Facilitating communication of persons with high support needs through iPad

Submitted by Karin Astegger 

Since 2014 one of our occupational therapists has specialised in augmentative and alternative communication through iPad and Apps developing individual solutions for service users with intellectual disabilities. The person centred approaches strongly enhance the users’ possibilities to communicate and their quality of life.

The iPad is a mainstream device with built in accessibility features that can be customized to individual needs, and offers all possibilities of a modern computer.

The occupational therapist and the service user together choose the most appropriate App to support his communication. In this process the user tries out different possibilities looking for the solution that responds best to personal needs and preferences. In the next step assistants of the day and/ or housing service are also involved. The occupational therapist helps with selection, set-up and customization of the assistive device, but after a period of training, trying out and implementation into everyday life, the local assistants help the service user to feed the communication device and/ or to handle problems. If possible, relatives are involved in training as well as they are important supporters in other environments.

In the past years several persons with intellectual disabilities experienced real success stories through this technology discovering new ways of communication that enhanced their independence and possibilities for participation at the service, in their families and communities.

For one service user it was the first opportunity to influence and shape his everyday live directly expressing his preferences and wishes. His verbal expressions are limited to “yes” and “no” responses. He gained more independence, goes shopping in the community without help etc.  He is able to tell his family about his work and at work what he has done over the weekend. He is able to use other features as well, e.g. internet, Youtube etc. By now he has even learned how to feed the communication aid with new contents.  This service user’s quality of life has changed tremendously, both at work and in his private life.

A service user with migrant background who had come to Austria as an adult, and isn’t able to communicate in German uses the iPad as translation device. It was a very touching moment for him when assistants and colleagues said good morning in his mother tongue (through the device). This service user’s possibilities for communication and participation have changed completely since he learned to use the communication aid.

Many more success stories could be told, but there are also challenges to overcome. Sometimes a service user is interested in and able to operate the iPad in the presence of the occupational therapist, but there is no one at the service or at home who feels able to support him in the use of the device in everyday life.

Training is essential to overcome these barriers. We provide training for staff on assistive technology’s potential as part of the support for service users, with a special emphasis on augmentative and alternative communication through iPad and Apps. Next year we will expand training for staff, and we will offer courses to persons with disabilities and relatives to raise their awareness for the benefits and reduce fears of getting in touch with technology.

Through these measures as well as an Erasmus+ project enabling us to learn from best practice we hope to increase the number of service users that can benefit from communication support through iPads and Apps.


Photograph: Lebenshilfe Salzburg; service user and assistant agreed to publication