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I pads as the universal aac device for students

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Contemporary Issues Conference 2012

Contemporary Issues Conference 2012

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  • Successful communication is the foundation of social interaction, learning and independence. For some students with developmental disabilities, developing functional speech does not occur throughout childhood, and results in increasing numbers of students entering schools without precommunicative skills. This results in an increasing need for AAC devices. In the current iPad revolution, schools are focused on the potential of new technology by implementing iPads as AAC devices for students with developmental disability, prompting the question – are ipads really the universal answer for dealing with selecting an AAC device for students with developmental disabilities?
  • Alternative and Augmentative communication, or AAC, devices are communicative systems or strategies that may be used to supplement an individual’s existing speech or as a primary communication alternative to speech.AAC is used by those with a wide range of speech and language impairments, including congenital impairments such as cerebral palsy, intellectual impairment and autism. AAC can be a permanent addition to a person's communication or a temporary aid. Students with multiple impairments typically use a range of modes to support their communication. An AAC device enables the development of systematic means of communication. Traditionally, two types of AAC devices existed, either Picture Exchange Communication systems, or PECS, or Voice Output Communication Device (VOCA). However, the rise in popularity of the iPad has led to the development of communication applications that combine both VOCA and PECS systems in the one portable device. The result? The iPad with an ever increasing range of communication apps
  • With a multifunctional, engaging platform allowing for convergence of tools, strategies, access to incentives and inbuilt data collection, the potential applications for such devices with students with multiple impairments is exceptional.It is also inexpensive and flexible, with one device potentially meeting the needs of several students. For more information, please visit the links at the bottom of the slide
  • So, what’s the problem here? It sounds like iPads with their seemingly unlimited potential could be the answer. And it’s not iPads that are the problem, but rather the idea that they could be a one size fits all, or universal answer to selecting an AAC device for students with developmental disabilities and communication impairments. Without a structured observation, evaluation and selection process, the AAC device selected for students could be inappropriate in function, mode and output. The result? Devices which do not meet the requirements and develop functional communication for students. Which in turn, leads to frustration, aggression, social isolation, educational deficits and challenging behaviour displayed by students
  • So, why is this a problem requiring investigation? A review literature published in communication journals from 2000 onwards indicates a great deal of research in specific areas – the potential of iPads in classrooms. While specific communication applications have received positive results, the single subject design methodology of these studies do not provide a comprehensive review of the rationale underpinning implementation or selection. There is a wealth of information on the selection and implementation process involving traditional AAC devices. However, this leaves a distinct gap in the literature combining these 3 areas, and in this gap sits a significant student population – those with developmental disabilities who have no formal communication system, and are trialing iPads as communication Apps. Add to this the pressure on teachers to develop communication systems, and a whole school rollout of iPads as AAC devices, and there lies a significant problem for teachers and administrators. Research has identified that a specific and systematic selection and implementation process for AAC devices improves student outcomes and increases staff confidence, yet such a plan for iPads as AAC devices presents as a gap in the literature. Reflecting this gap is a lack of comprehensive policy documents provided to schools within Education Queensland. All of which, leads to significant problems for the teachers responsible for selecting,implementing and managing AAC devices for students with developmental disabilities
  • In researching this topic, a retrospective case study was undertaken involving students with developmental disabilities at a Queensland Special School, examiningthe effectiveness of implementing iPads as communication devices. 8 students from 2 classrooms in a special school were selected for involvement. A criteria for student inclusion was specified.
  • Across the two classrooms, multiple design methodologies, implementation methods and data collection were utilised. Teachers selected times and objects that were a consistent part of the daily schedule, were motivating for all participants and provided a discrete opportunity to trial a communicative request. Across the classrooms, the communicative priority was requesting an item and the intervention were implemented in a one on one instructional setting. Teachers were provided the Education Queensland iPadManagement Plan and were required to use this specific communication application with the participants. No further restrictions or requirements were specified. Classroom 1 teacher elected to follow sections of the SETT framework, a selection and implantation framework for traditional AAC devices.
  • Classroom 1 results indicate that three participants demonstrated improvement, with student A achieving skill acquisition of ten accurate trials in concurrent sessions. Student D demonstrated minimal improvement, with only 1 correct trial achieved per session. This likely indicates that either the application was not appropriate or food was not a motivating reinforcer. After discussions with the teacher, it appeared that this student was motivated by food, but demonstrated difficulty demonstrating the fine motor control required to select the correct symbol on the iPad interface.
  • Classroom 2 demonstrated mixed results. While student F demonstrated skill acquisition sessions, the other students demonstrated little or no progress. Follow up conversations with the classroom teacher indicated that the application was not appropriate for students 5, 7 and 8 due to the size of the buttons, number of screens required to navigate and the pressure required to operate successfully.
  • So, what does this all tell us? Follow up conversations with the teacher demonstrated a high level of confidence in using iPads as AAC, but an awareness that they did not meet the needs of an AAC device for student D. showed low professional confidence in using iPads as AAC devices. In addition,
  • From the data and follow up conversations with the teachers involved, conclusions as to the study can be interpreted. The differences in student results can be attributed to many possible conclusions involving teacher confidence, student motor skills, or the use of a management plan. However, due to the presence of many variables, further study is required to test these hypotheses. While the results of the controlled case study indicate these results, it is still a single case design with limited generalisability, and further research with more participants is needed. It should also be noted that with retrospective case, many variables were not tightly controlled, and further study is required to validate results.
  • So, where to from here? While a single case study produces limited results, recommendations for future practice can be made to teachers, administrators and schools. iPads are a possible AAC device for stduents with developmental disabilities, only when accompanied by detailed observations and a specific assessment and management plan. However, the research supports the literature in determining that a single device, regardless of possible potential, is not a universal answer to AAC.
  • If you require further information or research, please refer to the following articles.

