Assistive Technology Assistive Technology Accommodating Students with Accommodating Students with

Communication and Learning DeficitsCommunication and Learning Deficits

Evita B Nepal-NaraineEvita B Nepal-Naraine

TechnologyTechnology Utilized Utilized

NAME:NAME: Picture Exchange Communication System (PECS) Picture Exchange Communication System (PECS)

via: VOCA (voice output communication aid) via: VOCA (voice output communication aid)

MANUFACTURERMANUFACTURER: Mayer-Johnson (Boardmaker): Mayer-Johnson (Boardmaker)

DESCRIPTION:DESCRIPTION: System which assist and promote System which assist and promote student’s communication skillsstudent’s communication skills

PLATFORM:PLATFORM: students with various communication or students with various communication or learning disabilities. learning disabilities.

PRICE:PRICE: 899.99-1000.00 or more per instrument 899.99-1000.00 or more per instrument

Why do students with disabilities Why do students with disabilities need technology?need technology?

Students that are in special education Students that are in special education need technology due to their different need technology due to their different learning styles and need of alternate learning styles and need of alternate teaching methods.teaching methods.

Students who have a lack of Students who have a lack of communications skills/social skills and communications skills/social skills and learning disabilities can be helped by learning disabilities can be helped by being taught to use the PECS (picture being taught to use the PECS (picture exchange communication system). exchange communication system).

Picture Exchange Comm. System Picture Exchange Comm. System or Pyramid Educational Products or Pyramid Educational Products

This system was developed to help students with autism This system was developed to help students with autism and developmental disabilities who are nonverbal or and developmental disabilities who are nonverbal or have limited verbal communication. PECS may also be have limited verbal communication. PECS may also be used in conjunction with a voice output communication used in conjunction with a voice output communication device.device.

Students that cannot communicate and are low cognitive Students that cannot communicate and are low cognitive functioning are the most appropriate candidates to utilize functioning are the most appropriate candidates to utilize this tool. Students with various types of deficits may use this tool. Students with various types of deficits may use this tool as well. this tool as well.

Some students may be taught how to use technology Some students may be taught how to use technology VIA THE SIX PECS PHASES, but some students may VIA THE SIX PECS PHASES, but some students may not COMPREHEND due to their disability or may not not COMPREHEND due to their disability or may not reach the last stages of the program. However, it is reach the last stages of the program. However, it is acknowledged through research that students have the acknowledged through research that students have the capability to communicate more than they did before. capability to communicate more than they did before.

SIX PHASES OFSIX PHASES OF PECS before using PECS before using Voice output communication aid (VOCA).Voice output communication aid (VOCA).

PHASE 1- DPHASE 1- Discover students likes through motivation. Identify what the child wants. Find the things that iscover students likes through motivation. Identify what the child wants. Find the things that they will "ask" for (a toy). In this phase, two teachers is mandatory. Verbal confirmation is given by the they will "ask" for (a toy). In this phase, two teachers is mandatory. Verbal confirmation is given by the first adult and the second teacher should slowly back off, working towards the child independently first adult and the second teacher should slowly back off, working towards the child independently reaching for the picture and handing it to the first teacher. The goal here is for the child to initiate reaching for the picture and handing it to the first teacher. The goal here is for the child to initiate communication.communication.

PHASE 2 -PHASE 2 - Independently make a request, child also begins expanding his vocabulary of symbols, Independently make a request, child also begins expanding his vocabulary of symbols, requesting different reinforcing objects or activities. At this time only one picture should be offered as a requesting different reinforcing objects or activities. At this time only one picture should be offered as a choice.choice.

PHASE 3-PHASE 3- The teacher asks the child to chose between several item, working toward making personal The teacher asks the child to chose between several item, working toward making personal choices. The teacher may begin by asking, "What do you want?" but this should be quickly faded out so choices. The teacher may begin by asking, "What do you want?" but this should be quickly faded out so the child will make choices spontaneously. “If the child finds it difficult to chose between too many the child will make choices spontaneously. “If the child finds it difficult to chose between too many pictures, reduce the number of choices to 2 or 3, and work towards a larger number”. pictures, reduce the number of choices to 2 or 3, and work towards a larger number”.

