What is ataxia?
Ataxia is a loss of coordination caused by nervous system issues, often affecting walking, balance, speech, and vision. It’s a symptom, not a diagnosis, and can vary day to day depending on fatigue, posture and other factors.
Practical AAC ideas for people with ataxia
If you’ve supported someone with ataxia, you know communication can be unpredictable. Missed targets, wandering eye gaze, fatigue and sudden setup changes are common. Small tweaks can make a big difference.
Voco Chat on a Talk Pad 10
Access method settings
- Bigger targets + more spacing: Fewer accidental hits; easier to land precisely.
- Dwell time: For eye gaze, touch, or switch access, a slightly longer dwell (or acceptance delay) can give the user enough time to aim and activate without rushing. There’s a fine line, though. Too long slows communication, too short invites mis-hits and can increase anxiety. Tune until selections feel steady- the right dwell can genuinely unlock access.
- Consider scanning: When touch or eye gaze is inconsistent, switch scanning can restore control. Start slower and add in clear auditory cues and highlighting options that indicate, not distract, and find a switch access point that doesn't fatigue quickly. Your OT or PT team members may be able to help with this!
- Eye-gaze basics: Calibrate when the user is alert, stabilize posture, reduce visual clutter during calibration and re-check later in the day. In Grid, these live under Settings → Access → Eye gaze; similar options exist across platforms.
Try it:
Some tips and tricks- where to jump in to improve someone's access.
- Layout and targets: It can be worth trying bigger targets, or buttons, on a page, and increasing the padding or spacing around those targets. There is a fine line between too big targets on a page, which means fewer communication choices, and too small targets, where the AAC user is making accidental selections, so this one can take some trial and error.
- Different user profiles for different moments: Create different user profiles to switch between at different points during the day. This could mean having an eye gaze profile set up for the morning, when fatigue levels are low and accuracy is high, and a switch scanning profile set up for the afternoon as energy levels wane and accuracy becomes more difficult. Settings can be matched to the moment.
- Consistency: Keep core tools, like the prediction row, navigation (Home/Back), and Speak/Clear, in the same spot every time (and across profiles). This reduces hunting, supports motor memory, and keeps the interface calm. If you must move something, flag the change and teach it.
- Stable suggestions: Show a small, steady set of predictions (usually 3–5) in one fixed row. Long or constantly shifting lists increase visual search and mis-hits; a predictable set is easier to scan and select.
- Phrase starters: Add a few high-frequency starters (e.g., “I need…,” “Not now,” “Can we…?”) near the keyboard. These cut down the number of presses for common messages and help pace stay comfortable. You can personalize and swap them as routines change.
Supporting someone with ataxia means planning for change. By making small, thoughtful adjustments to AAC tools and setups, we can help users communicate more clearly and confidently, even when coordination shifts throughout the day. Flexibility is key.
Written by:
Amanda Grabiner, MS, CCC-SLP, ATP
Clinical Training Specialist & Product Specialist