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
!
consultants@spectronics.com.au

facebook.com/Spectronics
twitter.com/Spectronics
Spectronics.com.au/Blog

Handout Landing page
bit.ly/SPED-assistivetechnology

“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

AT Options
Deciding the BEST OPTION

AT Implementation
Practical ideas and strategies for the classroom

ACTION PLAN
Be ready to make a plan of action for change and implementation
into your classrooms

Disabilities
Common difficulties
Students with moderate-to-high support needs

Discuss
What currently
happens in
your
classrooms?

Direct/indirect
Switches
Switch interfaces
Mouse control
Eye Gaze

Direct Access
Touch screen technology
Made previously impossible, possible!

Direct Access: Considerations for Success
Size of surface and targets
Touch pressure
Crossing midline - Access all targets
Not just touch, but drag, pinch, swipe, etc.
Hand dominance
Finger isolation

Switch Access: Considerations for success
Mounting
Positioning
Type of switch

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

Switching to Success
http://talksense.weebly.com/switching-skills.html

Stepping Stones to Switching Success
Linda 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

click
key press!
Eg. SPACE
Connect switch to iPad

click
key press!
Eg. SPACE
Connect switch to PC

https://delicious.com/chacullen/switch_activities
bit.ly/switchsuccess
http://www.ianbean.co.uk/programs.html

external
camera
screen
3 ways to access
switch control
on iPad

Discuss
Analyse the ACCESS skills of
some students in your class

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

PC-based Software and Programs
http://www.ianbean.co.uk
http://www.helpkidzlearn.com

More Websites
• 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

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/

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 Apps
GROUP
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

Early Learning Final Tips
Make it fun, age-appropriate, motivating, relevant and purposeful!
Look for ways to engage and interact!
Create opportunities for communication and literacy!

Discuss
Goal setting for Early Learning
in your Classroom

Communication systems
Students with little or no speech
AAC
Social communication

VS.
Classroom
Communication
Activities
Communication
Systems for
Individual students

Alternative and augmentative
communication (AAC)
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)
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.

AAC Myths & Realities
Romski, 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

!
!
Interactive
Motivating
Engaging
Purposeful
Fun
Best Practice

Choices
Comments
Feelings
Questions Protests
Opinions
News
telling
Help
Communication is for....
Best Practice

Vocabulary to program
Include a mix of:!
• Preplanned!
• Activity- specific!
• Scripted!
• Fast phrases & sentences!
• Core word for independent generation
Best Practice

Vocab for today...
Planning for tomorrow.....
Best Practice

Activity-specific vocabulary
Best Practice

Core vocabulary
Best Practice

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?

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.

PECS
Picture Exchange Communication System
can lead to choice boards, symbol boards and communication devices

LOW TECH HIGH TECH
VS
Boardmaker
+ Many AAC APPS!
Tools 2 Talk Proloquo2Go
Sounding Board
Dynavox T10

Group task: Create a Choice Board
Sounding Board

Choices
Comments
Feelings
Questions Protests
Opinions
News
telling
Help
Remember to EXTEND vocabulary!

Aided Language Stimulation
Modelling symbol use
Point as you TALK!
Modelling how the symbols can be used
to say real things in real situations
Goossens', Crain, & Elder (1992)

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

• 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

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

Choosing messages for ALS
Top tip: SCRIPTING!
• 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

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

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

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

1. Example of core word vocabularies: PODD
VS
Low tech (PODD book)
• 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

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

Social Communication
• 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
What to include in a social script…
Attention getters
Starters
Maintainers, holders and interjections
Turn transfers
Closings

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

Visual Scene Displays
Communication, schedules, video modelling

Scene & Heard
Autismate
VSD Apps

Engineering the Environment
Symbols, everywhere, and easily accessible

We use symbols to label the environment

The Autism Helper
Great website!

101 WAYS TO HAVE FUN COMMUNICATING WITH A:
BIGMACK
http://talksense.weebly.com/feature-101-ideas-for-a-bigmack.html
http://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

AAC Assessment
!
bit.ly/AACassessment

"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?

