2001 Conference Proceedings
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NOW I UNDERSTAND
Jamie Judd-Wall, Executive Director
Kathleen King, Consultant
Technology and Inclusion
Box 150878, Austin, TX 78715-0878
Phone: voice/message: (512) 280-7235
FAX: (512) 291-1113
Email: jamie@taicenter.com
Web site: www.taicenter.com
Abstract
Our center is a non-profit assistive technology training center in
central Texas. We work with Medicaid waiver programs, school
districts and rehabilitation programs. We refer to the folks we
work with as clients. Our clients range in age from 3 years old to
55 years old, though in the past we have had clients who are
younger and older. We see clients with a wide range of handicapping
conditions.
Like many of you, we work with students and adults with autism and
other severe communication delays. We followed the best practice
strategy of making information visual, using demonstrations prior
to performance and providing appropriate prompts. However, our
clients (both students and adults) weren't making the progress we
wanted. We identified four main areas in which our clients
continued to experience difficulty:
- following a sequence of instructions
- answering simple comprehension questions (who, what, when &
where)
- using yes and no with meaning
- reducing echolalic speech
With a lot of trial and error, we developed a technology-based
training program to help our clients progress in each of these
areas. It is our belief that without the use of technology in this
process that our clients would not have been successful. Surely,
they used seen flash cards and picture cues in the past. However,
these tools alone had not been enough to create success. In our
training we developed a repeatable process that not only takes
advantage of best practices like technology and visual strategies,
but also created a learning design that could be applied to any new
environment or set of information. We developed and repeated the
process of pictoral and voice support in the initial stages and
faded support as skills grew. The training strategies we used in
following directions and yes-no teaching were repeated in the
comprehension teaching. We had developed a reliable training cycle
that gave our clients both a successful experience with content,
but also a successful experince with faded support.
Here is a short description of the training of each of the
identified areas of difficulty:
1. Following Directions: Our program starts with strategies for
following directions. It was our assumption that if we wanted to
teach or impart information, we had to gain the client's attention
and they had to act on the specific information we provided ...
follow our directions. Because we wanted to make the process fun
and functional we worked in a drawing environment. We used commonly
found software, such as Kid Pix Studio. We started with following a
sequence. We made templates of letters or numbers and the client
had to draw a line to follow the sequence. We quickly discovered
that our clients had extreme difficulty moving across the screen.
They had specific directionality and locational preferences ... and
those preferences varied from client to client. They couldn't draw
a line from 1 to 2 to 3 to 4!
We wondered if our clients were putting so much effort into
maintaining movement and pressure with the mouse that they couldn't
attend to other aspects of the task. If that was the case, using
mouse alternatives might offer a solution.
We started using alternate mouse methods, trackball, joystick and
touch screens. Of these the least successful was the touch screen.
Our clients couldn't sustain the pressure needed to draw a line on
the touch screen just like they couldn't sustain pressure on the
mouse. We needed another approach, so we used trackballs &
joysticks to eliminate the requirement of continuous pressure.
These tools included programmable buttons that could be programmed
to create a 'drag' function eliminating the need for continuous
pressure.
Using a structured, multisensory training with alternate mouse
tools, we taught following directions. Our clients were taught to
follow directions to create items with a sequence of up to 10
steps... and they had fun doing it. We made and solved numbered
mazes, shuffled the letters in vocabulary words and the numbers in
phone numbers and drew lines in sequence. We required that our
clients create the sequence in one long line from item to item,
verbalizing the sequence as they went.
From the sequenced letters and numbers, we sequenced phrases in the
sequence of various tasks, coming home from school, walking in the
hallway and so forth. As the client drew lines from item to item
they read/repeated the phrases in the sequence. In short period of
time, they were repeating the phrases and using the information in
the situation... and reducing unwanted behaviors in those
situations. When I would ask about what to do in the hallway, my
clients could tell me, in sequence what to do. Over time, we have
also been able to use this information and this strategy in problem
solving when a step was skipped.
2. Using yes and no with meaning
It was our belief that our students with autism and severe
communication delays, especially those with many unwanted
behaviors, had experienced so much compliance training, that they
had learned to respond 'yes' to almost everything. 'No' was used
rarely and almost always as a last option with strong
emotions.
