More than Words

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Colton Moose, 19, never goes anywhere without his iPad — and it’s not because he’s “glued to a screen.”  

Colton has apraxia of speech, a motor speech disorder that makes communication difficult. His iPad is programmed as a speech-generating device, a type of augmentative and alternative communication (AAC). Augmentative communication is when you add something to your speech to help make a message clearer. Alternative communication is when you use something to replace your speech to communicate. Together, they form the tools, systems, and strategies that replace or support spoken language. 

Colton’s AAC device doesn’t replace his speech; it helps clarify it. Without it, people struggle to understand him, impacting his independence and putting his safety at risk. 

His iPad is essential for communication, allowing him to express immediate needs, seek help, and navigate daily life with confidence. So, imagine Colton’s distress when he lost his iPad in October 2024. 

But Colton knew exactly where to go to replace his iPad (and no, not the Apple Store). Just a few blocks from his high school is the Open Access Resource Centre (OARC), a non-profit organization and registered charity in Manitoba that helps find funding and supports for children and youth with communication challenges.  

But acquiring a communication device isn’t simple.  

First, a speech-language pathologist must submit an application on behalf of the person in need of a device. From there, OARC reviews the application and matches the child with a suitable funding source. Potential funding sources include the Disability and Health Supports Unit, Children’s Rehabilitation Foundation, Jordan’s Principle, Child and Family Services, and most commonly, private donations. 

Funding availability fluctuates, causing wait times to vary. As of January 2025, OARC’s waitlist has grown to 419 children — a staggering 675 per cent increase since 2022. Due to an increase in demand and limited funding, applications now face an 18- to 24-month wait before being fulfilled. 

While anyone can purchase an iPad and download a communication app, they won’t receive the setup, training, remote management, and ongoing support that OARC provides. 

Although the majority of funded devices are for first-time users, OARC does have a limited number of devices in their library to loan out in situations such as Colton’s — a long-time user waiting for a replacement.  

Fortunately for Colton, his wait time to secure long-term funding was short as he qualified for Non-Insured Health Benefits (NIHB), which provides coverage for health benefits to eligible First Nations and Inuit clients. Within a week of submitting his application, NIHB approved Colton’s new communication device. 

Soon, Colton’s new iPad was in his hands, and with it, a sense of relief. His autonomy was restored. 

The first thing Colton adjusted on his device was the voice, changing it from Scott (a teenage boy’s voice) to Rod (with intonation set to deep). Rod is one of the adult male synthetic voices created by Acapela Group, a leading developer of voice output technology. Known for its diverse range of voices, Acapela Group specializes in creating natural-sounding, expressive speech options that allow AAC users to find a voice that truly represents them.  

“Rod is specific to me,” said Colton. “I identify with him.” 

History of AAC

AAC has been around for a very long time. One of the first AAC tools was the F. Hall Roe Communication Board, introduced in 1920. This device consisted of letters, words, and phrases to which users could point at to communicate. Although simple, this communication board marked a turning point in assistive communication by becoming the first device to become widely available for users. 

In 1960, the first electronic AAC device, the Patient Operated Selector Mechanism (POSM), became available. The POSM used a “sip-and-puff” system, where users controlled several devices, such as a telephone, lamp, or typewriter, by inhaling and exhaling through a tube. This groundbreaking device empowered people with limited mobility to perform tasks independently. For typing, users followed a grid card that displayed letters arranged in rows and columns. They selected a column by sipping (inhaling) and then chose a specific letter within that column by puffing (exhaling).  

Other devices, like the Comhandi (1964) and PILOT (1967), also relied on typewriter-based input. While innovative for their time, these early AAC systems were bulky, impractical, difficult to operate, and expensive. Access was also limited, as they were only available in medical or research settings and not mass-produced. 

By the 1970s, more portable options emerged, including the Talking Brooch, a pocket-sized device with a small keyboard and a brooch-like display for typing messages on the go. While this was a step forward, these devices still had limitations as they required users to spell and type, making them accessible only to literate people with sufficient fine-motor skills. 

