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The boy whose brain could unlock Autism
SOMETHING WAS WRONG with Kai Markram. At five days old, he seemed like an unusually alert baby, picking his head up and looking around long before his sisters had done. By the time he could walk, he … more
What Nonverbal Kids Can Gain From Technology
Many parents and teachers of children with special needs wonder if using technology to communicate is a good idea, or if it will stifle and get in the way of oral speech production. I’m asked this question almost every day in the office — I can feel their worry, I know their concerns. It’s a really good question that needs a full answer. Screen Sense is a perfect forum to clear up the misconceptions and explain the benefits of technology for kids with special needs and without.
As children progress through typical stages of language development, they are usually quick to find oral speech to be the easiest and fastest way to get a message across. But for some children with a variety of speech, cognitive or physical impairments, verbal speech is not an effective way to communicate.
It’s important to remember that we communicate in many different ways. We use facial expressions, gestures and body language, writing and oral speech, to name a few. Ultimately, when we need to get our needs met, we are going to use whatever seems most efficient at the time. Children will naturally gravitate toward the mode of communication that’s easiest, and, when they are able, oral speech production is typically the most efficient. But for children who do not have reliable oral speech, supplementing with technology, sign language or pictures can be an important stepping stone on the path to building effective communication. We call these other forms of communication Augmentative and Alternative Communication (AAC). Think about AAC as a supplement to other forms of communication, not as a replacement.
When a child’s speech and language milestones are delayed, he needs a way to communicate wants, needs and feelings. If oral language production is hard, supplementing with AAC can help build the foundational language and communication skills that will serve him well as he continues to develop. In this way, technology is truly a beautiful thing. It gives voice, words and expression to an inner world that may otherwise lay dormant without the tools to access and express it. Who can forget The Diving Bell and the Butterfly, the memoir and movie about Jean-Dominique Bauby, the irrepressible French editor of Elle magazine, who suffered a stroke that left him in what’s called locked-in syndrome. The only thing he could move was his left eyelid. The urge to express himself was so powerful for Bauby that he dictated the whole book by blinking that eyelid to choose one letter at a time. In the same way, young children are wired to articulate and share their experiences, and if verbal speech is impeded, assistive technology can help them discover the joys of expressing themselves.
The iPad is a popular choice in assistive technology because it’s relatively cost effective, other kids will think it’s cool and there are hundreds of dedicated AAC apps. These apps can be programmed to use pictures, words, phrases or sentences so that a tap of a button generates a message. More sophisticated apps allow the user to type a unique message and produces voice output. But there are many products on the market dedicated to generating speech besides the iPad, and some others may work better, especially for children in the earlier stages of language development.
In choosing a speech-generating device, keep in mind that a child using it should be progressing through stages in the same way a child with typical speech development would be on a trajectory to more sophisticated language. While handing a child an iPad might be the easiest, most readily available and socially acceptable way to generate and supplement oral speech, the iPad may not be the first choice for building communication skills in children who have not yet developed speech production.
Since language is symbolic — a word or a picture represents an object, for example — children must develop the capacity to represent things mentally and symbolically in order to speak. The same is true of assistive technology; they have to understand that a picture represents a real life experience. For example, a child can hand you a picture of a glass of water, indicating that she wants water, even if she can’t say the word. In order to do that, she needs to understand that the picture represents the actual thing, water.
It’s also important to remember that communication happens between two or more people. Interaction is an important component of communication and children must learn to send and direct messages to another person in order for their communication to be intentional. This is true for both verbal speech and AAC. A child who uses speech must direct the word “water” toward a communication partner — a parent, for example — with body positioning, eye contact and intention in order to actually send the message. Interaction can be a challenge when using technology to communicate. Pressing a button may generate speech, but unless the child understands that she needs to direct the output toward a communication partner, tapping a picture on the screen and generating a word or a sentence won’t have much utility for communicating.
Some lower-tech options, such as the Picture Exchange Communication System (PECS), created by Lori Frost and Andy Bondy, may be better at fostering the underlying cognitive representational skills necessary for speech, as well as the intent to communicate, which comes before speech, whether produced verbally or generated by a device. PECS follows a structured teaching hierarchy, where a child learns to identify and discriminate between pictures (just as a verbal child does with words they hear and will eventually use) before they learn to exchange a photograph of an object and then a picture symbol for a real-life object. Later, the child learns to combine pictures and words. For example, instead of just exchanging a picture of juice, they may combine the symbol for “I want” and “juice” together on a sentence strip to begin to expand their language, in the same way that children who use spoken language begin to combine words. Because of this type of hierarchical teaching, there is some evidence that children who use AAC may learn the underlying cognitive representational skills necessary for speech. Children must first learn to think symbolically in order to use language, and PECS is designed to facilitate symbolic and representational thinking.
A low-tech system like PECS has its drawbacks. It can be time-consuming to make materials and difficult to implement. Eventually, switching to a speech-generating device like the iPad will be tremendously advantageous for children and adults who will continue to rely on AAC as an effective method of communication. A licensed speech language pathologist can help sort out the options and help determine a child’s readiness for the multitude of devices, apps and modes of communicating that are currently available.
