Abstract
In Ghana, people with communication challenges could benefit from gaze-based Augmented and Assistive Communication devices (AACs), widely used in countries with greater resources. However, there is limited evidence about the potential of such devices by people with communication disabilities in the Global South. Our study sought to evaluate the usability, identifying barriers and facilitators of adoption of a freely available Android-based eye-gaze AAC application called Look to Speak. The study included training of 10 local speech and language therapists and 15 people with communication difficulties. Our findings highlight how, despite some initial successes and the positive opinions of clients, caregivers and speech and language therapists the Look to Speak application largely failed to deliver substantial communication benefits to individual users. This was due to a combination of factors including the high cognitive load, design flaws of the application - such as the lack of optimization of the selection process depending on the chosen interaction mode, and lack of wheelchairs with adequate postural support, which are necessary for users to be able to successfully utilise the application. We contribute insights surrounding the mismatch between expectations and reality of gaze-base AACs, and considerations about the broader ecosystem required to support adoption and impact of such technologies in Ghana.
