Friday, May 20th, 2011

Like the Dysphagia Clinic appointment earlier this week, Mommy was actually looking forward to my assistive communication evaluation today.  A few months ago Mommy learned about UAAACT - Utah Augmentative Alternative Assistive Communication and Technology.  They are a part of the Utah State Office of Education and the Utah State Office of Rehabiliation.  UAAACT act as a resource for families and schools to find appropriate technologies for augmentative communication.  They work one on one to assess which technologies are best suited to each child's communication needs and physical limitations. 

I wasn't quite so sure about going but Scott came out to greet me and led me back to their office to start "playing".  Although a communication device will be a wonderful tool to assist me in being understood because my spoken language is not always understandable, as far as I was concerned this really was more like playing.  Because of my limited hand strength and how tiny I am, there aren't a lot of options that I can carry and manipulate.  First off I tried the iTouch, because it was basically just like Mommy's iPhone I had no trouble figuring out how to work it.  The iTouch was loaded with the most popular communication app - ProLoQuo2Go.  Once I got the hang of the right pressure to use it was no problem to push buttons and hear a girl's voice speak what I had pushed.  The iTouch was small and had a cool carrying case that acted as a much louder speaker.  The only problem was that because the iTouch was so small it was a little harder to make sure I was hitting the correct image all the time.  Scott then pulled out the iPad (first photo above) with the same app loaded.  Although it was definately heavier (espesically with a heavy duty case to prevent breakage) it was much easier for my little fingers to make sure I was touching the correct buttons. 

After playing with that for a while, we moved on to a more standard communication device the Vantage Lite (second photo above).  In some ways it was a little more difficult to navigate because of some assumptions it makes.  For example if I wanted to type out "don't like peas" I would push on an image of a knot to get to the no/don't/not type of words.  Since Knot and Not sound the same but have different meanings it is a little lost on a 3 year old as to why I would push the button with the picture of a rope with a knot in it.  Over time, I would obviously learn to memorize that but it is not real intuitive to someone my age.  But it was colorful and lighter than the iPad so it was certainly an option.

Finally, I got to play with a little three ring binder with several hundred tiny images made by BoardMaker.  It was definately not high tech but would be a perfect non techie communication method to put in my diaper bag/medical bag to point out what I am trying to say in the case that I don't have a communication device/can't get to my communication device, etc.  Mommy is for sure going to go back to UAAACT after purchasing the binder from BoardMaker and then use their software to make me one.

So what is the cost for something like this?  Well Mommy compared the iPad with the app and the case to Vantage Lite since they were most compareable and you can see the numbers below:

iPad 2 - $499 + Proloquo2go - $189 + iAdaptor (case/speaker) - $198 = $886

Vantage Lite - $7495

So comparing the two it seems like a no brainer - right?  Vantage Lite is almost 10 times the cost of the iPad so for similar technology why wouldn't we go with the iPad?  Well here's the kicker.  Although insurance companies will generally pay for something like the Vantage Lite it is pretty rare that they will pay for the iPad.  Because the iPad is not a dedicated communication device (read you can play games, play on the internet, etc) it is more likely an insurance company will spend 10 times the price for a Vantage Lite because that is all it can be used for - communication.  Scott already warned Mommy that Medicaid won't pay for it but there is a shot that one of my two commercial plans may.  If not, Mommy is completely prepared to appeal it based on the cost issue alone.  After all should there be a new app developed in the next few years that blows ProLoQuo2Go out of the water, it would just be an additional $200 or so to get a new app vs. replacing a $7500 communication device when the technology improves. 
 
Peyton Nicole Smith