Slide presentation from today's presentation by Gwendolyn Meier at the 28th Annual International Technology and Persons with Disabilities Conference in San Diego, March 1, 2013.

1. Autism: Communication
Options Using the iPad
Gwendolyn Meier, MA, CCC-SLP, MT-BC
Speech Language Pathologist, Music Therapist
Villa Esperanza Services
Pasadena, CA

2. Autism: Communication Options Using the iPad
March 1, 2013

3. The Speech & Language Center
x``
Autism: Communication Options Using the iPad
March 1, 2013

4. x``
AAC Services
Autism: Communication Options Using the iPad
March 1, 2013

5. App Explosion
“What app should I buy?”
Currently over 100 iPad apps designed as
communication tools
Variety of levels of complexity and co$t
Decision-making:
Speech Language Pathologists, special
educators, AT specialists and parents ALL
need guidance

6. A Tale of AAC Failure
• Parent bought an iPad...
• AT Specialist provided an iPad...
But, “It’s not working”
“He’s not using it”
• Teaching AAC is often the missing link
Autism: Communication Options Using the iPad
March 1, 2013

7. Non-oral Learners with Autism
Much of the info and education on teaching AAC
focuses on non-oral individuals with
INTACT SOCIAL SYSTEMS
• More is needed on how exactly to teach
AAC to learners who have social deficits
• Individuals with autism often have to be
taught to take pleasure in social
engagement as part of their AAC-learning
Autism: Communication Options Using the iPad
March 1, 2013

8. So much more than the app
An AAC System should
• Increase participation (classroom, work,
community, home)
• Address IEP, work and personal goals
• Support efficient and interactive
communication
• Provide the user with meaningful language
• Support language and literacy learning
• Provide a positive support to behavior
Autism: Communication Options Using the iPad
March 1, 2013

9. So much more than the app
An AAC System should
Y
Hwork,
• t W ting
Increase participation (classroom,
community, home) ou
l a b unica
alwork andm
• It’s com personal goals
Address IEP,
• Supportre
u’ efficient and interactive app
yo
communication
ut the
• o userabo meaningful language
Provide the t with
N
• Support language and literacy learning
• Provide a positive support to behavior
Autism: Communication Options Using the iPad
March 1, 2013

10. Early Language Stages
1. One word/hit at a time
2. Two- and three-word/hit phrases
3. Building phrases and early sentences
4. Learning grammar and sentence structure
5. Sentences with more grammatical
endings
Autism: Communication Options Using the iPad
March 1, 2013

11. Getting Communication Going
In autism we know we can teach:
Cause-and-Effect Requesting
Cause-and-Effect Rejecting
Autism: Communication Options Using the iPad
March 1, 2013

12. START with One-word/One-button Requesting
for items, actions or recurrence (“more”)
• Builds “buy-in”
• Adds pay-off to the effort of
communicating
Autism: Communication Options Using the iPad
March 1, 2013

13. START with One-word/One-button Requesting
for items, actions or recurrence
• BUT DON’T STOP HERE!
• It’s very easy to get stuck on requesting
Autism: Communication Options Using the iPad
March 1, 2013

14. Early Pragmatic Communicative Functions
• Attention Directing
• Requesting
• Rejecting
• Greeting
• Self-Expression and Self-Assertion
• Naming
• Commenting
• Giving Information / Requesting Information
Autism: Communication Options Using the iPad
March 1, 2013

15. Communicative Functions
In Nonverbal Autism
• Attention Directing
• Requesting
• Rejecting
• Greeting
• Self-Expression and Self-Assertion
• Naming
• Commenting
• Giving Information / Requesting Information
Autism: Communication Options Using the iPad
March 1, 2013

16. Communicative Functions
*Sometimes Present* In Nonverbal Autism
• Attention Directing
• Requesting
• Rejecting*
• Greeting*
• Self-Expression and Self-Assertion
• Naming
• Commenting
• Giving Information / Requesting Information
Autism: Communication Options Using the iPad
March 1, 2013

17. Early Pragmatic Communicative Functions
• Attention Directing
The s
• torie
sI
Requesting
• Rejecting hear
• Greeting ...
• Self-Expression and Self-Assertion
• Naming
• Commenting
• Giving Information / Requesting Information
Autism: Communication Options Using the iPad
March 1, 2013

