assistive technology for students with moderate to severe impairments

This workshop is for the Singapore

SPED Conference, November 2014

Amanda Hartmann Inclusive Technology Consultant (Speech Pathologist)

Spectronics Consultancy Team !

[email protected]

facebook.com/Spectronics

twitter.com/Spectronics

Spectronics.com.au/Blog

bit.ly/SPED-assistivetechnology

Handout Landing page

Today is about….

“I can buy the same golf clubs as Tiger Woods, but I can’t

play his game. Innovation is not in the tools - it’s in the use of them.”

John R. Wooden

Exploring

AT OptionsDeciding the BEST OPTION

Integrating

AT ImplementationPractical ideas and strategies for the classroom

Transforming classrooms

ACTION PLANBe ready to make a plan of action for change and implementation

into your classrooms

# 1 Reason

for Abandonment

People give up too soon

Technology Across Platforms

Students with moderate-to-high support needs

Disabilities Common difficulties

Strengths & Weaknesses

PRESUME COMPETENCE

What currently happens in

your classrooms?

Discuss

Access

Direct/indirect Switches

Switch interfaces Mouse control

Eye Gaze

REWARD

EFFORT

REWARD EFFORT

Direct Access

Touch screen technology Made previously impossible, possible!

Size of surface and targets Touch pressure

Crossing midline - Access all targets Not just touch, but drag, pinch, swipe, etc.

Hand dominance Finger isolation

Direct Access: Considerations for Success

Switch access

Switch Access: Considerations for success

Mounting Positioning

Type of switch

Switch assessment

http://acecentre.org.uk/Websites/aceoldham/images/InfoSheets/SwAssessmentFramework.pdf

http://talksense.weebly.com/switching-skills.html

Switching to Success

Stepping Stones to Switching SuccessLinda Burkart

• Single switch: cause effect • Single switch: multiple locations • Single switch: simple scanning • Two switches: two functions • Learning to two switch step scan (move, get/choose) • Two switch step scan: errorless learning • Two switch scanning to a target • Two switch scanning for accuracy • Two switch scanning: reduce time for success &

demonstrate knowledge

Switch Interfaces

click

key press!Eg. SPACE

Connect switch to iPad

Switch Accessible Apps

click

key press!Eg. SPACE

Connect switch to PC

Switch Accessible Software

https://delicious.com/chacullen/switch_activities bit.ly/switchsuccess

http://www.ianbean.co.uk/programs.html

Switch Control on the iPad

external

camera

screen

3 ways to access switch control

on iPad

Item Mode

Point Mode

Keyboard/ Mouse Alternatives

Eye gaze/ Head pointing

Discuss Analyse the ACCESS skills of some students in your class

Early Learning & Engagement

Cause and effect Concepts

Vocabulary Pre-literacy

Pre-numeracy Engagement and interaction

Discuss current practice

• attention development (focus on a person, object or event)

• cognitive development (object permanence, cause-effect)

• visual development (eye contact, visual tracking, joint attention)

• auditory development (attention to sound, sound localisation,

processing sounds)

• tactile development (exploration with mouth and hands)

• imitation development (gesture, movement, sound)

• social communication development (turn-taking, seeking and

responding to interaction.

Remember to consider ACCESS options

Cause and Effect

Cause & Effect Sensory Light Box Reactickles Magic Sensory Apps Peekaboo Farm (& others) Big Bang Pictures Peeping Musicians Little Lost Penguin ILoveFireworks Stop & Go !

Cause & Effect AppsGROUP

TASK

PowerLink 4

PC-based Software and Programs

http://www.ianbean.co.uk

http://www.helpkidzlearn.com

• Lego Bricks and more • OWLIE BOO Educational Games • CBeebies Games • Papunet Games • SEN Switcher by Northern Grid for Learning • Priory Woods School Switch / Touch Screen Videos • Specialbites • Shiny Learning’s Free Games • HelpKidzLearn • Ginger Tiger

More Websites

Virtuoso Piano Real Guitar Drums Mad Pad (smule) Songify Toca Band Sago Mini Sound Box B&F Piano

Music Apps

Listening to Music on the iPad

http://www.spectronics.com.au/blog/apps-and-mobile-learning/listen-to-the-music-using-timed-play-and-switches-on-the-ipad/

P

BEAMZ Interactive Music System

Song innovation

Engagement and Communication opportunities!

