QVoice AAC app

So I did a thing!  I created an AAC app for Quinn!!!!  I started it during COVID when my SLP said “There’s no such thing as a perfect app.”   I knew that wasn’t true.   I could make one. 

Looking back, it was as if my whole life was preparing me for this moment.

• I grew up in a multilingual family with many polyglots (people who can speak 3+ languages).   This background has helped me adopt languages very quickly.  When my peers would struggle with word-for-word translations, I easily accepted language differences.  The reverse was also a skill.  I knew how to translate broken English and could usually interpret communication intent with very little words exchanged. 
• I took many language classes in my high school and college career. I understand the fundamental building blocks of language, conjugations, and sentence structure. 
• I was a mobile software developer for 15+ years. I started out working on the Palm Pilots, followed by symbian phones, then Blackberry, iOS, and Android devices.  My career trained me to understand and implement best practices for good software development, stable foundations, code management, client server synchronization, strong security, and tech support.
• In my later career I worked very closely with UX (user experience) designers.  I’ve participated in usability studies and learned the importance of simple intuitive User interface design.
• I became a mother of a complex communicator.  This required many hours of speech therapy.  And I was picky!! This tiger mom was on the hunt for the best SLP out there.  I learned how to perform physical prompts, what the proper terminology+strategies to break down the fundamentals of language building, and how to observe all forms and functions of communication.  I learned how to be Quinn’s personal SLP.

We took speech samples of our daughter for a week where I recorded her independent language. After 3 years of doing speech prompts, drills, and pattern activities, it didn’t really make much of a difference to her independent language.  Her vocabulary count was still significantly low. It was time to look into Augmented Alternative Communication (AAC) device so she could increase her vocabulary count. Because a girl of 6 years needed more than 100 words.   So that’s what we did. Then, COVID happened.

The school issued us an iPad with ProluoquoToGo.  As a good software developer would do, I poured through every setting and familiarized myself with the tool. Her teachers knew my background so they kindly allowed me to take over.  I had a hard time with this program.

• The software interface was very outdated.
• When I deleted a button in a folder, it would rearrange all the buttons on the page.  This happened many times and it was quite aggravating.
• There were so many settings.  SO many.  It was overwhelming.
• A few weeks in, we quickly realized Quinn could not distinguish between an icon with one stick figure and two stick figures. 
• It was hard to tell the difference between a folder  versus a button.   Folder would open a new grid with more buttons and buttons added words to the sentence bar
• I had a hard time visualizing how her language was going to grow with the setup we had.
• Everything surrounded one device.  If I was modifying it, Quinn had no device.   If it ran out of battery, Quinn had no voice. 
• Data collection seemed very lacking, if not nonexistent, from these devices.  I wanted to tell how the device was being used in school and outside of speech therapy.  In the advanced systems, you could install additional software to track usage, but then you’d have to retrieve the data file and upload it to another software to process it.  Seemed quite cumbersome.

My daughter’s SLP was trying to convince me to push for the more expensive apps or devices but I didn’t see anything exciting there either to make it worth the fight.   The architecture was still old, built on old principals and design.  It placed the burden of maintaining the data on the SLPs or AAC users. The apps were very focused on AAC users, not the communication partners who had to teach.  

I know what technology can do. I know how to build technology that can make teaching Quinn a lot easier for me. I craved that level of control.  The impetus for this AAC endeavor  was when her SLP said “There’s no such thing as a perfect app.”   I knew that wasn’t true.   I could make one.  So I ventured into creating her own AAC app.  And it has been a game changer for her treatment.

• Quinn’s finger would repeatedly tap on the same button. This would lead to accidental taps and mis-hits. So we added animation to give her the visual indicator that a tap has been registered.   We also gray out the button temporarily so she doesn’t accidentally hit the button again.  Lastly , we played a soft beep when the system registered a tap.  Doing so eliminated her multi-tapping buttons.
• We use system icons that have already been optimized to communicate intent as well as reduce cognitive load. They are simple flat single colored icons that have been well tested by the large teams of UX (user experience) designers. This helps make the user interface easier to see and navigate when there is less data entering your eyes.
• We added GIFs (animated images) to her buttons.  Sometimes a word cannot be explained by a static image.   Her providers were worried about the GIFs being distracting but they didn’t distract her.   If anything, they engaged her and taught her more nonverbal communication.
• Like good software developers, we tracked everything.  We started off with the typical usage log.  We tracked whenever she opened a folder, opened a widget, used a word, etc.  We added a switch so that her communication partners could turn on when they were using the device versus when she was using the device.  This helped us more accurately track her usage/exposure, as well as inform everyone of the modeling levels of the team at school AND home.
• On a whim, we added AI to help fill out the sentences.  Quinn just have to learn the motor planning of 2 words (i.e. WANT + PHONE) and AI will fill out the rest (AI response: “I want my phone.”)
• Lastly, we were able to add any widget that could be of use to her.  She could have the reciprocal interaction with her peers by using the Jokes widget.  Or she could practice her number recognition and sequencing with the PIN Practice widget.  This widget was purposely set up to mimic the iPad lock screen so she could practice.