18. • It is rare for difficult-to-
motivate students to naturally
move out of the requesting
function
• No matter the AAC
system...Modeling and
Augmented Input are KEY to
the process of expanding
communicative functions
Autism: Communication Options Using the iPad
March 1, 2013

19. Model and Expand Language
• Oral language development
Autism: Communication Options Using the iPad
March 1, 2013

20. Model and Expand Language
• Non-oral language development
Sign language Speech Generating Device
Autism: Communication Options Using the iPad
March 1, 2013

21. Augmented Input
Partner Augmented Input
Point to pictures while you are
Speech
p talking.*
• Use parallel talk, self-talk, break down,
build up.
Pictures • Produce a variety of communicative
Pictures
functions such as questions, comments,
greetings, requests, etc.
• Use a large percentage of available
vocabulary
• Use a large percentage of vocabulary
as they appear in your speech
Build language skills by • 80:20 ratio of statements to
questions/commands
demonstrating use of AAC!
• Strive to provide Partner Augmented
Input at least 80% of ongoing daily
p g g y
Copyright notification: User may not copy or distribute these materials
except for use with the students, patients, clients, or other individuals who
Autism: Communication Options Using the iPad activities
receive instruction, therapy, supervision, assessment, care or other services
•
March 1, 2013Use scripts to develop ideas
directly from the User. Otherwise, these materials may not be copied without
the 1
written consent of DynaVox Mayer-Johnson.
* See references for sources

22. In autism, modeling is essential to:
First) Demonstrate the use and power of
additional functions of communication:
attention directing, commenting, sharing
opinions, greeting
Then) We can worry about teaching the
vocabulary/symbol location for these
functions
Autism: Communication Options Using the iPad
March 1, 2013

23. Augmented Input in ASD
VIDEO
• Ryan (20 years old) - Bracket Assembly
✴ Requests for items - Mastered
✴ Attention Directing - Modeled
What he’s saying / What I’m saying
Autism: Communication Options Using the iPad
March 1, 2013

24. Augmented Input
Our terminology:
• “Augmented Input” • “Aided language
stimulation” (ALgS)
• “Modeling”
• “Demonstration”
• “Aided language
support”
• “Aided language input”
• “Simultaneous
Communication”
AAC, the iPad and Autism - Moving Beyond Choice-making. CSHA 2013

25. Augmented Input
VIDEO
• Milo (4 years old)
✴ Naming - Modeled
Pogg - $0.99
Autism: Communication Options Using the iPad
March 1, 2013

26. Drawbacks to Augmented Input at
Early Language Stages
• Requires pre-planning
• Occupies valuable ‘real estate’ on the visual
display
• Takes dedicated modeller(s)
• Like oral language development,
aided language development also
TAKES TIME
Autism: Communication Options Using the iPad
March 1, 2013

27. One-Hit at a Time
• Requests
• Attention Directing
Do
• Sharing Opinions n’t
for
get
• Commenting the
se!
• Greeting
Autism: Communication Options Using the iPad
March 1, 2013

28. One-Hit at a Time
Inexpensive Apps
• Answers:YesNo ($1.99)
• Sounding Board (FREE)
• Picture Card Maker (FREE, $5.99)
• Digitized (recorded) voice
• Icons: Take a pic, online pic, Photos
Autism: Communication Options Using the iPad
March 1, 2013

29. Can be Done with
More Expensive Apps
• Full-featured Communication Apps with
a Robust Language system ($150-$300)
Autism: Communication Options Using the iPad
March 1, 2013

30. One-hit: Moving Beyond Choice-Making
Attention Directing
• Delivering a message
✴ Delivering/picking up items
✴ Social scripts
• Making announcements
✴ Before transitions, “It’s time for...”
Autism: Communication Options Using the iPad
March 1, 2013

31. AnswersYes/No - Requests
A RD
ND
STA
CUS
TOM
IZED
Autism: Communication Options Using the iPad
March 1, 2013

32. AnswersYes/No
Deliveries
Autism: Communication Options Using the iPad
March 1, 2013

33. Sounding Board
One-hit Requests Various Functions
Autism: Communication Options Using the iPad
March 1, 2013

34. Pic Card Maker
Attention Directing - Delivering Messages
Autism: Communication Options Using the iPad
March 1, 2013

35. Pic Card Maker
Attention Directing - Delivering Messages
3-button script;
one-hit per turn
Autism: Communication Options Using the iPad
March 1, 2013

