Monday, 24 October 2011

Ipads for Autism?

60 Minutes article on Apps for Autism
On Sunday, the US news programme ‘60 Minutes’ aired an article entitled ‘Apps for Autism’. As an assistive technology consultant it’s important for me to keep up-to-date with current practice in the use of technology to support people with disabilities. I watched it with interest.

The article opens showing an Autistic young man who has no speech using an ipad with Proloquo to communicate with the interviewer. The young man is able to navigate through a series of dynamic menu pages to find pictures and symbols which correspond to the words and phrases he wants to use. The ipad partnered with Proloquo provides an affordable dynamic communication system which rivals devices such as those from Dynovox et al and for the young man featured in the article and hundreds of other speech impaired people, it is truly changing their lives. So why was I annoyed when I was watching it?

It wasn’t that the article portrayed ipads as a panacea for Autistic students or that it furthered the popular portrayal of ipads as ‘Autism Therapy’ although it did both and both give me cause for concern. I was upset when I heard the young person’s parent say that this was the first intervention her son had received. Just think about that for a second…

The young man in question was 27 years old. Are we really to believe that this young man went through school without one teacher or therapist trying a PECS book or a communication aid with him? Really?

If what was broadcast was true then it’s a terrible indictment on the US education system. Are they asking us to believe that US teachers and therapists stood back and didn’t provide the technology and teaching strategies they know will help a child overcome at least some of their communication difficulties? I know better. US teachers and therapist are no different to their colleagues around the world who all work tirelessly to help their students make progress. They do whatever it takes, try whatever they can, and use whatever is available to them, often working many hours after school has finished to create the resources they need.

So why did 60 Minutes choose to portray it this way? The whole article served to further and reinforce the myth that ipads are THE tool for students with Autism. That using them provides something magical and that if we choose not to use ipads, we may be holding our students back. It’s sad really as ipads do have a place when it comes to meeting the communication, learning and leisure needs of people with disabilities and for some students they may be the tool of choice but they are just one of a multitude of tools in the teaching and therapy toolbox. Good teachers and therapists match the use of teaching strategies and technology to the needs of the student based on assessment and a sound knowledge of the student’s strengths and weaknesses, not on whim, fad or fashion.

60 Minutes could have shown me that student and the obvious joy he and his family were experiencing without wrapping it up in an advert for Apple products. Showing me a young man whose life has been enriched by the application of an appropriate technology would have been celebration enough.   

Saturday, 8 October 2011

Complex Needs and Switches: It Could Be You!

I had a lovely day yesterday. I spent it in the company of five colleagues from a special school in the Midlands who had asked me to work with them to develop their use of switches in school. This was a good school where ICT is used in a way which was meaningful and appropriate to the needs of their students and where possible, embedded in their lessons. We spent the morning session talking about processes… how the students used switches, what constituted success at each stage and how we might assess and record progress across the school. In the afternoon we put our work into practice by doing baseline assessments on some of their pupils.

I’ve done this so many times over the years, I know what to expect. Teachers always bring their most complex students. You know them… the student with CP for whom you have never found a consistent switch position. The student with severe autism who can’t attend to anything for more a couple of seconds and students like ‘Bill’ who I met yesterday. Bill is not his real name but that doesn’t matter. Bill is typical of that group of students who show no interest in technology or much else for that matter. They don’t explore the things we give them, they don’t initiate and they seem to spend their day sitting in a wheelchair waiting for that moment when somebody comes and interacts with them. Bill’s teacher describes him as a ‘people person’.

In situations like this I’m always careful to manage expectations. I don’t have a magic wand or special powers that can fix the problem. I apply an analytical approach, finding out as much as I can about what motivates the student, reviewing what the school has already done and offering suggestions for things the school might try. For some students, that’s confirming what the school already knows… that they have tried everything and for that student, at this moment in time, technology is not an appropriate tool.

I remember vividly a short while ago an ICT teacher in a special school voicing his frustrations at spending every session for almost a year trying to identify a switch position for a student with severe CP. He’d tried every kind of switch in every position and nothing had worked. I asked him a question. “Outside of ICT, how does the student interact with people?” He told me that the student was very good at eye pointing and he was doing really well with an E-Tran frame. 

“Why don’t you use that?” I said. “Is it really necessary that the student actually presses the switch himself, if he’s able to show you what he wants? Couldn’t someone help him with that part?” I could see his mind racing exploring the possibilities. So that’s what they did. The student indicated his choice by eye pointing and a TA pressed the switch for him. The result was a more engaged student who was now making progress and teacher who could go home at night not feeling guilty that he was ‘failing’ one of his students. I heard just recently that the school have bought an eye gaze system and the student can now access most things on the computer completely independently.

Anyway, back to Bill. His teacher told me that he doesn’t really use switches. They had tried a Big Mack to say ‘good morning’ and used some cause and effect software with him but he showed no interest in either. He occasionally moved his hand to the switch but never pressed it himself. At which point in the conversation, one of the colleagues in the room sneezed. Not a genteel sniffle but a full on, window rattling explosive sneeze. Bill’s face lit up and he started to chuckle. I asked her to sneeze again and in true pantomime style she did… “Ah… Ah… Ah… CHOOOOOOO” and Bill laughed so hard his wheelchair was rocking. Within seconds we had a sneeze recorded on a Big Mack and presented it to Bill and much to the amazement of the teachers in the room, his hand reached out and pressed the switch… again and again to watch his teacher almost fall off her chair rein acting the sneeze in that pantomime style that special school staff are so good at. Ideas started to flow. What else could we put on the Big Mack that Bill might respond to? Someone suggested “One… Two… Three… TICKLE” Billy pressed the switch and got tickled. He loved it!

Our session with Billy illustrates an important point that we need to consider when we are using switches with students who have complex needs. It’s not enough to simply provide a switch; we also have to provide a reason for pressing it. For some students, that may be the music and images generated by software or the colourful movement and vibration provided by a bubble tube. For others, like Billy it’s something else. They may press the switch to start the dancing hippo or farting dinosaur activity but they are not interested in that. What interests and motivates them to use the switch is YOUR reaction to what they have done. They don’t want to see the hippo dance, they press the switch to watch YOU dance. Many of the students I have seen using the Farting Dinosaurs activity I created at Priory Woods couldn’t possibly process and understand the subtleties of the animation. They press the switch to see the funny faces YOU pull at those smelly dinosaurs. The reward they seek from using the switch is YOUR reaction to what they have created.

When I left the school yesterday they had a long list of ideas they had come up with to engage Billy with switches. They had also remembered that our knowledge of the student informs our choice of technology and how we use it. They identified what motivates Billy and provided him with a mechanism to initiate it himself. We all knew that Billy had taken an important first step to understanding how a switch will help him interact with his environment on those in it.

Billy was learning how a switch will help him to communicate.