How Different Types of Assistive Technology Can Help Children with Autism
An anonymous speaker once said, “some people with Autism may not be able to speak or answer to their name, but they can still hear your words and feel your kindness.” Approximately thirty percent of people diagnosed with Autism Spectrum Disorder never learn to speak more than a few words (Forman & Rudy, 2018). Fortunately in today’s society, new technologies have made it possible for these individuals to communicate and socialize with others.
The primary focus of this paper is to determine how different types of Assistive Technology, such as AAC devices, iPad apps, and various accessibility features, can help children with Autism improve their communication and socialization skills. In addition, the paper will be addressing the varying levels of severity of Autism, as well as the different levels of technology that are out there to accommodate students’ different needs.
Rationale/Connection to Course
Given that the prevalence of Autism is high, this topic is worthy of research. It is relevant to us because we will encounter students with Autism in our classrooms, if we have not already. Therefore, as developing professionals, we need to know what the key challenges are for individuals with Autism, as well as how to support these difficulties through Assistive Technology (AT). By doing this, students will be able to better communicate and socialize with others, and succeed alongside their peers in the Least Restrictive Environment (LRE).
This current research makes use of the knowledge gained from the course at the Westchester Institute for Human Development because we learned a variety of ways that technology can help us modify the learning environment for students with a variety of disabilities, one of them being Autism. We also were able to practice directly using the different types of AT which not only allows us to be put in the “shoes” of students using these, but it gives us an advantage to helping our own students use them.
Goals & Objectives
To outline/establish the main challenges that individuals with Autism face.
To develop an understanding of the ways in which Assistive Technology devices can support students with Autism in communicating in the classroom.
Finally, this project also aims to assess how different AT can help students with Autism socialize appropriately with their typically developing peers.
- To describe the communication and socialization deficits that students with Autism experience
- To identify types of Assistive Technology
- To establish what populations the types of AT chosen are most appropriate for
- To determine how the types of AT chosen will improve or support the communication and socialization deficits that students with Autism face
II: Background/Overview of Autism
According to the National Institute of Mental Health, Autism Spectrum Disorder is a developmental disorder that can be diagnosed at any age, although in most cases, symptoms appear during the first two years of life. It is a “spectrum” disorder because of the fact that there are different severities of the symptoms that people with the disability experience. Based on the DSM-V, generally speaking, individuals with Autism have difficulties with communication and interaction with others, which results in a limited functional capacity in all areas of life. More specifically, students with ASD learn differently than other students and frequently have difficulty with spoken and written language expression. These students may not speak at all or have very limited words. They may have difficulty understanding spoken language. However, it should never be assumed that students with Autism who cannot speak do not want to communicate or do not have anything to say. In addition to difficulty speaking, experts have identified social skills deficits as another core characteristic of Autism (Southall & College, 2013, p. 24). In particular, individuals with Autism having poor social skills usually means they have an inability to read social cues around them, which leads to difficulty engaging in the social world (Southall & College, 2013, p. 24).
