{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T03:36:03Z","timestamp":1790825763699,"version":"4.1.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000923","name":"Australian Research Council","doi-asserted-by":"publisher","award":["220100253"],"award-info":[{"award-number":["220100253"]}],"id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001782","name":"University of Melbourne","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001782","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cerebellum"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The progression of multisystem neurodegenerative diseases such as ataxia significantly impacts speech and communication, necessitating adaptive clinical care strategies. With the deterioration of speech, Alternative and Augmentative Communication (AAC) can play an ever increasing role in daily life for individuals with ataxia. This review describes the spectrum of AAC resources available, ranging from unaided gestures and sign language to high-tech solutions like speech-generating devices (SGDs) and eye-tracking technology. Despite the availability of various AAC tools, their efficacy is often compromised by the physical limitations inherent in ataxia, including upper limb ataxia and visual disturbances. Traditional speech-to-text algorithms and eye gaze technology face challenges in accuracy and efficiency due to the atypical speech and movement patterns associated with the disease.<\/jats:p><jats:p>In addressing these challenges, maintaining existing speech abilities through rehabilitation is prioritized, complemented by advances in digital therapeutics to provide home-based treatments. Simultaneously, projects incorporating AI driven solutions aim to enhance the intelligibility of dysarthric speech through improved speech-to-text accuracy.<\/jats:p><jats:p>This review discusses the complex needs assessment for AAC in ataxia, emphasizing the dynamic nature of the disease and the importance of regular reassessment to tailor communication strategies to the changing abilities of the individual. It also highlights the necessity of multidisciplinary involvement for effective AAC assessment and intervention. The future of AAC looks promising with developments in brain-computer interfaces and the potential of voice banking, although their application in ataxia requires further exploration.<\/jats:p>","DOI":"10.1007\/s12311-024-01675-0","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T02:01:25Z","timestamp":1709776885000},"page":"2142-2151","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Optimizing Communication in Ataxia: A Multifaceted Approach to Alternative and Augmentative Communication (AAC)"],"prefix":"10.1007","volume":"23","author":[{"given":"Adam P.","family":"Vogel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Spencer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Burke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniella","family":"de Bruyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gibilisco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Blackman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Vojtech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thayabaran","family":"Kathiresan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"key":"1675_CR1","doi-asserted-by":"publisher","unstructured":"Poole ML, Brodtmann A, Darby D, et al. Motor Speech Phenotypes of Frontotemporal Dementia, Primary Progressive Aphasia, and Progressive Apraxia of Speech. J Speech, Language, Hearing Res. 2017:1-15. https:\/\/doi.org\/10.1044\/2016_JSLHR-S-16-0140","DOI":"10.1044\/2016_JSLHR-S-16-0140"},{"issue":"12","key":"1675_CR2","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1016\/j.autrev.2018.06.010","volume":"17","author":"G Noffs","year":"2018","unstructured":"Noffs G, Perera T, Kolbe SC, et al. What speech can tell us: A systematic review of dysarthria characteristics in Multiple Sclerosis. Autoimmunity Rev. 2018;17(12):1202\u20139. https:\/\/doi.org\/10.1016\/j.autrev.2018.06.010.","journal-title":"Autoimmunity Rev."},{"issue":"12","key":"1675_CR3","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1080\/14737175.2019.1649142","volume":"19","author":"M Magee","year":"2019","unstructured":"Magee M, Copland D, Vogel AP. Motor speech and non-motor language endophenotypes of Parkinson\u2019s disease. Expert Rev Neurotherapeut. 2019;19(12):1191\u2013200. https:\/\/doi.org\/10.1080\/14737175.2019.1649142.","journal-title":"Expert Rev Neurotherapeut."