The first successful attempt at electronic speech was in 1939 when Bell Laboratories introduced “Voder,” a keyboard-like system that used buzzing and hissing sounds to create a somewhat intelligible voice. Fast forward to 1961, also at Bell Laboratories, John Kelly and Carol Lochbaum programmed the first singing computer. In an eerily slow and monotone tune, the computer sang “Daisy Bell (Bicycle Built for Two),” a moment that was later referenced in the 1968 film 2001: A Space Odyssey. Decades later, the song resurfaced on TikTok, trending as a sound used to share ominous stories and photos. 

In 1964, Noriko Umeda developed the first text-to-speech system in Japan at the Electrotechnical Laboratory. By the 1970s, speech-generating devices (SGDs) using text-to-speech technology were making their way into the AAC market. These devices used speech synthesis, which is the process of converting text to speech in real-time, to make the photos, symbols, and written words “talk.” 

In 1981, Dennis Klatt introduced KlattTalk, a text-to-speech system that laid the foundation for many modern speech synthesis technologies. Klatt spent hours generating natural-sounding speech by feeding text into his computer and even used recordings of his own voice to create synthetic voices.  

These early speech-synthesized voices were monotone, robotic, and exclusively male. When a female voice was needed, developers simply increased the pitch and frequency, resulting in an unnatural and distorted voice. 

It wasn’t until 1990 that American psychologist and researcher Ann Syrdal developed the first genuine synthetic female voice. Rather than generating sounds from scratch, Syrdal and her team developed a way to piece together snippets of recorded human speech to create new words and sentences. While these voices still sounded robotic and monotone, they marked a significant step toward making synthesized speech more natural and inclusive. According to a 2020 article published by The New York Times, Syrdal’s work laid the foundation for modern virtual assistants like Apple’s Siri and Amazon’s Alexa. 

Some users embraced the robotic voices. Stephen Hawking, for example, chose Perfect Paul as his voice (one of Klatt’s synthetic voices). With its computerized tone and mechanical cadence, it became one of the most iconic and recognizable synthetic voices in history. Even as speech technology advanced, Hawking never changed his voice. In a 2006 interview, Hawking said, “I keep it because I have not heard a voice I like better and because I have identified with it.”  

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Fran Loewen, 33, received her first AAC device in 1997 when she was seven. With no genuine children’s voices yet available, Fran had to make do with an adult female voice raised to sound like she had inhaled helium.  

“I didn’t like to use my device outside of the house,” said Fran. “I was embarrassed.”  

Fran has cerebral palsy, a neurological condition that affects muscle control, movement, coordination, and speech to varying degrees. She operates her text-to-speech communication device using a single switch positioned next to the right side of her head. As her device scans through letters and words, she makes her selection by activating the switch with a quick head-tilt to spell her message.  

As technology progressed, Fran’s mom made sure her daughter’s voice reflected her age and personality. Aside from disliking her first voice, Fran didn’t mind the others she used. Now, she uses the adult American female voice Heather, which she says she “likes.” Ultimately, for Fran, being able to communicate and connect with others matters more than how she sounds. 

Listen to Heather:

How the iPad Changed Everything

Older AAC devices were heavy, bulky, and cost thousands of dollars. In 2009, AssistiveWare, a pioneer in AAC app development, released Proloquo2Go, the first full-featured AAC app for iOS. This app could do everything the most expensive AAC device could do but for a fraction of the price, making it widely accessible. As exciting as it was, users could only use this app on the iPhone or iPod, both with very small screens — even those with perfect vision and adept thumbs would find it tricky to use. 

A year later, Apple released the iPad. According to speech-language pathologist and AAC specialist Val Buissé (who happens to be my mom), the iPad revolutionized AAC. With nearly 40 years of experience in this field, Val has seen firsthand all the changes in voice-output technology. 

“The iPad was nothing we had ever seen before,” said Val. “It was just so exciting, I remember crying of joy because we could finally put this amazing app onto a device that everyone could access for a thousand dollars versus ten thousand dollars.” 

While the iPad made AAC technology easily accessible, one issue remained: the voices. Young AAC users were still stuck with high-pitched adult voices that didn’t represent them. 