STAGE 4-STAGE 4- requests for a variety of items, to different people, the program begins to focus on sentence requests for a variety of items, to different people, the program begins to focus on sentence structure The child will start combining a picture for "I want" with a picture of the requested item or structure The child will start combining a picture for "I want" with a picture of the requested item or activity. The two pictures will be attached to a sentence strip and the entire strip would be exchanged with activity. The two pictures will be attached to a sentence strip and the entire strip would be exchanged with the communicative partner for the pictured item or activity.the communicative partner for the pictured item or activity.

STAGE 5 AND 6 - STAGE 5 AND 6 - The child will start combining a picture for "I want" with a picture of the requested The child will start combining a picture for "I want" with a picture of the requested item. It challenges learners to build questions using sentence strips, starters and pictures. Students are item. It challenges learners to build questions using sentence strips, starters and pictures. Students are taught to comment on the world around them by responding to questions such as "what do you hear?" taught to comment on the world around them by responding to questions such as "what do you hear?" "what do you see?“, which is most complex."what do you see?“, which is most complex.

Students may not complete the program fully. If they do, it may take weeks, months or years for them to Students may not complete the program fully. If they do, it may take weeks, months or years for them to learn and use it effectively. After these steps, tools utilized as assistive technology can then be used.learn and use it effectively. After these steps, tools utilized as assistive technology can then be used.

Students who need technology using Students who need technology using PECS viaVOCA.PECS viaVOCA.

Disabilities / Mental retardation downDisabilities / Mental retardation down Autism Autism ADD / ADHD AIDS/ HIV autism ADD / ADHD AIDS/ HIV autism Palsy Deaf/ hearing impaired developmentalPalsy Deaf/ hearing impaired developmental BufidaTraumatic Brain injuryBufidaTraumatic Brain injury Disorder Speech DisordersDisorder Speech Disorders Alcohol Syndrome Sensory Integration Alcohol Syndrome Sensory Integration

Benefits of technology Benefits of technology (VOCA)(VOCA) with with specific students needsspecific students needs

Using PECS (VOCA) help students with the Using PECS (VOCA) help students with the following:following:

1.1. Decrease negative behaviors that were caused Decrease negative behaviors that were caused by frustrations by frustrations

2.2. Increase availability for learning and interaction Increase availability for learning and interaction

3.3. Increase relatedness and emotional closeness Increase relatedness and emotional closeness

4.4. Build spoken language skills (this is not a direct Build spoken language skills (this is not a direct outcome of PECS, but seems to occur as outcome of PECS, but seems to occur as PECS skills increase).PECS skills increase).

Information on VOCAInformation on VOCAIf a VOCA is being considered, there are several issues to keep in mind: If a VOCA is being considered, there are several issues to keep in mind: Devices need batteries - a child is unable to use the communicate device if the batteries die. Extra batteries Devices need batteries - a child is unable to use the communicate device if the batteries die. Extra batteries

should be kept on hand. should be kept on hand. Devices break down and need service. Devices break down and need service. Some devices require programming and can result in a tremendous amount of work. Some devices require programming and can result in a tremendous amount of work. Devices need to be portable, as children need to communicate all the time, even while walking or riding in a Devices need to be portable, as children need to communicate all the time, even while walking or riding in a

car. car. The device should be sturdy, as children tend to be hard on equipment. The device should be sturdy, as children tend to be hard on equipment. VOCAs can be very expensive, costing thousands of dollars. VOCAs can be very expensive, costing thousands of dollars. Some devices may be too difficult or complicated for the child to operate. Some devices may be too difficult or complicated for the child to operate. Once the method of AAC has been decided upon and the child is ready to begin using AAC, the next difficult Once the method of AAC has been decided upon and the child is ready to begin using AAC, the next difficult

task is teaching the child how to communicate with it. Determining how to teach AAC to a child must be task is teaching the child how to communicate with it. Determining how to teach AAC to a child must be highly individualized, however, the following are general teaching tips: highly individualized, however, the following are general teaching tips:

Both parents and teachers should work together in teaching the child to provide consistency and the Both parents and teachers should work together in teaching the child to provide consistency and the opportunity to use AAC in different environments. opportunity to use AAC in different environments.

Siblings and peers should use the same system while communicating with the child so that the use of AAC Siblings and peers should use the same system while communicating with the child so that the use of AAC feels more natural. feels more natural.

