An<unk>  user indicates a series of numbers on an eye gaze<unk>  board in order to convey a word.<unk>  <unk>  encompasses the<unk>  methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language.<unk>  is used by those with a wide range of speech and language impairments, including congenital impairments such as cerebral palsy, intellectual impairment and autism, and acquired conditions such as amyotrophic lateral sclerosis and Parkinson's disease.<unk>  can be a permanent addition to a person's<unk>  or a temporary aid. Stephen Hawking used<unk>  to communicate through a speech-generating device. Modern use of<unk>  began in the 1950s with systems for those who had lost the ability to speak following surgical procedures. During the 1960s and 1970s, spurred by an increasing commitment in the West towards the inclusion of disabled individuals in mainstream society and developing the skills required for independence, the use of manual sign language and then graphic symbol<unk>  grew greatly. It was not until the 1980s that<unk>  began to emerge as a field in its own right. Rapid progress in technology, including microcomputers and speech synthesis, have paved the way for<unk>  devices with speech output and multiple options for access to<unk>  for those with physical disabilities.<unk>  systems are diverse: unaided<unk>  uses no equipment and includes signing and body language, while aided approaches use external tools. Aided<unk>  methods can range from paper and pencil to<unk>  books or boards to speech generating devices (SGDs) or devices producing written output. The symbols used in<unk>  include gestures, photographs, pictures, line drawings, letters and words, which can be used alone or in combination. Body parts, pointers, adapted mice, or eye tracking can be used to select target symbols directly, and switch access scanning is often used for indirect selection. Message generation is generally much slower than spoken<unk> , and as a result rate enhancement techniques may be used to reduce the number of selections required. These techniques include "prediction", in which the user is offered guesses of the word/phrase being composed, and "encoding", in which longer messages are retrieved using a prestored code. The evaluation of a user's abilities and requirements for<unk>  will include the individual's motor, visual, cognitive, language and<unk>  strengths and weaknesses. The evaluation requires the input of family members, particularly for early intervention. Respecting ethnicity and family beliefs are key to a family-centered and ethnically competent approach. Studies show that<unk>  use does not impede the development of speech, and may result in a modest increase in speech production. Users who have grown up with<unk>  report satisfying relationships and life activities; however, they may have poor literacy and are unlikely to be employed. While most<unk>  techniques are reliable, two techniques (facilitated<unk>  and the rapid prompting method) have arisen which falsely claim to allow people with intellectual disabilities to communicate. These techniques involve an assistant (called a facilitator) guiding a disabled person to type on a keyboard or point at a letter board. It has been shown that the facilitator, rather than the disabled person, is the source of the messages generated in this way. There have been a large number of false allegations of sexual abuse made through facilitated<unk> . The Convention on the Rights of Persons with Disabilities defines<unk>  as forms of<unk>  including languages as well as display of text, large-print, tactile<unk> , plain language, accessible multimedia and accessible information and<unk> s technology.
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