III: AAC for Communication
Technology has become a tremendous part of our everyday lives, however assistive technology has changed the lives of those who depend on it. Assistive technology is defined by the Technology Related Assistance to Individuals with Disabilities Act of 1988 as “any item, piece of equipment, or product system that whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.” For children with Autism, there are many types of assistive technologies that help them function on a daily basis in, and out of the classroom. For those that are nonverbal or have limited vocabulary, there are Augmentative and Alternative Communication (AAC) devices. AAC refers to any communication method used to supplement or replace speaking or writing for people who are unable to produce or comprehend spoken and/or written language. There are many different types of AAC devices, all ranging in their use of technology. One no technology AAC device that students with Autism may use is the Picture Exchange Communication System (PECS). PECS allows non-verbal people to communicate a request, a thought, or anything else that can be relayed by showing a picture. They are taught to approach someone by giving them a picture of what they want. For example, if a student needed a pencil, they would go up to their teacher and show them a picture of one. This allows the child to initiate a conversation. There are six stages of PECS which are taught, in order, to students with Autism learning the system. Step one is how to communicate. Children with Autism are taught to exchange one picture for an item or activity they want. Step two is distance and persistence. These children learn to generalize the skill learned in step one by using it in more places with different people. This teaches the users to be persistent communicators. Step three is picture discrimination. Children with Autism will learn to pick from two or more pictures to ask for their favorite things. All of the pictures they use will be put into a book to make them more accessible for the user. Step four is sentence structure. Now children will learn to put the picture cards into short, simple sentences. For example, they would use the “I want” card with the “juice” card. By showing those two cards together, the child would be saying, “I want juice.” Step five is answering questions. This step teaches the user how to answer questions like, “what do you want?” which gives the user the ability to participate in more conversations. The final step is commenting. The child is taught to comment on multiple questions like “what do you see?” (National Autism Resources, “The Picture Exchange Communication System (PECS)”, 2019). These steps allow students with Autism to not only initiate conversations, but also comment and participate in conversations occurring around them. Step one is the most important because it teaches the child the power of exchange and the consequences. It also teaches the user that picking up a card and showing it to another person, can get him/her what they need. This step sets the stage for the rest of the steps. PECS should be considered for children who do not speak, who are unintelligible, or children who do not communicate effectively with their given communication system.
Types of AAC that are mid to low tech are Speech Generating Devices (SGDs). SGDs are portable devices that provide speech output. Speech output is a desire for many people who are nonverbal, as it is more easily understood and accepted by others. Since the output is spoken, peers do not need to learn a specific skill to understand the nonverbal person, like how to interpret pictures or movements. SGDs are also desired because they provide the nonverbal student with a model of how words sounds and should be spoken. One example of a SGD is Zuvo. This small device, which looks like an iPad, is specifically for a child or adult with impairments. Unlike an iPad, it is not permitted to access features other than communicating for its users. The vocabulary on this device ranges from very simple and symbol based, to more advanced keyboards, incorporating word and phrase prediction. There are many other features to make the Zuvo a perfect fit for any age. Lastly, Zuvo is just one type of SGD. Being that there are others, it is important to find the right one that is most supportive of the student’s needs.
Finally, on the high tech end of the spectrum, there are many AAC iPad apps to help children with Autism communicate. SGDs are extremely expensive, making an iPad app a more feasible solution for many families, in terms of affordability and ease of use. For example, Proloquo2Go is an AAC app that is symbol based. Just like the SGDs, there are many features to customize it, including being able to add buttons that are more personal to the user’s life, and folders to organize the symbols that are most used by the student.
IV: iPad Apps for Socialization
In addition to communication apps like Proloquo, there are many apps that can be downloaded to help students with Autism socialize. One app that can be used to help improve social interactions for students ranging from ages 2-17 years old is called “Going Places”. This app, which is a free download, contains six different social stories that are designed to help individuals with Autism communicate. Social stories are cognitive interventions that describe social cues and appropriate responses, which are extremely beneficial to individuals with Autism (Flores et al., 2014). The purpose of these social stories are to introduce a new skill or routine without increasing fear or aggression in the student. In order for social stories to be effective, they must explain cues, model appropriate responses, and use flexible language. For example, in the Going Places app, appropriate phrases and behaviors are paired with images of a child who is going to places such as the hairdresser, the mall, the doctor, the playground, the grocery store, or a restaurant. These story-based interventions are especially effective for children between 6 and 14 years old, as they “produce favorable outcomes for individuals with ASD in the areas of interpersonal and communication skills, social behavior, choice and play skills, understanding emotions, self-regulation…and reduction of challenging behaviors” (National Autism Center, 2009, as cited in Flores et al., 2014). Furthermore, it was found that, on average, children with special needs played with peers for two minutes during play periods after social stories were implemented (Flores et al., 2014). This finding is noteworthy, as there was typically no social interaction during these sessions prior to this intervention (Flores et al., 2014).
