title: Critical issues using brain-computer interfaces for augmentative and alternative communication.
abstract: Brain-computer interfaces (BCIs) may potentially be of significant practical value to patients in advanced stages of amyotrophic lateral sclerosis and locked-in syndrome for whom conventional augmentative and alternative communication (AAC) systems, which require some measure of consistent voluntary muscle control, are not satisfactory options. However, BCIs have primarily been used for communication in laboratory research settings. This article discusses 4 critical issues that should be addressed as BCIs are translated out of laboratory settings to become fully functional BCI/AAC systems that may be implemented clinically. These issues include (1) identification of primary, secondary, and tertiary system features; (2) integrating BCI/AAC systems in the World Health Organization's International Classification of Functioning, Disability and Health framework; (3) implementing language-based assessment and intervention; and (4) performance measurement. A clinical demonstration project is presented as an example of research beginning to address these critical issues.
authors.affiliation: Research Services, Pittsburgh VA HealthCare System, Pittsburgh, PA; AAC Performance, Testing and Teaching Lab, Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA. Electronic address: khill@pitt.edu.
authors.forename: Katya
authors.initials: K
authors.lastname: Hill
authors.affiliation: Research Services, Pittsburgh VA HealthCare System, Pittsburgh, PA; AAC Performance, Testing and Teaching Lab, Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kovacs
authors.affiliation: Research Services, Pittsburgh VA HealthCare System, Pittsburgh, PA; AAC Performance, Testing and Teaching Lab, Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Sangeun
authors.initials: S
authors.lastname: Shin
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000534:rehabilitation; D062207:Brain-Computer Interfaces; D003143:Communication Devices for People with Disabilities; D016287:Computer Peripherals; D006801:Humans; D007802:Language; D026741:Physical Therapy Modalities; D014584:User-Computer Interface
keywords: Amyotrophic lateral sclerosis; Brain-computer interfaces; Communication aids for disabled; Language; Rehabilitation; Translational medical research