36. Pic Card Maker
3-button Script in Choiceboard View
Autism: Communication Options Using the iPad
March 1, 2013

37. One-hit: Moving Beyond Choice-Making
VIDEO
Nicolas (6 years)
• Attention Directing, Delivering
flyers - Teaching
Autism: Communication Options Using the iPad
March 1, 2013

38. AnswersYes/No - Deliveries
Autism: Communication Options Using the iPad
March 1, 2013

39. AnswersYes/No - Deliveries
Autism: Communication Options Using the iPad
March 1, 2013

40. Pic Card Maker
Attention Directing - Making Announcements
One-hit:
“It’s time for...”
Autism: Communication Options Using the iPad
March 1, 2013

41. Pic Card Maker
Attention Directing - Making Announcements
One-hit:
“It’s time for...”
Autism: Communication Options Using the iPad
March 1, 2013

42. One-hit: Moving Beyond Choice-Making
Attention Directing
✴“Look!”
✴Naming
• Item or action label
✴Descriptive word
• Broken, dirty, cute...
Autism: Communication Options Using the iPad
March 1, 2013

43. One-hit: Moving Beyond Choice-Making
Attention Directing
✴“Look!” - Versatile
- Best use of real estate
✴ Naming
• Item or action label
✴Descriptive word
• Broken, dirty, cute...
Autism: Communication Options Using the iPad
March 1, 2013

44. One-hit: Moving Beyond Choice-Making
Comments & Sharing Opinions
• Expressing taste
• Cool, oh man, good, bad,
gross...
• Giving Compliments
Autism: Communication Options Using the iPad
March 1, 2013

45. Sounding Board app
One-hit: Mixed Function Board
Attention Directing, Comments, Sharing Opinions
Autism: Communication Options Using the iPad
March 1, 2013

46. Sounding Board app
One-hit: Mixed Function Board
Comments, Sharing Opinions
Autism: Communication Options Using the iPad
March 1, 2013

47. Sounding Board app
One-hit: Mixed Function Board
Attention Directing
N
a
m
i
n
g
Autism: Communication Options Using the iPad
March 1, 2013

48. Sounding Board app
One-hit: Mixed Function Board
Directing Action
Autism: Communication Options Using the iPad
March 1, 2013

49. One+ Hit: Moving Beyond Choice-Making
VIDEO - Augmented Input
• Gissette - (16 years old)
Comments, Describing (cute) -
Modeling
Autism: Communication Options Using the iPad
March 1, 2013

50. AnswersYes/No (Compliments)
Autism: Communication Options Using the iPad
March 1, 2013

51. Sounding Board app
Just Comments
Autism: Communication Options Using the iPad
March 1, 2013

52. Autism: Communication Options Using the iPad
March 1, 2013

53. One-hit: Moving Beyond Choice-Making
• Versatile Requests for actions
• Attention Directing
• Sharing Opinions
• Commenting
• Greeting
Autism: Communication Options Using the iPad
March 1, 2013

54. Sounding Board
Core Vocabulary Board:
Sym bol
wed ns
B orro x ico
Sti
Autism: Communication Options Using the iPad
March 1, 2013

55. Sounding Board
Core Vocabulary Board:
Request Action
Autism: Communication Options Using the iPad
March 1, 2013

56. One-hit: Request Action
VIDEO
• Milo - Firefighters
- Augmented Input, Core Words board
Question:
What will be Milo’s first core word?
Autism: Communication Options Using the iPad
March 1, 2013

57. Sounding Board
Core Vocabulary Board:
Request Action
Autism: Communication Options Using the iPad
March 1, 2013

58. One-hit: Moving Beyond Choice-Making
Greetings
✴Hey / Good Morning / Hi
✴Bye / See you later / Have a good weekend
(Any of the low cost apps)
Autism: Communication Options Using the iPad
March 1, 2013

59. One-hit: Moving Beyond Choice-Making
Attention Directing
Sharing Opinions
Comments
Greeting
Teach it! Model and demonstrate
Reinforce it! Provide motivation to perform
Autism: Communication Options Using the iPad
March 1, 2013

60. One-hit: Mixed Functions
Book Reading - Requests,
Comments, Directions
Autism: Communication Options Using the iPad
March 1, 2013

61. One-hit: Mixed Functions
Butterfly Coffee filter craft -
Requests, Comments, Sharing
Opinions
Autism: Communication Options Using the iPad
March 1, 2013