AAC on iPads
Benefits & Challenges
McNaughton, D. & Light, J. 2013

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

Customise
and
personalise
Planning vocabulary needed

Easy to
access
Instant & central

Create visual
environment
Pictures- symbols - words

Modelling
Receptive input by all

Repetition
with
variety
One is never
enough

Modelling
• 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….

Create
opportunities
to
communicate
Motivate- reasons- embed

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

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

Guided Reading
Self-selected Reading
Working with Words
Writing

Presume competence
Literacy for all

Time
Teaching
Technology
http://inclusiveeducationpdresources.com/literacy/
conversation_with_caroline_musselwhite.php#0

Discuss
Discuss current literacy
opportunities in your class.

The Four Blocks Literacy Model
http://www.litdis.com
http://www.janefarrall.com/literacy/
http://fourblock.wikispaces.com

iOS 8 features iOS
Speak Selection
Speak Screen

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/

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

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.

Symbol supports for language and reading

Writing Apps
Clicker Sentences
Clicker Docs
Clicker Books

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

iOS 8 features iOS
Word prediction, aka
Predictive text

iOS 8 features iOS
Third Party Keyboards

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

Early Literacy Apps
Firstwords Deluxe
Montessori Crosswords
Word Wizard
Reading Doctor apps
Letter School

Workstation
Explore different Literacy tools at
work stations

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

Discussion
Goal setting for Literacy in your
Classroom

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

Answer the BIG Question!
WHY?

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?

Keys%to%Behavioral%Success!
Effec*ve!
Interven*on!
Implementation Implementa*fidelity on!
is
a measure of fidelity!
accurately you !!!
how
are
! implementing your
intervention
Measured!
Outcomes!
!!
!

Success Process
• Target one behaviour
• Identify appropriate strategy
• Consider delivery mechanism
• Document what is working

Social Stories
Visual, video, photo stories created for
specific learning of specific behaviours
Originally developed by Carol Gray
www.thegraycentre.org

Prepare someone for new
events and experiences

3 Types of Sentences
Descriptive

Directive

Perspective

I
The 3 “Musts”
Present
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

Apps to create Social Stories
Book Creator
Pictello
Strip Designer
30 hands
!
Book VS Video

Boardmaker

Group task: Create a Social Story
Book Creator

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
• Feed-forward
• Self-review
• Speech, Social behaviours, Eating
behaviours
Bellini & Akulian (2007)

Video Self-modelling
• 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

Remember This!
• Behaviour must be attainable
• Be aware of cognition level
• Be aware of appropriate age
• Be sure it’s a model worth perfect
imitation

Apps for Video Modelling
iMovie
Puppet Pals HD
Aurasma
Autismate

Group task: Create a Video Model
iMovie

PBS STRATEGIES
Consistent routines, supported with visual schedules
Environment organised
Establish rules, responsibilities & expectations
First - then for activities
Support sensory processing issues
Time and timers
Reward positive behaviour (tangible & social)
Decrease difficulty/time/number to encourage
task completion and success

SUPPORTING ROUTINES & SCHEDULES

on task
clear expectations
changes to routine

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

LOW TECH
Boardmaker
Tools 2 Talk

Group task: Create a Video Schedule
30 Hands

Apps for Behaviour Support
ASD Tools
FTVS-HD
Working 4
Wait 4 it
Token Board
Calm Counter
Sharing timer

Symbol Supports
for Behaviour & Social Skills

Workstations
Explore different behaviour
tools at work stations

Behaviour/Social Skills - Final Tips
Teach and replace
One target at a time
Choose what will have the most impact
Functional communication
Keep data
Implementation Fidelity

Discuss
Goal setting for Behaviour/
Social Skills in your Classroom

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!

SHARE
Share your key goals
for change with
someone at a
different table

Subscription
spectronics.com.au/online

Amanda Hartmann
amandah@spectronics.com.au
Stay in touch!
Ask questions!

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Assistive Technology for Students with Moderate to Severe Impairments