},{"key":"1675_CR4","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/j.neubiorev.2019.08.009","volume":"107","author":"JCS Chan","year":"2019","unstructured":"Chan JCS, Stout JC, Vogel AP. Speech in prodromal and symptomatic Huntington\u2019s disease as a model of measuring onset and progression in dominantly inherited neurodegenerative diseases. Neurosci Biobehav Rev. 2019;107:450\u201360. https:\/\/doi.org\/10.1016\/j.neubiorev.2019.08.009.","journal-title":"Neurosci Biobehav Rev."},{"key":"1675_CR5","doi-asserted-by":"publisher","unstructured":"Gibilisco P, Vogel AP. Friedreich ataxia. BMJ 2013;347 https:\/\/doi.org\/10.1136\/bmj.f7062","DOI":"10.1136\/bmj.f7062"},{"key":"1675_CR6","doi-asserted-by":"publisher","unstructured":"Vogel AP, Graf LH, Magee M, et al. Home-based biofeedback speech treatment improves dysarthria in repeat-expansion SCAs. Annals Clin Trans Neuro. 2022;n\/a(n\/a) https:\/\/doi.org\/10.1002\/acn3.51613","DOI":"10.1002\/acn3.51613"},{"key":"1675_CR7","doi-asserted-by":"crossref","unstructured":"Venugopalan S TJ, Yang SJ, Seaver K, Cave RJ, Jiang PP, Zeghidour N, Heywood R, Green J, Brenner MP. Speech Intelligibility Classifiers from 550k Disordered Speech Samples. IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP) 2023:1-5.","DOI":"10.1109\/ICASSP49357.2023.10095933"},{"issue":"1","key":"1675_CR8","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1111\/j.1460-6984.2011.00078.x","volume":"47","author":"JE Folker","year":"2012","unstructured":"Folker JE, Murdoch BE, Rosen KM, et al. Differentiating profiles of speech impairments in Friedreich\u2019s ataxia: a perceptual and instrumental approach. Int J Language Commun Disorders. 2012;47(1):65\u201376. https:\/\/doi.org\/10.1111\/j.1460-6984.2011.00078.x.","journal-title":"Int J Language Commun Disorders"},{"issue":"2","key":"1675_CR9","doi-asserted-by":"publisher","first-page":"243.e9","DOI":"10.1016\/j.jvoice.2016.04.015","volume":"31","author":"AP Vogel","year":"2017","unstructured":"Vogel AP, Wardrop MI, Folker JE, et al. Voice in Friedreich Ataxia. J Voice. 2017;31(2):243.e9-43.e19. https:\/\/doi.org\/10.1016\/j.jvoice.2016.04.015.","journal-title":"J Voice"},{"key":"1675_CR10","doi-asserted-by":"crossref","unstructured":"Folker JE, Murdoch BE, Cahill LM, et al. Articulatory Kinematics in the Dysarthria Associated with Friedreich's Ataxia. Motor Control 2011;15(3):376-89. [published Online First: 2011\/09\/01]","DOI":"10.1123\/mcj.15.3.376"},{"issue":"1","key":"1675_CR11","doi-asserted-by":"publisher","first-page":"66","DOI":"10.3109\/02699206.2010.511760","volume":"25","author":"JE Folker","year":"2011","unstructured":"Folker JE, Murdoch BE, Cahill LM, et al. Kinematic analysis of lingual movements during consonant productions in dysarthric speakers with Friedreich\u2019s ataxia: A case-by-case analysis. Clin Linguist Phonetics. 2011;25(1):66\u201379. https:\/\/doi.org\/10.3109\/02699206.2010.511760.","journal-title":"Clin Linguist Phonetics"},{"issue":"1","key":"1675_CR12","doi-asserted-by":"publisher","first-page":"46","DOI":"10.3109\/02699206.2014.954734","volume":"29","author":"ML Poole","year":"2015","unstructured":"Poole ML, Wee JS, Folker JE, et al. Nasality in Friedreich ataxia. Clin Linguist Phonetics. 2015;29(1):46\u201358. https:\/\/doi.org\/10.3109\/02699206.2014.954734.","journal-title":"Clin Linguist Phonetics"},{"issue":"3","key":"1675_CR13","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1159\/000287207","volume":"62","author":"JE Folker","year":"2010","unstructured":"Folker JE, Murdoch BE, Cahill LM, et al. Dysarthria in Friedreich\u2019s ataxia: a perceptual analysis. Folia Phoniatrica et Logopaedia. 2010;62(3):97\u2013103.","journal-title":"Folia Phoniatrica et Logopaedia"},{"key":"1675_CR14","doi-asserted-by":"publisher","unstructured":"Vogel AP, Maruff P, Reece H, et al. Clinically meaningful metrics of speech in neurodegenerative disease: Quantification of speech intelligibility and naturalness in ataxia. medRxiv 2023:2023.03.28.23287878. https:\/\/doi.org\/10.1101\/2023.03.28.23287878","DOI":"10.1101\/2023.03.28.23287878"},{"issue":"4","key":"1675_CR15","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1159\/000255341","volume":"15","author":"G Rance","year":"2010","unstructured":"Rance G, Corben L, Barker E, et al. Auditory Perception in Individuals with Friedreich\u2019s Ataxia. Audio Neuro. 2010;15(4):229\u201340.","journal-title":"Audio Neuro."},{"key":"1675_CR16","doi-asserted-by":"publisher","unstructured":"Seyer LA, Galetta K, Wilson J, et al. Analysis of the visual system in Friedreich ataxia. J Neurol. 