Exploring AT for Autism

Presented by: Diana Jurist, M.Ed.,AT AT Specialist/Consumer Educator Pennsylvania’s Initiative on Assistive Technology

"For people without disabilities, technology makes things easier.

For people with disabilities, technology makes things possible.”

A program of the Institute on Disabilities at Temple University

What is Assistive Technology?

• An assistive technology device is any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, used to increase, maintain, or improve the functional capabilities of individuals with disabilities.

From the Assistive Technology Act (AT Act) of 1998, as amended. Also from the Individuals with Disabilities Education Act (IDEA).

Thought provoking questions! • Who providing Assistive Technology Services to your

organization • Do you follow an AT consideration process? • What does your AT consideration process look like?

– SETT – WATI

• Has direct service staff been trained to both identify the need for AT and implementation strategies?

The Scope of Assistive Technology

• Seating and Positioning • Power Mobility • Manual Mobility • Mobility Aids • Assistive Listening • Vehicle Modification • Communication

• Leisure/Recreation/Play • Worksite Modification • Home Modification • Learning Aids • Environmental Controls • Vision Aids • Self Care/Activities of

Daily Living

What is Assistive Technology? • Assistive technology services are any services

that directly assist an individual with a disability in the selection, acquisition, or use of an assistive technology device.

• Includes: evaluation of needs; customizing, repairing, and maintaining; coordination with other services; training for the individual; training for professionals, employers, or others substantially involved in the “major life functions” of the individual.

Is there “AT for Autism?”

Common Attributes • Communication Difficulties • Difficulty relating to people, things, and

events; • Playing with toys and objects in unusual

ways; • Difficulty adjusting to changes in routine or to

familiar surroundings; and • Repetitive, Ritualistic behaviors/body

movements DSM-V

Specific or Comorbid Impairments & AT • ADHD

– Executive Function Impairments • Hyperlexia • Social impairment (s) • Dysgraphia • Communication Impairments

Specific or Comorbid Impairments & AT

• Sensory Difficulties – Auditory – CAPD (Central Auditory Processing

Disorder) – Visual

Do all people with autism have all of these characteristics?

– No! – Although there can be common traits,

each person with autism is unique – As with any person, we must look at their

functional needs

AT for specific functional needs

Importance of Routines and Schedules

• Lists and schedules – Written or pictorial

• Planners and calendars – Low tech (single page or book) – High tech (on a computer or other device)

• Alerts – Multi-alarm wristwatch – Timers – Computer or handheld device

Executive Functions

Allows us to: • Plan • Keep track & finish on

time • Multi-task • Organize and sequence

information • Retain information

PLAN AHE A D

Executive Dysfunction

• Similar tools can be used as those for routines and schedules – visual cues

• Voice memo recorder – audio cues • Transitioning • Task software and apps

Executive Dysfunction

• Graphic organization software (for organizing writing assignments)

• Color-coding strategies

Some apps

• Evernote • MyHomework • Simple2Do • Priority Matrix

• Remember the Milk • TaskMeOut • ToDo Too

AutisMate

Video Modeling Visual Schedules

Social Stories

Is there “AT for Autism?”

Reading Difficulty

• Difficulty with text because of attention or visual sensory difficulty – Low tech solutions – Text to speech software – Tools to remove visual distractions on web

pages – Tools offering graphic representations of text – Word prediction software; grammar checkers

Writing Difficulty

• Physical writing difficulties (dysgraphia) – Supports for writing manually – Keyboarding as an alternative – Speech recognition software

• Help with written expression – Word prediction/expansion software – Graphic organization software – Multi-media software

Writing Difficulty

• Software / apps to help organize research and writing

• Dictionary / thesaurus software or devices

• Word prediction software

Auditory Difficulty • Assistive Listening

Device (FM System) – Allow speaker’s

voice to be more prominently heard than background noise

• Noise cancelling headphones

Social Difficulties

• A video of both appropriate and inappropriate social behaviors can help individual learn to respond to various social situations

• Software that reinforces appropriate social behavior

Augmentative-Alternative

Communication (AAC)

Augmentative and Alternative Communication (AAC)

• AUGMENTS – Enhances spoken communication

• For example, when speech is present but difficult to understand

• ALTERNATIVE – When spoken communication is unsuccessful or

ineffective • For example, vent-dependent person

*AAC is Assistive Technology for Communication

Who uses AAC?

