More specifically, the solution bundle enables the person with PLS to:

Companion (TM), a flexible authoring tool, served as a desktop organizer for these multiple applications.

Overview of Multitasking Components


Historical: Traditionally, a computer user starts up or launches a software application from what is known as a traditional desktop. There are computer conventions associated with a desktop and for the person who is computer literate this first step in computer usage is not a problem or at all confusing.

Current Application: The current multi-tasking solution uses the Companion software as a scene based metaphor to replace the traditional desktop strategy. The advantage of this approach for a person with PSL is the high likelihood such an individual may not be computer literate, initially confused by the desktop concept, but more readily be able to use a more intuitive desktop to launch a series of interdependent applications - all part of this multi-tasking approach.

Interactively Communicate

Historical: Historically, computer based communication technology for persons with PSL have focused on several strategies to make the communication process easier and more efficient (i.e., faster). These have included:

Current Application: This application suite features the integration of several commercial programs including Speaking Dynamically Pro (with custom displays); Co:Writer; and Write:Outloud. The specific program used would depend on the needs of the user including the rate enhancement features selected, whether a message is pre-formulated or generative, etc.


Historical: Programs for writing are generally are dedicated writing applications or popular word processors with rate enhancement or on-screen keyboard capability running in the background.

Current Application: this application uses both an internal, dedicated writing approach (e.g., Speaking Dynamically Pro) and a terminate and stay resident approach (e.g., Co:Writer).


Historical: Use of a telephone for a person with a motor disability requires assistance with 1. lifting the receiver off the cradle, 2. dialing (or pushing numbers on a key pad), and 3. connecting of a communication device to telephone or via speakerphone.

Current Application: The current approach allows choice of wired (direct connection of device) or speakerphone as a means of enabling independent (and private), ability to off-hook the telephone line, dial a telephone number or look up a stored "speed dial" number, maintain a telephone conversation (speaking with synthesized or recorded output from their device, and listening with a headset or to speakerphone), and then terminate the connection.

Internet Access

Historical: Not generally considered until recently; with the advent and availability of and popular use of the Internet, disabled users have found limited built-in accessibility of mainstream applications used to browse the World Wide Web (WWW) or send and receive e-mail.

Current Application: The current application integrates text created through the user's choice from their communication program (i.e., see above description of Speaking Dynamically Pro), or writing program (i.e., Write:Outloud), or on-screen keyboard, with a mainstream Internet application such as Internet Explorer or Netscape Navigator. This will allow the user to compose, send, and receive e-mail and to browse the Web.

Play Games and Entertain

Historical: In the past there have been limited choices for adult-oriented "games" (e.g. chess) and limited accessibility of these mainstream programs for persons with progressive motor loss.

Current Application: In the current strategy, choices and accessibility although still somewhat limited at present, are made at least somewhat accessible using keyboard commands via an on-screen keyboard, either through direct selection, use of a pointing device, or scanning.

Control their Environment

Historical: In the past, control of appliances in one's environment meant the use of a separate system. Furthermore, these systems were often tedious and cumbersome to use and required hard wiring (of both house and computer control system).Accordingly, these approaches limited accessibility of home automation and computer interfaces.

Current Application: Freestyle* offers mobile (wireless) computer control within one's home, while Companion offers an accessible computer interface and option of scene-based metaphoric representation of a home environment. Thus, as a way of example, the turning on of a room lamp is accomplished by selecting the lamp image displayed on the screen.


The final presentation will provide a demonstration of the multi-tasking capability of this solution bundle for persons with progressive speech loss. Also in the presentation, links to each of the sub-components (conversation, writing, games and entertainment, Internet access, and telephony) will be shown in an interrelated manner.

*Freestyle (TM) is a tablet computer based on the Macintosh Power PC. The Freestyle was designed as a tool for persons with disabilities. It offers considerable access options including multiple single switch ports, voice input control, alternative mice capability, and alternative keyboards.

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