This past week was Spring Break for most of the school districts in the area, so almost all of the kids I usually work with were unavailable for therapy (since the districts don’t fund therapy when school isn’t in session, which I think is ridiculous– do they think autism stops existing for those weeks? But that’s a rant for another post). As a result, I got the opportunity to work with a kid that I’ve never worked with before. I always look forward to meeting and working with new kids, because they always challenge me to reassess my view of what autism is and isn’t. It is so easy to assume that my experience with autism, the individuals I have met and worked with, encapsulates all of autism, but that is completely false. The common saying is true– If you’ve met one person with autism, you’ve met… one person with autism. And, in my case, if you work with six kids with autism on a regular basis, you have a good sense of what autism looks like… in six kids. So despite my frustrations about most of my kids not getting funding this past week, I was pleased that the change in schedule gave me a chance to go meet another kid with autism and expand my knowledge and experience tiny bit. In this case, the lesson I learned was how amazing different forms of communication can be, and how beneficial technology can be.
A bit of context: The kids I work with have varying levels of verbal communication ability. Some are highly verbal, with some idiosyncrasies to their speech that make it stand out at times but do not impair their general ability to communicate and converse. Other kids that I work with have extremely limited verbal vocabularies, usually consisting of words expressing (and thereby requesting )their favorite toys, actions, and experiences. For these kids, verbal communication is supplemented with some form of nonverbal communication system, with varying levels of success on a case-by-case basis. Until this past week, I had experienced nonverbal communication systems in two ways– basic American Sign Language (especially for words like “help” and “more”) and PECS.
This past week, I got to “meet” my first high-tech Augmentative and Alternative Communication (AAC) device. The boy I got to work with has a device similar to the one pictured to the right. It has a touchscreen, on which a myriad of icons are displayed. Most of the icons are headers, which lead to a screen of related icons when pushed (for example, pushing the sheep leads to an entire screen of animals). When an icon is pushed, the word associated with that icon appears at the top of the device; once all of the desired words have been selected, the newly formed sentence can be tapped and the device reads it out loud, giving a voice to the user who might otherwise not be able to engage in verbal communication.
I’ll admit that I was fairly skeptical when I first saw him using the device– one of my coworkers asked him how old he was, and he quickly chose the icons to say “I am 6,” then looked to her for praise. I’m a huge fan of anything that makes communication possible, but I try to be critical of the rote learning that can happen with ABA; was he really answering her question, or had he simply learned that you push those three icons in that order when the therapists asks that question? However, as I spent more time with him, my skepticism began to fade. Later in our session, when he wanted something that he wasn’t allowed to have, he pushed “want (the object)” multiple times without any prompting from any of us, and then pushed the icons for “feel mad feel angry feel sad” after my coworker had made it clear to him that he would not be getting her cellphone. She never asked him “How do you feel?” or otherwise prompted him to express his feelings about the situation– that was all him.
Watching this kid interact with us through his device was phenomenal. Previously, I had only worked with kids who either had strong verbal communication, or who had limited verbal communication plus limited nonverbal supports. In contrast, this boy had limited verbal communication, but had such a strong nonverbal communication system that I stopped noticing. His device very much was his voice, and he clearly viewed it as such– at the end of our session, it was the first thing he grabbed to take with him, before grabbing any of his toys or shoes.
After just 2 hours (the length of our session), my head was filled with questions and ideas about how technology-driven communication devices could be used with the other kids I work with, and to what effect. Clearly not every kid will take to them; the labyrinth of icon menus is intimidating, even for someone as “fluent” as the boy I was working with, and can definitely lead to frustration-fueled behaviors and meltdowns. And technology is, unfortunately, expensive. Really expensive. As in, more-than-$10,000 expensive, if your insurance doesn’t feel like helping. Which is ridiculous– this isn’t a luxury item, this is a communication device! A quick search of the iPhone app store reveals an app that claims to be somewhat similar in function for $15.00, but it clearly would be limited in vocabulary. I’m curious as to what exists for the iPad, because it seems like that would be the perfect platform for a communication program, and is comparatively inexpensive.
For any special needs parents reading this, what forms of communication does your kid use? Does technology play a part in their communication? If not, do you think it might help? I’m curious to hear others’ experiences!