Behold the ipad

Anybody know how remove washable markers?

R. was entranced by the ipad from the moment she saw it.  At first she just watched, and seemed kind of reluctant to touch it.   It is a little confusing to teach her, because each app works slightly differently in terms of what to touch and if she should press or swipe.     It works best if I show her hand over hand, but she prefers to watch me do it, and then use my finger as a stylus at first.

I don’t have a PECS program yet.  I’m going to research it a bit before spending the money.  I don’t think we will use it as a true AAC device if her language continues to progress.   But I think it could still be useful.  I would like to find something so that I could offer choices, like breakfast options or where she wants to go.

I’m kind of amazed how much the ipad inspires her to speak.  She echoes, she labels and even a little commenting if I can count Oh no.   In just a few days, she’s already used to a bit of ipad time before dinner.  We forgot the other night because we had visitors, and she actually started saying ipad, ipad, ipad, totally unprompted and with it out of sight.

I’m going crazy downloading apps, trying to find ones that are good and that she will like.   Many of them have intro or accompanying music that she hates.      Some of the apps do have settings to turn off music and other sounds.  I have to go through the apps before I show them to her.

The free flash card app My First Words by Smart Baby is helpful to show her how to manipulate things on the ipad.  They are flash cards of objects in different categories of items (more categories are available for purchase).  Each card shows a picture, the word and the word is also spoken.  The app can be set up to automatically scroll through the cards, or manually so that the cards only advance after you touch them.  I found setting it up manually really showed her how to use the ipad.  She is really interested in the pictures and words, she will repeat them and it just looks like she is absorbing everything with such interest.  Another neat feature about this app is that you can record your own voice for each of the flash cards.

Another free app, Z is for Zebra is helping to teach her swiping/scrolling.   A screen comes up with the letters of the alphabet, and when you press one it takes you to a page with the letter in upper and lowercase and a picture of an object that starts with that letter.  You can touch each letter or the object and hear the letter or word.  I wish they actually displayed the word too.    You can also scroll through the alphabet by swiping left or right, she really liked doing this once she figured it out.   If you touch the wrong place it just goes back to the alphabet screen.  Many apps have lots of buttons that when touched accidentally take you out of the app, or other places.

iWrite words was suggested by the school’s OT.  The free version gives you the letters A,B,C  in upper and lower case, the numbers 1-9 and a few three letter words.   I upgraded this for $2.99, now we have the full alphabet, the numbers up to twenty and more words.    It displays the outline of a letter, and a little crab appears at the start point followed by numbers showing the direction to write.  You drag the crab through the numbers (connecting the dots) and the line shows up on the screen.   After the letter is completed a copy of what is drawn shows up in the upper left hand corner, and a small box with the same letter drops down so you can either tilt or drag it to a wheel that spins and the letter disappears.  It doesn’t sound very exciting, but R. loves doing this.  So each letter has  built in reinforcer.  R. usually starts using my finger, and after a few letters she will do it herself.   I wish you could select the letter or letters you want to work on instead of having to go through them in sequence.    I wonder if they will come up with some ipad-friendly stylus for handwriting practice.

Color SlapPs is a free program to practice color recognition.  You can select which colors you want as options, (I removed peach) and choose from one, two or three colors on the screen at a time.   A voice says touch brown or whatever color is next, and when brown is touched it spins and disappears.  You can choose to cycle through five or ten times, and when the round is completed two stick figure children appear and jump up and down and the sounds of cheering and applause is heard.  I’m surprised how much R. likes this, she smiles at those little figures.

The Dr. Seuss interactive book apps are amazing.  When you select read to me, the words turn red as they are being said.  R. is so fascinated.    I am too, because while she might occasionally sit through part of the ABC book, she will leave the room if I read Cat in the Hat.   On the ipad, she is fully engaged with both books.   She actually likes them better than the sample of a Sesame Street book I downloaded.  I think it is the words lighting up red that is so engaging.   Who do I have to talk to for an app for Polar Bear, Polar Bear?