Transcript

  • 1. Presented by Elise CrawfordContemporary Issues Conference 2012
  • 2. PECSVOCA
  • 3. Flexible InexpensiveSocial isolation Socially appropriateSocial isolation Incentives Combines PECS and VOCA http://www.youtube.com/watch?v=E2LnUxFAaMQ&feature=related http://www.youtube.com/watch?v=W-eWvnWMx6c&feature=related
  • 4. Lack of functional communication FrustrationChallengingbehaviour Aggression Social isolation Educational deficits
  • 5. Literature Review Selecting andPotential of Students implementing iPads in traditional AACclassrooms devices Implementation Plan Selected communication apps
  • 6. • 8 Students from two classrooms in a special school• Criteria for student inclusion: • Developmental Disability • Aged between 6 – 8 years • Speech Language Impairment (non verbal) • Notable fine motor, gross motor and hand eye coordination deficits • No visual impairment • Previous iPad experience • No functional communication system • Challenging and aggressive behaviours with identified communicative function
  • 7. Trial Students Implementation Plan Setting Reinforcement Data collection FrequencyclassroomsClassroom 1 A, B, C, D iPad Management Plan Lunch time Food Discrete trial 10 sessions of 10 (Ed. QLD) and SETT trials FrameworkClassroom 2 E, F, G, H None Structured construction Preferred toy Goal Attainment 3 sessions per week play Scaling
  • 8. Classroom 1 Data 12 10Correct trials per session 8 Student A 6 Student B Student C 4 Student D 2 0 1 2 3 4 5 6 7 8 9 10
  • 9. Classroom 2 Data 4 3Goal Attainment Scaling 2 Student E 1 Student F 0 Student G Student H -1 -2 -3
  • 10.  4 of 8 students demonstrated communicative success For these students: ◦ Challenging behaviour (biting, spiting) decreased ◦ iPad is an appropriate AAC 4 of 8 students demonstrated no communicative improvement For these students: ◦ The reinforcer was in appropriate ◦ The device was inappropriate ◦ The AAC did not meet the communicative needs
  • 11. Difference in results could be due to:• Teacher confidence in using iPads• Teacher skill in selecting and implementing AAC• The use of a systematic management plan• Individual student motor skills
  • 12. 1. iPads are a possible AAC devices for students with developmental disabilities2. Detailed observation is required in selecting an AAC3. A specific assessment, selection, implementation and management plan is necessary for teachers to be confident in implementing in classrooms4. One device is not a universal answer to AAC
  • 13.  Cannella-Malone, H. I., DeBar, R. M., & Sigafoos, J. (2009). An Examination of Preference for Augmentative and Alternative Communication Devices with Two Boys with Significant Intellectual Disabilities. Augmentative and Alternative Communication, 25(4), 262-273. doi: doi:10.3109/07434610903384511 Chapple, D. (2011). The Evolution of Augmentative Communication and the Importance of Alternate Access. Perspectives on Augmentative and Alternative Communication, 20(1), 34-37. Harding, C., Lindsay, G., OBrien, A., Dipper, L., & Wright, J. (2011). Implementing AAC with children with profound and multiple learning disabilities: a study in rationale underpinning intervention. Journal of Research in Special Educational Needs, 11(2), 120-129. doi: 10.1111/j.1471-3802.2010.01184. Hyatt, G. W. (2011). The iPad: A Cool Communicator on the Go. Perspectives on Augmentative and Alternative Communication, 20(1), 24-27. Kennedy, C. H. (2005). Single-case designs for educational research. Boston: Allyn & Bacon. Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The Impact of Augmentative and Alternative Communication Intervention on the Speech Production of Individuals With Developmental Disabilities: A Research Review. Journal of Speech, Language & Hearing Research, 49(2), 248-264. doi: 10.1044/1092-4388(2006/021) Rispoli, M. J., Franco, J. H., van der Meer, L., Lang, R., & Camargo, S. P. H. (2010). The use of speech generating devices in communication interventions for individuals with developmental disabilities: A review of the literature. Developmental Neurorehabilitation, 13(4), 276-293. doi: doi:10.3109/17518421003636794 Rummel-Hudson, R. (2011). A Revolution at Their Fingertips. Perspectives on Augmentative and Alternative Communication, 20(1), 19-23. Schlosser, R. W., & Sigafoos, J. (2009). Navigating Evidence-Based Information Sources in Augmentative and Alternative Communication. Augmentative and Alternative Communication, 25(4), 225-235. doi: doi:10.3109/07434610903360649 Schlosser, R. W., Wendt, O., Angermeier, K. L., & Shetty, M. (2005). Searching for evidence in augmentative and alternative communication: Navigating a scattered literature. Augmentative and Alternative Communication, 21(4), 233-255. doi: doi:10.1080/07434610500194813 Sigafoos, J., Arthur-Kelly, M., & Butterfield, N. (2006). Enhancing everyday communication for children with disabilities. Baltimore: Paul H. Brookes. Sigafoos, J., Green, V. A., Payne, D., Son, S.-H., OReilly, M., & Lancioni, G. E. (2009). A Comparison of Picture Exchange and Speech-Generating Devices: Acquisition, Preference, and Effects on Social Interaction. Augmentative and Alternative Communication, 25(2), 99-109. doi: doi:10.1080/07434610902739959 Van der Meer, L. A. J., & Rispoli, M. (2010). Communication interventions involving speech-generating devices for children with autism: A review of the literature. Developmental Neurorehabilitation, 13(4), 294-306. doi: doi:10.3109/17518421003671494