• There are no standard or “typical” users Complex communication needs (CCN) Any discrepancy between ability and need

• Temporary vs. Long Term • Receptive vs. Expressive

• No one should be denied a chance

• AAC is not just about a technical solution

Assistive Technology process & AAC Evaluations

Just as we do with any Assistive Technology device we must consider the following before recommending: Person Environment Tasks Tools

Selecting an inappropriate tool can lead to “device/system abandonment

Assistive Technology process & AAC

This includes but is not limited to:

• Sensory needs • Sight, sound and tactile

• Seating & Positioning • Motor Abilities

• Access method • Cognitive Abilities • System portability, durability

and appearance

• Time and skills required to learn system

• Potential AAC users interest • Potential AAC users motivation • Support

• Staff • Family • Community

AT Team Members • Potential AT User

– Family Members • School Team (if applicable)

– Teachers – Support Staff – Peers

• Specialists working with individual – Licensed SLP (for AAC evals) – Special Ed teacher – Assistive Technology Consult – School Psychologist – Behavior Specialist – OT / PT

₋ Case Manager/ Supports Coordinator ₋ Community Members ₋ Transition / Job Coach ₋ Medical Staff ₋ Rehabilitation Engineer ₋ And more

AAC Hierarchy

No Tech

Low Tech

Mid Tech

High Tech

AAC • No Technology Strategies

– No extra equipment involved – Use natural communication abilities – May be difficult to interpret

• Specific to the individual • Ask the person about preferred communication

style – Example Strategies

• Ask yes/no questions to clarify • Partner-Assisted Scanning (offer choices out loud, person answers with “that one”)

AAC

• Low Technology

– Simple, usually home-made “equipment” – Printed pictures, communication books, ABC

boards – Need support selecting vocabulary, symbol types,

creating, & using low-tech systems

AAC

• Mid Technology – Recordable device (range of <8 to >40 minutes) – Paper “overlays” (static display) show 1-128+

buttons/msg – Can hold multiple pages (levels) of recordings &

pictures

AAC • High Technology

– Speech-generating device • synthesized speech = no need to pre-record

– Computer screen (dynamic display) • Variety of screen sizes (hardware) • RANGE of vocabulary/language layout (software)

– Direct and/or Alternate Access • Switch scanning or eye gaze options

– Other advanced features • Environmental Control Unit • Therapy tools, Calendar, games, etc. **Cloud-based software?**

Styles of AAC

Within the following: Low tech, mid tech and high tech categories you may see: • Scene based boards (VSD)- • Grid based boards-(Schematic) • Text Based boards- which may include Wordpower,

predictable for example • Unity language system- (Semantic compaction) • Pragmatic Organization Dynamic Display (PODD) language

system-

AAC • i Technology

– Portable, generic, easily-available devices • Music/game players (Apple iPod Touch, Nintendo DS) • Smart phones (Droid, iPhone, Samsung Galaxy S) • Tablet computers (Kindle Fire, iPad, Galaxy Tab)

– Run Communication apps (software) • NOT dedicated or DME • Limited “alternate access” options (so far) • Fewer vocabulary/language layout options

– Especially ones with SLP input or evidence-based design

CommunicatePA.wikispaces.com • iTechnology

– Communicatepa.wikispaces.com/iTechnology

COMMUNICATION APPS

Sort Apps with Similar Features Low Tech • Simple Mid Tech • Starter • More Features High Tech • Robust Text-to-Speech • Alphabetic • prediction/completion

AAC Ferret

AAC TechConnec

My Choice Board

Look 2 Learn

PhotoVOCA

* Sends file attachments *

• Free! • Scans

AutisMate

Visual Scene Displays

Schematic Grid Displays

TalkRocket Go • Use GPS to find

location-specific vocabulary

SpeechTree • ABA-based design • PECS format • Lessons for Receptive &

Expressive Vocabulary

Proloquo2Go

Text-To-Speech Features • Spell Check vs. Word Prediction • Speech

– Adjust speed, pitch

• Text Size • Keyboard Layout • “Function” buttons (clear, speak) • Saving/Storing/Organizing Messages • Scanning? Highlights?

Allora

Forte Fusion

LightWriter

Spelling

• MUST be able to Read, Write, Spell (literate) – May allow few pictures

• Additional Features = more expensive – Word prediction, – Pre-programmed vocabulary – Categorization, etc.

• Range in quality of computer-generated (synthesized) voices

Assistive Chat

SpeakIt Predictable

TalkaDroid)

Tap Talker

Remember…. • People learn/respond to different modalities - one size does

not fit all • Positive reinforcement and consistency is critical when

implementing AT • AT recommendations should be based on a functional need • Sometimes a combination of tools may be needed • Generalizing the use of AT from one environment to another

can be challenging • Try before you buy!!! (Borrowing devices, device

demonstrations) • NEVER underestimate anyone’s potential – presume

competency

FOR INFORMATION contact: PIAT - Pennsylvania’s Initiative

on Assistive Technology

1755 N. 13th Street Student Center, Room 411 S

Philadelphia, PA 19122 Tel: 800-204-7428 (voice) 866-268-0579 (TTY) Fax: 215-204-6336 Email: ATinfo@temple.edu Web: http://disabilities.temple.edu/piat

Contact me:

Diana Jurist, M.Ed., AT AT Specialist, Consumer Educator, PIAT & TDDP programs

215-204-5097 (voice) 866-268-0579 (TTY) diana.jurist@temple.edu