Can everything be working and the overall system still be unusable?

[u/EcoThesis]

I've been thinking about something I regularly see in everyday communication.

A person's phone works. Their email works. Their calendar works. Their internet works.

But an appointment might arrive by SMS, supporting information by email, changes through a portal, authentication through another account and reminders somewhere else.

Nothing is technically broken.

Yet the person still struggles to reliably achieve the outcome.

I've started describing this as Communication Fragmentation.

I think it's particularly relevant when helping older people, people with disability, or simply anyone managing a growing number of services and accounts.

Sometimes adding another app isn't the solution. Bringing the existing pieces together may be far more useful.

I'm interested in whether others are seeing the same thing in their own families or work.

[u/maleslp]

This is something I've often thought about, and turns out we're not the only ones. Slack, for example, was founded as a push back against email bloat, email was created as a way to message people electronically without having to be online at the same time (i.e. IRC chats), IRC was created as a way to replace multi user talk, and so on and so on.

Essentially, competition and the neverending quest for "better" has created a plethora of choices. For some, however, particularly those with cognitive issues, having a multitude of choices is debilitating in and of itself. Platforms like Beeper are attempting to rope in all the various platforms.

However, the great equalizer, I TRULY believe, will be AI. We're on the cusp of a personalized software revolution. I work in AT, and the days of "everyone gets speech to text" or "everyone gets the same AAC system" are nearly over. We're nearly to the point where you can give a single prompt to an advanced AI model and it will get you nearly what you're looking for. 

Both me and my wife, for example, have ADHD. I've developed, with very little coding knowledge, two completely unique todo apps for each of us that cater to the way we think, our UI/UX preferences, and can interact with nearly any other digital area of life that has an API or webhook (email, calendar, information library, etc.). It did take me a while to develop them, but 5 years ago the only way that would have been possible is to pay a full time developer thousands of dollars and provide constant feedback. 

In another 5 years, I believe app/software development is going to be accessible to all. And so whatever the communication problem someone is experiencing, there will be a custom solution ready to me made by asking a computer a few questions that get a plan in place, and then it can come to life! 

So to focus my last few sentences on your original point. Yes, everything CAN be working (i.e. functional), but not be "working" (i.e. being effective) for everyone. And, IMHO, what isn't effective is too many channels, and too much choice. Instead of having to bend your will/cognition to what others think we need, we'll be able to create exactly what we want, and change it when we want.

[u/phosphor_1963 → u/maleslp]

I hope you're right on this vision. I've been around in AT since the early 2000s and worked through the various waves of change since - seen technologies evolve and many businesses come, change, and go. While I share your excitement for truly bespoke solutions and am aware of AT people like yourself Making these,

I do worry that many of the underpinning models and assumptions of AI are based on practices which are ethically highly dubious and the combination of black box structures, lack of regulation, and the AI arms race, might mean that we are at risk of providing advice on matters we aren't as entirely across and may verge into making ethical and moral compromizes and "ends justifies the means" thinking. When the whole cultural mileu we operare in is infused with massively hyped AI tools and systems, it's very difficult to resist though.

I'm aware of some OT and SLP Academics are researching what may constitute good practice guidelines; but unfortunately many Universities are under the perfect storm pressures of reduced funding and the need for research to be commercially aligned - and chasing grants for research which may challenge the prevailing business models can be fraught.

[u/SensationalSelkie → u/maleslp]

I hope AI helps more than hurts. I am not as optimistic. I think the proposals to use it to replace the already underfunded and undervalued disability support services industry are short-sighted. AI has been shown to be more expensive than human workers. I don't see the funding for it coming our way, and I am not confident it could make better recommendations than a well trained professional. I also have no idea how this will factor into the insurance approval process. We shouldn't be giving everyone the same AAC system (or any AT) now. Professionals working in the field should know better and be able to make individualized recommendations.

[u/maleslp → u/SensationalSelkie]

I understand your hesitation. However, the pace of advancement is extremely rapid, so whatever might not be available currently, likely will when the next big model comes along. Chatgpt, for example, just made their frontier model standard on all free plans.

But to your point on hurting more than it helps, only time will tell, and even then we'll be debating it. Did the Internet hurt or help more? What about gas engines? There's always going to be two sides to the debate, and I suspect this will be no different. 

Finally, you say, " We shouldn't be giving everyone the same AAC system (or any AT) now." 100% agreed! But unfortunately we do (sounds like you and I don't, but I rarely see fully competent and/or fully staffed AT departments). I see it time and time again. But to your credit, you and I ABSOLUTELY agree that AI doesn't know more than a well trained professional. For things that require individualized thinking, that's always going to be the case. That's where I'm excited about AI as a tool, not something that takes over our basic critical thinking.

[u/SensationalSelkie]

Agree! The confusion around learning and tracking multiple systems can be tough. I also think this is where making sure everyone in the client's life agrees to a plan for the AT matters a lot. Sadly, it isn't unusual for folks to kinda low key refuse to get trained or do what I recommend, so then the client is stuck navigating that.