We wanted to teach what we referred to as a neutral no. It's like
the response you'd give if someone asked if you wanted another
piece of pizza or if you were cold and wanted a sweater; 'no,
thanks' ... not angry, not refusal; just communicating the concept
of 'that's not it'.
We started with listing items in favorite categories. We eased the
language load by using software that combined text with pictures,
like PixWriter. The trainer would create a bank of 12-15 pictures
and type the heading is it ... (food, clothing, colors etc.) The
client would click on each item and then type yes or no. Each 'no'
response was combined with comments about the silliness of
including the specific item- ie: "Do you eat bricks? No, no, no,
that's so silly!" The software offered the additional feature of
voice output so that all our 'silly lists' were repeated and we
could laugh at ourselves over and over.
We quickly moved to silly sentences, asking each other is that
right, and answering "No, that's silly". Our client's parents and
care givers reported that 'no' responses increased in general
conversation ... occasionally accompanied by short explanations
"No, it tastes yucky."
We started to see meaningful use of yes and no emerge ... although
I cannot say that all our parents, teachers and care givers were as
excited by the increase in 'no' responses as I was!
3.Answering Simple Comprehension Questions (who, what, when &
where)
In examining the errors made by our clients in responding to simple
questions... those questions whose response was contained in the
text of the sentence, we found that responses were locationally
based. In other words, a client either answered the item at the
beginning of the sentence or at the end of the sentence. The
response was not related to the content of wither the
question.
We began to think that our clients didn't understand the
catrgorization of responses, who is a person, where is a place and
so forth. If they didn't understand that when is a time and that
table isn't a time, then they couldn't answer a question about the
sentence "Sit at the table at 2:00."
We restructured our 'yes-no' training activity to address the basic
concepts represented in simple questioning. "Is table a time? No
that's silly a table is a thing." Even of our highly literate
clients found this activity challenging. We decided to start every
client doing this activity with a picture based word processor like
PixWriter or Writing with Symbols. They really needed the support
of the graphics due to the the language load of categorizing
abstracts. It was much easier to identify the bus driver as a
person when there was a picture with the text. We were able to
gradually fade the pictures and rely on the yes-no strategy as the
clients gained comfort with the tasks.
After categorizing, we moved to sentence writing with the picture
based word processor, the client could then identify the person,
time, place etc in each sentence. The final step was the move to a
text only process.
4. Reducing Echolalic Speech
Unlike most of my colleagues, our approach at TAI was to use
echolalic speech. It was our belief that echolalic speech is a step
in language development that will be abandoned when no longer
needed. Our job was to create sufficient language support that the
client could confidently abandon echoing as a communication
strategy.
We tried to set the language stage so that echoed speech provided
information or reinforcement to the client. We acknowledged the
echoed speech as a comment, occasionally echoing the clients speech
to show that their message had gotten across.
By combining echoed speech with information sequencing, yes-no
messages and categorical comprehension, we were able to direct
echolalic speech into functional use. Part of that process was the
scripting of echoed speech on the computer. As the client echoed
our speech, we would type their words into the a voice out word
processing program, like IntelliTalk or PixWriter. We would perform
one of several different tasks with their echoed message:
- re-order the text creating the desired statement
- type yes-no comments to accept or negate the message
- answer a question about the contents of the message
- expand on the contents to elaborate on the message.
In each case we used the voice out software to assist in the
process. By using voice out software, the voicing of the message
was a separate task from the training. The trainer was no longer
the voice of the client. The client could create his/her own voice
via the technology. It was easily and clearly understood when the
message was the clients and when it was the trainers. Sure enough;
echoed speech reduced in length and frequency.
References:
KidPix Studio, by Broederbund Software
Joystick Plus by Penny & Giles
Joystick with keyguard by RJ Cooper
Trackball by Kensington
PixWriter by Slater Software
Speaking Dynamically, and Writing with Symbols by Mayer Johnson
Company
Touch Window by Edmark Corporation
IntelliTalk by IntelliTools
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