With the help of AssistiveWare, Acapela Group was on a mission to create the first 100 per cent genuine synthetic child voices. But this was no small feat. It took Acapela more than 2,500 hours of research, recording, processing, and developing to achieve this breakthrough. The result? A diverse range of natural-sounding synthetic child voices. 

Acapela released the first children’s voices in 2012: British voices Harry and Rosie. Shortly after, they released American children’s voices Josh and Ella. 

Seeing these voices’ impact on the AAC community, Acapela was determined to expand its voice options to be more inclusive. They created voices with different accents, like Australian, and dialects, like African American. They also made voices in other languages, like Dutch, Spanish, and French. In 2024, Acapela released the first bilingual French-Canadian voices.  

Acapela doesn’t only make synthetic children’s voices. They have also created teenage and adult voices, ensuring AAC users of all ages can find a voice that reflects their age, gender, culture, ethnicity, and personality — a voice they can identify with.  

Voice and Identity

A study by disability researcher Mary Wickenden described the importance of an individualized voice. Wickenden examined how teenagers using AAC perceive themselves and how they believe others perceive them. According to Wickenden, some teens felt their AAC voices lacked individuality and personality, making self-expression more challenging. Wickenden’s study highlights the need for AAC technology to offer more personalized options, such as using intonation and having more voices with regional dialects, allowing users to better express their identities. 

To address this issue, many specialized communication apps now offer in-app customization options that allow users to personalize their speech. They can adjust the speed, pitch, and tone of their AAC voice, making it feel more natural and individual. Users can also whine, shout, whisper, or giggle to express their emotions. 

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Cheryl Lisowski, mother of three non-speaking boys, recalls when all her children sounded like Josh, one of the first English-American child voices available on iPad-based speech-generating devices. 

“It was a challenge. We had to look at the devices to see who was talking,” said Cheryl. Her sons, Joshua (19), Isaac (16), and Benjamin (13) have Cabezas syndrome, a rare genetic disorder characterized by significant communication challenges.  

Cheryl found it difficult to adapt to an AAC household. When Joshua was five, he was the first to get a device but wasn’t all that interested in using it. Still, he wasn’t thrilled when his younger brother, Isaac, got his own device a few years later with the exact same voice.  

“My Josh was so put off,” said Cheryl. “He was like, ‘Hey, that’s my voice!’ He couldn’t figure out why Isaac sounded like him.”  

Not only did this cause confusion, but it also affected Joshua’s sense of individuality. Having his little brother sound exactly like him made it feel like his voice wasn’t uniquely his. 

Now, each of the boys has a distinct voice that better reflects their ages and personalities — Joshua with Scott (a teenage American voice), Isaac with Josh (with intonation set to deep), and Benjamin with Owen (an alternative child American voice). Their mom and dad no longer have to look to see who’s bossing them around. 

“It’s amazing to see my non-verbal children talk amongst each other,” said Cheryl. “Sometimes they’ll press the same button on their devices and notice the different inflection they make.”  

Now, Cheryl can’t imagine life without AAC and appreciates the autonomy it has given her boys.  

“I try to instill in them: ‘That’s Josh’s voice. That’s Isaac’s voice. That’s Ben’s voice,” she said. “I’d like to think it gives them that independence — the understanding that ‘this is my voice, and I’m the one controlling it, talking, and using it.’” 

After the Lisowskis resolved the voice dilemma at home, it was time for Benjamin to start kindergarten. To his surprise, another child in his classroom also used a communication device — with Owen’s voice. 

“He was like ‘that’s mine!’” said Cheryl. Although Benjamin was confused, Cheryl said he adjusted to this situation a bit better than his older brothers had.   

A similar situation happened with M.B. (full name removed for anonymity). M.B., 17, has cerebral palsy, which affects her mobility and speech. She received her first communication device when she was five years old, an iPad-based SGD with Ella as her voice.  

M.B. went to school with other AAC users, and some of her classmates also used Ella. M.B. remembers feeling “funny” and “weird” hearing other people using the same voice as her. 