Choice Music Boards Clicker 6

Boardmaker Plus

http://www.spectronics.com.au/blog/techniques-and-tips/creating-a-choice-board-to-play-music/

…. Or even MOVIES! Choice Board for Movies in Clicker 6!

http://www.spectronics.com.au/blog/techniques-and-tips/making-a-choice-board-for-playing-movies/

Early Learning

Bugs & Bubbles My Playhome Toca Kitchen Monsters Aunty Maggies Recipe Choose it Maker 3 Bitsboard Pro Sago Mini Pet Cafe Smarty Pants Sound Touch !

!

Early Learning AppsGROUP

TASK


http://www.helpkidzlearn.com

BONUS FUN TIP: Use a switch to take a photo on the iPad

http://www.spectronics.com.au/blog/apps-and-mobile-learning/everybody-say-cheese-using-a-switch-to-take-a-photo-or-video-on-the-ipad/

H

Workstations Explore different tools for Early

Learning at work stations

Make it fun, age-appropriate, motivating, relevant and purposeful! Look for ways to engage and interact!

Create opportunities for communication and literacy!

Early Learning Final Tips

Discuss Goal setting for Early Learning

in your Classroom

Communication

Communication systems Students with little or no speech

AAC Social communication

VS.

Classroom Communication

Activities

Communication Systems for

Individual students

Augmentative communication is the use of materials or techniques that supplement existing verbal abilities.

Alternative communication is communication methods used by a person without any verbal ability.

(Vanderheiden and Yoder, 1986)

Alternative and augmentative communication (AAC)

Alternative and augmentative communication (AAC)

Strategies, techniques, aides and tools that support a person with little or no speech

When to use AAC?

No age prerequisite As speech is developing To support speech that is hard to understand When no speech has developed !

Where to use AAC?

Everywhere. Anywhere.

Who should use AAC?

Everyone. Anyone.

Types of AAC

AAC Myths & RealitiesRomski, M., & Sevcik, R. A. (2005). Augmentative communication and early intervention: Myths and realities. Infants & Young Children, 18(3), 174-185.

Symbols vs Photos

• iconicity = how easy it is to recognise image/picture/symbol • iconicity of symbols - does not affect early language acquisition

!

!

studies showed that children, with consistent input, learnt what the symbols meant,

regardless of how easy/hard/closely matched to the real object the symbol was

Problems - photos over symbols

• Unclear photos & photos with distractions • Emphasis on nouns - naming and choice making • Does it limit flexibility? Drink-cup example

For communication

Symbols as main !visual medium

With occasional photos as needed.

Supported and linked to REAL

OBJECTS

Symbol Consistency• Want generalisation and matching of symbols, especially

nouns, verbs, adjectives • Does not matter what symbol/photo you use for these • Do need to PICK and STICK to core words that are more

difficult to represent visually

VOCABULARY Consistency of words and symbols

!

!

MotivatingEngaging

Interactive

PurposefulFun

Best

Prac

tice

ChoicesComments

ProtestsQuestions

Feelings

Opinions

News telling

Help

Communication is for....

Best

Prac

tice

Include a mix of:!

• Preplanned!

• Activity- specific!

• Scripted!

• Fast phrases & sentences!

• Core word for independent generation

Vocabulary to programBe

st Pr

actic

e

Vocab for today...Planning for tomorrow.....

