1997 Conference Proceedings

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Computer assisted sensory stimulation for children with profound and multiple disabilities

P. Blenkhorn
Technology for Disabled People Unit (TDPU)
Department of Computation
PO Box 88
M60 1QD
United Kingdom
Email, P.L.Blenkhorn@umist.ac.uk
Tel: +44-161-200-3368, Fax: +44-161-200-3373


For some years in the UK personal computers have been used to provide sensory stimulation in schools for children with profound and multiple learning disabilities. For historical reasons these systems were developed using the (now dated) BBC micro. Although the resolution of the screen, the number of colours available, and sound capabilities were limited, the system proved to be of benefit. More recently work has been underway to exploit the capabilities of more powerful multimedia PCs to provide a range of stimulating software for some of the least able pupils. Although functionally these programs are fairly simple, they can prove to be effective tools for the carer working with such children. This paper outlines some of the lessons learnt in those early days and describes these recent developments.

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1. Introduction

Since the first half of the 1980's personal computers have been used to support the education of children with profound and multiple learning disabilities in the UK [1]. In the early days much of the materials available were for Acorn's BBC micro which had up to 4 colours, floppy discs and sound (limited to mono). These 'advanced' capabilities proved attractive to many special schools in the UK, and the BBC micro became the main system used in a large number of schools [2]. Many developers produced software for the machine which, in turn, encouraged schools to purchase even more. In the UK this situation continued through a range of Acorn systems, although gradually more 'industry standard' systems have become established.

In this paper the term child is generally used. However, these comments are just as relevant to many adults. If you prefer, read adult or client where the word child is used. For historical reasons much of the author's work has been with Visually Impaired children and this is reflected in the style of this paper. However, the work described here also applies to other children with profound and multiple disabilities.

This paper looks at some of the lessons learnt in those early days, and some Windows software that is currently being developed to continue the work.

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2. Lessons gained in the past

Many schools used the software and systems developed and a number of lessons were learnt.

One of the advantages of the BBC micro was its interfacing capabilities. A wide range of peripherals were available that proved invaluable for children with profound and multiple learning difficulties. These included: switches (up to 8 in interface box); joysticks (both proportional and switches), the Micromike (a microphone whose volume could be detected by the computer); Touch Screens; and overlay keyboards. It was clear that providing a user with suitable access that both facilitated the child's interaction and provided the appropriate educational materials was of great benefit.

Having made sure that the child was in a suitable (and comfortable) position, the career would often be sat with the child using the software. This could, on occasion pose difficulties. Consider the area of visual stimulation. The area to be used was generally kept quite dark apart from the computer's monitor. If possible the computer was already set up with the program ready to run. The light on the monitor (or Touch Screen) was covered up - it sometimes proved more attractive than the material on the screen! Sometimes the child would be sat sideways on to the screen and suitable stimulation was provided - the carer waiting to see if the child's head would turn. If the carer needed to see where the child was looking, a simple solution was to use a mirror above the monitor so that the child eyes could be seen whilst still being held.

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3. Towards multimedia PCs

Over the past few years there has been a steady increase in the number of multimedia PC. These are invaluable in terms of: the screen resolution and palette size - allowing 'real' images; high quality stereo sound - allowing 'real world' sounds; vast increases in computational power and memory - enabling real-time control of the images and sounds. However, it is worth noting that these advances have not always resulted in associated benefits. One teacher recently reported difficulty with some software that used a wide range of colours. She said that on the older systems (with limited colours) the children could name all of the colours - this was much more difficult with a large palette. Of course, this does not mean that all images should be limited to colours that children can name, but it does encourage the creation of a library of basic images for certain activities.

A further question that has been raided is whether to use 'real world' images or more representational images. There has been some disagreement recently when talking to teachers of the visually impaired about which are most appropriate. Some more investigations are needed in this area.

However, what the multimedia PC are going to permit is a much wider range of sound and image resources to be made available, and also more powerful tools to enable children to interact with them. Such systems can then be controlled by an appropriate input device, and using suitable materials for a given child.

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4. Ongoing work

A number of packages have been produced to initiate work in this area. Some require no interaction, whereas others use the child's voice (like the Micromike - see above), switches or a Touch Screen.

Apart from the Speak Up package (Windows 95 only) all of the software runs on Windows 3.1 and Windows 95.

4.1 Look Here

This package has been designed for basic visual stimulation, displaying coloured shapes, lines and patterns in sequence. The aim is for users with limited vision or visual perceptual skills to be attracted to and focus on the display. A suite of presentations can be adapted using effects menus to set up options such as speed, size, colours etc.. These settings can then be saved as visual effects files and used later.

4.2 Listen Hear

Listen Hear has been developed for basic auditory stimulation. It plays recorded sounds in a number of different ways, e.g. The sounds can come from the left speaker or the right, they can be made to move around, get louder and quieter, play once or loop. These settings can then be saved in a sound effects file. Sound effects can be created using standard windows sound files (. wav). This creates the potential for sounds using the child's own voice, their friends and family, or even their pet.

4.3 Speak Up

This package has been designed to encourage vocalisation. There are two parts to the system: one presents striking visual effects that grow as the user makes sounds; the other uses pictures that can be made to move, get bigger, taller, wider as the user makes sounds. Again pictures can be used that are appropriate to the child - e.g. a family member.

4.4 Build It

The view was expressed that there was a limited number of picture building activities for switch users. As a result Build It was produced. Build It is a simple picture building program with sounds. It uses the keyboard, mouse buttons or switches (one or two). Windows metafiles are used and Build It enables them to be 'broken down' into stages that are built every time that a child presses a switch. Tools are provided to enable carers to build their own activities. This has enabled a wide range of picture building activities to be produced.

4.5 Picture This: Knockout and Reveal

This package enables children to interact with pictures in a number of ways. (Ideally it is used with a Touch Screen.) Knockout lets the user change areas of an image - such as the colour of the windows and the door in a house, or to colour in patterns. Some options enable users to receive a sound reward on completion of a task. Reveal allows you to uncover areas of an image in steps. It includes a snaking option that only permits a limited area of the picture to be displayed. Applications are in visual assessment/training and also to use just for fun.

4.6 Kaleidoscope

This is an early painting program for the young and developmentally young. The size and colours in the palette can be set for a particular activity as can other options such as whether to allow painting, filling, picture stamps, symmetry and up to four picture 'stamps'. Feedback from teachers of the visually impaired has resulted in options that change the colour used for painting either on each click of the mouse (or Touch Screen) or at a given time interval. When set to full symmetry mode (8 way) this can result in very attractive 'paintings' for some very disabled children.

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5. Discussion

The feedback regarding the current software has been most positive to date. Early comments resulted in the options for controlling the speed to be changed to allow the system to present information much more slowly (for the least able). Further feedback has resulted in options to enable carers to set the size of the palettes available to children, and the colours in those palettes.

With respect to development of activities - there has been considerable interest in using the packages both for the production of age appropriate materials (particularly for adults), and for developing switch-based activities that fit into the national Curriculum in the UK.

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6. References

(1) P. L. Blenkhorn, "The RCEVH project on computer assisted learning", The British Journal of Visual Impairment, IV(3), pp. 101-103, 1996

(2) P. L. Blenkhorn and M. J. Tobin, "Report on computer hardware in schools and units for the visually handicapped", University of Birmingham, Research Centre for the Education of the Visually Handicapped, 1983.

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