Winter 2011                              Volume 6, Issue 1Cover artwork created by Nathaniel Mackin
CONTENTSEditorial                                                                Editorial Team                           ...
EDITORIALEditorialBy Vera Bernard-Opitz     The latest technologies sure are exciting for us all,   lenges our familiar wa...
EDITORIAL     The current focus issue of the Autism News OCsummarizes some of the exciting recent develop-ments. We thank ...
RESEARCHIf At First You Don’t Succeed…: Teaching Persistence inSocial Initiations to Children with Autism Using aPortable ...
RESEARCH    Persistence in social initiations can be challeng-    marketing and media communities, 31% of childrening for ...
RESEARCHfirst clip, the actor approached a peer with a ball and        intervention was successful.asked, “Will you play wi...
RESEARCHadult relationships in the future. More importantly,we can use this technology to capitalize on the child’sexistin...
RESEARCHInteractive and Collaborative Visual Supports for Children with AutismBy Gillian R. Hayes    ºFor the last several...
RESEARCH    During caregiver-initiated communication, caregivers set up communication choices using the library of “cards”...
RESEARCHresponding incorrectly or not responding at all                     troubleshoot both the hardware and the softwar...
RESEARCH     The SenseCamform factor (left) issmall enough to becomfortably worn bya child (center). Achild-friendly viewi...
RESEARCH    The iSoC system is a mobile-phone based aug-             environment–though the educators and autismmented rea...
RESEARCH   Woodbine House, USA, 2007.                                    L.A., Hayes, G.R. vSked: Evaluation of a System t...
RESEARCHIntegrating Information Technology in Therapy and LifeBy Gondy Leroy, Juliette Gutierrez, HyeKyeung Seung & Gianlu...
RESEARCH    The potential advantages of using a digital              Uploading and downloading files, cropping orcommunicat...
E D U C AT I O N / T H E R A P YEffectiveness of a Computer-Assisted Instructional Program forChildren with AutismBy Chris...
E D U C AT I O N / T H E R A P Ychooses and starts a lesson by clicking on a building in      images). Gradually introduci...
E D U C AT I O N / T H E R A P Ymotivation, and generalization (Dunlap & Koegel,1980). In addition to providing a motivati...
E D U C AT I O N / T H E R A P YFor further information please contact:     Christina Whalen, PhD, BCBA-D                 ...
E D U C AT I O N / T H E R A P YKeeping up with TechnologyBy Hiroka Yamada & Debbie Ferrante    Stein Education Center is ...
E D U C AT I O N / T H E R A P Yment as well as places that are fre-                                       students this m...
E D U C AT I O N / T H E R A P YTouch2Learn ProgramBy Bill Thompson    The Orange County Department of Education          ...
E D U C AT I O N / T H E R A P Y                                                            the number of autism-specific a...
