Apps for AAC - Adding iPads to your AAC Toolkit Part 1

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Pre-conference workshop presented at the AGOSCI Conference 2013

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Apps for AAC - Adding iPads to your AAC Toolkit Part 1

  1. 1. Apps for AACAdding iPads to your AAC ToolkitJane Farrall, Janelle Sampson and Kelly Moore
  2. 2. Outline – ‘til morning tea….—  What we know◦  Evidence base in AAC◦  Key Frameworks◦  Relevant research to consider—  Benefits and Limitations of the iPad—  Types of Apps—  A process for selecting and setting up apps—  Review – the good, the bad and the ugly.
  3. 3. What do you love about yourfavourite app?
  4. 4. What frustrates you about anyapps you have used.
  5. 5. What we know (AAC)…..—  Evidence base◦  Approximately 40 year history◦  Significant body of evidence on which we baseour practice (incl. published systematicreviews)
  6. 6. •  Non-electronic forms are also important•  Communication is multi-modal•  Important considerations for vocabulary selection and arrangement•  Core and fringe•  Pragmatic functions•  Visual considerations•  Scanning v’s direct access•  Attitudes, skills and knowledge of communication partners isimportant.•  Voice output supports speech developmentWhat we know about supportingcommunication…
  7. 7. •  A system needs to be for today and tomorrow. (Beukelman & Mirenda,2005)•  Nothing is perfect before you use it•  Not limited to face to face communication (Raghavendra et. al., 2012)•  Needs vary depending on partner and situation (Blackstone and Hunt-Berg,2003)•  MODEL MODEL MODEL – Aided Language Stimulation (Goossens’,Crain & Elder, 1992)•  MAKE IT REAL!!!! (Participation focus)What we know about supportingcommunication…
  8. 8. Key Frameworks—  Participation Model – Beukelman and Mirenda (2005) along withCOPM (Law et.Al., 2000) or other discussion of preferences foractivities and interests—  Janice Light’s definition of communicative competence (1989) –operational, linguistic, social, strategic - (AAC Profile. Kovach,2009)—  Social Networks assessment (Blackstone and Hunt-Berg, 2003)—  Pragmatic Profile – (Dewart and Summers, 1995).
  9. 9. • The aim of any communication system is for the person to meet his/her varied communicationrequirements as• Intelligibly – easy for communication partners to understand and listen..• Specifically – to make the exact message clear (near enough is not always good enough)• Efficiently – time, ease of access, likelihood that others will take listen• Independently• In as socially valued manner as possible – being part of the group, regarded by others .• To understand others and to be understood. -• Porter, G, (1997).Key Frameworks
  10. 10. Research: Success versusAbandonment of AACFactors impacting long-term success—  Person who uses AAC system experiences success 91.76%—  Degree to which the system is valued by the user and partnersas a means of communication 90.58%—  System serves a variety of communicative functions 89.85%—  System is used for communication, not just as a toy or therapytool (Real communication) 87.20%—  Other areas:◦  Appropriate device selected◦  Support for systemJohnson, et al. (2006). Perspective of Speech Language Pathologists Regarding Success versus Abandonment of AAC
  11. 11. Research: Success versus Abandonment of AACFactors leading to inappropriate abandonment.—  Communication partners believe they can understand messagewithout AAC (not solving anything) - 77.75%—  Insufficient opportunities - 76.80%—  User prefers a simpler means of communication (effort higher thanoutcome) 70.02%—  Vocabulary does not meet individualized daily living needs 67.70%—  Other areas◦  Lack of support – training, time for programming, knowledgeableprofessionals,◦  Time!!!!◦  MotivationJohnson, et al. (2006). Perspective of Speech Language Pathologists Regarding Success versus Abandonment of AAC
  12. 12. Communication challenges?—  If technology (or any kind of AAC) is not being used to meet acommunication challenge, it is not going to be used.—  Don’t solve a problem that doesn’t exist. Who really needs PicnicPants????
  13. 13. Research: ‘‘When I First Got It, IWanted toThrow ItOff a Cliff’’: (reflections from adults who use AAC)—  Discusses the importance of:◦  Autonomy◦  Real life experiences◦  Not just requesting!!!◦  Communication Partners◦  Practice, learning and opportunities◦  Role models/modellingRackensperger, et. al. (2005). ‘‘When I First Got It, IWanted toThrow It Off a Cliff’’:The Challenges and Benefits ofLearning AACTechnologies as Described by Adults who use AAC
  14. 14. Opinion Papers: Mobile Devices—  RERC White Paper:◦  “partnering will serve the AAC professionalbetter than resistance”◦  “There is a real danger of succumbing to themedia’s interest in smaller, faster, morepowerful devices, and ignoring the otherfeatures (customizability, learnability, durability,supports for training) that are critical tosuccessful use of AAC”Mobile Devices and Communication Apps. (2011).White Paper. Gosnell, J., Costello, J. & Shane, H. (2011). Using aClinical ApproachTo Answer “What Communication Apps ShouldWe Use?.
