Filed under: iPhone, iPod touch, App Review
Proloquo2Go: Assistive communication for the iPhone and iPod touch
Proloquo2Go [iTunes Link] is not your usual iPhone/iPod touch app. It turns the mobile device into a full augmentative and alternative communication (AAC) device. According to the AAC Institute, an estimated 2.5 million Americans are speech disabled to the extent that they experience significant difficulty being understood by other people. Reasons vary, but are often the result of congenital illness or ALS (also known as Lou Gehrig's disease). One alternative is learning how to use sign language, but that requires both adequate sensory motor ability of the user and a knowledge of sign language expected in the listener. It's a solution that helps some, but not all.
When signing is not available or appropriate, using an AAC device may well be. AAC devices use combinations of symbols, words, sounds and technology to allow people without functional vocal abilities to communicate. The cost of such devices range from around US$3,500 to US$8,500 for something about the size of a Speak and Spell.
In contrast, the Proloquo2Go app has a price of US$189.99. If someone is in the market for an AAC system, it is one of the biggest bargains in the entire App Store for any iPhone or iPod touch running OS 2.1 or higher.
Proloquo2Go took the uncommon route of using existing hardware to run a complex AAC system. It's nearly impossible to describe the use of the system through words, though I'll try, but I'd suggest you check out some detailed videos walking you through the process in some depth.
The home screen is a totally configurable grid defaulting to 4X4 (16 boxes) and can be changed to show anywhere from 32 boxes to 1 box depending upon the user's preference and ability. From here you start to construct your phrase, which will be spoken in a very natural sounding voice by a variety of voices, young or mature, male or female, with an American or English accent. The stock version comes with 4 American accented voices while English accented ones may be downloaded. Downloading a voice can take as much as 115 megabytes of space which should give you an idea of how natural the voices sound. The base app itself is 235 megabytes in size.
Through a totally customizable set of intuitive screens, you build a phrase by clicking on a symbol with words under it. You start on the home screen where you choose from categories such as: Hi-Bye, I need, I want, Comments etc. Tapping one gives you underlying words and phrases. Tapping again moves the phrase and symbol to the top bar as you construct your phrase or sentence. From this point you go back and choose another category to find the next word or phase, but more often than not, the system is so well organized that it takes you to where you want to be seemingly by magic. The magic here is extensive research into AAC using common elements and conventions of the field.
Here's an example of putting together the sentence: I want a drink of cranberry juice.
- From the home screen choose the I want icon. Tap it and the words I want and a symbol appear on the top phrase bar.
- On the I want screen that appears there are choices ranging from: something to eat, to listen to music, a drink, among others. Tap on a drink of and a drink of along with its icon appears after I want on the phrase bar. It also takes you to the a drink page.
- The a drink page contains 42 choices with appropriate icons. Tap on Cranberry Juice and those words along with a symbol of a cranberry juice bottle appears on the phrase screen. Double tap on the bar to hear the phrase clearly spoken. Of course, for most uses there would be speakers attached to the iPhone or iPod touch to improve audibility.
More importantly, you can add anything you like to the vocabulary by typing it in on either an overlarge keyboard or a usual keyboard that doesn't do landscape mode. There is a section marked word spaces for this, but you can really add anything to anywhere. I believe the idea is to take what they gave you as a jumping off place and customize it until it perfectly suits the user. It seems that nothing is really set in stone.
That does bring up the potential of really screwing things up, which is solved by having the device communicate with a host computer to frequently back up data. It would have been easy to leave something like that out, but the attention to detail is commendable. The more you play with Proloquo2Go, the more you find, like auto-morphology which allows you to auto conjugate verbs and auto pluralize or personalize nouns. This works not just for their canned vocabulary but for any user created content as well.
At this point one might expect an iPhone developer to scoff a bit and say that this can be programmed in a weekend and sold for US$20 at a huge profit. I disagree, since this is more than the nuts and bolts purport. It's based on a huge amount of research and experience in the AAC field and is quite a bit more than just branching screens and buttons.
To put it in perspective, it brings the field down from the thousands-of-dollars range to the price of a $199 iPod touch plus the app. It can be the center of a full AAC system with speakers for under US$500, opening up AAC to a world of users that couldn't afford to pay for it themselves and couldn't get it covered under Medicaid or Medicare, which covers most AAC devices. This customary medical coverage may well be one of the reason for the high prices these devices currently command.