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
Autism news  winter´11
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Autism news winter´11

  1. 1. Winter 2011 Volume 6, Issue 1Cover artwork created by Nathaniel Mackin
  2. 2. CONTENTSEditorial Editorial Team Vera Bernard-Opitz, Ph.D., EditorLatest Technologies............................................... 3 Ginny Mumm, Associate EditorResearch Editorial BoardTeaching Persistence in Social Initiations ............. 5 Nicole Gage, Ph.D. Wendy Goldberg, Ph.D.Education/Therapy Gillian Hayes, Ph.D. Leslie Morrison, Ph.D.Interactive and Collaborative Visual Supports ..... 9 Christina McReynolds, Ed.S., MS, BCBA.Technology in Therapy ..................................... 15 Janis White, Ed.D.Computer-Assisted Instructional Program ......... 17 Executive BoardKeeping up with Technology ...............................21 Carol Clayman Valerie K. deMartino, EsqTouch2Learn Program ....................................... 23 Joe Donnelly, M.D.Technology Employment .................................. 25 Dennis Roberson Janis B. White, Ed.D.Parent/Family Advisory BoardGrace App ......................................................... 26 LOCALRethink Autism ................................................. 30 Valerie K. deMartino, Esq.Assistive Technology .......................................... 31 Long Beach, California Wendy Goldberg, Ph.D.News/Highlights University of California, Irvine Beth Huntley-FennerCover Artist: Nathaniel Mackin ........................14 Irvine, CaliforniaSupportors/Sponsorships/Donations ..................20 Belinda Karge, Ph.D. Cal State University, FullertonUpcoming Seminars ...........................................36 Connie Kasari, Ph.D. University of California, Los Angeles Jennifer McIlwee Myers C O V E R F E AT U R E Orange County, California Emily Rubin, MS, CCC-SLPWe are pleased to feature one of our local artists, Nathaniel Communication Crossroads, MontereyMackin. Read more about Nathaniel on page 14. Bryna Siegel, Ph.D. Dept. of Psychiatry, University of California, San FranciscoMission Statement Marian Sigman, Ph.D. University of California, Los Angeles Autism News of Orange County & the Rest of the World Becky Touchetteis a collaborative publication for parents and professionals Saddleback Valley Unified School Districtdedicated to sharing research-based strategies, innovativeeducational approaches, best practices and experiences in NATIONAL/INTERNATIONAL Barbara Bloomfield, M.A., CCC-SLPthe area of autism. Icon Talk, Goshen, New YorkSubmission Policy Marjorie H. Charlop-Christy, Ph.D. Claremont McKenna College and The Autism News of Orange County–RW is available free The Claremont Autism Centerof charge. The opinions expressed in the newsletter do not V. Mark Durand, Ph.D.necessarily represent the official view of the agencies involved. University of South Florida, St. Petersburg Patricia Howlin, Ph.D. Contributions from teachers, therapists, researchers and St. Georges’s Hospital London, Englandrelatives/children of/with autism are welcome. The editors David Leach, articles and make necessary changes. Murdoch University, Australia Please submit articles in Microsoft Word using font size Gary Mesibov, Ph.D. University of North Carolina,12, double spaced, and no more than four pages in length Chapel Hill Division TEACCH(2600 words). Photos are encouraged and when submitted Salwanizah Bte Moh.Saidwith articles the permission to include is assumed. Early Intervention, Autism Association, Singapore Please E-mail all correspondence to: Friz Poustka, M.D. University of Frankfurt, Germany Dr. Vera Bernard-Opitz Diane Twachtman–Cullen, Ph.D., CCC–SLP ADDCON Center, Higganum, Connecticut Please visit our website: Pamela Weolberg, Ph.D. San Francisco State University2 Autism News of Orange County – RW Winter 2011
  3. 3. EDITORIALEditorialBy Vera Bernard-Opitz The latest technologies sure are exciting for us all, lenges our familiar ways of being. In an earlier issuebut for individuals with autism and their parents, fam- on Technology and Play (Autism News, Fall 2007)ilies, friends and involved professionals these advances we discussed the need for establishing a balanceoften constitute a true “blessing.” All of a sudden kids between technological advances, hands-on learningequipped with iPod touch and iPad are the stars in and play activities as well as personal face-to-facerecess instead of being outsiders because of some cum- interactions. Whether books, games, schools andbersome communication device. Many teachers and seminars can survive is a decision families, teachers,therapists welcome apps, which allow their fingers to therapists, and administrators face. If technology isheal from endless work on teaching material with used for the right individual at the right time – and“good old” Velcro. Organizations like “Mothers with “dosage” – for the right purpose, it sure can be a hugeApps” have started lucrative