Formal instruction should occur frequently and for short periods of time. Formal instruction should occur frequently and for short periods of time. Teaching should occur in natural settings - places where the child feels at ease - and focus on communication Teaching should occur in natural settings - places where the child feels at ease - and focus on communication

skills that fit into the activities that take place within that environment. skills that fit into the activities that take place within that environment. Respect the child and teach with compassion and humor. Children enjoy playing, so to keep their interest and Respect the child and teach with compassion and humor. Children enjoy playing, so to keep their interest and

attention, teaching sessions should be fun. attention, teaching sessions should be fun. Allow the child to experiment in non-communicative ways with his or her AAC. This is how children learn Allow the child to experiment in non-communicative ways with his or her AAC. This is how children learn

about and feel comfortable with their AAC. about and feel comfortable with their AAC. Begin using AAC around areas of interest to the child (food or toys). Begin using AAC around areas of interest to the child (food or toys). Children need control. Incorporate messages that allow the child to make a decision over what happens to him Children need control. Incorporate messages that allow the child to make a decision over what happens to him

(i.e., selecting a video, where to go on an outing).(i.e., selecting a video, where to go on an outing).

Examples and pictures of PECS Examples and pictures of PECS devices (VOCA)devices (VOCA)

Voice output is produced and used Voice output is produced and used in this formatin this format

Using VOCA Using VOCA

Way student will use technology with VOCAWay student will use technology with VOCA

PECS Effectiveness with children with PECS Effectiveness with children with Autism: assessment of acquisition, speech, Autism: assessment of acquisition, speech,

social communicative and problem behavior.social communicative and problem behavior.

Article of effectiveness: http://autism.healingthresholds.com/research/using-the-picture-exchange-commu

This article states that the picture-exchange communication system (PECS) can help improve speech and decrease problem behaviors in children with autism.

“This research report focused on three children with autism (3-12 years old). All three children were trained in PECS for 15 minutes, two times a week, over 7-11 weeks. Before, during, and after the training period, the children were videotaped during play sessions. These videotapes were scored by several different people, who counted the number of times the children spoke, the length of their sentences, the number of times they made eye contact, and instances of problem behavior. They also noted other measures of language and social behavior. The results showed that by the end of PECS training, each child improved in both the use of speech (including both speaking to others and responding when spoken to) and social behavior. Problem behaviors were also reduced after PECS training was complete, as compared to before the training period”.

Tools used for effectiveness (ACC)Tools used for effectiveness (ACC)

Augmentative/alternative communication (AAC) Augmentative/alternative communication (AAC) is any device, system or method of is any device, system or method of communication that can help individuals with communication that can help individuals with communication difficulties to communicate more communication difficulties to communicate more easily and effectively. easily and effectively.

Although AAC is often used to refer to formal Although AAC is often used to refer to formal communication devices and systems such as communication devices and systems such as communication boards, voice output communication boards, voice output communication aids (VOCAs), or sign language, communication aids (VOCAs), or sign language, it can include less sophisticated means of it can include less sophisticated means of communication, such as facial expressions, non-communication, such as facial expressions, non-speech vocalizations, and gestures.speech vocalizations, and gestures.

Recommendations Recommendations I would recommend VOCA to students with communication deficits any age I would recommend VOCA to students with communication deficits any age

group after the PECS tool is mastered. group after the PECS tool is mastered. This device can be used in schools and in homes with their child. This device can be used in schools and in homes with their child.

Teachers and family members should be trained how to use it and then they Teachers and family members should be trained how to use it and then they can utilize this type of assistive technology with their students or child. can utilize this type of assistive technology with their students or child.

It is feasible due to the importance of children learning how to communicate It is feasible due to the importance of children learning how to communicate with others and to have their needs met. with others and to have their needs met.

Even though this tool is very expensive ($1000 per unit for a child), and that Even though this tool is very expensive ($1000 per unit for a child), and that the system needs to be highly individualized and maintained, price should the system needs to be highly individualized and maintained, price should not matter because it effectiveness and benefits are immense.not matter because it effectiveness and benefits are immense.

District may pay for assistive equipment if required and included in child’s District may pay for assistive equipment if required and included in child’s individualized Education Plan (iEP) individualized Education Plan (iEP)