62. Early Language Stages
1. One word at a time
2. Two- and three-word phrases
3. Building phrases and early sentences
4. Learning grammar and sentence structure
5. Sentences with more grammatical
endings
Autism: Communication Options Using the iPad
March 1, 2013

63. 2- and 3-hit Goals
Choice-Making and Beyond
• Elaborated requests: “I want” + item, “More”
+ item/activity, “I want” + “to go” + place
• Attention Directing: “Look” + item/location,
“It’s time for” + activity
• Directing other’s actions, core vocab: Open
it, give me, my turn, put in, you go
• Greet using names
Autism: Communication Options Using the iPad
March 1, 2013

64. 2- and 3-hit Goals
Choice-Making and Beyond
• Elaborated requests: “I want” + item, “More”
+ item/activity, “I want” + “to go” + place
• Attention Directing: “Look” + item/location,
“It’s time for” + activity
• Directing other’s actions, core vocab: Open
it, give me, my turn, put in, you go
• Greet using names
Autism: Communication Options Using the iPad
March 1, 2013

65. 2- and 3-hit Goals
Choice-Making and Beyond
Elaborated requests Wi l l
requ
links ire s
Attention Directing ome
betw navig
Directing other’s actions een ation
boar /
Greet using names ds
Autism: Communication Options Using the iPad
March 1, 2013

66. 2- and 3-hit Goals
Choice-Making and Beyond
Elaborated requests Wi l l
requ
links ire s
Attention Directing ome
betw navig
Directing other’s actions een ation
boar /
Greet using names
ds
• Comments/Sharing Opinions often still one-hit
Rather than expecting a sequence of hits
Lots of modeling/augmented input & reinforcement
Autism: Communication Options Using the iPad
March 1, 2013

67. Apps for 2- and 3-hit
2- and 3-Button Phrases
• Sounding Board (FREE)
• Picture Card Maker (FREE; $5.99)
• Full-featured Communication Apps
($149+)
Autism: Communication Options Using the iPad
March 1, 2013

68. Sounding Board - Requests
Autism: Communication Options Using the iPad
March 1, 2013

69. Sounding Board - Requests
Autism: Communication Options Using the iPad
March 1, 2013

70. Request embedded in a Multi-Function board
At Work Break Choices
Autism: Communication Options Using the iPad
March 1, 2013

71. Picture Card Maker
Sentence Strip -
2, 3, or 4 symbol
Elaborated request
Autism: Communication Options Using the iPad
March 1, 2013

72. 2- and 3-hits
Directing Actions & Attention
VIDEOS
• Gissette (16 years)
1. Descriptive request, funny dance
- Emerging
Autism: Communication Options Using the iPad
March 1, 2013

73. 2- and 3-hits
Moving Beyond Choice-Making
• We know we can teach: Elaborated requests:
“I want” + item, “More” + item/activity, “I
want” + “to go” + place
• Directing attention: “Look” + item/
location, “It’s time for...”
• Directing other’s actions, core vocab: Open
it, give me, my turn, put in, you go
• Greet using names
Autism: Communication Options Using the iPad
March 1, 2013

74. Sounding Board
Core Vocabulary
Autism: Communication Options Using the iPad
March 1, 2013

75. TouchChatHD ($149.99)
Autism: Communication Options Using the iPad
March 1, 2013

76. 2- and 3-hits
Core Vocab, Directing Actions & Attention
VIDEO
• Gissette (16 years old)
Comments, Directing actions
- Put on (nail polish) - Emerging
Autism: Communication Options Using the iPad
March 1, 2013

77. Teaching the Power of Core Vocab
• Single button - or - a sequence
• Same page - or - navigating between
board/pages
Autism: Communication Options Using the iPad
March 1, 2013

78. Teaching the Power of Core Vocab
• Gissette’s Symbol Recognition?
Requesting action - “Put on”
Autism: Communication Options Using the iPad
March 1, 2013

79. Motor Plans are extremely important
when...
• Teaching the use of core vocabulary and
use of more abstract vocab/symbols
• When using multiple pages of vocabulary
• When symbol recognition is weak
Autism: Communication Options Using the iPad
March 1, 2013