companies, based on suc- blessing, especially for kids with autism. On the othercessful development of applications, which in most hand there is the risk that the virtual world takes overcases started with their own child. and that individuals with autism are even less exposed In addition, training in the field is also undergoing to regular social interactions, face-to-face interactivea silent revolution. While face-to-face contacts in con- play, haptic experiences, sensori-motor or self-helpsultation sessions, workshops or other training pro- demands. This population surely needs our help, begrams used to be the main avenue for acquiring relevant it through traditional play and teaching material, aknowledge and training experience, web-seminars, cool communication device with the latest app, avideo-training-programs and tele-consultations now caring parent, excellent teachers or therapists, aare available often 24 hours a day, from every part of close network of peers or a supportive community.the world with fast Internet access. Will puzzles, lottos, dominos, board games and a few comments from our readers...self-made TEACCH material soon be a thing of thepast, just like books, replaced by electronic versions? “It’s such a great resource for the parents IHow about good old teaching using textbooks and work with with kids with autism!”black-/whiteboards? We must admit that even the mostanimated teacher or enthusiastic parent has a hard time “I am thrilled to receive it.”beating a fast-paced computer game. Will family time, “Found great pleasure reading because itstudent-teacher or peer interaction increasingly be shows hopes and light in helping andreduced because emailing and online courses are so supporting people with autism.”much easier to fit into busy schedules? Who wants totake photos, laminate, label, cut and paste pictured “Excellent collection of practical articles–schedules, if an application can be downloaded for lit- full of helpful suggestions–I havetle money and in no time? Thousands of electronic recommended this to parents and students,learning programs, games, pictures or visual displays are and have received much positive available on increasingly smarter devices. Voice-to- I haven’t found anyone who didn’t like it.”Speech programs make typing unnecessary and Text-to-Speech options allow text to be read with the tip of the “It is very important for parents of autisticfinger. Children can now film their weekend with an children to get information. The AutismiPod touch and present it to their class on Monday with News is a valuable support.”added text or speech on a large Smart Board. “I love it, look forward to it and like to see For some of us these developments sound like the the local news and latest info.”“Brave New World,” which comes too fast and chal-Winter 2011 Autism News of Orange County – RW 3
  4. 4. EDITORIAL The current focus issue of the Autism News OCsummarizes some of the exciting recent develop-ments. We thank our authors, reviewers and support-ers for all their good effort.A small word of warning For the last two years the Autism News of OrangeCounty has struggled with lack of adequate financialsupport, since the former sponsors (RCOC, OCDE,CEC and For OC Kids) are no longer able to contributefinancially. Though the work of soliciting articles,reviewing and coordinating the newsletter currently hasto be done on a volunteer basis, we need some funds toprovide for Web publishing, proofreading and layout.Without your donations the current issue will be thelast of a series which started in 1992. We urgently needand very much appreciate your support. With thanks to all our supporters and best wishes, Vera Bernard-Opitz, Ph.D. Clin. Psych, BCBA-D Editor Website: E-mail: HIGHLIGHT Proud to support the Autism News of Orange County Big Button Mack In Röderhof, a German residential facility, the daily lunch menu is announced with pictures and a talking Big Button Mack. AUTISM NEWS is also available online at: www.autismnewsoc.org4 Autism News of Orange County – RW Winter 2011
  5. 5. RESEARCHIf At First You Don’t Succeed…: Teaching Persistence inSocial Initiations to Children with Autism Using aPortable Video Modeling InterventionBy Denise Grosberg & Marjorie H. Charlop For most of us, the iPod touch is a fun gadget to think back to when you were a child and wanted toplay with, surf the Web, or watch videos. But for a play with others. Most people report that if onechild with autism, it has the potential to be so much child didn’t want to play, they would typically movemore: A device like the iPod touch can be pro-grammed as a “learning toy” for important behaviorssuch as communication or social skills. The iPodtouch can therefore have a dramatic effect on the tra-jectory of the child’s treatment. Modern day treat-ment procedures for the problems children withautism continue to face are now incorporating tech-nology such as the iPod touch. From the first coining