I could talk about AAC all day!!

We have worked very closely with her BCBA and SLP to develop QVoice into what it is today.  I’ve attended many conferences to learn about the current research, as well as the current deficits amongst the SLP community.  I’ve met so many SLPs, assistive tech (AT) specialists, and parents who are excited for this app and very supportive of our mission.  I’m super charged to help whoever I can. 

So we’re finally doing it!  In 2025, we are hoping to launch QVoice officially.  I’m terrified but hopeful.  If we can help one other family communicate with their non-speaking or minimally speaking child, wouldn’t it all be worth it?  Here’s what Quinn can tell me NOW that she couldn’t before 2020:

• On the week of using AAC, she could say “look up”.  We used the “look up” button in therapy to play this game she made up.   Before AAC, she would gesture to the ceiling and make grunts until I looked up.  Then she would immediately tickle me.  A laugh-fest would ensue. She made it up.  We created a button to say “look up” and used it in a pattern activity.  Because the AAC device can say this phrase the same way, multiple times, it entered her brain faster.  She could hear it.  AAC improved her receptive language (internal language), therefore making expressive language easier to teach. This was the moment I was sold on AAC.
• A few months into the AAC journey, she could tell me exactly what type of snack she wanted.  Pre-AAC, we would just give her the same snack for 3 weeks because she would eat them for 3 weeks straight.  Post-AAC, I can finally see her snacking pattern.  Yes she does stick to her usuals but now, I don’t have to carry her to the pantry or hold up 20 snacks before she can tell me which snack she wamts.   I know the exact moment her mood and tastes change.
• A year into AAC we experienced SOOO many times how our “educated” guesses about what she wanted were so very flawed.  —  Example: we were getting ready to serve dinner–takeout from a ramen place.  Her BCBA was there to assist her.  Quinn kept gesturing to my ramen bowl that was still in the special takeout container that keeps the noodles separated from the broth.  Ok, being a mom, I always share my food. So I scooped her a small amount of noodles and broth into a separate bowl and gave the bowl to her.  Still , she kept gesturing towards mine.  Her BCBA and dad said “I think she wants the takeout container.” I told her “it’s the same thing, Quinn.  Look!  It’s the same thing”.  I didn’t want to give her the takeout container because I was hoping to save my ramen for the next day and really wanted to keep the noodles separated from the broth.  After many attempts to convince her that her bowl contained the same stuff as my bowl, she remained steadfast at gesturing towards my bowl.  Meanwhile the adults in the room were now convinced “she wants the bowl” and advised me to not give it to her. She needed to learn that she can’t always get her way.  So I compromised.  I gave her the AAC device and made her work for the bowl.  I even helped her find the word “bowl” or “noodle” but she refused to tap them.  Instead, she tapped her way to the Food folder, took her time scanning the page and eventually tapped in “egg”.  The room erupted in humble laughter, professed apologies, and stunned amazement.  We really need to stop assuming things about her.  We really do not know what’s going on inside her head!
• She can tell me what movie/show she wants on TV, as well as what music she wants to play in the car.  Pre-AAC:  It started with a very LONG gesturing game in the car (“Is it this?  Is it this?  Is it this?”) before we figured out she wanted the CD player, which had the clean version of Hamilton in it.  Then, we taught her how to say “music” in the car because she ALWAYS wanted to play the CD in the car.   We had to listen to Hamilton for years.  Post-AAC: she now uses her device to say PLAY+SHREK.  We learned she was obsessed with Moana for a few months, then Shrek, then Sing, then back to Shrek, and now Bluey.  Her movie folder happens to be very musical so that folder is always accessed in the car for music and the living room for movies. 
• Quinn sleeps with her AAC device.  The first thing Quinn does when she gets up in the morning is grab her AAC device.  We know this because she’s usually at the door calling for

Our journey is still long and we still have a long way to go.  But I’m hopeful.  Preparing presentations and going through Quinn’s old videos has been therapeutic.   I recognize how far she’s come.  And that keeps me hopeful.