According to the New York Times and Gizmodo, Medicaid and Medicare will only pay for single-purpose devices, and since the iPhone and iPod touch are multi-purpose they are not included in the coverage. Forcing consumers who want to get their device covered to buy one that's 10-20x more expensive seems foolish. Once again it seems that technology has outstripped law, and I hope that this inexcusable coverage hole will be repaired.
The design and implementation of Proloquo2Go is a great example of thinking outside the box. Instead of a huge price-tag for a uni-purpose device, AssistiveWare decided to use existing hardware and begin changing the game, making AAC more accessible to more people for less money than ever before -- and that's quite an accomplishment.
Take a look at this video for a brief news story involving Proloquo2Go.
Note: TUAW was provided with a review copy of this application. For more information, please see http://www.tuaw.com/policies
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Reader Comments (Page 1 of 2)
Zane said 9:45AM on 10-21-2009
This is incredible!
I must commend Apple for designing a hardware/software platform that is so robust and versatile, but the most praise must go to the programmers who came up with this app. The portability alone is great, and the thinking that went into the design is amazing.
I hope this inspires other programmers and people who work with the disabled to create more apps that allow people to overcome any obstacle in their lives.
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Travis Walls said 10:00AM on 10-21-2009
I work for an IT department at a research institute, and, a few weeks ago, I was asked to help troubleshoot an issue one of the departments was having with some iPod touches. It was all fixed with a simple restore, but what caught my attention was the app that they were wanting to put on them, Proloquo2Go. They had actually just got it from the iTunes Store, so my jaw dropped when I saw how much it cost. My thoughts went something like "They spent HOW MUCH on an app?!?" Once the woman had explained to me that devices that offered similar functionality cost several thousands of dollars, it made much more sense. I looked up the app online to learn more about it and found something that made a lot of sense. Kids who have conditions like these would rather whip out a shiny iPod touch than one of those dorky, bulky devices they used to have to carry. Pretty cool that a device from Apple meant to play music can also save thousands of dollars for research groups and families, as well as make a difficult condition a little bit easier for kids. I dunno. Kinda made me feel warm n fuzzy inside and thought I would share. Thanks for the thorough attempt to explain more about how this app is used.
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Cat Harlan said 10:20AM on 10-21-2009
I think this app is AWESOME! One problem. The price tag. The people that could really benefit from this app really shouldn't have to fork out that kind of money. Isn't their life difficult enough?
I'd like to see the Open Source community take a shot and at this one and give it away. I would GLADLY donate to that cause.
But well done! Great app!
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Dirk said 11:09AM on 10-21-2009
That's what I was thinking. I see that it's a far lower price than with other devices, but still ... I would support such a project too, with money and/or code.
But the main part of what you pay here might well be license costs for the speech synthesizer, or the voices. I can imagine the costs of obtaining licenses for those might be very high.
L Victor Marks said 3:24PM on 10-21-2009
It isn't just the voice work that costs - it's the licensing of the images. Think about the cost of an icon. Now think about the cost of 49 of them for drinks.
Now think about the cost of somewhere between 500 and 1000 icons, knowing that a basic working vocabulary is around 700 words - it's a huge cost.
Add to that the time and work spent determining menu paths so that you don't ever go backwards up a hierarchical tree, and the project becomes a huge and expensive undertaking.
I should note that there was some very very early work at an application of this sort for the Sugar OS (Linux) based OLPC - but that this work has yet to amount to anything useful.
topypunk said 10:52AM on 10-21-2009
APPLE IS INCREDIBLE!!! As a person who is disabled and may one day lose my ablity to talk, this makes me feel more comfortable.
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Dave Boyd said 10:43AM on 10-21-2009
This is great news. The price is lower than many of the specialized products out there, but still uncomfortably high.
Another app worth checking out in this area is iPrompts. I haven't used it, but the description and ratings on the app store are encouraging - so is the price: $49.99.
http://www.handholdadaptive.com/
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Victor said 11:28AM on 10-21-2009
tobypunk- apple has nothing to do with this app...
I would like to see an application like this developed for soldiers. Would be an excellent translation device for simple communication.
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David Winograd said 3:02PM on 10-21-2009
What a wonderful alternative use of an existing product!
I can see this easily being re-tooled to be a translator.
Andrew said 4:21PM on 10-21-2009
You really don't know about the US Army's iPod translator software? They've had it for years now.
http://www.newsweek.com/id/194623
David Winograd said 1:20PM on 10-21-2009
iPrompts looks quite useful but for totally different reason. iPrompts has nothing to do with AAC, it doesn't even use voice. It's reason for being is as a life organizer for cognitively disabled children.