Speech-language therapist, Child Mind Institute
New chairs help calm wiggles of students at SLC autism school, officials say
SALT LAKE CITY — On Monday morning a special donation from a company called Safco came to Spectrum Academy, a school that teaches children with autism.
Cheering children welcomed in 18 Runtz chairs into their classroom. The chairs help students control their wiggles.
Jacqueline Whitaker has been teaching children with autism at Spectrum Academy for four years. She knows that it’s not always easy to get the kids to sit still.
“They have a hard time sitting, staying in their seat, staying on task because of their vestibular needs,” Whitaker said. “Their need for balance and knowing where they are in space.”
Last September Brian Culley, vice president of Office Products Dealer, bought one of these chairs for his son with autism. He noticed a significant difference – and encouraged spectrum academy to give the chairs a try.
“These chairs really stabilize them and get them more comfortable in their own skin and ready to learn.” Culley said.
The chairs were originally made to be a sleek, modern design for an office. The manufacturers had no idea of the impact the chair would have on the lives of children with autism.
“It’s literally life changing. It’s like someone who can’t walk and getting a wheelchair and being able to move. It’s on that level. It’s amazing.” Whitaker said.
The school will now study the children’s progress in the classroom with the chairs. Spectrum Academy will give Safco a monthly update of their studies.
“It will help the students learn more. They won’t have to get up and wiggle as much. You’ll see more attention to task and you won’t see them falling out of their chairs.” Said Crystal Coffman, occupational therapist at Spectrum Academy.
Spectrum Academy hopes that they will be able to get Runtz chairs for all the classrooms.
Click here for more information about Runtz chairs.
Sensory Friendly Movie
Occupational Therapy for Kids?
A common question we get is something along the lines of, “I understand why a child might need speech therapy or physical therapy, but why would they need occupational therapy? Children don’t have an occupation.”
We like to think that a child’s main job is playing and learning, and an occupational therapist can evaluate a child’s skills for play activities, school performance, and activities of daily living and compare them with what is developmentally appropriate for that age group. Occupational therapy practitioners address psychological, social, and environmental factors that may hind an individuals functioning in different ways. This unique approach makes occupational therapy a vital part of health care for some kids.
So who might use an occupational therapist? Kids with the following medical problems may benefit from occupational therapy:
- Birth injuries or birth defects
- Sensory processing/integrative disorders
- Traumatic Injuries (brain or spinal cord)
- Learning problems
- Pervasive developmental disorders
- Juvenile rheumatoid arthritis
- Mental health or behavioral problems
- Broken bones or other orthopedic injuries
One of the activities that occupational therapists can address to meet children’s needs is working on fine motor skills so that kids can grasp and release toys and develop good handwriting skills. Occupational therapists also address hand–eye coordination to improve play skills, such as batting a ball or copying from a blackboard.
An occupational therapist can also:
- Help kids with severe developmental delays learn some basic tasks, such as bathing, getting dressed, brushing their teeth, and feeding themselves
- Help kids with behavioral disorders learn anger-management techniques (i.e., instead of hitting others or acting out, the children learn positive ways to deal with anger, such as writing about feelings or participating in a physical activity)
- Teach kids with physical disabilities the coordination skills required to feed themselves, use a computer, or increase the speed and legibility of their handwriting
- Evaluate each child’s needs for specialized equipment , such as wheelchairs, splints, bathing equipment, dressing devices, or communication aids
- Work with kids who have sensory and attentional issues to improve focus and social skills
What is the difference between Occupational Therapy and Physical Therapy?
When Amy and I were discussing opening The Shandy Clinic’s, Amy’s vision was to have a multidisciplinary clinic with Speech-Language Pathologists, Occupational Therapists, and Physical Therapists all working together to help patients. The fact that all three worked together was very important to her so I just went with it, even though at the time I had absolutely no idea what the difference was between a physical therapist and an occupational therapist. We even interviewed and hired a couple OT’s and a PT and I still didn’t fully understand what they did.
I think I’ve got a better handle on it now, so to avoid having to bluff your way through appointments like I did I’d like to help you out. First off, both types of therapy help kids improve the quality of their lives, the just focus on different areas. Physical therapy deals with the issues of pain, strength, joint range of motion, endurance, and gross motor functioning. Occupational therapy deals more with fine motor skills, visual-perceptual skills, cognitive skills, self care, and sensory-processing deficits. If that’s still too much medical jargon, try this: PT = big muscles; OT = small muscles. That’s not technically 100% accurate, but it will get you pretty close.
Since I’ve already posted about occupational therapy, following is some more information on physical therapy. Doctors often recommend physical therapy for kids who have been injured or have movement problems from an illness, disease, or disability; really any time a child has difficulty moving in such a way that it limits daily activities.
The physical therapist at The Shandy Clinic guide kids through:
- Developmental activities such as crawling and walking
- Strengthening around an injury
- Adaptive play
- Safety and prevention programs
- Instruction on how to avoid injuries
- Improving circulation around injuries by using heat, cold, exercise, and massage