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Critical Issues Using Brain-Computer Interfaces for Augmentative and Alternative Communication

  • Katya Hill
    Correspondence
    Corresponding author Katya Hill, PhD, CCC-SLP, Associate Professor, Communication Science and Disorders, University of Pittsburgh, 6017 Forbes Tower, Pittsburgh, PA 15260.
    Affiliations
    Research Services, Pittsburgh VA HealthCare System, Pittsburgh, PA

    AAC Performance, Testing and Teaching Lab, Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
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  • Thomas Kovacs
    Affiliations
    Research Services, Pittsburgh VA HealthCare System, Pittsburgh, PA

    AAC Performance, Testing and Teaching Lab, Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
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  • Sangeun Shin
    Affiliations
    Research Services, Pittsburgh VA HealthCare System, Pittsburgh, PA

    AAC Performance, Testing and Teaching Lab, Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
    Search for articles by this author

      Abstract

      Brain-computer interfaces (BCIs) may potentially be of significant practical value to patients in advanced stages of amyotrophic lateral sclerosis and locked-in syndrome for whom conventional augmentative and alternative communication (AAC) systems, which require some measure of consistent voluntary muscle control, are not satisfactory options. However, BCIs have primarily been used for communication in laboratory research settings. This article discusses 4 critical issues that should be addressed as BCIs are translated out of laboratory settings to become fully functional BCI/AAC systems that may be implemented clinically. These issues include (1) identification of primary, secondary, and tertiary system features; (2) integrating BCI/AAC systems in the World Health Organization's International Classification of Functioning, Disability and Health framework; (3) implementing language-based assessment and intervention; and (4) performance measurement. A clinical demonstration project is presented as an example of research beginning to address these critical issues.

      Keywords

      List of abbreviations:

      AAC (augmentative and alternative communication), ALS (amyotrophic lateral sclerosis), BCI (brain-computer interface), ICF (International Classification of Functioning, Disability and Health)
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