Augmentative and Assistive Communication (AAC) devices, often called communication aids, help people communicate as effectively as possible when speech is impaired. Data suggests that AAC device usage can decrease over time, even when the benefits to the individual's well-being are clear. The aim of this project is to understand what factors cause someone to stop using their AAC device. By adopting a system-aware design approach, we will investigate all determining factors. When used effectively, an AAC device can help someone living with complex disabilities to: * communicate with a personalised text-to-speech voice * control the environment around them remotely * engage with social media, email and messaging in an accessible way * comprehend text through symbolised content _"It has completely changed my life, I can express myself again."_ - Rob Burrow MBE, former rugby league scrum-half and user of Smartbox and SpeakUnique products, speaking to The Guardian. (https://www.theguardian.com/sport/2021/may/07/rob-and-lindsey-burrow) Understanding how AAC is implemented and how to maximise the potential of a device, both from the point of view of the user and of the supporter, can be a complicated process. To fully explore the AAC implementation process we are co-designing the research methodology with four stakeholders, including direct users and persons who support AAC users. Throughout the project we will conduct interviews with key opinion leaders as well as surveys of professionals, users and advocates. Our data collection will also be strengthened by a mini systematic review of literature on device abandonment and AAC user success. Smartbox and SpeakUnique will work in partnership and through collaboration with our network of AAC users, families, and professionals, will identify the root causes of device abandonment and propose solutions that will lay the foundations of next generation AAC products. **About us** Smartbox (thinksmartbox.com) is a UK based company who create AAC (Augmentative Assistive Communication) devices to help disabled people to communicate and be independent. Since 2003, Smartbox has provided voices for disabled people through innovative hardware and software solutions. SpeakUnique (speakunique.co.uk) develop state-of-the-art voice banking technology, allowing people to create high-quality, personalised synthetic voices. SpeakUnique began in 2012 as a University of Edinburgh research project.

A number of medical conditions can result in the inability to communicate naturally. These can be degenerative diseases, like Motor Neurone Disease and Parkinson's Disease, disorders present from birth, such as Cerebral Palsy; or the result of a brain injury, such as a stroke. Individuals that can no longer communicate naturally, often end up relying on a communication aid. This can be in the form of a tablet or a more specialised eye-gaze machine. These devices, whilst valuable, come pre-installed with a generic voice, that rarely reflect the age, gender or regional accent of the user. Recent advances in speech synthesis technology, have made it possible to create a personalised synthetic voice by using a recording of an individual. Speak:Unique has developed technology that allows patients to record their voice before it is lost and use this in their communication aid. The technology in its current state, does however, have a number of limitations. The first is that synthesis technology lacks the ability to control _how_ a sentence is said e.g. it lacks intonation, emphasis and emotion. These features can subtly alter the meaning of a sentence. Secondly, the technology Speak:Unique has developed requires users to record their voice in a specialised facility in Edinburgh, Scotland. This puts obvious limitations on scalability and accessibility for patients. This grant will deploy cutting edge technology to address these unmet needs and enhance Speak:Unique's offering. It will make them more user-friendly, scalable and accessible, allowing patients to retain an integral part of their identity by communicating in a voice that is identifiably theirs.