Admirable and from what I can tell from the site, quite useful, but one really has nothing to do with the other.
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Kathy said 1:36PM on 10-21-2009
"75% of people using AAC devices have ALS." I looked at this link source and think you may have drawn the wrong conclusion. The source indicates that 75% of people with ALS use AAC technology.
Proloquo is an amazing piece of software! Thanks for the post.
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David Winograd said 7:30PM on 10-21-2009
Thanks. I've redacted the line.
Dave Boyd said 2:04PM on 10-21-2009
@David Winograd - True, iPrompts is a very different product. But it is another one that is bridging the gap on overly expensive communication aids. It does involve AAC, but is simply targeted for a different audience.
Before this product, people were relegated to using cumbersome flash cards, bulky books, or intrusive devices to help their child communicate.
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David Winograd said 3:00PM on 10-21-2009
Yes, re-reading the definition of AAC, iPrompt certainly can be categorized as using AAC. I wonder how broad the definition goes.
Proloquo2Go is about the disable person communicating with another.
iPrompt instead seems to deal with organizing tasks for a disabled person and isn't about speech per-se, but it IS about communication.
metalgimpsolid said 2:57PM on 10-21-2009
While Proloquo2Go does cost more than the typical iPhone app, its price is still a fraction of the $2,000 to $8,000 price range that comparable AAC solutions run. As Dirk correctly surmised, the developer must pay a licensing fee for the text-to-speech voices; however, their expenses do not end there, as they must also pay licensing fees for the symbols and grammar technology, and pay a staff to handle tech support and pre-sale inquiries, which is much more than the typical iPhone app and probably more in line with desktop software. When you add that all up, plus Apple's 30% take of App Store sales, the price is easier to understand.
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Samuel Sennott said 3:38PM on 10-21-2009
Thank you very much TUAW for the review and encouragement. You, Gizmodo, and the NY Times have helped bring people with speech disabilities to the forefront of conversation around the world.
As both a PhD student in the field of augmentative and alternative communication, as well as being a co-developer of Proloquo2Go, I have a deep knowledge of the systems that are involved with the people who it is served by, the environments and contexts we are working in, as well as the possibilities for the future.
Regarding price, we straight up compete with $8,000 devices. For the $189.99 we charge, we license a range of technologies including symbols, high quality voices, and grammatical technology. We have stuck our necks out there and placed a flag in the moon so to speak for accessibility on the iPhone and iPod touch. We are so happy to offer a huge value to our users. Yet, know that we provide a ton of support and trainings around the US and the world. I just want to be crystal clear that we do this for the love. We are very committed and very lean, which enables us to keep the cost low.
That being said, there is great risk in throwing together open source special education technology in that people depend on the technology. I know there are huge upsides and I commend the awesome developers who provide free services to the community. It is awesome! Thank you for doing that. Yet, the risk is always that people get hurt by abandoned efforts. Anyway, it is great to engage in these conversations. For all together we will make a difference!
Cheers,
Samuel Sennott
First, know that people's lives are at stake with this technology. There are plenty of hastily created special education apps cropping up. Yet,
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SaintStryfe said 4:33PM on 10-21-2009
Aces to you friend.
I never really thought of my iPhone as a Adaptive Device, until I was sitting with it on the table and my three year old niece picked it up, opened the photo app and started looking at the photos in there.
If a three year old could use it, with little prompting and minimal instruction, it's use as an adaptive device is remarkable. I would have to believe that an Apple Tablet, which would be bigger and more capable would be an even greater boon.
I do believe that the insurance industry has given license for Adaptive Tech developers to charge ridiculous prices for things that technology has developed that should be much less. I hope your application is a first strike towards brining this sort of tool to greater numbers of people. Thank you.
Moose said 4:51AM on 10-22-2009
My girlfriend, who is a speech therapist and loves this app for her clients, also had another fantastic point: a lot of kids that use this device, are just that... kids. Its embarrassing to them to have to lug around a speak and spell sized, expensive device that "outs" them in public. And beyond simply providing them with a highly capable AAC device, they also get a hot MP3/video player, so its something that they *want* to carry around and use. So as a surrogate for the GF, kudos to you guys!
Robert said 7:30PM on 10-21-2009
As the parent of a child with Autism I purchased this app as well as iConverse. My 8 year old son now carries his iPod Touch with him all of the time. It is really the ideal device for him, I have some movies and TV shows he loves on it as well. I am very thankful for this software as it has really helped us mitigate his tantrums when he can not "find the right words"
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