Free AAC app for ALS patients in India — communicate with eye blinks

When a person is diagnosed with ALS (Amyotrophic Lateral Sclerosis) in India, the conversation around communication often comes too late. By the time motor neurone disease has progressed to the point where speaking and typing become impossible, many families are scrambling for solutions — and the solutions they find are expensive, complicated, or simply unavailable in India.

Voxetu is a free AAC (Augmentative and Alternative Communication) app built specifically for this moment. It works on any smartphone or tablet in a browser — no download, no installation, no hardware purchase required. And its most powerful feature is blink communication: the ability to say YES, NO, and HELP using only your eyes.

How blink communication works

Voxetu's blink mode uses your phone's front camera and on-device AI (Google's MediaPipe Face Mesh) to track 468 facial landmarks in real time. The system calculates the Eye Aspect Ratio — the ratio of eye height to eye width — and detects when it drops below a threshold, indicating a blink.

The detection happens entirely on the device. No video or image data is ever sent to a server. No internet connection is required once the page has loaded.

For someone in the late stages of ALS who retains only voluntary eye movement, these three responses are often enough to answer a doctor's questions, tell a family member they are in pain, or call for help at 3am.

What makes this different for ALS patients in India

Eye-tracking AAC devices like the Tobii Dynavox cost between ₹2 lakh and ₹5 lakh and require specialist configuration. Most Indian families with an ALS patient cannot access or afford this. Government schemes like the Assistance to Disabled Persons (ADIP) scheme cover some assistive devices, but eye trackers are rarely included and waiting times can be months.

Voxetu works on the phone you already have. If the person with ALS has a smartphone mounted near their bed, they can begin using blink communication in under five minutes. The sensitivity calibration adjusts automatically for different lighting conditions and individual blink patterns.

Other communication modes in Voxetu

Blink mode is one of several hands-free options in Voxetu:

• Breath mode — a short puff says YES, a long blow says NO, two puffs say HELP. Uses only the microphone. Coughs are automatically identified using frequency analysis and ignored.
• Gaze keyboard — rows of the keyboard highlight automatically, the user blinks to select a row, then blinks again to select a key. Slower than blink mode but allows free-form typing.
• Emotion board — 28 illustrated faces. Tap any face (or blink while looking at one in gaze mode) and the phrase speaks aloud. No typing required.

The caregiver dashboard

One of the most overlooked problems in late-stage ALS care is the carer's inability to monitor communication when they are not in the room. Voxetu's caregiver dashboard shows every communication — every blink response, every phrase, every emotion board tap — in real time on any device, anywhere.

If a patient blinks HELP at 2am and nobody is in the room, the carer's phone receives the notification. Pain logs, medication tracking, and daily check-ins are also visible on the dashboard, giving the care team a complete picture without requiring the patient to communicate everything repeatedly.

Voice banking — before it is too late

Voxetu also includes voice banking — the ability to record up to 50 phrases in your natural voice while you can still speak clearly. These recordings are stored and can be used as the spoken output when you later communicate using the keyboard or blink mode.

"Record 'I love you', 'Thank you for everything', and 'I need help' as early as possible. These are the phrases that matter most and the ones that should sound like you."

Voice banking is available on the Pro plan, but the free plan covers blink mode, breath mode, the gaze keyboard, emotion board, and caregiver dashboard — everything needed for basic communication.

How to start

Total setup time: under 10 minutes. Total cost: zero.

Voxetu is built and maintained by PISRO Consultancy Pvt. Ltd. as part of the PalsyWorld platform — India's assistive technology community. The free plan has no expiry and no feature time limit.