80. Picture Communication
Books
Rely on symbol understanding
Autism: Communication Options Using the iPad
March 1, 2013

81. Motor Plan VS. Icon Recognition
• We have found that consistent placement of
icons may be more important than symbol
recognition
• Learners don't need to be able to
recognize/"point to"/"give" a symbol that is
named before they can use that symbol to
get something done in the world.
THIS IS COUNTER-INTUITIVE...
Autism: Communication Options Using the iPad
March 1, 2013

82. Location, Location, Location!
When teaching AAC: Teach location
Why??
• Motivating outcomes/consequences of the act
strengthen motor plans
• Stable key location enables the development
of motor automaticity
• Consistent motor plans reduce the cognitive
requirement of symbol recognition
Autism: Communication Options Using the iPad
March 1, 2013

83. We can take advantage of motor
planning when:
• Each word has its own motor pattern due
to consistent icon location
• Motor patterns don’t change
• Patterns build upon themselves as
language grows - preserve relative location
Autism: Communication Options Using the iPad
March 1, 2013

84. Motor patterns don’t change
Autism: Communication Options Using the iPad
March 1, 2013

85. As language system grows...
Autism: Communication Options Using the iPad
March 1, 2013

86. PIC Core Vocab hidden buttons
Autism: Communication Options Using the iPad
March 1, 2013

87. Using Motor Planning to Our
Advantage...
• Our lower-functioning students can
generate multi-word phrases...
• ...across multiple pages
• ...using core vocabulary
We’re ready for Language Stage 3
Autism: Communication Options Using the iPad
March 1, 2013

88. Multi-Word Language Stages
1. One word at a time 3+ words
in length
2. Two- and three-word phrases
3. Building phrases and early sentences
4. Learning grammar and sentence
structure
5. Sentences with more grammatical
Autism: Communication Options Using the iPad
March 1, 2013

89. Stage 3+ Goals
Beyond 3-word phrases...
• Visual sentence strip or message window
• Useful for the learner
• Useful for the
communication partner
Autism: Communication Options Using the iPad
March 1, 2013

90. Language Stage 3+ Goals
Meaningful word order
Adding more verbs and adjectives to requests
Describing phrases (Object+Action+Location)
Including word endings (-ing, -s)
• Navigation between multiple pages (Core vocab,
actions, descriptors, multiple categories, etc.)
• Extensive icon library is a plus for abstract vocab
• Larger vocab: Synthesized (text-to-speech) voice
Autism: Communication Options Using the iPad
March 1, 2013

91. SGDs Apps
Full-Featured
Communication
- Expanded, Word-based Vocabulary
- Variety of Phrase Types
- Multi-Word Language Construction
- Intuitive Navigation
- Grammatical Endings
- AAC Assessment and Therapy is Essential!

92. Apps for Stages 3+
ProLoQuo2Go TouchChat HD
• $189.99 • $149.99
• The first, not necessarily the • Highly customize-able
best
• Unique features: Button
Actions more varied, Copy
and move pages between
users, iShare mobile upload/
download
• Language Stages 4, 5 -
WordPower version $299.99
Other apps: Words For -Life, Sonoflex, GoTalk Now, Talk Tablet
AAC, the iPad and Autism Moving Beyond Choice-making. CSHA 2013

93. TouchChat Family of Apps
Today’s presentation:
Students used customized
TouchChat HD
vocabularies
AAC, the iPad and Autism - Moving Beyond Choice-making. CSHA 2013

94. TouchChat Starter Vocabularies
• Different users: Different needs
• Main key to success of a communication app -
VOCABULARY
• Autism: Communication Options Using the iPad
Vocabularies set this app apart
March 1, 2013

95. The iPad is not the best Communication
Tool for everyone
Play on the iPad may not necessarily lead
to communication skills

96. That being said…exposure to visually supported
communication and a variety of communicative
functions may lay the foundation for future skills!!

97. • Monthly email blast - write to join
socalaacnetwork@gmail.com
• Blog - www.scaacn.blogspot.com
Updated weekly with AAC-related news, materials,
trainings, jobs
• Facebook - SoCal Aac Scaac-n
• Twitter - @SCAACN
Autism: Communication Options Using the iPad
March 1, 2013

98. • FREE Quarterly “support group” meetings,
Pasadena, CA
Next meeting: Tuesday, 4/23/13
6:30-8:30 p.m.
Topic: TBD
Autism: Communication Options Using the iPad
March 1, 2013

99. Thank you!
Gwendolyn Meier, SLP, MT
Villa Esperanza Services
gmeier@villaesperanzaservices.org