Abstract Introduction: Due to the increasing popularization of computers and the internet expansion, Alternative and Augmentative Communication technologies have been employed to restore the ability to communicate of people with aphasia and tetraplegia. Virtual keyboards are one of the most primitive mechanisms for alternatively entering text and play a very important role in accomplishing this task. However, the text entry for this kind of keyboard is much slower than entering information through their physical counterparts. Many techniques and layouts have been proposed to improve the typing performance of virtual keyboards, each one concerning a different issue or solving a specific problem. However, not all of them are suitable to assist seriously people with motor impairment. Methods: In order to develop an assistive virtual keyboard with improved typing performance, we performed a systematic review on scientific databases. Results: We found 250 related papers and 52 of them were selected to compose. After that, we identified eight essentials virtual keyboard features, five methods to optimize data entry performance and five metrics to assess typing performance. Conclusion: Based on this review, we introduce a concept of an assistive, optimized, compact and adaptive virtual keyboard that gathers a set of suitable techniques such as: a new ambiguous keyboard layout, disambiguation algorithms, dynamic scan techniques, static text prediction of letters and words and, finally, the use of phonetic and similarity algorithms to reduce the user's typing error rate.

AbstractIntroductionLocked-In Syndrome is admittedly the worst case of motor and speech impairment, it seriously damages the ability of oral and gestural communication of patients. In recent years, alternative and augmentative communication technology has provided resources to restore these patients' ability to communicate.MethodsIn order to relate and classify the main methods with that purpose, this work conducted a systematic review on several journal databases.ResultsWe found 203 related papers and 55 of them were selected to compose the study. After that, we classified them into three major groups and we identified the main difficulties when using each approach.ConclusionIn order to overcome these difficulties, we propose a new system concept to develop an adaptive, robust and low cost communication environment. The proposed system is composed of five modules: data entry, communication, aid to the caregiver and external interaction.