Best

Prac

tice

Activity-specific vocabulary

Best

Prac

tice

Core vocabularyBe

st Pr

actic

e

Discuss How communication

happens in your classroom

Discuss current practice

PLANNING CLASSROOM COMMUNICATION ACTIVITES

PLANNING CLASSROOM COMMUNICATION ACTIVITES

DISCUSS: Who is it for?

When & where will it be used? How will it look?

What is it trying to achieve?

Choice Making

SO MANY Opportunities!

• Lots of opportunities to make choices • Choices from real objects is easy for beginnning

learners • Symbol choice cards or boards can also be useful • In classrooms: choice of: toys, food, activities,

colours, who, songs, where, art, etc.

PECSPicture Exchange Communication System

can lead to choice boards, symbol boards and communication devices

VS

LOW TECH HIGH TECH

Boardmaker

Tools 2 Talk Proloquo2Go

+ Many AAC APPS!

Sounding Board

Dynavox T10

Group task: Create a Choice Board

Sounding Board

ChoicesComments

ProtestsQuestions

Feelings

Opinions

News telling

Help

Remember to EXTEND vocabulary!

Aided Language Stimulation


Goossens', Crain, & Elder (1992)

Point as you TALK!Modelling symbol use

Modelling how the symbols can be used to say real things in real situations


Students with little or no speech will have difficulty learning to using symbols (aids) for communication if people around them

never model the use of them.

model interactively

model throughout the day

Gayle Porter

• Model language using symbol boards • Model all parts of communication function:

requesting, asking questions, initiating, commenting – not just responding to teacher questions!

• Individuals learn to communicate in the way they experience the system of communication being used



Success for the users = They need ALS to be: • frequently use • repeated often • interactive • in real and everyday activities

Group task: Use ALS board

Play Toca Kitchen Monsters on iPad and use ALS board

Aided Language Displays

• Aided Language Displays are NOT choice making boards.

• Choice making boards supplement these boards • E.g. during lunch time there is a choice board for

foods followed by lunch conversation board

Lunchtime ALS

VS

Creating ALS boards

Choosing activities for ALS

• What happens across the day? • How frequently does it occur? • What activities are motivating?

Choosing messages for ALS

• Think about what things you would say to each other when you do the activity

• Focus on messages that the user could “say”, rather than just teacher instructional words

• 12 - 36 messages per activity (depending on student ability level)

• Write them down and decide which ones will go on the board

Top tip: SCRIPTING!

Words or phrases on ALS boards?

• Cognitive level of the user • Language goals • Selection technique/ physical access • Time dependent nature of the activity • Effort vs Payoff

Quick and Successful vs. Word Combinations

Group task: Design ALS board• Fold paper to 4 x 3 grid • Choose a motivating high

frequency activity • Plan a list of words that could be

used in the activity • Include vocabulary such as

names, actions, positions, requests, commands....

• Design them on the paper. • Try to keep left to right

Rough outline of words on ALS boards

Starters eg. I Questions social

Verbs Adjectives,eg. colours big.more, etc. Prepositions, eg in

Nouns

Colour-coding can be used

Examples for: Everyday Routines

Curriculum Activities/Games

Stories/Books Songs/Rhymes

137

VS

LOW TECH HIGH TECH

Boardmaker

Tools 2 Talk Proloquo2Go

+ Many AAC APPS!

Sounding Board

Dynavox T10

Screen Capture ie. Photo of what’s currently on the iPad screen

Core words

Core Vocabulary

Based on teaching student to use frequently used/ common words on their AAC system, which helps them to

learn independent generation

Core Vocabulary

FRINGE VOCAB • Low frequency words

• Only useful in one or two situations

• Often related to a specific topic

CORE VOCAB • High frequency words

• Can be combined to get your message across in lots of different situations

VS

1. Example of core word vocabularies: PODD

• developed by Gayle Porter

• PODD is a way of organising whole word and symbol vocabulary in a communication book or speech generating device to provide immersion and modelling for learning.