  15. 15. Assistiveware survey - Taking the Pulse of Augmentativeand Alternative Communication on iOS—  Showed that AAC apps for iPad led to improvements incommunication but with the following challenges:Niemeijer, Donnellan & Robledo, (2012)..Taking the Pulse of Augmentative and Alternative Communication on iOShttp://www.assistiveware.com/taking-pulse-augmentative-and-alternative-communication-ios•  Professional support (availability andknowledge/skills).•  Limited use of pragmatic functions –eg.starting and changing a conversation.
  16. 16. Bottom line…….—  We know what we are doing in AAC but not alldevelopers look at this when creating apps. —  There is a need for better implementation ofAAC apps to ensure positive outcomes.
  17. 17. APPles and Oranges..—  Example 1◦  We know that category based AAC organisation slows down communicationand impedes the development of language and communication skills◦  We have known this since the 80s◦  Despite this, around 60 of the AAC Apps on the App store (at the time ofwriting) are straight category based apps—  Example 2◦  We know that voice output encourages speech development◦  Some app developers dont include speech in their AAC Apps claiming thatthis is because speech output will impede speech development—  Example 3◦  We know that providing an AAC system at all times and modelling use of thesystem throughout the day in multiple situations leads to maximum languagedevelopment and best outcomes◦  In the instructions for several AAC Apps users are advised to allow access tothe user only a couple of times a week until they become more competent
  18. 18. So, don’t let the APPle fall too farfrom the tree!—  Although apps are cheap, we are not just wasting money with thewrong apps.◦  Time…Valuable time!◦  Opportunities◦  Attitude – user and communication partners
  19. 19. Benefits of mobile devices…•  Cool factor and general acceptance•  “There’s an app for that!!” – over 290 apps for AAC•  Real life models of use – much more than other devices•  Always with you – for other uses•  Portable•  Battery life•  Other uses•  Relatively cheap•  No Gatekeepers
  20. 20. Limitations and disadvantages•  Distractions•  Speakers•  Apps don’t ‘link’……yet.•  Durability•  Some limits in accessibility features•  Ongoing change•  Attractiveness to other kids (good and bad)•  No gate-keepers (good and bad)•  Less documentation and R&D behind them
  21. 21. Types of AppsComprehensive AAC Apps◦  Symbol based only◦  Symbol and text based.◦  Text onlySpecific situations or activities◦  Eg. Phone calls, games, etc.Pre-planned or sequenced messages–  Eg. Reciting, counting, social scriptsInitiating or encouraging interaction◦  Eg. Intro strategy, getting attention, partner focussed questions, conversation startersFringe vocabulary◦  Movies, friends, mapsSharing information and chat books◦  Specific for this purpose or mainstream eg. iMovieAs the activity itselfComprehensive apps can usually do most of thesefunctions too
  22. 22. A Process for Selecting AppsCreated 12/09/2012 : Janelle Sampson - Janelle@twowaystreet.net.auCHOOSING APPS FOR COMMUNICATIONWhat do you want todo? (goal orcommunicationchallenge)What communicationis required and withwho?How do you envisageyour (or your childs)participation?What can you/theyalready do?What do you/theyneed to add?Priorities andcompromises.(See attached list)Is the iPad the bestway to acheive this?I need an app thatdoes .........List possible apps andpros and cons. Usefeature comparisoncharts.Select app for trial.Set up preferred app andprepare for situation. MODEL, ROLE PLAY ANDPRACTICEUSE , Modify, update, USEConsider preferences, issues,breakdowns, compare with others,etcIs the iPad the best option? Whatother modes might be used forparticipation in this setting.
