Assistive Technology in Education/Autistic

Assistive Technologies for Non-communicative Students

Introduction

Bob Williams (2000) expressed, “The silence of speechlessness is never golden. We all need to communicate and connect with each other….It is a basic human need, a basic human right” (Dell, Newton & Petroff, 2008, p. 88). This page will provide guidance on how to build sustainable uses of assistive technologies in schools to assist the communication of students and adults with disabilities such as autism, cerebral palsy, Down syndrome, developmental disabilities, or apraxia.

With the recent advances in assistive technology, there are new possibilities available to enhance the quality of the lives of all students. With the advent of speech generating devices (SGD) and an array of Alternative and Augmentative Communication (AAC) approaches, educators and families now have new tools to enhance the learning of all students. “It is now believed that regardless of an individual’s disability or the severity of that disability, all non-speaking individuals should be given the benefit of augmentative communication consideration” (Dell et al., 2008, p. 216).

When to Start? NOW!

Happy child and AAC user

1) Don’t wait until your child is “ready.” Waiting could be detrimental to the further development of communication skills (Kangas & Lloyd,1988; Van Tatenhove, 1987).

2) Don’t worry that it will inhibit natural speech development; it possibly will increase speech development (Daniels, 1994; Finch & Romski, 2004; Schlosser, 2003)

3) Literacy skills and certain behaviors are not required before implementing and assistive and augmentative communication system. (Beukelman & Mirenda, 2005; Hetzroni, 2004; Erickson, 2000; Musselwhite & King-DeBaun)

Those that have little or no communication skills beyond pulling you toward something they want you to acknowledge or throwing a tantrum if something is not understood are not successfully communicating. Negative behavior results when a student’s needs are not met in an appropriate way.

The time to start is now. Adhere the team approach to the selection process in the following section, and be sure all involved parties have proper training to maximize the likelihood of long-term success of the chosen system within all of the environments the child experiences.

Selection Process and Training

For successful implementation of assistive technology, proper analysis is required by a core team of stakeholders. AAC solutions should be based upon the student’s strengths and needs not the available technology. The student is the most important stakeholder, so despite the student’s abilities or challenges, “the student must be involved in every step of the process and must be a major contributor to all decisions” (Dell et al., 2008, p. 219). Without the student's involvement there is a higher risk of the student abandoning the use of the provided technology.

Assessment Team

According to Dell et al. (2008), “All augmentative communication assessment teams must include the following: (1) professional, such as a speech-language therapist, who is trained and experienced in augmentative communication assessment and applications; (2) the student; (3) his or her parent(s) or family members; and (4) the teacher(s) or other professionals involved in the student’s everyday school, community, or work environment.” Others such as physical therapists, occupational therapists, and a peer of the student may also be valuable members of the assessment team.

Although this team’s primary purpose is to initiate the selection of an appropriate AAC solution, it should be realized this is an ongoing process with updates and revisions to be expected.

Assessment Factors

Assessment Considerations for Augmentative Communication

Considerations	Questions
Level of Development	How are the student’s fine motor skills, problem-solving skills, etc.?
Level of Communication	How does the student currently communicate? Are these methods effective and efficient in the current environment? Will they work for the student’s future environments?
Environmental factors	What are the needs for communication in the student’s current and future environments? What communication difficulties exist in the student’s environments?
Needs	What student communication needs are not being met effectively through his or her current forms of communication
Solutions	What augmentative communication solutions can be used to reduce the unmet needs?
Analysis	Are the student’s communication needs in all environments with the selected augmentative communication solutions?

Symbols, vocabulary and access method are the components of the AAC that must be determined.

Symbols

Photographs, line drawings and written words are all examples of symbols that may be used. The team will need to observe the student to establish if the student has the ability to decide the function of the symbols. Further determinations for symbol size, number displayed at one time, how many to introduce at the start, ability of the student to access multiple categories of symbols must be made. Some parents have found greater initial success for their new AAC user when using actual pictures of the child's personal items.