Perhaps this is why M.B. never truly identified with Ella. At twelve years old, M.B. picked her own voice, and she chose Rosie — the British female child voice.  

Why did she want a British accent you ask? “To be fancy,” said M.B with a grin. 

M.B. has spoken with a British accent for five years, which has now become part of who she is and how people recognize her.  

Should M.B. want to transition to a young adult voice and keep her British accent, she has the option to use Sophia, Rachel, Lucy, or even Queen Elizabeth. 

But right now, she identifies with Rosie and will consider changing her voice “later.”  

The Future of AAC

The latest breakthrough in AAC voices is using artificial intelligence (AI) to preserve or create a voice. In September 2023, Apple introduced Personal Voice, a feature that lets anyone create a custom synthetic version of their own voice from the comfort of their home.  

The process is simple yet time-consuming: users record 150 random phrases, ranging from fun ones like “What do bears like best? Honey!” to more complex ones like “About three and a half months later, her cubs are born in a thicket.” Once all the phrases are recorded, the system takes about a day to generate a fully personalized digital voice. 

Once completed, users can transfer their AI-generated voice to their communication app of choice, and just like that, a replica of their spoken voice becomes their AAC voice. 

This innovation is especially promising for individuals with a degenerative disease like amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS), which can gradually affect their ability to speak. Personal Voice provides a way to preserve their spoken voice, allowing them to continue communicating in a way that feels natural and authentic. Instead of losing their voice entirely, they can maintain their sense of identity and independence, ensuring that even if they can no longer speak with their vocal chords, their words still sound like them. 

But this technology isn’t just for people who can record their own voices. It can also help AAC users who want a voice that better represents their background, culture, or loved ones. 

Colton’s family on his dad’s side is from Nisichawayasihk Cree Nation, more than 850 kilometres north of Winnipeg, where English is spoken in a regional dialect. However, there is no AAC voice that “sounds” like Colton’s family or fits his ethnicity. With Personal Voice, Colton could have a family member or someone from his community help create a customized voice. 

“I would want my dad,” said Colton.  

Another AI-driven app impacting AAC is Voiceitt, a speech recognition tool designed for individuals who are speaking, but hard to understand, just like Colton. Users train the system by repeating phrases, allowing the AI to adapt to their voice and how they speak. Over time, the software improves, recognizing the user’s voice and speech patterns and converting them into text or spoken words. 

However, Voiceitt is still relatively new and requires further development to improve accuracy. Regardless, this innovative technology provides a new layer of independence for people who rely on AAC to clarify their speech.  

Whether preserving a familiar voice, creating one that reflects culture, or making speech clearer, technologies like Personal Voice and Voiceitt are making AAC voices more personal than ever.  

More than Words

On a hot July morning in 2024, campers at Camp yAAC gather in a large tent as Fran reads The Darkest Dark by astronaut Chris Hadfield — a book fitting this year’s theme, space. The campers listen intently, their eyes moving between Fran and the book’s illustrations as a camp organizer flips through the pages. 

Hosted by OARC, Camp yAAC is a three-day camp for kids and youth ages six to 21 who use AAC to communicate. It not only gives campers the chance to connect with others who communicate like them, but does so in a fully AAC-friendly environment. For some, it may be their first time in a space like this, fostering a sense of community and representation. Among this year’s campers are Josh, Isaac, Ben, and M.B., some of whom have been attending since 2016, when Camp yAAC first started. 

While every camper relies on a communication device, no two are exactly alike. One camper has a purple case covered with stickers, while another uses a plain black one with a strap. Some campers use Proloquo2Go, while others use different communication apps like TD Snap. Some campers use Ella as their voice, while others choose Josh, Scott, Rosie, or one of the many other options.  

Individuality and choice are at the core of AAC. Users can choose how they want to sound and express themselves. As technology advances, AAC continues to create more opportunities for individuality and autonomy, ensuring users can communicate in a way that feels authentic to them. Ultimately, AAC is about having a voice that truly represents you. 

Audio recordings sampled from YouTube or created with Proloquo2Go.