  23. 23. Summary of key points and howthey relate to selecting apps.— ◦ —  Consider social networks—  Consider practicalities and other realities—  Multi-modal—  Meet communication challenges—  Feature matching—  Vocabulary considerations—  MODEL MODEL MODEL—  Learn in natural contexts - practice and modify
  24. 24. Summary of key points and howthey relate to selecting apps.—  Need to address participation needs and pragmatic functions— —  Consider practicalities and other realities—  Multi-modal—  Meet communication challenges—  Feature matching—  Vocabulary considerations—  MODEL MODEL MODEL—  Learn in natural contexts
  25. 25. Summary of key points and howthey relate to selecting apps.—  Need to address participation needs and pragmaticfunctions—  Consider social networks— —  Multi-modal—  Meet communication challenges—  Feature matching—  Vocabulary considerations—  MODEL MODEL MODEL—  Learn in natural contexts
  26. 26. Summary of key points and howthey relate to selecting apps.—  Need to address participation needs and pragmaticfunctions—  Consider social networks—  Consider practicalities and other realities— —  Meet communication challenges—  Feature matching—  Vocabulary considerations—  MODEL MODEL MODEL—  Learn in natural contexts - practice and modify
  27. 27. Summary of key points and howthey relate to selecting apps.—  Need to address participation needs and pragmaticfunctions—  Consider social networks—  Consider practicalities and other realities—  Multi-modal— —  Feature matching—  Vocabulary considerations—  MODEL MODEL MODEL—  Learn in natural contexts
  28. 28. Summary of key points and howthey relate to selecting apps.—  Need to address participation needs and pragmaticfunctions—  Consider social networks—  Consider practicalities and other realities—  Multi-modal—  Meet communication challenges— —  Vocabulary considerations—  MODEL MODEL MODEL—  Learn in natural contexts
  29. 29. Summary of key points and howthey relate to selecting apps.—  Need to address participation needs and pragmaticfunctions—  Consider social networks—  Consider practicalities and other realities—  Multi-modal—  Meet communication challenges—  Feature matching— —  MODEL MODEL MODEL—  Learn in natural contexts
  30. 30. Summary of key points and howthey relate to selecting apps.—  Need to address participation needs and pragmaticfunctions—  Consider social networks—  Consider practicalities and other realities—  Multi-modal—  Meet communication challenges—  Feature matching—  Vocabulary considerations—  MODEL MODEL MODEL – Aided Language Stimulation—  Learn in natural contexts
  31. 31. Summary of key points and howthey relate to selecting apps.—  Need to address participation needs and pragmaticfunctions—  Consider social networks—  Consider practicalities and other realities—  Multi-modal—  Meet communication challenges—  Feature matching—  Vocabulary considerations—  MODEL MODEL MODEL— 
  32. 32. User preferences—  Voice—  Symbol set—  Learning style and vocabulary organisation—  Preconceived notions and experience—  Importance of user buy-in—  Opportunities to trial
  33. 33. “How do you like them APPles….”—  Select a couple of apps—  Have chat or simulate a common activity for an individual you know—  Review the ‘What to look for’ list and Flowchart and rate the appdepending on the needs of that person.
  34. 34. References—  Beukelman, D., & Mirenda, P (2005).AAC: Supporting children and adults with complex communication needs, 3rd Edition, Paul H.Brookes.—  Blackstone, S., & Hunt Berg, M. (2003). Social networks:A communication inventory for individuals with complex communication needs and their communication partners-manual& Inventory Booklet. Monterey, CA:Augmentative Communication, Inc—  Dewart, H & Summers, S (1995) The Pragmatics Profile of Everyday Communication Skills in Children. wwwedit.wmin.ac.uk/psychology/pp/children.htm—  Gosnell, J., Costello, J. & Shane, H. (2011). Using a Clinical ApproachTo Answer “What Communication Apps ShouldWe Use?. Perspectives on Augmentative and AlternativeCommunication.Vol. 20(3). 87-96—  Johnson, J.M., Inglebret, E., Jones, C., & Ray, J. (2006). Perspective of Speech Language Pathologists Regarding Success versus Abandonment of AAC,Augmentative & Alternative Communication, 22:2, 85-99.—  Law, M., Baptise, S., Carswell,A., McColl, M.A., Polatajko, H., & Pollock, N. (2000). Canadian Occupational Performance Measure. CAOT Publications,ACE—  Kovach,T.M.(2009). Augmentative and Alternative Communication Profile:A Continuum of Learning. LinguiSystems. Inc.
  35. 35. References—  Mobile Devices and Communication Apps. (2011). Retrieved fromhttp://aac-rerc.psu.edu/documents/RERC_mobiledevices_whitepaper_final.pdf—  Musselwhite, C.R., & Burkhart, L.J. (2001). Can we chat? Co-Planned sequenced social scripts,A make it/Take it book of ideasand adaptations. Eldersburg, MD.—  Niemeijer, Donnellan & Robledo, (2012).Taking the Pulse of Augmentative and Alternative Communication on iOShttp://www.assistiveware.com/taking-pulse-augmentative-and-alternative-communication-ios—  Porter, G, (1997). Integrating AAC into programs applying the principles of conductive education. Conductive Education News,12 (3), 2-8.—  Rackensperger,T., Krezman, C., McNaughton, D., Williams, M.B., & D’Silva, K. (2005). ‘‘When I First Got It, IWanted toThrow ItOff a Cliff’’:The Challenges and Benefits of Learning AACTechnologies as Described by Adults who use AAC. Augmentative andAlternative Communication,VOL.21 (3), 165-186.—  Raghavendra, P., Olsson, C., Sampson, J.,McInerney, R., & Connell,T (2012). School Participation and Social Networks of Childrenwith Complex Communication Needs, Physical Disabilities, and Typically Developing Peers. Augmentative and AlternativeCommunication, 2012; 28(1): 33–43—  Raghavendra, P.,Wood, D., Newman, L., Grace, E., & Connell,T. (2012). Strategies for supporting Internet use to increase socialparticipation of adolescents with complex communication needs. Proceedings of the 15th Biennial Conference of theInternational Society for Augmentative and Alternative Communication, Pittsburgh, USA.—  Tatenhove, G.M. (1994) What is Minspeak? Prentke Romich Company, Wooster, USA—  http://www.janefarrall.com/html/ipad.html

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