Please remember that there are licensing issues around photographs, line drawings and any other picture. While a picture may be available on the internet that does not mean you can use it. Every picture on the internet is automatically associated with a copyright licence usually stopping you from using it! Wikipaedia has images that can be used but may need to be attributed in keeping with the license. Attribution means giving information about who the picture belongs to, where you link to it etc. Public Domain images do not need attributing which makes them easier to use. There are some Wiki images with a public domain license, the creative commons CC0. There are sites online where you can find public domain images you can use. If you take the images yourself you obviously do not need to worry about this,

Vocabulary

“Many teams make the mistake of identifying vocabulary that is important to caregivers or teachers rather than to the student who will be using the system. Instead the team must work to select vocabulary that is empowering to the individual” (Dell et al., 2008). The child's available vocabulary should sound like their peers, not like adults. It should enable them to greet others and start a conversation. With their vocabulary, they should be able to address the important people in their lives, and they need to be able to communicate about their favorite things such as pets, objects, toys or activities. Students' feelings must be able to be expressed including a way for the student to protest. Humor and sarcasm seem to be popular with students so they should be included on an age appropriate level. Vocabulary should be updated on an ongoing basis to continually meet the needs and desires of the student.

Access Methods

The access method is determined by the child's strengths and may include point and select, eye scan, or a simple switch. If the child has the coordination and fine motor skills to use a point and select method, it is generally used. If, however, the child has limited movement or difficulties with fine motor skills the options of larger symbols, a switch or eye gaze selection are other possibilities.

Training

It is very important that all people involved with the child be trained in the use and modification of the chosen augmentative communication system along with appropriate wait times used to enhance the likelihood of communication. If this is accomplished it is more likely the child will achieve success in the use of this system in all environments leading, to an overall greater success of the implementation. Most companies offer some type of free online training on their equipment, in addition to their regular training options.

Variety of AAC Technology Available

One of the simplest forms of AAC is commonly known as a picture board. It can be a sheet of paper with pictures printed on it or a laminated sheet with Velcro strips on which to place pictures. This is limited by the selection of pictures available, but is relatively inexpensive way to start to get a user familiar with this non-verbal method of communication.

Other forms of AAC are available, and they range from software for computers to dedicated hand-held devices to apps on smart phones. Costs can range from free apps on an android phone costing less than a hundred dollars to almost ten thousand dollars for a system. Regardless of which device is ultimately selected, it would have to be tried out with the student in the child's various environments for an extended period of time to see if it was a good fit or not.

Computers and Software for AAC

Children_working_ playing,_learning.

There is software made to turn a computer into a talking picture board. This software often also includes capabilities for the user to write text and the computer will translate it to spoken word. This is called text-to-speech. In order to increase the speed of the communication process, programs often include word prediction, word recognition and memory for common phrases. Word prediction is seen in most smart phones but is less commonly seen in a laptop or PC. Having word prediction speeds up communication greatly as the user does not need to type each letter - instead they choose the word from a short list shown. In case of multiple disabilities, some software offers switch scanning for those who can’t operate a mouse or keyboard.

This multitude of features make it a powerful student-learning tool for a previously non-communicative student. Some concern exists about the steepness of the learning curve that accompany its use. That is why training is vital and why parents and teachers need to be trained on the equipment prior to implementing it with the student. Most companies offer a thirty day trial of their software and have online training available along with other training options.

Some Software Options for AAC

Company	AAC Software Name
Dynavox	Boardmaker with Speaking Dynamically Pro
Smartbox	Grid 2 & 3
Gus Communications, Inc	SpeechPRO
Rehabtool.com	Vocalize

Some companies bundle their software with hardware and add options like preprogramming infrared signals for most brands of TV’s, VCRs, DVD players, satellite and cable receivers into it. So the user has total control from one location of many of their electronics. With the option of additional equipment these devices can also be used to turn on and off lights and household appliances. The DynaVox V and V max are examples of bundled computer with pre-installed software. The Communicator series from Gus Communications is another example.

