Saturday, October 29, 2011

60 minute segment – Apps for Autism

First let me say, I am a special education teacher and assistive technology professional for over 18 years. In my 18 years, I have never seen such a hard sell for a tool like I have for the iPad. For 60 minutes to jump on the band wagon and hard sell for this device is mind blowing. I used to respect the news pieces from 60 minutes. Now I will have to question everything they say and show.

If no one else is going to Autism sells. If this segment was APPS for individuals that are non-verbal, APPS for special education, APPS for individuals with disabilities, Let’s Talk APPS, I am sure the hype around this segment wouldn’t have been there. Autism sells. We all know someone that is on the spectrum. We are all seeking a tool that opens the window, the door to individual's thoughts. But one device isn’t the answer for every individual with autism.

I take offense with this segment on a couple of different levels. The first part, seriously do you want me to believe that Josh has NEVER been exposed to any other form of communication device be it a dynamic screen, a text to speech device or even a better developed static board? Really? In his 27 years on this earth, he has never so much as used a PEC, a computer keyboard, a computer program that has text to speech or give the young man a Franklin speller with speech would have been better and more productive than a STATIC crumbled QWERTY board. If I put things in perspective, maybe he wasn’t. The first Dynavox was introduced in 1991. They were big, heavy devices that were marketed to individuals with physical disabilities. The first device that I can recall being used with individuals with autism was a PRC device in the late 90’s I believe it was the Alphatalker. Josh is a 27 year old man who would have ended his educational / transition year 6 years ago. That would have given his educational placement, medical professionals, parents and other professionals that came in contact with Josh 10 years to try ANYTHING. But everyone waits until the miracle iPad was designed by Apple. So if that miracle iPad was never designed and marketed, poor poor Josh would have nothing to use. Come on, Really? You want me to believe this.

First off, why is he using proloquo2go. Josh has the ability to type whole words? Why is he using a symbol based communication system? I am sure he has more to say than what is programmed into the device which means he should be using an app or device that gives him much more flexibility in language. Has Josh used the device to spell at all since he has gotten the “miracle” iPad? If not, why not? He should be using the tool to the fullest of its capacity and not just relying on the picture supported communication. Please someone offer to evaluate Josh so he can have a tool that meets his language needs. If in the end proloquo2go is the tool that gives him the greatest language capacity for his ability wonderful.

As for the rest of segment, the school in Canada. So they are using proloquo2go in a study with their students and a few others apps. Here is a shocking statement. There are more apps on the market then proloquo2go. Yes, proloquo2go was the first app for AAC but it isn’t the only one and dare I say it, NOT ALWAYS appropriate for every user. If the school is actually doing research on the effectiveness of the iPad for communication shouldn’t they be using tools that are appropriate for the user. Some of the students are emergent users. Emergent users – limited fields, no categories immediate feedback. Hand over hand assistance to select out of a HUGE field is not appropriate and is counter productive. Where is the independence in that?

How about the young girl “counting”? Let’s define counting. Name or list (the units of a group or collection) one by one in order to determine a total as defined by I will give you on the iPad our little friend was visually attending. But how long was it after her introduction of the iPad was it instant like we are lead to believe? Again, I am going to say it DOUBT IT. As for counting on the iPad, our little friend was NOT counting. She was visually attending to an activity that was working as a VIDEO. If she would have touched 1 then 2 I would say she was counting. I can’t even say she was doing number identification because she was not an ACTIVE participate in that activity. She was PASSIVE.

The one piece that I have to say was the best piece was the young man that was doing the cause effect activity and he kept returning to the TIGER and reacting. That was believable and his mother saying there is no such accomplishment as a "tiny little thing". Those are the experiences that I have every day. In my 20 years in special education, regardless of the tool, it is always the small things in life. It is the small accomplishments that we take with our students, children and the disability community.

So many say the iPad is the “miracle” tool. Let’s try the same population of children with a different tablet type tool. Do we get the same responses if so does that not make us question why? Giving it some thought here are a few of my ideas. The first I would think that the device is positioned that there is not background issues. The device often is laid flat. There is an end visually. So it could be that children aren’t struggling with depth perception or other visual concerns. Second, computers students have to use a mouse. Mousing skills are tough for some individuals. It is a second layer of understanding. I move this item, an item on the screen moves and then I have to target the item I want. Mm… multitasking skill which we already know children with disabilities struggle with. Even with a touch window you are looking at difficulties because children struggle with proximal stability. Without proximal stability children struggle with distal mobility. In non therapy language, you have to have good mobility and strength in your trunk before you can use your hands and fingers. So if the touch window is in a vertical plane, it is harder because I don’t have a steady base of support. With the iPad, I can rest my arms on the table, have a smaller movement so I don’t lose my base of support. Thirdly, portable. Computers have to stay at one place. With the iPad student can go where they are more comfortable.