of the term “infantileautism” by Leo Kanner in 1943 (Kanner, 1943),marked deficits in social skills were noted in affectedchildren. Indeed, children with autism have difficul-ties with many social behaviors ranging from eyecontact, turn taking, and smiling to more sophisti- Nathaniel Mackin having fun with his iPod touchcated social skills such as social conversations. Thesocial skill deficit that we will be focusing on is per-sistence in pursuing a playmate. This complex social on and ask another. This is common for most chil-skill involves a child asking successive peers to play dren, yet persistence in social initiations is a majorafter one or two attempts have failed. To illustrate, deficit for children with autism. We Need Your Support to continue the Autism News of Orange County! Please donate through the new Autism News OC Fund at the School of Medicine of UCI (Go to: Autism News of Orange County). For further information please e-mail: FREE SUBSCRIPTIONS to the Autism News of OC are possible through www.autismnewsoc.orgWinter 2011 Autism News of Orange County – RW 5
  6. 6. RESEARCH Persistence in social initiations can be challeng- marketing and media communities, 31% of childrening for children with autism for several reasons: aged six through ten now use digital music players,Typically, these children have difficulty interacting with the iPod and iPod touch being the most popularwith peers for extended periods of time; they gener- brand at 54%. The iPod touch ranks high as a poten-ally make and accept few social initiations from tial learning tool for children with autism because of itspeers; and they usually prefer to play alone (Koegel, portability, ease of operation, and “coolness” factor forKoegel, Frea, & Fredeen, 2001). These social deficits use around neurotypical peers. The time has come tocan determine whether a child with autism will ulti- take advantage of this novel, portable visual technolo-mately integrate effectively with his or her classmates gy platform so that it can have a meaningful impact foror remain a social outsider. The question then the children that need it the most.becomes, how can we effectively motivate children In a recent study conducted by The Claremontwith autism to learn a complex social skill that they Autism Center at Claremont McKenna College incan practice on the playground with their peers? Southern California, a Portable Video Modeling The iPod touch is a clear choice for several rea- Intervention (PVMI) was used to teach persistencesons. First, the general appeal of technological in social initiations to high functioning childrendevices for children with or without autism is evi- with autism. The study was constructed based on evi-dent in today’s society. Second, we can leverage a dence suggesting that the mobility, simplicity, andchild with autism’s inherent strengths using visual popularity of the iPod touch would contribute to par- ticipants’ learning to persist in social initiations in sev- Persistence in social initiations is a major eral ways. First, it allowed children with autism to use deficit for children with autism. the intervention tool independent of adult assistance. Second, because of the compact size of a portable device, the potential for learning could reach beyondmedia as well as the portability of an electronic the traditional therapy setting and into the communi-device. The use of visual technology has a history of ty. Lastly, and arguably most important, social skillssuccess in teaching children with autism a variety of training with neurotypical peers would be less stigma-social skills. For example, video modeling (in which tizing for the children with autism based on the pop-child learns by observing a videotaped model) has ularity of the iPod touch among children today.been extremely effective in using the inherent visual In our study, three children aged 6-9 participat-strengths and interest of children with autism in ed in weekly sessions at our afterschool behavioraltechnology to teach a number of socially relevant treatment program. Before the study began, none ofbehaviors including conversational speech, perspec- the children interacted effectively with typical peerstive taking, and social initiations (Charlop & or persisted in their social initiations. For the study,Milstein, 1989; Charlop-Christy & Daneshvar, the child watched three different clips visible on the2003; Nikopoulos & Keenan, 2004). The progres- screen of the iPod touch. The order in which thesion of visual technology represented by devices like child saw the clips varied so that s/he did not learnthe iPod touch allows for a natural extension of this to socially initiate in a specific sequence (known as aresearch. Today, it is possible to extend the benefits chained behavioral sequence). Instead, the child hadof video modeling beyond the therapy room and to learn to respond appropriately to each separateinto the lives of children with autism. social situation with his or her peer. The introduction of devices like the iPod touch All the clips used four student therapists ashas made video modeling methods mobile and capital- actors. Three of the actors were engaged in play activ-izes on the prevalence of this technology among today’s ities (i.e., board games, imaginary play with tools) inchildren. For instance, according to a report by The different areas of an outdoor playground, while theAdAge Group (Bulik, 2008), an online resource for fourth actor approached these “peers” to play. In the6 Autism News of Orange County – RW Winter 2011
