This is a plain-language summary of a journal article. The article is one of 21 articles in a special issue of the AAC journal (Volume 41, Issue 3, 2025). All the articles are written or co-written by AAC users. The articles are free to read. Plain-language summaries of research are important for accessibility. Providing summaries in plain language helps make complex information easier to read. This helps to better understand and put the research into practice.
Summary of: The first word in accessibility is “access” by Regan (2025)
This paper focuses on the access challenges that Patrick Regan has experienced. Patrick uses augmentative and alternative communication (AAC). The paper describes how he and his team have resolved access challenges over the years. It describes the challenges he faces now.
The Challenges of Access
Patrick hopes researchers will learn about the challenges that AAC users face. He says AAC users’ needs should guide AAC development.
Patrick uses his AAC and assistive technology (AT) for work. He uses them to take part in and serve on several committees for people who use AAC. He uses them to attend virtual, live-taught exercise classes. He uses them to socialize and take part in other community-based activities too.
Patrick experiences Spinal Muscular Atrophy (SMA). SMA is a motor neuron disorder. It causes his muscles to atrophy, or weaken. The muscle weakness led him to use technology to communicate. He doesn’t feel defined by SMA. Still, Patrick’s SMA can make it harder to access technology and the world around him.
Patrick uses eye gaze to access his speech generating device (SGD). This works when he is sitting up in his wheelchair. When he uses his computer, he uses a trackball. He lays on his left side to use his computer. His physical weakness has the most impact on him.
Growing up, Patrick had good fine motor skills. Fine motor skills are the ability to make small movements. One example is being able to type. Patrick could never walk. After his second birthday, Patrick was hospitalized with pneumonia. He had a tracheostomy. This is when a hole is put in someone’s throat to help them breathe. Patrick needed AAC to talk after the tracheostomy.
Patrick tried several AAC devices, including low or no tech devices. With some, he couldn’t push hard enough to use the buttons. As technology improved, he replaced his AAC devices.
Patrick worked with his speech-language pathologist (SLP) and a local computer store to find the right technology. A speech-language pathologist is a therapist who helps people find the best ways to communicate for them. Patrick tried out monitors and mice. He found devices that worked for him. He learned he could use the computer longer if he lay down on his side. He learned he could attach a trackball mouse to his SGD. He and his team continued to change devices as technology changed. He was able to adapt his use of computers at his job, and he eventually added eye gaze to his SGD. The eye gaze system made it possible to use his SGD even more.
Now, Patrick uses his computer and the Internet to take part in every aspect of his life. He works. He attends virtual adapted fitness classes. There are some limitations. His eye gaze system can only work for one screen at a time. Even in split screen mode, it only works for one side of the split. Patrick wants the technology to be improved to let him use both sides of the split screen. This would increase his ability to fully join in.
Patrick has used other software and applications for access. Some of these are designed for accessibility, and others are not. Software increases his access to education, work, community, and communication beyond just speech.
Computers, the Internet, and related technologies support independence. People with disabilities need access to these technologies. They allow people with disabilities to manage their medical care. They allow people with disabilities to communicate with healthcare teams. They can make it safe to get medical care when the weather is bad. They help people with disabilities to take part in education and community.
AAC is usually seen as a speech replacement. Patrick views AAC as more. It supports every aspect of communication. It supports education, employment, and healthcare. Communication technology allows people with disabilities to function, join in, and communicate. It is important to Patrick that we work on improving access to SGDs, telecommunication (like the phone and the Internet), written communication, and all computer applications.
Patrick emphasizes that communicating through AAC isn’t easy. It takes a lot of energy, work, patience, dedication, and planning ahead. Improving access will improve communication.
Citation:
Regan, P. (2025). The first word in accessibility is “access.” Augmentative and Alternative Communication, 41(3), 300–303.
Access the full article: https://doi.org/10.1080/07434618.2025.2513912
Portions of this paper were presented at the Future of AAC Research Summit held May 13-14, 2024, in Arlington, VA. A video of the presentation is available at https://www.youtube.com/watch?v=FNQlyL2Jjj0.
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