As an assistive technology consultant, I struggle every day with hopes that the suggestions that I am making are sound reasonable meeting the needs of the individuals with disabilities that I come in contact with. This segment just trivialized assistive technology for individuals with disabilities. It managed to put chips, dings and holes in all the work that has been done in the field of assistive technology. Assistive technology professionals, parents and therapist have worked tirelessly to get the message out “ONE SIZE DOESN’T FIT ALL”. We need to look at the individuals needs and abilities. In 13 minutes, they had the message sent “If your child has autism, the iPad is the ONLY tool to use.”

Tools are tools. The tool is not the miracle. The tool may help unlock the window but it is the individuals that push, pull and are consistent with using the tool that opens the window and allow the potential flow out. This means it is the parents and professionals that work hard and are dedicated to improving their children/students they work with that make things happen.

I remember a saying my grandmother used to tell me “Remember it is not fancy paper, the bows or even what might be inside the the package that makes it special but it is the the message of the package that makes it special.”

The iPad is supposed a tool for the masses. It is a UDL dream come true. However, again that wasn’t what was expressed and shown. So is it a miracle, no. I am almost positive Steve Jobs didn’t have individuals with disabilities in mind. He was thinking of the MAJORITY not the minority. We were just lucky to benefit from the tool. It still doesn’t make it a miracle tool. It makes it a well designed tool. It is a tool with the right app it is can be a door opener. But honestly, the iPad isn’t anything without the APPS. If the device just had work based apps, how many children with disabilities would be benefiting?


Mary Alice said...

Whoa, Jeannette! Although you make some valid points, you seem to be missing the big picture. The popularity and "coolness" of the ipad are what is helping those of us in the field to get them for our kids who can benefit from them.
A couple of facts--some of us were using augmentative comm. devices in the seventies with our very few clients with autism. Secondly, Proloquo2Go can be set up exactly the way you describe.
I have had a number of teenage students respond to the ipad when they have rejected every other form of communication provided to them over the years. In that sense, they truly are a "miracle".
Yes, kids need to be evaluated, and, or course, their programs need to be individualized. That said, it's pretty hard to justify a cost of $7000 and up, when the ipad can be configured to do the same thing, plus much more.
The 60 Minute segment wasn't perfect, but it sure helped spread the word about the need for and benefits of augmentative communication tools.

Jeannette Van Houten said...

Hello! Mary Alice
Thank you for taking the time to write a comment.
I understand that augmentative communication has been around for years which now my point goes that Josh was never shown any other device but a STATIC piece of paper.
I also didn't miss the bigger picture of it is "cool". Last time I checked according to IDEA, 504 and any other law, COOL did not play a part in my justification of a tool for communication or any other tool. Last time I checked, cool was subjective. One persons idea of cool isn’t another persons idea.
I respect that the iPad is an accessible tool for MOST not all individuals. But there is a danger in saying that this tool is designed for a specific population or meets the needs of this population more than another. It is a TOOL. This tool is designed for many types of users.
I know how to use Prologoquo2 and I know that it can be modified and adapted to meet the many users' needs. However, it is not the ONLY tool on the market and it is not the best tool for all users. There are many wonderful tools that can be used with less modification, less cost and still be beneficial.
My point and you made it perfectly is that there are individuals that this tool can be ground breaking for whatever reason. That this is the tool that works with the individual. However, if this is where you start and stop, the student is not getting the benefit of the doubt on their abilities. You have to admit that Prologoquo2 is limited to giving access to language that is programmed. So unless the individual can type, the student is limited to the language set provided.
Sorry if a student is evaluated and it is found that the iPad is not meeting their needs than I can very well find a justification for a more appropriate tool. Because the iPad is not the tool for EVER individual that needs AAC. The iPad doesn’t switch access, access is very difficult if you haven’t controlled touch, also very poor for an individual with visual deficits that may need a larger screen or icons, what happens if the person needs access to the device touch off instead touch on…. So yes, I would have no problem justifying a device that may cost more especially if the iPad does not meet the needs of the student or individual I am working with.
As for the iPad doing so much more, so do most AAC devices that are computer based. Most if not all of the AAC devices that are digital displays can access the internet, have a very good screen reader with great voices, can have computer based install software.
The 60 minute segment was far from perfect. It didn’t help spread the benefits about AAC. It spread the word about how wonderful the iPad is for individuals with autism.

I would have been fine if this segment showed the possibility of the tool for all populations. However they picked the hot disability.