Encouraging Communication-What’s working Part 1

Find an alternative communication method.
We used PECS (Picture Exchange Communication System) with R.  We were fortunate that our ABA provider made all the icons and set up the binders.  We used a combination of the standard icons and actual photographs.  We started hand over hand and offered preferred items.    In the beginning the therapists would put her trampoline against the wall and she would have to hand over the icon for the trampoline to get them to put it down so she could play with it.   We keep two PECS books around the house,  one for food and the other for activities.  R. does not use them as much as she used to, I think she really understands it is easier to be prompted to say the word than retrieve the icon, but she will occasionally go back to them and bring us one of the cards.

Sign language is another option.  R. did not have the imitation skills when we began, so this really was not a good fit for us.  I have met other children with ASD who are as adept with signing as R. is with PECS.  One advantage to signing is that you don’t have to bring your PECS book everywhere and keep track of all of those icons.

Our former program director would talk about PECS enabling R. to learn the power of communication. It really is not possible to physically prompt a child to speak, but both of these methods can be physically prompted.  The advantage of being able to physically prompt the correct response, in ABA speak is errorless learning.  The prompt level will be gradually decreased.  When R. started using PECS the prompt was to hand over hand help her remove the icon and hand it over.   After a while the only prompt she needed was for us to show her the PECS book.

Several family members asked me if R.’s using PECS was going to delay her ability to speak.  They were concerned that it appeared easy for her, and she would become reliant upon the method.  I think PECS is what enabled R. to get to the point she is now with speaking.   She was not at the developmental point to be able to access language, but she was able to be taught how to communicate.  NT infants and toddlers in the pre-verbal stage are becoming experts at non-verbal communication,  R. needed to develop these skills before she could speak.  PECS enabled her to have the benefit of being able to communicate at her developmental level.

The ipad and other devices will be opening up new worlds in alternative communication for children on the spectrum.

Don’t reward crying/tantrums

Crying and tantrums are a form of communication.   They were R.’s main method when we started on this journey.  ABA was very helpful in teaching me that I should not give her what she wants when she cries, I should prompt her to communicate her wants.  I wrote about this a few months ago. I’ve read discussions on different ASD boards that describe this method as not acknowledging or ignoring crying/tantrums, and I think this is an incorrect interpretation.   Crying should be acknowledged for what it is, a complaint.  The message I want to send R. is that, I hear you, you are upset, but if you want whatever it is you have to say a word or give me an icon.  Crying may get my attention, but only communication is going to get you what you want.
At this point I can usually prompt R. to say a word if she is crying for something she wants.  This actually happens rarely, because most of the time she will start with a gestural communication (hand leading) and then will either say or be prompted to say what she wants.  But sometimes she can’t have what she wants, or she has to wait and then she will cry.  This is probably more accurately described as a complaint, she usually has no tears and there is babble and sometimes words among the yells.  I also try to explain why she can’t have what she wants and offer an alternative.  So if she’s crying because she’s impatient for the popcorn to finish in the microwave, I can show her the bag that is popping, the countdown timer and say we have to wait.   It’s always harder if it is something she can’t have, but it is getting so much better.  So if she is crying because she wants to go outside, I can tell her it is too late to go out and offer something else to do.  I’m still in awe every time this works.

Consider that communication is more than just words.
Shortly after we started ABA, R. began hand leading.  I realize now this is quite common among children with ASD.  At the time it seemed quite amazing, and now it is so much a part of how she communicates.  Prior to any gestural communication it seemed her only method of communicating was by crying or with a look or expression .   The first programs that ABA started with were what they called anticipation games.  They would do something she liked – tickles, spins, bubbles… and then wait for her to look at them to repeat it.    It wasn’t long before she would gesture by grabbing their hand to continue the activity.     These play activities taught R. that people could do fun things if she communicated.

In the book The Special Needs Child by Dr. Stanley Greenspan, he writes about closing circles of communication.   If I tickle her and she looked at me to continue, that would be one circle of communication.  I really liked this concept because it gave me a sense of actually doing something using skills she already had.    It still feels like a game to see if I can get her to close just another circle or two.   Floortime lite Mama writes about Floortime as a lifestyle, and that is how we do things around here.