Speech-generating devices (SGDs), also known as voice output communication aids, are electronic augmentative and alternative communication (AAC) systems used to supplement or replace speech or writing for individuals with severe speech impairments, enabling them to verbally communicate. SGDs are important for people who have limited means of interacting verbally, as they allow individuals to become active participants in communication interactions. They are particularly helpful for patients suffering from amyotrophic lateral sclerosis (ALS) but recently have been used for children with predicted speech deficiencies. There are several input and display methods for users of varying abilities to make use of SGDs. Some SGDs have multiple pages of symbols to accommodate a large number of utterances, and thus only a portion of the symbols available are visible at any one time, with the communicator navigating the various pages. Speech-generating devices can produce electronic voice output by using digitized recordings of natural speech or through speech synthesis—which may carry less emotional information but can permit the user to speak novel messages. The content, organization, and updating of the vocabulary on an SGD is influenced by a number of factors, such at the user's needs and the contexts that the device will be used in. The development of techniques to improve the available vocabulary and rate of speech production is an active research area. Vocabulary items should be of high interest to the user, be frequently applicable, have a range of meanings, and be pragmatic in functionality. There are multiple methods of accessing messages on devices: directly or indirectly, or using specialized access devices—although the specific access method will depend on the skills and abilities of the user.
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