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Your child is too young for assistive technology... and other myths about communication in early childhood Molly Heck, BS-SLPA Deanna Hughes, PhD, CCC-SLP.

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Presentation on theme: "Your child is too young for assistive technology... and other myths about communication in early childhood Molly Heck, BS-SLPA Deanna Hughes, PhD, CCC-SLP."— Presentation transcript:

1 Your child is too young for assistive technology... and other myths about communication in early childhood Molly Heck, BS-SLPA Deanna Hughes, PhD, CCC-SLP Larissa LaPine Ferill, MA, CCC-SLP April 11, 2012 San Diego Infant Development Association

2 Introduction

3 Assistive Technology (AT) vs. Augmentative Alternative Communication (AAC) Assistive Technology: an umbrella term referring to adaptive and rehabilitative devices for people with disabilities and the process for selecting and implementing Augmentative Alternative Communication: a subset of assistive technology designed to replace or supplement verbal language

4 Maintaining a Perspective Technology Should Never Replace Play, Engagement & Interaction

5 Stages of Early Communication (Ingersoll & Dvortcsak, 2010) Pre intentional Pre linguistic Intent First WordsTwo Word Combinations SmilingCommunicative Intent One word can have varied meaning Rapidly expanding vocabulary CryingNon verbalVaries rhythm of speech Increased awareness of listener GazingPointRequests, responds, protests Talks about concrete topics GraspingShow item to adult Labels, greetsRepairs communication breakdowns

6 Pre- intentional Pre- linguistic Intentional First Words Two- Word Combos Early Syntactic- Semantic Later Syntactic- Semantic Communicative Competence Stages of Early Communication (Ingersoll & Dvortcsak, 2010; Searcy, 2011)

7 Early Stages of Play (Ingersoll & Dvortcsak, 2010) ExploratoryCombinatorial Cause & Effect Functional Self Directed Pretend Other directed pretend Symbolic TouchesNests objectsPop up toys Pushes Car Pretends to eat Feeds parent play food is yummy MouthsPuts objects in containers Musical toys Catches ball Pretends to talk on phone Dresses doll Pretend s blocks are cars SmellsLines up toysWind up toys Puts people in cars Pretends to sleep Puts bear to sleep Makes dolls walk

8 Request objects and items Continue an action Stop an action Request social interaction Express a feeling Make a choice Initiate and terminate an interaction Request assistance (Gamel-McCormick & Dymond, 1994) Functions of Communication

9 Assessment

10 Receptive/Expressive Communication Cognitive Skills Motor Skills Visual Skills Auditory Skills Physical Health Consider Profile of Individual Child

11 Ability of typical communication partners Settings where the communication is used Child preferences Family and caregiver preferences Durability and Portability Potential for growth Projected rate of growth Other AAC Considerations

12 Amount of training for families and caregivers Implementation: consistent use across settings Low-tech vs. high-tech Permanency of the disability Age of the user and caregivers Existence of prior knowledge vs. new learning Cost effectiveness Even More Considerations

13 Selecting a Device

14 Given the breadth of assistive technology available, much can be adapted for very young children Developmental stage of child must be considered before including some features (e.g., symbols versus pictures to represent language) Children and infants are often already exposed to abstract forms of assistive technology (e.g., prenatal sound machines and cause:effect toys) The question is not "Can my child use AT?" but "What AT can my child use?"

15 Both a challenge and liberty of AT is that can be continuously adapted to meet the needs of specific individuals, including: Language skills and needs Visual/hearing complications Sensory integration Portability Access (can be activated by feet, fingers, whole hand, eye gaze, head, etc.) Children Need to Have Good Motor Skills to Access AT

16 With increased experience, it becomes easier to creatively adapt AT so that it can be accessed appropriately Teachers and therapists can use household objects to adapt AT (e.g., utility belt to enable a child to carry an AAC device) Rapidly Changing Technology Offers More Options

17 Common Myths

18 iPads can offer financially reasonable solutions to families, but it is important to consider all options specific skills are necessary to use iPad applications (ability to isolate and activate buttons, scroll, categorize, access "home" and/or "back" button) although many apps target language and pre-literacy skills but pre-requisite abilities must be considered adults can provide live adaptations to enable interaction with a device example: if child taps his hand on the floor, adult can push a button to activate preferred, animated response (on iPad or computer) An iPad Will Help All Children

19 If a child is not effectively able to use verbal language, another communication modality must be identified Teaching children with (or without) language delay to augment communication with adapted sign language or AAC, frustration can be decreased, while enabling the development and use of communication Similar to 'baby sign', AAC may increase verbalization, and provide a concrete and consistent verbal model Verbal Children Will Not Benefit From AT

20 While editing applications and AAC devices can be difficult to learn, they tend to be similar and can become familiar overtime Once the "lingo" and concepts for one device are acquired, it becomes easier to problem solve, program other devices, and communicate to others using them Most companies offer live tech support that can help with any issues Communication Devices and Applications are too Complicated for Most Parents to Edit

21 With an assessment completed by a Speech Language Pathologist, funding for AT is available through: Insurance Companies School Districts MediCare and MediCal There is no funding for AT

22 Focus of ALL therapy should be: Engagement and play skills Interaction with adults and others Language development within the activity Goals for young children should target successful transition to Kindergarten

23 Despite language and/or cognitive abilities all children will benefit from activities which are engaging and promote language development Some children are too "low functioning" for AT

24 AAC devices have changed dramatically in recent year Many AAC devices look just like the iPads and iPhones that all children use An AAC device will stigmatize a child

25 AAC provides a bridge for functional communication by reducing frustration and sparking language development Current research reveals increased verbal skills in children who are exposed to symbolic language, such as icons, gestures and pictures AAC will prevent my child from learning and using verbal language

26 AAC Dos and Donts

27 Have a plan: how and why technology will be used in your intervention Be able to articulate your rationale with families: why are you getting paid to play with your iPad? Acknowledge that families may have more technology savvy than you or none at all: collaborate with families Use technology as a concrete support for parents that may require minimal training: help parents find a way to play successfully with their children Technology Dos

28 Be prepared: be sure that equipment is charged; have knowledge of applications and programs before introducing them Incorporate other, more familiar tools: visual timers, alerts, camera, video, and alarms in addition to applications Understand and appreciate how technology is typically used in the familys home: (e.g., distracter; entertainment for the child; reinforcer) Know professional standards: American Academy of Pediatricians and ASHA Technology Dos (continued)

29 Never use technology as a substitute for good therapy: it must enhance interaction, not replace it Technology must never be used as a time-filler or distracter: use it for functional communication requests and to provide visual representation of language Block access to self-stimulating activities on the device: e.g., limit scrolling and access to repetitive videos Maintain control of the device: avoid tug-of-war Never assume one technology is right for every child Technology Donts

30 Never narrow your choices to one specific type of technology Avoid assumption that technology will hold the childs interest Never minimize the importance of face-to-face interaction Never exclude use of natural gestures and modified sign Never forget the power of engagement, and the role it plays in communication and interaction Technology Donts (continued)

31 iPad Applications for Communication Advance March 19, 2012 AAC LANGUAGE Proloquo2Go Touch Chat HD Tap to Talk Custom Boards Grace Aunt Maggies Recipes ACT Spell Categories Learning Center Conversation Builder Easy Concepts Fun and Functional Fun with Directions Image Spinner Language Builder Story Line RJ Coopers Rad Sounds

32 Cookie Doodle Go Away Big Green Monster Icebox Doodle Music Colors Toca Hair Salon and Toca Tea Party Sound Touch The Social Express Cinderella by Nosy Crow NoodleWords Communication and Learning


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