  7. 7. RESEARCHfirst clip, the actor approached a peer with a ball and intervention was successful.asked, “Will you play with me?” The peer said, “Yes, All three children learned persistence in socialI’ll play with you” and the two actors began to play initiations using the PVMI. Moreover, these chil-with the ball. In the second clip, the actor dren generalized their persistence in social initiationapproached a peer with a board game and asked, behavior with a minimum 66% success rate (asking“Will you play with me?” The peer responded, “No, up to two friends to play) in at least one untrained set-I’m busy.” The actor then had to walk across the play- ting (park or community recreation room) and main-ground to a second peer and ask, “Will you play with tained the target behavior at follow-up one monthme?” This time, the peer said “Yes, let’s play” and the after the intervention was over. This research providestwo actors began to play the board game. In the third some initial evidence of the success of a PVMI toclip, the actor’s play request was declined on her first teach persistence in social initiations to children withand second social initiation attempt. This meant that autism. The next logical progression in this research isthe actor had to approach a third peer and ask her to to examine whether the PVMI protocol can be repli-play before being socially accepted. cated with other skills, in other settings, and be imple- Then it was the child’s turn. The experimenter said,“Now it’s time to play, pick a toy and choose a friend to Devices like an iPod touch have madeplay with.” The child was then filmed for one session video modeling methods mobile(consisting of three trials lasting three minutes each) inan outdoor play setting with at least three neurotypicalpeers. If a child with autism asked a peer to play, the mented by different instructors like peers or parentsneurotypical peer was prompted by a student therapist As new generations of children become familiarto either accept or reject the social initiation request. with advances in technology, researchers and cliniciansSometimes the first peer said “yes” when a child with have the opportunity to modify and use these tools toautism asked him to play, other times the child with design effective interventions for children with autism.autism had to approach two or three peers to be social- For example, researchers could collaborate with engi-ly accepted. By varying the occurrence of a peer accept- neers to help adapt and create new technologies specifi-ing or declining the initiation attempt over the three tri- cally targeted to better serve children with autism. Thereals, the child with autism learned that although his are currently many applications for the iPod touch thatsocial initiation to a peer may not initially be accepted, are designed to help children with autism learn lan-his play request could be accepted on a second or third guage, communication, and social skills. Unfortunately,attempt. The child was considered to have learned many of these applications are designed to generate salesthe behavior once he or she was able to persist in as commercial products and are not grounded in evi-asking up to three friends to play over two consecu- dence-based research. Since these applications are sotive sessions (this would equate to 100% accuracy). If easily accessed and utilized by the general public, it isthe child could not successfully ask up to three peers to imperative that researchers and clinicians empiricallyplay over the three trials, s/he received the PVMI again. test the effectiveness of these applications so that par- To demonstrate generalization, the child was ents and providers can select appropriate technologi-given one session (three trials), to persist in asking cal aids for the child.up to three friends to play in an indoor community Our study is one step in empirically testing a newrecreation room with familiar peers and also at a technology that demonstrates the effectiveness ofcommunity park with unfamiliar peers. After a one- devices like the iPod touch as an intervention tool.month period, the child was then assessed to see if Clearly, the ability to persist in social initiations is sig-s/he remembered how to persist in social initiations. nificant not only for the immediate social benefits forThis was done to demonstrate that the behavior had a child with autism, but also increases opportunitiesbeen maintained over time and therefore that the for friendships, responsiveness to others, and successfulWinter 2011 Autism News of Orange County – RW 7
