Helpful as these devices are, they are limited to pre-set messages. Computer-generated speech lets users say what they want to say. A portable machine called the Lightwriter has existed since the 1970s, allowing people who can type to display messages on a screen and also speak synthetically. More recently, Reeves says, “we’ve seen some great apps being developed for iPads and the like. If they work for you, they’re brilliant. Especially for kids, because they’re cool.”
One, Proloquo2Go, even features a couple of authentic British children’s voices, as well as “sad” and “happy” versions of the same voice; until recently synthesized speech robbed users of accent, emotion and intonation.
At the top end are the systems used by Martin, Nicklinson and Hawking: fully functioning computers, controlled in any number of ingenious ways. Hawking now uses a muscle in his cheek; another system moves the mouse through minuscule lip movement. These systems are capable of e-mailing, texting and even opening doors, turning on lights and operating the TV.
There are, Reeves says, perhaps 260,000 people in Britain using AAC equipment, about 10 percent of them using this kind of hi-tech aid. Their conditions range from serious physical and learning disabilities through sensory impairment to autism, motor neurone disease, stroke and, commonly, cerebral palsy.
“There are also many who are undiagnosed, who simply present to us with an inability to communicate,” she says. “It’s far more common than people think.”
Formed this summer by the merger of two separate charities to develop what would be, astonishingly, Britain’s first national AAC/AT service, the ACE Centre holds open information days, carries out in-depth needs assessments on individuals, and advises and trains children and adults with AAC needs as well as teachers and carers.
However, it doesn’t have the money to provide actual aids for any longer than a short test period. Reeves wants to see a proper, secure, nationwide provision model that would ensure everyone in the country who needs communication aids gets them, preferably on long-term loan.
“At the moment,” she says, “we feel a bit like ladies in a sweet shop. We say: ‘Look, this is all the lovely stuff available. Now fund it.’ Which is wrong: communication is not a privilege, it’s a fundamental right.”