iPads: Communicating Across the Autism Chasm

We are well into the age of ubiquitous computing, where the blurring of the interface between humans and technology is changing the ways in which we communicate and interact with our world. While all of us are feeling that impact, it is and especially poignant development for those of us looking to communicate across the chasm of autism.

If you’ve been involved with individuals with autism, whether as a teacher, parent, or researcher, it is likely that you are well aware of the huge benefits that can be reaped by introducing these individuals to computer technology. Recognition of those benefits is not a new thing. During the last 30 years, the practice of matching technology with individuals with autism has actually raced ahead of the research.

Parents, teachers, and therapists eager to seize hold of any opportunity to improve the lives of their charges have not needed research to confirm what they’ve witnessed. The impact is so profound that it can be seen the very first time many individuals with autism are introduced to technology. Even today, practical application in this area of opportunity continues to outpace the research.

The introduction of the iPad and other touch screen devices is making technology affordable, simple, reliable, and flexible enough to benefit almost every single individual with autism.

“Recent developments in portable touch-pad devices, such as tablets, iPads and iPods now provide fantastic opportunities for those with limited communication abilities, including those diagnosed with ASD. There are now applications that, when used effectively, can become tools to promote significant gains in receptive and expressive language. This technology provides powerful but affordable access to devices with capabilities that used to cost many thousands of dollars.

These devices can become individually customized to help children with communication difficulties and provide them with a voice. When combined with appropriate programs and support they can become a valuable system to allow effective communication and assistance with the development of verbal language,”

-Simon Mitchell, MS, SLP-CCC

Perhaps, the most important development is the way that the iPad facilitates communication for those with limited verbal skills.

A 60 Minutes segment (CBS, October 23, 2011) discussed how the iPad in particular is giving children with ASD the means to express themselves. In a way, the iPad has become the Rosetta Stone of ASD. It has provided a way for all of us on both sides of the autism divide to understand and communicate with each other.

Previously, those individuals lacking verbal abilities had to spell out words by touching letters on an alphabet sheet or by pointing. This often would result in those individuals giving up out of frustration and retreating back into their minds. Now, software designed specifically for individuals with autism, place icons on the iPad, which allow them to communicate quickly and accurately with a few touches of the finger.

For many years, those involved with autism research, evaluation, and treatment have employed computer technology as an assessment tool. While it may have been done initially for the convenience of the professionals, other benefits were soon recognized. Numerous studies indicated that children who were tested with technology demonstrated dramatically higher cognitive capabilities than when tested by pencil and paper.

Furthermore, these children seemed to respond much more willingly and with greater focus to the prompts of a computer than they did to human testers. (Ozonoff, 1995; Goldsmith and LeBlanc, 2004). One thing led to the next and it soon became clear that the use of computers can dramatically lessen the time it takes for individuals with ASD to learn new skills and behaviors. While it may take hours of repetition for a therapist to teach someone to connect a picture with a vocabulary word, this connection occurs after just a few attempts when the lesson is taught by a computer. (Tseng and Yi-Luen, 2011)

Computer technology is exceptionally effective with improving many different areas of an individual’s life. It has been shown to help support or improve:

• Cognitive development
• Language skill mastery
• Academic performance
• Behavioral changes
• Abilities to cope with transition and change
• Social interaction
• Choice-making skills
• Facial recognition and the reading of human expression

Individuals with ASD are said to have monotropic interest systems. This means that they function best in stable environments that offer restricted stimuli and clearly defined boundaries, and are not reliant on interpreting text. (Murray, 1997) Practically speaking, the use of technology is especially effective, because hi-tech devices:

• Rely primarily on visual cues, which are much more effective than auditory cues for individuals with autism
• Provide as much time as needed for those with processing delays
• Don’t object to endless repetition, as they are nonjudgmental, infinitely patient, and don’t hold grudges
• Provide the specific types of stimulation that attract rather than overwhelm individuals with autism
• Offer large measures of predictability and consistency, compared to the unpredictable nature of human responses
• Do not send conflicting social interaction cues that are a staple of typical human communication
• Place the user in control

Many parents of children with Autism have continually asserted that their children are far more creative, perceptive, and intelligent than most assume. Computers have proven that they are right.