In addition to the Going Places app, there is an app called “First Then Visual Schedule HD”, which costs $14.99 in the app store. Although it is not free like “Going Places”, it is still low cost and is worthy of purchasing because it is more personable and can be customized to fit the needs of the student. In other words, this app is akin to “Going Places” in that it helps teach social skills to students with Autism via social stories. However, it differs from “Going Places” because this app allows the user to create their own social stories by using photos from their own personal photo library. In addition to teaching social skills, this app is useful because it allows users to make choice boards and visual schedules. Thus, by using these social skill apps, it provides more support to children with Autism when socializing in their everyday lives.
V: Accessibility Features
In addition to AAC devices for communication and iPad apps for socialization, there are also ways to modify computers to make them more supportive of students with Autism, called accessibility features. This includes changing the settings on the actual computer or laptop, in addition to downloading programs that will add additional supports to the user. Accessibility features can be used for any population of students with Autism, young and old, as long as the user has access to some type of computer, regardless of if it is a Mac, Windows, or Chromebook. For Mac and Chrome users in particular, these accessibility features are more commonly known as browser extensions. A browser extension is a tool that extends the web browser with additional features, allowing the user to customize the page they are using to make it more supportive of their needs. There are various browser extensions that can support a wide range of needs, such as visual impairments, physical disabilities, and learning disabilities. For the purposes of this paper, accessibility features and browser extensions related to communication are the primary focus. Some examples of settings that can be changed directly on the computer that relate to supporting communication involve modifications of the keyboard. One setting that can be turned on is VoiceOver, which speaks what is on the screen out loud. On an Apple device, this can be turned on by pressing command and F5 simultaneously. This is an accessibility feature because it allows a student that has trouble speaking out loud to communicate what he or she wrote in a different way. Another example of a keyboard modification that can be changed directly in settings is the use of shortcuts. For a student with Autism that may struggle with the writing and spelling aspects of communication, it may be easier to type a few letters that the computer will transfer into words, such as “omw” for “on my way”. As for software/extensions that can be downloaded to add supports, one example is SymWriter. SymWriter is a widget tool that can be used to help students with disabilities such as Autism because it is soft
ware that allows the user to see the meaning of the words that they are typing (Kirinic et al., 2010, p. 14). This is beneficial because it helps the student that struggles with communicating to process the words they are typing by seeing if the meanings match up to what they are trying to say. In addition, the software also has the ability to let the user communicate through symbols if they are not yet typing words, by selecting symbols and pictures from grids (Kirinic et al., 2010, p. 14). Lastly, there is a feature on SymWriter that speaks individual letters, words, or whole documents back to the user, which is supportive if a student that is nonverbal or has a limited vocabulary has to read something that they wrote out loud. In addition to SymWriter, there are several other browser extensions that can help with word prediction and communication via pictures and symbols. On a chromebook, there is “Read and Write for Google” which again, reads words out loud, but most importantly predicts words as the user is typing, which is crucial for students that struggle with spelling (Van Den Heuvel, 2019). CoWriter is a similar extension that also helps struggling spellers by predicting letters as the user is typing, but this one has a text-to-speech option that will also speak the word that it predicts out loud (Van Den Heuvel, 2019).
There are many different types of assistive technology that can be used to help the communication and socialization skills of students with Autism, ranging from low to high functioning. These technologies vary in areas such as price, level of sophistication (low tech vs. high tech), and ease of use. Thus, a thorough evaluation of the student’s needs should be conducted, in order to choose the type of assistive technology that will be the most beneficial in improving the functional capacity of the student. Finally, being that there is a high possibility that most, if not every, special education teacher in the world today will engage with a student with Autism at some point in their teaching career, it is crucial for educators to keep up with advancing technology and have the knowledge to support students in using the different options that are out there.