High tech (Dynavox T10/Compass)

PODD= Pragmatic Organisation Dynamic Display

Low tech (PODD book)

2. Example of Core word vocabulary: Proloquo2Go

• Core word vocabulary on Proloquo2Go

• Easy to personalise and customise

• http://www.assistiveware.com

Social Communication


Social communication and interactions make up a large part of our day.

Small talk

Greetings & Farewells

Storytelling


• Refer to the work and research by Janice Light: • http://praacticalaac.org/praactical/communicative-

competence-in-aac/ • Reminds us of the importance that social

interaction and social competence plays in communication

Small Talk

• greetings (eg. Hey!) • openers (eg. What’s up? How are you?) • commenting/ continuers (eg. cool, awesome,

bummer, Really? Tell me more) ***most common • Often not included in an AAC vocabulary system

Small talk in AAC• Include vocabulary that allows AAC users to make

comments and small talk.

• Include generic small talk that can be applied to a wide variety of social situations.

• Choose words that relevant to the person’s age and culture, eg. “bummer”; “Totes amazing”, etc.

Snappy chat

The range of apps by Snappy Chat - have great words for SMALL TALK and Social interaction

Sequenced Social Scripts

• GOALS for students using Sequenced Social Scripts: • Learn about conversations •Develop turntaking skills • Learn to interact with a variety of partners • Enjoy successful interactions

REFERENCE: “Can We Chat? Co-Planned Sequenced Social Scripts: A Make It / Take It Book of Ideas and Adaptations”

by Caroline Musselwhite and Linda Burkhart


• We write Social Scripts for interactions such as joke-telling, sharing life stories and general conversations

• Opportunity to use 'real' communication for conversational purposes

• Fun and engaging with great social interaction


Anatomy of a social script

Attention getters Starters

Maintainers, holders and interjections Turn transfers

Closings

What to include in a social script…

Program the script onto: !Step by Step Communicators

Personal Storytelling

• Use symbols and photos to create Chat books • Low tech and high tech • Social starters • Engagement • Connection with people around them • Personal histories, about me, recounts

Create in: Boardmaker Powerpoint

Clicker 6

Group task: Create a Personal History

Book Creator

VISUAL SCENE DISPLAYS

Visual Scene Displays

VSDs portray events, people, actions, objects and activities against the backgrounds in which they exist.

Communication, schedules, video modelling

Visual Scene Displays

Scene & Heard Autismate

VSD Apps

Environment

Engineering the Environment Symbols, everywhere, and easily accessible

We use symbols to label the environment

The Autism Helper Great website!

20 second rule

101 WAYS TO HAVE FUN COMMUNICATING WITH A: BIGMACK

http://talksense.weebly.com/feature-101-ideas-for-a-bigmack.htmlhttp://www.spectronics.com.au/article/101-ideas-for-using-the-bigmack-or-other-single-message-communication-devices-3

COMMUNICATION SYSTEMS FOR INDIVIDUAL STUDENTS

Exposure to symbols, symbol boards, core words in the classroom Share resources home

Trial high-tech systems in class Implement AAC system with personalisation and customisation

Model, model, model

!

bit.ly/AACassessment

AAC Assessment

"Dance with the girl you brought"

Caroline Musselwhite!http://www.aacintervention.com/

Before you do anything....

Consult

Trial

Invest time and money

An individuals success depends on……..

Customise and

personalise

Planning vocabulary needed

Modelling

Receptive input by all

Discuss How you may set up a

communication system for an individual student

in your class?

COMMUNICATION ON IPADS

Since April 2010

Benefits & Challenges

McNaughton, D. & Light, J. 2013

AAC on iPads

Guided Access

SYMBOLS EVERYWHERE

Our mission:Symbols everywhere!

Once you start using Symbols…

• extend use to all areas of the Classroom: • Support language development • vocabulary building • improve comprehension • sentence structures and grammar • extending language • link to books, music, class themes, everyday

activities and contexts

Home-school communication boards

Group task Explore different Communication

tools at work stations

Success for all…..