Communication is more than just the spoken word, and autistic children need to learn to recognize the non-verbal communications people use everyday. Moore and his colleague found that collaborative virtual environments (CVE) can help autistic students recognize emotions displayed by avatars. The research is beginning to point to positive learning results for children who use AAC assistive technologies both at home and school; ;.

Portable AAC

Although computers are nice, sometimes they are cumbersome to carry or may not be as durable as a dedicated device. The AAC technology providers have developed several answers to the need for both portability and durability with items such as the Communicator U1 and QU1 from Gus Communications, Inc. or the DynaVox Tango, M³. Portable text to speech units are also available such as the LightWRITER by Toby Churchill Ltd. and the Dynawrite are some options.

Many use tablets that are adapted for use with their dedicated software. But a standard tablet can be loaded with appropriate software and used as a communication aid. This may be much cheaper but you do need to think about how rugged the device is - will it cope with the child dropping it once a day? Also how loud is the speech - will a speaker need to be added to the tablet etc.

Handheld AAC

Recent advances in technology have put literally put the power of communication in the palm of our hands. The invention of the Android phones, the iPod, the iPhone, the Personal Digital Assistant (PDA) and other Smart phones have opened a new door in SGD. Most of the AAC companies have a PDA or other handheld alternative. The popularity of Android phones, the iPod and iPhone with today's youth combined with the multitude of applications written for this format, have made it a powerful platform for SGD. Non-communicative students no longer have to stand out as "different" because they are carrying strange, special devices around. They can be the same as their peers and siblings, by using the same technology, just in a unique way.

The Android phones, iPod touch & iPhone now have thousands of applications available to them with more being developed every day. The costs of these applications range from free to 99 cents to $200+ depending upon their capabilities. An android smart phone may cost just $50 making it far more affordable then thousands of dollars commonly associated with the dedicated units. There are more AAC apps available for the iPhone as the iphones came out before the Android phones. However the lower cost of the android phones means around the world these are more common than the iPhones. Apps for the android are becoming more readily available and thankfully many are free.

iPod/iPhone Apps for AAC and Autism

App Name	Characteristics
TapSpeak Button & TapSpeak Picture	Simple switch activation. Allows recorded messages associated with a button. Picture version can be customized with pictures for buttons.
iConverse, Look2Learn, Voice4U, MyTalk, and Proloquo2Go	These AAC apps come with pre-installed symbols with messages and allow the user to add pictures and messages. Some use text to speech and others use recorded audio. The amount of preinstalled symbols vary from 6 to 7000. The customization options vary greatly between apps as do the fees charged for the app.
NeoPaul, NeoKate and NeoJulie	Male and female voice text to speech programs
iCommunicate	A storyboard program that allows the user to create picture storyboards with audio accompaniment
Behavior Tracker Pro	Enables behavioral patterns in those with autism to be tracked and graphed
Autism newsreader	Grabs top stories from various autism health news and information sites allowing you to keep up with autism issues and developments in one place.

On Going Process

Not only is technology innovation and additional research into augmentative communication occurring at a rapid rate, but the students and their needs are continuously evolving. These needs must be constantly evaluated. Available vocabulary must be kept current and reflect the relevant environments, age appropriate terminology and slang in order to increase the child's capability for communication.

Fortunately keeping informed of current technology and innovations is becoming easier through the use of RSS feeds. The AAC Institute and AAC Rehabilitation Engineering Research Centers are sources of current research in the field of augmentative communication. Auditory news can be obtained through the use of podcasts subscriptions such as Abilities, Autism Research Institute, Autism Insights, and the autism Podcast. The use of the iPod or iPhone equipped with the Autism Newsreader will grab the top stories in autism and bring them directly to those devices.