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To Be or Not to Be Dedicated

By: Rachel Moore, M.S., CCC-SLP
“Why should I spend thousands of dollars on a dedicated speech device or exhaust my funding source on this option when I can buy an iPad and download a communication app much cheaper?”

I often have families and caregivers come to me with this question. While this is a very valid point and tablet-based applications (TBAs) may be appropriate for some individuals, there are factors that deem dedicated speech-generating devices (SGDs) or augmentative communication devices (ACDs) more suitable in many cases. Let’s take a look:

1. Funding Sources

Medicaid/Medicare and private insurance do not typically cover the cost of iTechnology or applications. Durable Medical Equipment (DME) vendors generally have their own funding department that assists with the submission and processing of funding information to obtain recommended equipment at little or no cost to beneficiaries.

2. Warranties

In general, most DME vendors include a 1-5 year warranty that protects equipment from product defects occurring from normal or intended use and sensible repair options should a problem occur. Some companies even provide free loaner equipment for use while devices are being repaired. Warranties can come in handy should a device malfunction or break prior to the expiration of insurance/funding replacement windows (e.g. Medicaid will generally only fund one ACD every five years. Some companies’ warranty plans protect the equipment for the extent of this timeframe.)

3. Support

Technical support almost always comes as part of the package for dedicated communication devices. Most DME vendors offer tech support via telephone, live online chat, email and consultant visits for the entire team (i.e. parents, teachers, caregivers, therapists). Consultants can offer training on device set-up, programming and implementation. Support for TBAs is generally limited to online avenues such as video tutorials, email, paid trainings, social media groups, etc.

4. Accessories

Built into the price of many dedicated device options you will find certain accessories and added features that enhance the functionality of the equipment for daily use. Examples include carrying cases, carry straps, durable casing, kick stands, speech amplifiers, a stylus, editing software and add-ons like key guards, additional voices and different symbol options. TBAs require a “DIY- Do It Yourself” approach with researching, purchasing and applying these accessories separately.

5. Support pages and Profiles

Free access to support pages and the ability to create user configurations (e.g. bilingual page sets, snapshots for changing access needs) are only available on dedicated devices. These options usually require an in-app purchase or special subscription for TBAs.

6. Protecting content

Dedicated device options usually have their own editing software for backing up vocabulary files, while applications require file back-up to respective operating software (e.g. iTunes, iShare, Helium).

7. Access Options

If the individual using the device is unable to directly select (i.e. use their finger to select icons on touch screen), other access options must be considered (e.g. use of key guards, switch scanning, head pointing, eye gaze technology). These access options are generally easier to use and configure on dedicated ACDs.

8. Programming

In many cases, the convenience of programming vocabulary is increased when using dedicated ACD options. Applications can be more cumbersome to edit.

9. Speech Volume

Most tablets require a separate speaker to increase output volume. Dedicated devices generally have an integrated speech amplifier for increasing volume.

10. Differentiating use

What is the tablet used for already? Does the individual have an idea what the purpose of the equipment is? Communication vs. YouTube or gaming? Can the view be easily shifted to a communication focus if the technology was previously used for entertainment?

As you can see, there are many things to think about! A trained speech-language pathologist with experience in ACDs can help guide your family in making the best choice, helping give a voice to your loved one and improving their overall quality of life.

*Disclosure: Information for this blog was taken from a discussion on ASHA’s Special Interest Group 12 with input from a device representative/consultant.