Customise and

personalise

Planning vocabulary needed

Easy to access

Instant & central

Create visual environment

Pictures- symbols - words

High and low tech options

Modelling

Receptive input by all

Repetition with

variety

One is never enough

• Provides receptive language opportunities • Model using symbols • Model using puppets • Model using other children • Model all day- every day

Modelling

!

It is important to remember…….

•Children need much exposure and learning of symbols before they can be expected to use them effectively to communicate with us;

•Children need to see the symbols used in everyday situations, consistently;

Modelling

•Children are more likely to use symbols if they see peers and siblings and other role models use them;

• If they can point to symbols to communicate, we can start thinking about technology and speech generating devices;

•Model, model, model and then model some more…. Same words, same activities, repetition is king….

Modelling

Create opportunities

to communicate

Motivate- reasons- embed

I need pencils!

Verbal Referencing

label communication attempts

Verbal Referencing

!

• You tell the child what it was that he/she did (is doing) that expressed the message to you

• Eg. “You looked at the balloon, you want the balloon”, “You pointed to ‘more’, you are

asking for ‘more’!”

Find motivators and use

them

Prompting Hierachy

least-most shape- fade

Following the child’s

lead

Joint Attention

Support comprehension

Visuals improve understanding

Support behaviour

Visuals support behaviour

Support social skills

Visuals support social skills

Discuss Goal setting for Communication

in your Classroom

Literacy

Guided Reading Self-selected Reading Working with Words

Writing

Literacy for allPresume competence

Time Teaching

Technologyhttp://inclusiveeducationpdresources.com/literacy/

conversation_with_caroline_musselwhite.php#0

Discuss Discuss current literacy

opportunities in your class.

The Four Blocks

The Four Blocks Literacy Model

http://www.litdis.com http://www.janefarrall.com/literacy/ http://fourblock.wikispaces.com

Self selected reading

Speak Selection Speak Screen

iOS 8 featuresiOS

Group task: Select and read a book

Tar Heel reader (website) iBooks

Guided reading One shared book reading per week

Different purpose each day

http://www.janefarrall.com/literacy/guided-reading/

Collins BIG CAT books Grasshopper Books Don’t let the pigeon run this app! Plus LOADS more!

Guided Reading Apps

Choose simple, age-respectful, repetitive and engaging books. You don’t always have to read the words, you can modify to suit your class.

Create your own using Book Creation apps or software.

Sym

bol s

uppo

rts fo

r lan

guag

e an

d re

adin

g

Writing

Clicker Sentences Clicker Docs Clicker Books

Writing Apps

Book Creator Explain Everything Strip Designer Pic Collage Skitch Kid’s Journal Write About This

More

Word prediction, aka Predictive text

iOS 8 featuresiOS

Third Party Keyboards

iOS 8 featuresiOS

Sym

bol s

uppo

rts fo

r writ

ing

BONUS WRITING TIP: Writing Poems

List poems Acrostic

Simple rhymes Alliteration

http://aacintervention.com (Poetry Power!) http://www.csun.edu/~hfdss006/conf/2002/proceedings/130.htm

Working with words Phonological Awareness

Firstwords Deluxe Montessori Crosswords Word Wizard Reading Doctor apps Letter School

Early Literacy Apps

Sym

bol s

uppo

rts fo

r Lite

racy

Workstation Explore different Literacy tools at

work stations

Repetition with VarietyVariety of purposes, approaches, texts…..

Discussion Goal setting for Literacy in your

Classroom

Behaviour & Social Skills

Social Stories Video Modelling

Positive Behaviour Supports

Behaviour

• Visual tools to support positive behaviours • Schedules /timetables • Class rules/ expectations • Rewards and reinforcement

Social Skills

• Social Stories • Social rules/expectations • Conversations skills • Context based • Scripting what to do and say

WHY?Answer the BIG Question!

