What is a Dedicated Device? An AAC Rundown

I have recently had discussions with some of my colleagues in regards to the “true” definition of a dedicated device. Something that has been up in the air recently, is the way that we are defining these AAC systems (i.e., Speech Generating Devices/SGD). Why is it even important? Well, insurance, for one!

Oftentimes, dedicated devices are more likely to be covered by private insurance, Medicare, and Medicaid as opposed to non-dedicated devices. If you are a client or caregiver interested in applying for funding for an SGD, it seems like a dedicated device is the way to go, right? Maybe. Maybe not. With an increase in new communication software on the market (think: speech generating applications on an iPad - aka non-dedicated device), this has changed client and caregiver accessibility to augmentative communication. The “defining” piece is important because insurance policies that only report dedicated devices as considered/approved for funding can make an enormous difference in the options we provide to clients.

For those of you who are newer to the AAC game, therapists tend to think of SGDs in two different categories: dedicated devices and non dedicated devices. Again, the way that we define each subcategory of SGDs tends to vary slightly depending on who you ask - there is variability across insurance carriers and policies state by state. For example, in the state of Massachusetts, MassHealth will consider funding for non-dedicated devices; however, there is only “limited” coverage under “certain circumstances.” Let’s take a closer look… how do these devices seem to differ?

	Dedicated Devices	Non-dedicated Devices
Purpose	to increase communication/intelligibility for individuals with severe expressive language disorder	to increase communication/intelligibility for individuals with severe expressive language disorder
Often defined as...	devices that are deemed medically necessary (usually require a script from primary care physician) and intended purpose is solely to augment expressive communication	devices that are not for "medical" use; can be used as a communication tool but is multi-functional (can access additional features and serve purposes other than for expressive communication)
Manufacturers/software	e.g., Tobii Dynavox, PRC-Salitillo - software like LAMP Words for Life, TouchChat Express, Snap Core First	e.g., iPads, computers, smart notebooks - software like Speak for Yourself, TouchChat, ProloQuo2Go
Promoted features	commonly covered by insurance, durability, increased tech support and training, extended warranties/repair services available, accessories/device accommodations	easier to access, increase in communication software offered, decreased cost, accessibility to other features (calling, SMS messaging, functional apps, etc.)
Average costs (no funding)	Accent 1400 by PRC - $7,595.00 (additional cost for certain software - $395.00)	iPad mini 4 with TouchChat with WordPower, protective case, and Apple Care - approx. $900.00

As you could probably notice, there are definitely pros and cons for each type of device. One of the largest being the gap in cost. Though, most of the time, if the client/caregiver applying for funding is in great need of the device and has clinical evidence to support its need, the individual should not have a problem obtaining a funded dedicated device. It should be noted that turnaround time is something to consider. It can take several months, lengthy paperwork, and support from a certified speech-language pathologist (usually a comprehensive AAC evaluation) by the time you receive your device. Yes, you could technically buy, download, and put together a completed non-dedicated device in one day (excluding time to edit layouts/vocabulary), but that is still just under a grand coming out of someone's pocket. Either way, it is important to know and understand your options.