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Issue Editor Foreword

Augmentative and Alternative Communication Technology to Support Language Across the Lifespan

Section Editor(s): McCarthy, John W. PhD, CCC-SLP; Issue Editor

doi: 10.1097/TLD.0000000000000199
Issue Editor Foreword

The author has indicated that he has no financial and no nonfinancial relationship to disclose.

I would like to thank the Editors and welcome the readers to this issue of Topics in Language Disorders titled, “Augmentative and Alternative Communication Technology to Support Language Across the Lifespan.” When I first embarked on developing this issue, I thought it would be a fairly linear process where examples of technology use would be heralded for all stages of people's lives. I speculated that the body of knowledge would accentuate the facilitative role of technology in language development, especially for individuals with complex communication needs who require augmentative and alternative communication (AAC). As submissions came in and the journal issue took shape, I was confronted with a more circuitous picture. As I worked to understand the phenomenon, I revisited some classic contributions in the field of AAC. What I was reminded of is that language and technology are so complicated that their union leads to invocation of ideas of magic (Beukelman, 1991), fantasy (Light, 1997), extended metaphor (Mirenda, 1993), or outright paradox (Beukelman, 1988). There were no simple ideas related to integration of language and technology.

I am certainly familiar with the delegation of technology to the role of a tool. The status of neutrality assigned to technology is a useful one. It prevents individuals from seeing technology as a pursuit in and of itself. Technology is something to assist in allowing something else to happen. As this journal issue evolved, the idea of technology as neutral seemed to hold less true. This was not the result of abandonment of the idea that the focus of professionals working with individuals with speech and/or language disorders should drift from application to meet communication needs, but rather on the ways in which technology has become so intertwined that it creates new avenues for study. I considered the persistent questions raised, such as: Is technology a wondrous tool that enables personal connections, or is it a distraction from actual or “real world” relationships? Are people more connected or more isolated when using technology? Is technology making things easier or more complicated when communicating? The answer for me as someone who works in AAC is, “yes.” All of the above are true at once. They are not true because technology is neutral, they are true because technology inclusion and intrusion into our society results in simultaneous gains and losses. There are complex choices at hand when using technology and it creates a new space for interactions. That space requires further study, increased scrutiny, and a fearless embrace.

The concept of visual scene displays in AAC is philosophically an assimilation of real-world contexts into AAC interfaces. The space created is one where the digital world resembles and enhances the real one to improve interactions. Holyfield and Caron's (2019) article explored and explained applications of visual scene displays for adolescents with a particular focus on language impacts. Scrutiny and an embrace of complexity was a theme in Fulcher-Rood and Higginbotham's (2019) article. I have always admired Dr Higginbotham's work for his meticulous analysis of interactions in AAC. He has always embraced the complexity of AAC interactions and his work helps to develop tools and approaches for future study.

In true paradoxical fashion, my journey to working with individuals who could not use their natural speech capabilities came from my background as a voice performance major. I never abandoned music, but instead have looked at how the arts create a strong milieu for interaction rich with opportunities for communication in an environment that does not require right or wrong answers. The idea of spaces where people come together has always interested me. I tried to embrace the milieu approach in my article with Jamie Boster, where we examined the spaces created by technology-mediated interactions with AAC. We used a series of photographs to explore the possibilities of technology inserted into communicative interactions (McCarthy & Boster, 2019).

The idea of machines replacing jobs is not a new concern, but I will admit to feeling fairly little anxiety about it for my job. Technology applications are entering into my work space though. How would I feel about an artificial intelligence application taking over what I do clinically? Ultimately, their emergence has already changed aspects of my job and will continue to do so. Sennott, Lee, Akagi, and Rhodes (2019) explored the possibilities and cautions of artificial intelligence in their article.

It is my hope that the resulting issue is not a confusing story, but rather a positive narrative. There may be more for clinicians to learn, but the applications described in the articles for this issue could ultimately make their jobs easier. Tools may allow for easier microanalysis of interactions on a more complex scale. Digitally mediated interactions can be made more real and digital spaces can be assets (and sometimes liabilities). Through the challenges of technology application emerge a truth, reflected in a quote from Oscar Wilde (1891): “Well, the way of paradoxes is the way of truth. To test reality we must see it on the tight rope. When the verities become acrobats, we can judge them” (p. 89).

—John W. McCarthy, PhD, CCC-SLP

Issue Editor

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Beukelman D. (1988). She was setting a world's record, and we thought she was drowning, right Dad? Augmentative and Alternative Communication, 4(2), 122–123. doi:10.1080/07434618812331274697
Beukelman D. (1991). Magic and cost of communicative competence. Augmentative and Alternative Communication, 7(1), 2–10. doi:10.1080/07434619112331275633
Fulcher-Rood K., Higginbotham J. (2019). Interacting with persons who have ALS: Time, media, modality, and collaboration via speech generating devices. Topics in Language Disorders, 39(4), 370–388.
Holyfield C., Caron J. (2019). AAC technology innovations to build skills and compensate for limitations in adolescent language. Topics in Language Disorders, 39(4), 350–369.
Light J. (1997). “Let's go star fishing”: Reflections on the contexts of language learning for children who use aided AAC. Augmentative and Alternative Communication, 13(3), 158–171. doi:10.1080/07434619712331277978
McCarthy J., Boster J. B. (2019). Growing up with technology: Does the device go in the middle? Topics in Language Disorders, 39(4), E1–E16.
Mirenda P. (1993). AAC: Bonding the uncertain mosaic. Augmentative and Alternative Communication, 9(1), 3–9. doi:10.1080/07434619312331276361
Sennott S. C., Lee M., Akagi L., Rhodes A. (2019). AAC and artificial intelligence (AI). Topics in Language Disorders, 39(4), 389–403.
Wilde O. (1891). The picture of Dorian Gray. Retrieved from
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