Finding Their Voices

Speech pathologist Michael O’Leary is the assistant clinical director of the ICAN Talk Clinic, which uses adaptive technology to enable people with disabilities to communicate. He is working with 9-year-old Abby Gabriel. /Photo: Elizabeth Hruby McCabe

Michael O’Leary communicates for a living but some days may not hear a word. The conversation flows through a range of assistive voice technology, where his clients converse with pictures, sounds, spelling or the blink of an eye. His life’s work is helping people who are unable to speak, because of a range of conditions, learn to communicate.

O’Leary, Seneca Drive, is assistant clinical director of the ICAN Talk Clinic of the AAC Institute. Founded in 2000, AAC Institute is a (501c3) nonprofit organization dedicated to the most effective communication for people who rely on augmentative and alternative communication (AAC ). The ICAN Talk Clinic is AAC’s full-service speech and language pathology outpatient center, an important resource for people of any age who rely on AAC technology and training to say what they want as fast as they can.

O’Leary, a speech pathologist, specializes in working with students with severe autism spectrum disorders, and people with severe movement disabilities who need alternative access methods to AAC systems, especially eye gaze and brain computer interface. A recognized expert in best practices, he also works with the ICAN Talk AAC Summer Camp.

Success for his clients means looking beyond the devices that assist them and immersing their world in language, similar to learning a second language, he says.  And success looks different for everyone. While some people with speech disabilities may learn to communicate virtually anything they want using AAC, a small accomplishment such as a child with autism learning to communicate a simple need can be life-changing for the family.

“Assistive tech for speech has been around for about 30 years, but the advent of iPads and mobile phones really brought it into prevalence,” O’Leary says. Rather than relying on commercial technology, however, the AAC staff uses more durable medical equipment that are typically covered by insurance. And because technology can rapidly become obsolete, research into the best way to meet clients’ needs is ongoing.

The ICAN Talk Clinic uses an array of technology to enable people with disabilities to communicate.

O’Leary and his team see children, adolescents and adults with a vast range of challenges, including speech apraxia, Down syndrome, autism spectrum disorders, traumatic brain injury, aphasia, dementia, cerebral palsy, Parkinson’s and ALS. People sometimes think they have tried everything, and then they discover AAC, he says.

There are many factors that determine what technology or methodology matches the person’s need.  For instance, “A child cannot yet spell or read, so for him or her, we need to be visual,” he explains.  Young children build their vocabularies through colors, shapes, sorting and sequencing in a way that helps them see these ideas in action in their daily lives.

Securing adequate funding is an ongoing issue for the nonprofit.  O’Leary and AAC’s executive director and co-founder Dr. Katya Hill, who heads the Speech Pathology and Communications Sciences and Disorders program at the University of Pittsburgh, are constantly seeking grants to remain on the cutting edge of available technology.

“We are working on how to convince donors to help people (who can’t speak) to tell others they love them, to relay important information,”  O’Leary says. Helping people communicate simple things that those who can speak take for granted are a part of O’Leary’s daily world.

Conversations people are able to have with the help of AACs are often touching. O’Leary recalls a priest who had ALS, and because of a particular device, was able to share some final stories before he died. “He wanted to tell his loved ones his wishes for his funeral. He told them about little time capsules and knick-knacks he’d stashed all over the church throughout his career with the parish,” O’Leary says.

In another instance, a well-known Pittsburgh nonprofit and business leader lost her ability to communicate as the result of a tracheotomy. She initially resisted the eye gaze technology he offered—basically an infrared camera that reflects light off the eyes and then back to where the person is looking. O’Leary  worried that perhaps she was cognitively lost and even wrote and presented a scholarly paper about it at a national conference. He persisted, however, and eventually started her on an eye gaze keyboard. It worked. Using her eyes, she immediately typed back: “You realize I have a brilliant IQ?”

O’Leary presents at regional and national conferences. Animated images and icons continue to open up the world for his clients. And there’s always exciting research on the horizon. Currently, he’s excited about brain-computer interface, where an electronic cap connected to the head allows people to talk using their brainwaves. 

O’Leary is proud of the ICAN Talk Clinic’s role in helping people communicate. “We try and be a leader in focusing on what works best and how to apply it to real people,” he says.

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