(I-341) Wearable, accessible, assistive communication device providing customized non-auditory communication and support for left- or right-handed users

Introduction:: Two to three children out of each thousand born in the U.S. are deaf or hearing impaired, and 15 percent of adults are diagnosed with hearing impairments. This totals to 37.5 million people in the U.S. and 430 million globally (1). Additionally, 12 percent of the U.S. population will be diagnosed with a level of Social Anxiety significant enough to interfere with daily activities for at least a portion of their life (2). Moreover, one in every 44 children born in the U.S annually is diagnosed with autism spectrum disorder (ASD) and 40 percent of these individuals are nonverbal (3). Statistics indicate a need for assistive communication options for over 450 million people worldwide, and though the lack of affordable and accessible assistive devices is well defined in the literature, there remains a gap between this demonstrated need and commercially available devices (4). Smartphone Apps can provide assistive communication modalities, but since the user must disengage from their current smartphone activity to use most Apps, these are not truly on-demand support (5). Many stand-alone communication devices are larger than a mobile phone and cost in the hundreds of dollars (5). Because assistive communication devices often rely solely on auditory outputs, these technologies are ineffective or useless to individuals with auditory hypersensitivities, including some individuals on the autism spectrum (6). Our Communication Assistive Technology (CAT) provides inexpensive, stand-alone, wearable, on-demand communication support for left-or right-handed users, is fully customizable, and operates without sound to support sound-averse users.


Materials and Methods:: Currently available devices for assistive personal communication are expensive and complicated, yet data clearly demonstrate that millions of people could benefit from an affordable and accessible communication support device. The Communication Assistive Technology (CAT) device has an outer device housing is flexible and washable allowing the user to customize the device to their desired dimensions or change the appearance of the device to meet the users style preferences. CAT attaches to common apparel such as backpack straps and can alternatively be worn on the body by attaching the device to the lower arm. CAT has a customizable touch capacitive textile array to support left- or right-handed use, and the user displays their desired text or image via tactile engagement with the array. The layout shown in Figures 1A and B permits 24 statements or images per profile, on each of four customizable profiles (profiles examples shown in Fig 2A and B). Tactile orientation elements can be included adjacent the array to enhance tactile discrimination allowing the user to orient their hand without looking down at the device. CAT provides haptic or LED feedback to ensure the desired message was conveyed and is a stand-alone device, not requiring a user to discontinue use of their cellphone to communicate. CAT has an internal support frame to increase the device rigidity which is removable for wearing on the body. The conductive threads, touch array materials, force sensing elements, capacitive sensors, microprocessors, and displays are from Adafruit Industries.


Results, Conclusions, and Discussions:: CAT, shown in figures 1A-B and 2A-B, addresses the lack of accessible, inexpensive, portable assistive communication devices. CAT allows the user to display their choice of 24 text or image messages in each of four selectable profiles. Profiles could be for different users of for different aspects of a single user’s daily routine, such as profiles for home or work, or profiles in a different language. CAT profiles are completely customizable as is the layout and size of the touch capacitive array. The internal textile frame and removable textile housing permit the user to change the appearance of the device to blend in or stand out, as desired based on style preferences. CAT also includes conductive threads instead of traditional wiring permitting removal of the electronics and display screen for cleaning or reorientation of the touch array, as desired. CAT is inexpensive, portable, and suitable for a wide range of users and provides on-demand communication without sound to support sound-averse users.



There is a demonstrated need for accessible and affordable assistive communication alternatives, and CAT is designed to address this need. CAT is simple and provides on-demand, customizable communication with minimal complexity. Because CAT is inexpensive and operates without sound, CAT reduces common barriers to accessing communication support technologies. Future work includes consultation with experts in speech and language pathology to inform further design developments so that the device remains accessible to a variety of users. We will also collaborate with these experts to design appropriate clinical trials.


Acknowledgements (Optional): : Research reported in this presentation was supported in part by the Rhode Island Institutional Development Award (IDeA) Network of Biomedical Research Excellence from the National Institute of General Medical Sciences of the National Institutes of Health under grant number P20GM103430


References (Optional): : 1. “Quick Statistics About Hearing.” NIDCD, https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing. Accessed 22 Nov. 2022.

2. “Social Anxiety Disorder.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/statistics/social-anxiety-disorder. Accessed 28 Nov. 2022.

3. “Autism Statistics and Facts.” Autism Speaks, https://www.autismspeaks.org/autism-statistics-asd. Accessed 22 Nov. 2022.

4. Morris, John, et al. “Clinician Perspectives on MRehab Interventions and Technologies for People with Disabilities in the United States: A National Survey.” International Journal of Environmental Research and Public Health, vol. 16,

5. “Communicators — AAC Devices Archives.” Enabling Devices, https://enablingdevices.com/product-category/communication-devices/. Accessed 22 Nov. 2022.

6. Lucker, Jay R. “Auditory Hypersensitivity in Children With Autism Spectrum Disorders.” Focus on Autism and Other Developmental Disabilities, vol. 28, no. 3, Sept. 2013, pp. 184–91. SAGE Journals, https://doi.org/10.1177/1088357613475810.