It’s a chilly November day, and three preschoolers have important decisions to make: What should they wear?
They look out the windows and are told of the frigid conditions outside. They’re already dressed, of course; this is merely an exercise designed to sharpen their cognitive skills. Their task: build suitable theoretical outfits for paper cutout people.
It sounds like a fairly typical activity for any preschool across the country, but these three boys all have Down syndrome and delays in their speech and language skills. So, to make choices and to request items, they supplement their signing and speech with verbal output from a communication app on the iPad.
The boys receive speech and language services at the University of Wisconsin Speech and Hearing Clinic in the AAC Story Time Preschool. Their therapists are graduate students in the Department of Communication Sciences and Disorders.
The graduate students work under the supervision of Clinical Professor Jamie Murray-Branch, who specializes in augmentative and alternative communication (AAC), an area of clinical practice and research that focuses on populations with severe and complex communication needs. Technology is integrated into treatment to help those with disabilities learn and communicate.
In the AAC Story Time Preschool, as well as other clinical practica offered through the UW Speech and Hearing Clinic, Communication Sciences and Disorders graduate students incorporate the latest technology, including iPads loaded with a variety of apps, to foster speech, language and cognitive skills in children and adults with severe communication needs.
“With the iPad and customized communication apps, children have a means by which to speak in a way that is not currently available to them without the assistive technology,” Murray-Branch says.
Murray-Branch’s students use a wide variety of computer-based communication systems, depending on each individual’s motor, linguistic and cognitive abilities. The iPad is an attractive option as an AAC solution because of its flexibility (there is a wide range of apps available), portability (it’s incredibly light- weight compared to some other devices) and cost (while other devices cost well into the thousands, an iPad with a suite of AAC apps can be had for less than $1,000).
Murray-Branch says iPad use as an AAC tool took off after the 2009 release of Proloquo2Go, a now-popular app created by AssistiveWare, a company that specializes in assistive software. Communication Sciences and Disorders purchased its first set of iPads in early 2010. In May, the department received an Internal Lab Modernization grant from the College of Letters & Science and purchased 15 more iPads and other forms of assistive technology to enhance its classroom and clinical training offerings.
Through an innovative collaboration with the Department of Computer Sciences’ Text-to-Speech Synthesis Project, Communication Sciences and Disorders has developed several instructional apps that have been integrated into clinical work at the UW Speech and Hearing Clinic. With the Text-to-Pictures app, clinicians are able to quickly create pictures or symbols to visualize what they are saying. These pictorial stimuli help achieve a multitude of communication goals, including direction following, vocabulary learning and speech production.
But the iPad isn’t a perfect fit for everyone. While Apple has improved its operating system to allow for motor interface adaptations – users can change the sensitivity of the touchscreen, for example – the tablet still isn’t ideal for those with severe motor issues. To choose the proper assistive technology, critical questions must be considered.
“You have to think about the user’s modes of communication, how they can interact with the device, and what they’re ready for, because a lot of the devices have different features and layouts and they’re designed in different ways,” says Ali Holt, a first-year graduate student who works in the AAC Story Time Preschool and has two adult clients with severe communication needs.
Murray-Branch sees two distinct challenges facing the professional speech and language community as technology continues to evolve: 1) using evidenced-based practice when making critical decisions related to customizing technology to meet the needs of the individual; and 2) teaching clients and those around them to utilize tools in an effective way.
“Our students are becoming quite skilled in bridging theory and practice,” she says. “They are using their knowledge of development and effective teaching strategies when providing services. I know that this generation of practitioners will be well equipped to integrate information about an individual’s particular profile, in terms of speech, comprehension, cognition and motor, to make sure the tools are a good fit.”