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pathologists have an ethical responsibility to work with
families who desire mobile devices and provide unbiased
information and advice in regards to the potential benefit to
the person who uses AAC. However, mobile technology
AAC does not currently provide all of the features and
functions available within dedicated speech-generating
devices, and it is important that all relevant AAC options be
considered in a feature matching assessment (AAC-RERC,
2010).
Risks to privacy and confidentiality in
AAC communications
A distinctive risk relating to privacy in the field of AAC is
related to (a) the involvement of communication partners in
supporting communication and thus being privy to what
might otherwise have been treated as private conversations
(e.g., consultations with the doctor or legal representatives),
and (b) the potential for communications delivered by AAC
to be captured and kept in a file (commonly called “history”)
within the speech-generating device or mobile technology
app for AAC. It is recognised that collection of a history of
the person’s communications might be of benefit, but there
may be less awareness of the potential harms arising from
the storage and retrieval of messages in the history. The
record or log of every keystroke, word, or phrase entered
into an AAC system is akin to recording the person’s voice.
It should be treated as containing potentially sensitive and
private communications and subject to the same
restrictions and permissions prior to collection, storage, or
release as audio or video recordings of the person.
As yet, there is no industry standard on the processes
for designing a history feature of a speech-generating
device or mobile technology app that takes into account
all ethical issues pertaining to privacy, confidentiality of
communications, freedom of choice and autonomy, and
safety. An AAC system that does not enable the history
feature to be switched on and off or to clear or delete
messages potentially places the person at risk of breaches
of privacy and confidentiality. Speech pathologists need to
consider the potential harms of sensitive information shared
with one person becoming known to people other than the
intended communication partner. Risks to privacy posed by
the history feature of a system is particularly pertinent to the
situation where people with complex communication needs
might wish to discuss personal issues or report abuse (see
Bryen, Carey, & Frantz, 2003).
Conclusion
In summary, speech pathologists, being aware of ethical
issues in AAC, have an important role in ensuring that AAC
interventions are not only timely and effective, but also of
greatest benefit and least harm to people who use AAC.
Considering the range of options available, effective and
ethical practice will rest heavily upon person-centred,
collaborative, and evidence based practice. In this way,
multi-modal communication services may truly improve the
lives of people with complex communication needs, their
families, and society as a whole.
References
AAC-RERC (2010). Mobile devices and communication
apps. Retrieved from
pages/show/id/46
Ballin, L., Balandin, S., Stancliffe, R. J., & Togher, L.
(2012). The views of people who use speech generating