Access method

Also called Access technique, Selection method, Alternative access

The physical route between a person's body and their communication aid: touch, switch, eyes, head or voice. Get this wrong and nothing else matters.

What it is

An access method is the way a person physically operates their communication aid. Most people touch a screen. Some press a switch. Some look at the cell they want and a camera notices. Some move a pointer with their head, a joystick or a stick strapped to a headband.

The vocabulary on the screen and the access method are two separate decisions, and it helps to keep them separate in your head. A person can have a superb page set and still be unable to say anything, because the route from their body to the screen was never sorted out.

Who it can help

Everyone who uses an aid has an access method, even if nobody ever chose it. The question only becomes live when the default, a reliable fingertip on a screen, isn't available: cerebral palsy, motor neurone disease, a spinal injury, a tremor, fatigue, or a hand that works in the morning but not by teatime.

It is also for people who are fine on a good day. An access method that only works when the person is fresh is not a working access method.

How it works

The broad families are direct selection (touch, eye gaze, head tracking, a head pointer, joystick access) and indirect selection, which almost always means switch scanning. Direct is faster; indirect needs less of the body.

An assessment looks at the most reliable movement the person has, how many times an hour it can be repeated without pain, and how it changes across the day and across the illness. Then it matches that movement to the least effortful method that can drive it. Timing settings do the rest: touch settings for a finger, dwell selection for eyes, scanning speed and timing for switches.

Getting started

This week, watch. Where does the person's body go when they want something? A reach, a head turn, a glance, a knee lift, a breath. Write down three movements they make on purpose, and note the time of day each one was reliable.

Then try the cheapest version of the matching method. Touch: a tablet with a large grid size. Eyes: a paper alphabet board held up between you. A switch: any big button, and partner-assisted scanning before you buy a thing. If one of those works for ten minutes, you have evidence to take to an assessment. If none does, you have evidence too.

Where to get help

Ask your speech and language therapist or occupational therapist about an AAC assessment; in England the specialised AAC services are commissioned by NHS England for people with the most complex access needs. Communication Matters explains every method in plain language, and the ACE Centre and CALL Scotland publish free guides on assessment and access.