<p>Voice Output Communication Aids (VOCAs) are devices that have been developed to allow pictures, symbols or words to be used with speech synthesis. The devices may be specialist items with built in systems carrying the symbols. They may also be a generic computer, tablet or mobile with specialist software or apps. The symbols are activated by single or multiple touches, eyes dwelling on a chosen image or manual use of a keyboard or switches. An external input device usually allows for step by step scanning up and down rows and columns of symbols on a grid. Symbols and word choices are personalised to suit the user, representing known objects, actions and happenings.p>
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