2013;260(9):2362-9. https:\/\/doi.org\/10.1007\/s00415-013-6978-z [published Online First: 20130618]","DOI":"10.1007\/s00415-013-6978-z"},{"issue":"2","key":"1675_CR17","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1111\/j.1468-1331.2008.02396.x","volume":"16","author":"F Menegoni","year":"2009","unstructured":"Menegoni F, Milano E, Trotti C, et al. Quantitative evaluation of functional limitation of upper limb movements in subjects affected by ataxia. Eur J Neurol. 2009;16(2):232\u20139. https:\/\/doi.org\/10.1111\/j.1468-1331.2008.02396.x.","journal-title":"Eur J Neurol"},{"key":"1675_CR18","unstructured":"Veruggio G, Panella M. Cerebral Palsy: Springer."},{"key":"1675_CR19","doi-asserted-by":"publisher","unstructured":"Elsahar Y, Hu S, Bouazza-Marouf K, et al. Augmentative and Alternative Communication (AAC) Advances: A Review of Configurations for Individuals with a Speech Disability. Sensors (Basel) 2019;19(8) https:\/\/doi.org\/10.3390\/s19081911 [published Online First: 20190422]","DOI":"10.3390\/s19081911"},{"key":"1675_CR20","unstructured":"Beukelman DR, Light J. Augmentative and alternative communication: Supporting children and adults with complex communication needs: Brookes Publishing 2020."},{"key":"1675_CR21","doi-asserted-by":"publisher","unstructured":"Creer S, Enderby P, Judge S, et al. Prevalence of people who could benefit from augmentative and alternative communication (AAC) in the UK: determining the need. Int J Lang Commun Disord 2016;51(6):639-53. https:\/\/doi.org\/10.1111\/1460-6984.12235 [published Online First: 20160426]","DOI":"10.1111\/1460-6984.12235"},{"key":"1675_CR22","doi-asserted-by":"publisher","unstructured":"Vogel AP, Sobanska A, Gupta A, et al. Quantitative Speech Assessment in Ataxia-Consensus Recommendations by the Ataxia Global Initiative Working Group on Digital-Motor Markers. Cerebellum 2023 https:\/\/doi.org\/10.1007\/s12311-023-01623-4 [published Online First: 20231028]","DOI":"10.1007\/s12311-023-01623-4"},{"issue":"3","key":"1675_CR23","doi-asserted-by":"publisher","first-page":"148","DOI":"10.3109\/07434618.2012.704521","volume":"28","author":"A Dietz","year":"2012","unstructured":"Dietz A, Quach W, Lund SK, et al. AAC assessment and clinical-decision making: the impact of experience. Augment Altern Commun. 2012;28(3):148\u201359. https:\/\/doi.org\/10.3109\/07434618.2012.704521.","journal-title":"Augment Altern Commun"},{"key":"1675_CR24","unstructured":"Bailey RL, Stoner JB, Parette Jr HP, et al. AAC team perceptions: Augmentative and alternative communication device use. Educ Train Develop Disabilities 2006:139-54."},{"key":"1675_CR25","doi-asserted-by":"publisher","unstructured":"Moorcroft A, Scarinci N, Meyer C. Speech pathologist perspectives on the acceptance versus rejection or abandonment of AAC systems for children with complex communication needs. Augment Altern Commun. 2019;35(3):193-204. https:\/\/doi.org\/10.1080\/07434618.2019.1609577 [published Online First: 20190715]","DOI":"10.1080\/07434618.2019.1609577"},{"key":"1675_CR26","unstructured":"ASHA. Augmentative and Alternative Communication American Speech and Hearing Association2023 [Available from: https:\/\/www.asha.org\/practice-portal\/professional-issues\/augmentative-and-alternative-communication\/ Accessed 17 November 2023 2023."},{"issue":"2","key":"1675_CR27","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1177\/1046496493242001","volume":"24","author":"TW Treadwell","year":"1993","unstructured":"Treadwell TW, Leach E, Stein S. The Social Networks Inventory: A Diagnostic Instrument Measuring Interpersonal Relationships. Small Group Res. 1993;24(2):155\u201378. https:\/\/doi.org\/10.1177\/1046496493242001.","journal-title":"Small Group Res."},{"key":"1675_CR28","volume-title":"CAT: Comprehensive Aphasia Test","author":"K Swinburn","year":"2004","unstructured":"Swinburn K, Porter G, Howard D. CAT: Comprehensive Aphasia Test. Hove, UK: Psychology Press; 2004."},{"key":"1675_CR29","unstructured":"Dunn DM. Peabody picture vocabulary test fifth edition (PPVT-5). Minneapolis, MN., 2018."},{"key":"1675_CR30","unstructured":"Switch Assessment and Planning Framework for Individuals with Physical Disabilities: AceCentre; [Available from: https:\/\/acecentre.org.uk\/resources\/switch-assessment-planning-framework-individuals-physical-disabilities Accessed 5th January 2024."