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need to consider a wider range of options than previously available in arriving at ethical decisions. Speech pathologists have an ethical responsibility to work with families who desire mobile devices and provide unbiased information and advice in regards to the potential benefit to the person who uses AAC. However, mobile technology AAC does not currently provide all of the features and functions available within dedicated speech-generating devices, and it is important that all relevant AAC options be considered in a feature matching assessment (AAC-RERC, 2010). Risks to privacy and confidentiality in AAC communications A distinctive risk relating to privacy in the field of AAC is related to (a) the involvement of communication partners in supporting communication and thus being privy to what might otherwise have been treated as private conversations (e.g., consultations with the doctor or legal representatives), and (b) the potential for communications delivered by AAC to be captured and kept in a file (commonly called “history”) within the speech-generating device or mobile technology app for AAC. It is recognised that collection of a history of the person’s communications might be of benefit, but there may be less awareness of the potential harms arising from the storage and retrieval of messages in the history. The record or log of every keystroke, word, or phrase entered into an AAC system is akin to recording the person’s voice. It should be treated as containing potentially sensitive and private communications and subject to the same restrictions and permissions prior to collection, storage, or release as audio or video recordings of the person. As yet, there is no industry standard on the processes for designing a history feature of a speech-generating device or mobile technology app that takes into account all ethical issues pertaining to privacy, confidentiality of communications, freedom of choice and autonomy, and safety. An AAC system that does not enable the history feature to be switched on and off or to clear or delete messages potentially places the person at risk of breaches of privacy and confidentiality. Speech pathologists need to consider the potential harms of sensitive information shared with one person becoming known to people other than the intended communication partner. Risks to privacy posed by the history feature of a system is particularly pertinent to the situation where people with complex communication needs might wish to discuss personal issues or report abuse (see Bryen, Carey, & Frantz, 2003). Conclusion In summary, speech pathologists, being aware of ethical issues in AAC, have an important role in ensuring that AAC interventions are not only timely and effective, but also of greatest benefit and least harm to people who use AAC. Considering the range of options available, effective and ethical practice will rest heavily upon person-centred, collaborative, and evidence based practice. In this way, multi-modal communication services may truly improve the lives of people with complex communication needs, their families, and society as a whole. References AAC-RERC (2010). Mobile devices and communication apps. Retrieved from http://aac-rerc.psu.edu/index.php/ pages/show/id/46

Ballin, L., Balandin, S., Stancliffe, R. J., & Togher, L. (2012). The views of people who use speech generating devices on mentoring new learners Disability and Rehabilitation. Assistive Technology , 7 , 63–74 Beukelman, D. R.; Mirenda, P. (2005). Augmentative & alternative communication: supporting children & adults with complex communication needs (3rd ed.). Baltimore, MD: Paul H. Brookes Publishing. Body, R., & McAllister, L. (2009). Ethics in speech and language therapy . West Sussex, UK: Wiley-Blackwell. Bryen, D. N., Carey, A., & Frantz, B. (2003). Ending the silence: Adults who use augmentative and alternative communication and their experiences as victims of crimes. Augmentative and Alternative Communication , 19 (2), 125–134. Chabon, S. S., Denton, D. R., Lansing, C. R., Scudder, R. R., & Shinn, R. (2007) Ethics education . Rockville, MD: American Association of Speech and Hearing. Goldbart, J., & Marshall, J. (2011). Listening to proxies for children with speech, language and communication needs. In S. Roulestone, & S. McLeod (Eds.), Listening to children and young people with speech language and communication needs . London: J&R Press. Farrall, J. (2012). Switch accessible apps for ipad/iphone. Retrieved from http://www.janefarrall.com/html/resources/ Switch%20Accessible%20Apps%20for%20iPad-1.pdf Farrall, J. (n.d.) ipad/iphone apps for AAC. Retrieved from http://www.spectronicsinoz.com/article/iphoneipad- apps-for-aac Kaiser A. P., & Goetz, L. (1993). Enhancing communication with persons labelled severely disabled. Journal of the Association for Persons with Severe Handicaps , 18 (3), 137–142. McNaughton, D. B., & Beukelman, D. R. (Eds.). (2010). Transition strategies for adolescents and young adults who use AAC . Baltimore, MD: Paul H. Brookes Publishing. Markkula Centre. (n.d.) Ethical decision making . Retrieved from http://www.scu.edu/ethics/practicing/decision/ Speech Pathology Australia. (2002). Ethics education for Australian speech pathologists . Melbourne: Author. 2002 version retrieved from http://www. speechpathologyaustralia.org.au/library/Ethics%20 Education%20Package.pdf Speech Pathology Australia. (2011). Competency-based occupational standards (CBOS) for speech pathologists . Melbourne: Author. Speech Pathology Australia. (2012a). Ethics education for Australian speech pathologists. Report in preparation. Speech Pathology Australia. (2012b). Clinical guideline on augmentative and alternative communication. Report in preparation. St James Ethics Centre. (n.d.). What is ethics? Retrieved from www.ethics.org.au/ Sutherland, D., Gillon, G., & Yoder, D. (2006). AAC use and service provision: A survey of New Zealand speech-language therapists. Augmentative and Alternative Communication , 21 , 295–307. Speech Pathology Australia. (2010). Code of ethics. Melbourne: Author. Retrieved from www. speechpathologyaustralia.org.au/library/Ethics/ CodeofEthics.pdf

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JCPSLP Volume 17, Supplement 1, 2015 – Ethical practice in speech pathology

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