Functions of Behaviour

Access or Avoid Attention

Access or Avoid an Item

Avoid a Task or Demand

Access or Avoid Sensory Input

Discuss Consider some

behaviours/ social skills observed in

your classroom - Can you link them to one of the four functions?

Implementation fidelity is a measure of how accurately you are implementing your intervention

Keys%to%Behavioral%Success!

Implementa*on!fidelity!

!!!!

Measured!Outcomes!

Effec*ve!Interven*on!

!!!

Success Process

• Target one behaviour

• Identify appropriate strategy

• Consider delivery mechanism

• Document what is working

Visual, video, photo stories created for specific learning of specific behaviours

Originally developed by Carol Gray www.thegraycentre.org

Social Stories

Teach a required social skill

Prepare someone for new events and experiences

Teach a positive behaviour

Teach a new skill

Descriptive

3 Types of Sentences

Directive


Perspective


The 3 “Musts”

IPresent tense

Positive Language

Tips for success

• One skill per story • Visual supports • Involve the person or their team • Practice BEFORE the challenging situation occurs • Clear instructions for use • Consistent across all support • Review and revise

Tips for success

Book Creator Pictello Strip Designer 30 hands !

Apps to create Social Stories

Book VS Video


Boardmaker

Group task: Create a Social Story

Book Creator

VIDEO MODELLING

Video Modelling

Models target skills

Desirable behaviours are learned by

watching a video & imitating

Video Modelling

Videos of others

Video self-monitoring

Point of view modelling

Video Self-modelling

Bellini & Akulian (2007)

• Feed-forward

• Self-review

• Speech, Social behaviours, Eating behaviours

• Task-analyze behavior

• Collect baseline data

• Prepare video (consider point of view, co-stars, voiceover)

• Provide similar stimuli & display (or make available) the video (, location, display, number of times)

• Prompt (when necessary) & reinforce

• Collect data

• Fade video & prompting

Video Self-modelling

• Behaviour must be attainable

• Be aware of cognition level

• Be aware of appropriate age

• Be sure it’s a model worth perfect imitation

Remember This!

iMovie Puppet Pals HD Aurasma Autismate

Apps for Video Modelling

Group task: Create a Video Model

iMovie

POSITIVE BEHAVIOUR SUPPORTS

PBS STRATEGIESConsistent routines, supported with visual schedules

Environment organised

Establish rules, responsibilities & expectations

Support sensory processing issues

First - then for activities

Time and timersReward positive behaviour (tangible & social)

Decrease difficulty/time/number to encourage task completion and success

SUPPORTING ROUTINES & SCHEDULES

on task clear expectations changes to routine

30 Hands Movenote Book Creator Aurasma FTVS-HD Visual Routine Choiceworks

Apps for Schedules

LOW TECH

Boardmaker

Tools 2 Talk

Group task: Create a Video Schedule

30 Hands

First..... THEN

REWARDS & REINFORCEMENT

TIMERS

ASD Tools FTVS-HD Working 4 Wait 4 it Token Board Calm Counter Sharing timer

Apps for Behaviour Support

Stop Playing in iPad timer

Symbol Supports for Behaviour & Social Skills

Workstations Explore different behaviour

tools at work stations

Teach and replace One target at a time

Choose what will have the most impact Functional communication

Keep data Implementation Fidelity

Behaviour/Social Skills - Final Tips

Discuss Goal setting for Behaviour/

Social Skills in your Classroom

KEY MESSAGES

Give it a go! Start. Go. Begin.

Be consistent.Regular and reliable.

Be flexible.Be ready to change and evolve.

Be persistent.Don't give up too soon!

Keep data.What works and what doesn't.

Be fun and engaging!Give them a REASON to participate!

Group task Planning time

SHARE Share your key goals

for change with someone at a different table

facebook.com/Spectronics

twitter.com/Spectronics

Spectronics.com.au/Blog

spectronics.com.au/online

Subscription

Amanda Hartmann [email protected]

Stay in touch! Ask questions!

THANK YOU!