The 60 Minutes segment discussed how teachers and parents discovered that the children in their charge had interests, thoughts, and abilities that no one ever knew about until those children were put in front of a computer or iPad. One child had an incredible passion for opera that no one knew about until that child had the opportunity to explore the internet independently. (CBS, 2011)

Currently, software makers are collaborating with specialists in Applied Behavior Analysis (ABA) to create programs specifically for the iPad. These programs are already making the difference in the lives of many.

Recognized as a highly successful approach to education and behavioral modification, ABA-based interventions are most effective when they are applied one-on-one for a minimum of 40 hours a week. Practical considerations and cost make it a challenge to provide those hours through human support. Researchers have begun to demonstrate that interactive computer programs can be used to supplement training with very effective results. (Grynszpan, Martin, and Nadel, 2007)

Among dozens of applications, a variety of function-specific programs allow individuals with ASD and/or their instructors to:

• Create customizable choice boards
• Practice language skills and overcome both genetic and acquired speech challenges
• Build and practice vocabulary including meaning and nuance
• Create pictures, flashcards, storyboards to facilitate communication
• Develop readily accessible visual schedules
• Learn to navigate challenging locations in the community
• Learn about good oral health and ease anxieties around dental visits
• Develop listening and language skills that are fundamental to learning
• Practice basic social skills, including verbalization, emotion recognition, and following directions

They also promote the practice and mastery of human skills that are intuitive for most children, but often must be taught to individuals with ASD:

• Appropriate eye contact
• Smiling
• Reading facial expressions
• Balance, coordination, and rhythm
• Storytelling

A number of programs are available that turn the entire iPad screen into a large-button keyboard, with either icons or text display with word prediction. Offering various levels of sophistication, these programs enable people of all cognitive capacities who are speech-challenged to express needs and ideas or ask questions directly and independently by building sentences from relevant images or from text.

Some specialists and researchers are now looking at the creation of products that can become supportive devices and extensions of an individual over the course of an entire lifetime, much like cell phones have become permanent assistive technology for most of us.

One researcher suggested the use of a technological “Jiminy Cricket” who would serve as a lifelong mentor. (Ijichi and Ijichi, 2007) But while doing this, we need to remember that technology should never be about replacing human interaction, but improving it. Children with ASD are just like everyone else. They thrive when they are loved and touched and feel connected to the world about them. It’s important that we use technology to help enlarge that world for them, rather than shrink it.

At Butterfly Effects, we have knowledge of the best products and technology currently available. We can provide support and answer your questions. Never hesitate to give us a call.

References:

CBS News, 2011. “Apps for Autism: Communicating on the iPad.” 60 Minutes Segment, October 23, 2011 / CBSnews.com. Retrieved from http://www.cbsnews.com/8301-18560_162-20124225/apps-for-autism-communicating-on-the-iPad/

Goldsmith T R and LeBlanc L A, 2004. “Use of technology in interventions for children with autism.” Journal of Early and Intensive Behavior Intervention, 1, 166-17. (cited in Tseng R Y and Yi-Luen E, 2011)

Grynszpan O, Martin J C, and Nadel J, 2007. “What influences human computer interaction in autism?”Development and Learning, 2007. ICDL 2007. IEEE 6th International Conference. doi 10.1109/DEVLRN.2007.4354047

Ijichi S &Ijichi N, 2007. “Computerized lifelong mentoring support using robot for autistic individuals. Medical Hypotheses, 68, 493-498. doi:10.1016/j.mehy.2006.08.016. (cited in Tseng R Y and Yi-Luen E, 2011)

Murray D K C, 1997. “Autism and information technology: Therapy with computers.” In Powell & Jordan (Eds.),Autism and Learning (pp.100-117). London, UK: David Fulton Publishers. (cited in Tseng R Y and Yi-Luen E, 2011)

Ozonoff  S. 1995. “Reliability and validity of the Wisconsin card sorting test in studies of autism.”Neuropsychology, 9(4), 491-500. doi:10.1037/0894-4105.9.4.491

Tseng R Y and Yi-Luen E, 2011. “The Role of Information and Computer Technology for Children with Autism Spectrum Disorder and the Facial Expression Wonderland (FEW).” International Journal of Computational Models and Algorithms in Medicine, 2(2), 23-41, April-June 2011 23. Retrieved from https://wiki.cc.gatech.edu/…/IHI-Facial-Expression-Wonderland.pdf