Visual scene displays

Also called VSD, Scene displays, Hotspot displays, Photo scenes

A photograph with hotspots that speak. For people who think in situations rather than categories, including very young children and adults with aphasia.

What it is

A visual scene display is a photograph or drawing of a real situation, on a screen, where touching parts of the picture speaks a message. A photo of the kitchen where touching the kettle says "can I have a cup of tea" and touching the biscuit tin says "I'd like a biscuit". The context is in the picture, so the person doesn't have to translate a situation into a grid of separate symbols.

VSDs are an alternative to grids, not an add-on. Some systems mix them: a scene with a small strip of core words along the edge.

Who it can help

Adults with aphasia after a stroke, who often recognise a photograph of their own kitchen instantly and find a grid of symbols meaningless. Very young children, for whom a photo of their own bedroom is more legible than a page of icons. People with dementia, for whom a picture of a familiar place carries the words. And beginning communicators of any age, where the aim is to get a first message across quickly.

VSDs are poor for generating new sentences. A scene says what was recorded for it; it can't say "not that, the other one". So they usually sit alongside a grid or a keyboard rather than replacing them, and a person who is building language should not be left on scenes alone.

How it works

Someone photographs the person's own environment: the front room, the day centre, the shop, the family at a table. On a device, the photo is loaded and hotspots are drawn over objects and people, each with a spoken message. The person touches the hotspot. Some systems let a hotspot open another scene ("go into the garden"), which makes a navigable picture-book of the person's life.

The photographs have to be the person's own. A stock image of a kitchen has none of the recognition that makes the approach work. That means the setup is personal, quick to do and easy to update: a new scene takes ten minutes with a phone.

Getting started

Take five photographs of the places and people in the person's week, with the phone you have. Load them into an app that supports scenes (several of the main AAC apps do) and add three or four hotspots to each with messages the person is likely to want there.

Show, don't explain. Touch the hotspot yourself, in that place, and let the device speak. Then leave it within reach.

Add a way out. Every scene should have a hotspot for "something else" or a link to a keyboard or core page, so the person is never trapped inside the picture.

Where to get help

Say Aphasia and the Stroke Association support people with aphasia, for whom scenes are most used. ACE Centre publishes guidance on scene-based systems and which apps support them. A speech and language therapist will build the first scenes with the person and family.