  8. 8. RESEARCHadult relationships in the future. More importantly,we can use this technology to capitalize on the child’sexisting strengths and teach skills that can significant-ly impact the quality of life of a child with autism. It has been said that one can never keep up withtechnology, and this is probably true. However, thepoint of our research is to demonstrate the useful-ness of certain technologies that are motivating forchildren with autism and make treatment easier.Some types of technological advances designed forchildren with autism are so confusing that parentsand teachers can’t figure them out, or the child justdoesn’t bother with them. That is why we recom-mend that technology should be easy to use and evi-dence-based protocols developed for ease of imple-mentation with the child and other stakeholders.Also, these technologies should be designed toincrease motivation for use with the children. Welook forward to new advances that keep user andchild friendly technology in mind. For further information please contact: Denise Grosberg Claremont Graduate University E-mail: and Marjorie H. Charlop E-mail: Claremont Autism Center, Claremont Graduate University, and Claremont McKenna CollegeReferences • Bulik, B. (2008). Little Ears Are Big Bucks for Music Players. The AdAge Group. Retrieved from • Charlop, M. H., & Milstein, J. P. (1989). Teaching autistic children conversational speech using video modeling. Journal of Applied Behavior Analysis, 22, 275–285. • Charlop-Christy, M., & Daneshvar, S. (2003). Using video modeling to teach perspective taking to children with autism. Journal of Positive Behavior Interventions, 5, 12–21. • Kanner, L (1943) Autistic disturbances of affective contact Nervous Child, 2, 217-250. • Koegel, L. K., Koegel, R. L., Frea, W. D., & Fredeen, R. M. (2001). Identifying early intervention target for children with autism in inclusive school settings. Behavior Modification, 25, 754–761. • Nikopoulos, C. K., & Keenan, M. (2004). Effects of video modeling on social initiations by children with autism. Journal of Applied Behavior Analysis, 37, 93-96.8 Autism News of Orange County – RW Winter 2011
  9. 9. RESEARCHInteractive and Collaborative Visual Supports for Children with AutismBy Gillian R. Hayes ºFor the last several years, I have been conduct- Mocotos: Mobile Communication Toolsing research on how we can use novel interactive and Current analog visual communications toolscollaborative technologies to support the education vary greatly from classroom to classroom, and evenof children with autism (e.g., Hayes et al. 2004, from child to child. Visual communication toolsHayes and Abowd 2006, Hayes et al. 2010). Here at take a variety of forms, from small single pictureUC Irvine, I have a great team of students and low-tech cards to advanced computational systemsresearch assistants focused on creating and evaluat- that perform text to speech functionality. A massiveing novel visual supports for children with autism. array of material, devices and methods surroundVisual supports include everything from body lan- these analog methods for visual communication.guage to natural cues within the environment to Unfortunately, there are many problems inherent totools explicitly created to support individuals who the cards themselves. Teachers and caregivers oftenmay have trouble interpreting naturally occurring struggle to manage the large number of cards beingvisual cues. These constructed artifacts sometimes used. Likewise, they must invest significant effort touse images or tangible objects to represent simple create the cards. Commercial vendors, such aseveryday needs and elements of basic communica- BoardMaker™ sell sets of pre-fabricated cards, buttion (Cohen and Sloan 2007) and can reduce the these are not flexible enough to meet the needs ofsymptoms associated with ASD (Hodgdon 1999). many of the caregivers with whom we worked, who Despite their benefits, use of visual supports instead often opted to create custom cards fromcontinue to be difficult for many teachers, parents, physical artifacts or digital imagery. Finally, theseand other caregivers. There are significant challenges paper-based visual tools often have to be used into the use of these analog, and largely paper-based, conjunction with particular devices. Each devicetools. First, these tools must provide support for often serves a different purpose, operates differently,children with ASD to improve their communication and can require custom configuration.skills and social skills. Second, they must be flexible There are several advanced digital technologiesenough to support each unique child now and as the for augmentative communication (e.g., GoTalk,child develops. Finally, caregivers