2000 Conference Proceedings

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Jamie Judd-Wall, Executive Director
Technology and Inclusion
P.O. Box 150878
Austin, TX 78715-0878
Phone: (512) 280-7235
FAX: (512) 291-1113
Email - jamie@taicenter.com
Website: www.taicenter.com

No group of students challenges the special education system like students with autism. Their unique combination of ritualized behaviors like rocking and spinning combined with severe language deficits make it difficult to put into place the 'teach to their abilities' philosophy. The use of technologies, like augmentative communication devices and software, which seem to hold so much promise cannot be taught to students with autism with the same instructional strategies that are use with students with disabilities like cerebral palsy and down syndrome. An instructional strategy must be put into place which is both highly structured, to control the ritualized behaviors of the student with autism, and communicatively challenging, to make communication worth the effort of using the device or software.

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The PECS (picture exchange communication system) is a highly successful process for instruction in symbol meaning and the augmentative communication process, but it uses no technology. Augmentative communication devices and software get the message across, but are so open ended that their use is problematic for students with autism. In an attempt to bridge the gap between these two highly successful components, we developed a communication training strategy for students with autism that combines PECS strategies and highly controlled environment and the voice output messaging capabilities of aug com devices and software.

In 1998-99, we piloted the program with 5 individuals with autism, ranging in age from 13 to 35. This year we have expanded the program to 15 students. Every person has shown improvement in communication abilities with decreased behavioral outbursts, increased initiation behaviors, increased meaningful use of symbols to communicate, increased communication topics and increased compliance.

The training program is a five phase process. It begins with traditional PECS strategies, the exchange of the picture symbol for the desired object. However, the process is enhanced through the use of simple technologies such as the TechTalk (a digitized speech, battery operated portable communication device) or Intellikeys (a programmable expanded keyboard for either Macintosh or Windows computers). Later in the training the equipment used switches to a dynamic display communication software, such as Speaking Dynamically Pro, and a touch screen such as the TouchWindow.

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In Phase 1, the process is a simple expansion of the PECS training process. A velcro responsive base overlay is created for the device. Velcro hook fabric is attached to the picture. The device is programmed with requests for the items as represented by the picture. As the picture is removed from the device and handed to the trainer, the request statement is made by the device.

Programming procedures will vary by device. For the IntelliKeys, referenced above, the software used is Overlay Maker and IntelliPics. The programming capacities are integrated into the TechTalk and no additional software is needed.

As soon as the student is able to independently participate in the physical aspect of the picture exchange, Phase 2 begins. He/she is switched to a dynamic display system. In this process, the picture is touched rather than removed and handed to the trainer. Upon touching the picture, the voiced request is made by the device and the desired item is provided (in VERY small quantities). Typically, especially at the initial stages, the

desired item is food, although we have frequently had students whose desired item is a physical interaction such as tickle or bounce. The dynamic display system, we use Speaking Dynamically Pro, makes it easy to move the pictures on the screen to be sure that the student is actually attending to the content of the picture, not just randomly touching the screen.

In Phase 3, social comments are added to the training process. As the student requests the desired item, the display changes to an array of 2-5 social comments such as "This is fun.", I'd like more please", and "Thank you" . In order to return to the screen with the food or play requests, the student needs to make a social comment. The screen then automatically returns to the set of desired options. Many students will work on various sets of desired items at the Phase 3 level for quite some time. Students at this phase are functional initiators of communication and interact well with their trainers. However they are not yet independently able to select communication topics or solve problems in the communication process.

In Phase 4, the student is taught how to select and switch between communication topics. Typically we will have students who have 3-4 sets of desired requests with which they are being successful. We then introduce the topic setters, such as snack, TV, computer games, and play time. As the student selects the topic setter, the screen changes to the familiar request set. The social comments page is fortified with termination statements such as "I'm finished", "That's enough" or "Let's do something different." The selection of a termination statement results in a return to the topic setting page. At the early stages of Phase 4 training students may return to the same topic area repeatedly as they familiarize themselves with the topic setting to requesting sequence. For many students with autism, termination of an activity is an anxiety producing time and may cause unwanted behaviors. This extended practice in termination and initiation is an important learning time because it teaches the student how to end and begin desired activities. We have seen a substantial reduction in unwanted behaviors as students overcome the anxieties of activity termination.

Finally in Phase 5, we add problem solving. What happens if you eat all of the most preferred food item ... or the batteries on the vibrating pillow wear out? How do you choose an alternate activity when the desired activity is still visible on the choice board? In traditional PECS the picture is removed. However, in electronic communication this means creating a new program every time some food is consumed or some toy is left on the bus... not a very reasonable option! In Phase 5 we add statements to the social comments page to reflect these situations. Comments such as "I ate it all", "It's all gone" and "What else can I eat/play with?" help students learn that something can be visible on the choice set put not physically available. As you can imagine, many students find this a challenging skill to master!

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In our experience, the combination of the voice output and the picture exchange substantially enhances the learning process for the individual. In one case being reviewed the student, previously not a successful communicator, was able to successfully use 15 different symbols and switch between three different communication topics independently within one year of beginning the training. He is now in the Phase 5 part of the training, asking repeatedly for Pepsi & granola bars ... but with his unwanted behaviors eliminated! When we recently met with the family to discuss the expansion of his communication system, his parents reply was: "We don't know what else to add. We never thought he'd get this far!" This year we are expanding the number of students in the program and the number of schools participating in the project. We believe that our success can be replicated in other classrooms.

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IntelliKeys, IntelliPics, Overlay Maker by IntelliTools, 55 Leveroni Ct, Novato, CA

Speaking Dynamically, TechTalk by Mayer Johnson Company, Box 1579, Solana Beach, CA

Touch Window by Edmark Corporation, Box 97021, Redmond, WA

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