},{"key":"1675_CR31","doi-asserted-by":"publisher","unstructured":"Forest M, Pearpoint J, O'Brien J. MAPS. Educational Psych Prac. 1996;11(4):35-40. https:\/\/doi.org\/10.1080\/0266736960110407","DOI":"10.1080\/0266736960110407"},{"issue":"2","key":"1675_CR32","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1080\/07434610500483588","volume":"22","author":"JM Johnson","year":"2006","unstructured":"Johnson JM, Inglebret E, Jones C, et al. Perspectives of speech language pathologists regarding success versus abandonment of AAC. Augment Altern Commun. 2006;22(2):85\u201399. https:\/\/doi.org\/10.1080\/07434610500483588.","journal-title":"Augment Altern Commun."},{"issue":"5","key":"1675_CR33","doi-asserted-by":"publisher","first-page":"392","DOI":"10.3109\/17483107.2013.769122[publishedOnlineFirst:20130423]","volume":"8","author":"T Iacono","year":"2013","unstructured":"Iacono T, Lyon K, Johnson H, et al. Experiences of adults with complex communication needs receiving and using low tech AAC: an Australian context. Disabil Rehabil Assist Technol. 2013;8(5):392\u2013401. https:\/\/doi.org\/10.3109\/17483107.2013.769122[publishedOnlineFirst:20130423].","journal-title":"Disabil Rehabil Assist Technol."},{"key":"1675_CR34","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.jocn.2019.04.009[publishedOnlineFirst:20190422]","volume":"64","author":"LA Corben","year":"2019","unstructured":"Corben LA, Yiu EM, Tai G, et al. Probing the multifactorial source of hand dysfunction in Friedreich ataxia. J Clin Neurosci. 2019;64:71\u20136. https:\/\/doi.org\/10.1016\/j.jocn.2019.04.009[publishedOnlineFirst:20190422].","journal-title":"J Clin Neurosci."},{"issue":"6","key":"1675_CR35","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1007\/s12311-019-01044-2","volume":"18","author":"CD Stephen","year":"2019","unstructured":"Stephen CD, Schmahmann JD. Eye Movement Abnormalities Are Ubiquitous in the Spinocerebellar Ataxias. Cerebellum. 2019;18(6):1130\u20136. https:\/\/doi.org\/10.1007\/s12311-019-01044-2.","journal-title":"Cerebellum"},{"key":"1675_CR36","unstructured":"ABS. Australians Living with Communication Disability: Australia Bureau of Statistics, 2017."},{"key":"1675_CR37","doi-asserted-by":"publisher","unstructured":"Penner IK, Paul F. Fatigue as a symptom or comorbidity of neurological diseases. Nat Rev Neurol. 2017;13(11):662-75. https:\/\/doi.org\/10.1038\/nrneurol.2017.117 [published Online First: 20171013]","DOI":"10.1038\/nrneurol.2017.117"},{"key":"1675_CR38","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1038\/s42256-023-00714-5","volume":"5","author":"A D\u00e9fossez","year":"2023","unstructured":"D\u00e9fossez A, Caucheteux C, Rapin J, et al. Decoding speech perception from non-invasive brain recordings. Nature Machine Intel. 2023;5:1097\u2013107. https:\/\/doi.org\/10.1038\/s42256-023-00714-5.","journal-title":"Nature Machine Intel."},{"key":"1675_CR39","unstructured":"Azemi E, Moin A, Pragada A, et al. 2023. USA."},{"key":"1675_CR40","doi-asserted-by":"publisher","unstructured":"Mills T, Bunnell HT, Patel R. Towards personalized speech synthesis for augmentative and alternative communication. Augment Altern Commun 2014;30(3):226-36. https:\/\/doi.org\/10.3109\/07434618.2014.924026 [published Online First: 20140715]","DOI":"10.3109\/07434618.2014.924026"},{"key":"1675_CR41","doi-asserted-by":"publisher","unstructured":"Metzger SL, Littlejohn KT, Silva AB, et al. A high-performance neuroprosthesis for speech decoding and avatar control. Nature 2023;620(7976):1037-46. https:\/\/doi.org\/10.1038\/s41586-023-06443-4 [published Online First: 20230823]","DOI":"10.1038\/s41586-023-06443-4"}],"container-title":["The Cerebellum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12311-024-01675-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12311-024-01675-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12311-024-01675-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T18:04:24Z","timestamp":1729361064000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12311-024-01675-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,7]]},"references-count":41,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["1675"],"URL":"https:\/\/doi.org\/10.1007\/s12311-024-01675-0","relation":{},"ISSN":["1473-4230"],"issn-type":[{"value":"1473-4230","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,7]]},"assertion":[{"value":"23 February 2024","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 March 2024","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"<b>Ethical Approval<\/b>not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"APV and TR are employees of Redenlab Inc, a speech analytics company.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure of all financial associations"}}]}}