often struggle to Tango, Dynavox, Activity Pad). The teachers andcreate, use, and monitor the effectiveness of these experts we interviewed listed a variety of concernstools. Thus, these tools must support the children with these technologies, from usability to lack of flex-for which they are designed, with minimal burden tocaregiver and support the caregivers in accomplish-ing their goals as well. Tax-deductible donations Over the last three years, our team has spent a to ANOC are possible through thesubstantial amount of time conducting fieldwork in Autism News OC Fund at the School of Medicine of UCI. Support is possible at the following levels:schools, interviewing parents, students, and teachers,and designing and developing new technologies. Benefactor: $5,000 and aboveWhat we present here is just a quick sampling of Sustaining Member: $3,000 - $4,999some of these projects. In particular, this article Supporter: $1,000 - $2,999overviews some of the systems we have designed and Contributor: $500 - $999 Friend: $25 - $499developed. We encourage interested readers to readour scientific publications to get a better sense of the Please visit we do. for more information or to make a donation today!Winter 2011 Autism News of Orange County – RW 9
  10. 10. RESEARCH During caregiver-initiated communication, caregivers set up communication choices using the library of “cards” andcan offer as few as one choice for directed instruction or as many as eight choices for advanced children (left). The studentsthen make their choices by pushing the appropriate card, which then invokes sound output and optional visual output(center with four choices and right with six).ibility. Furthermore, these devices typically require providing rapid access to the library of virtual cardsprofessional training and expertise, making it difficult and real-time and ad hoc setup of new activities.for many parents to use them at home. In our designs, vSked: Interactive and Intelligent Visual Scheduleswe were focused on reducing the barrier to entry for In schools, visual schedules can assist studentsthese technologies by using familiar platforms, like with transitioning independently between activitiesthe mobile phone, and simple end user programming and environments by telling them where to go andto create flexible but customized interfaces. helping them to know what they will do when they Mocotos are augmentative communication get there (Cohen and Sloan 2007). By providingdevices that support visual communication, such as structure, visual schedules reduce anxiety and sup-the Picture Exchange Communication System (PECS) port behavior intervention plans focused on students(Bondy and Frost 2001). Our prototype system with severe behavior problems. Because the informa-includes a portable device not much larger than popu- tion must be kept up to date and the schedules them-lar cell phones, such as the Nokia N800. Both children selves tend to be more effective when they are engag-and adults can use the touch screen on the device for ing to the individuals using them, the traditional peninteractions. Adults can also use a computer-based and paper “low tech” assistive technology approachinterface for organizing images, uploading new images, can be improved.and generally managing the library on the device. vSked is an interactive system that augments and The primary interface metaphor consists of virtu- enhances visual schedules. The vSked system assistsal picture cards. Mocotos come with a preinstalled teachers in managing their classrooms by providingcomprehensive library of cards. These cards include interfaces for creating, facilitating, and viewingthe standard iconography used throughout PECS progress of classroom activities based around anand other visual communication strategies. Using interactive visual schedule. vSked includes threeMocotos, caregivers can also add custom cards to the different interfaces: a large touch screen displayinterface by taking pictures using the built-in camera, viewable by the entire classroom, a teacher–centricimporting digital images from a standard memory personal display for administrative control, and acard, or by tethering the device to a computer. Cards student-centric hand-held device for each student.can have multiple audio cues assigned to them; these The large touch screen, placed at the front of thecues may be either recorded through the on-board classroom, acts as a master timetable containing visu-microphone, or be synthesized using the built-in al schedules for all students. The current activity cantext-to-speech function. Each card includes both a be activated by the teacher, which in turn starts thename and other customizable meta-data, which activity on the networked students’ hand-heldenables categorization, searching and management, devices in the form of choice boards. Students10 Autism News of Orange County – RW Winter 2011
  11. 11. RESEARCHresponding incorrectly or not responding at all troubleshoot both the hardware and the software onreceive a prompt to help them identify the correct those days when the computers don’t want to work.response. Upon successful completion of a task, each SenseCam: Automatic Recording of Everyday Imagesstudent is presented with a reward, such as an anima- The Microsoft SenseCam provides an ideal platform for exploring the potential for automatically gen- erated, situated and contextualized picture- based communication and therapy. SenseCam is a wearable digital camera designed to take photographs of every- day life without user intervention. It is acti- vated by a variety of sensors while it is being worn (Hodges et al. 2006). Images of every- day activities from the perspective of the indi- (left) A student sits at his desk during individual work time, while the large display indicatates vidual wearing thethat everyone is working. (top-right) The large classsroom display showing multiple children’s sched- camera can be usefulules at once. In this case, the schedules are are the same, but that is not necessarily true in all cases.(button right) As individual student’s vSked device showing the first activity of the day, picking a visual supports.reward toward which the child will work. We developed antion of fireworks. Using a combination of shared intervention in whichlarge displays for the whole class and smaller net- children wear SenseCam for all or part of a typicalworked displays for individual children, new interac- day. Parents and caregivers at home can then reviewtion models are enabled in classrooms, including photographs captured during private therapies or insocial and peer learning as well as more efficient and their own or other people’s homes, and teachers andrapid feedback for students and staff about individ- school staff can review photographs captured outsideual progress and abilities. For example, student of school. Additionally, children and caregiversprogress and rewards are echoed on the shared dis- review images together to aid in creating visual socialplay, thereby alerting students and teaching staff stories that are a part of communication and speechalike to students who may be struggling so they can therapy (Gray 1998). Caregivers make use of thebe proactive with help. vSked has been in use in one SenseCam viewing interface to pause the pictureschool off and on for over a year. We have seen stream, ask questions, and so on. In this way, thereductions in the amount of effort classroom staff recorded pictures both serve as a type of log,have to put forth to help students transition and gen- enabling improved communication between homeeral acceptance of the system (Hirano et al. 2010). and school, and as a platform through which to con-However, more work needs to be done to make it duct communication therapy with the child.easy for teachers to use every day, including helping Three families used SenseCam for three to fiveWinter 2011 Autism News of Orange County – RW 11
  12. 12. RESEARCH The SenseCamform factor (left) issmall enough to becomfortably worn bya child (center). Achild-friendly viewinginterface allows chil-dren to review photoswith their parents,teachers, and othercaregivers (right).weeks each. During that time, SenseCam was used to with which the caregivers made use of SenseCam,provide a “voice” for a child who cannot speak, as they might develop more elaborate interventionswell as additional information to support communi- themselves given more time. Furthermore, the clini-cation among caregivers and their children. These cal efficacy of such user-designed interventions—incase studies provide information about how these addition to those created by researchers, educators,types of technologies can be incorporated into every- and therapists—should be investigated with a largerday life, revealing the potential benefits, costs, and population over an extended period of time.risks across stakeholder groups. These considera- iSoC: Interactive Social Compasstions are fundamental for the design and develop- The Social Compass is a social skills curriculumment of novel ubicomp assistive technologies. They based on cognitive and behavioral theory (Baron-also demonstrate how caregivers can creatively make Cohen 1991). This curriculum was developed byuse of flexible capture and access technologies for a autism experts in Southern California over the last tenvariety of purposes. years and has been tested with thousands of students. The results of this work indicate promise for the The majority of the students enrolled in the Socialuse of novel technologies for augmentative communi- Compass intervention are diagnosed as high function-cation and other related uses. Their applicability and ing. The Social Compass curriculum includes 26potential for adoption over long-term use, however, lessons divided into four modules: Nonverbalshould be investigated further. Given the creativity Communication; Emotion; “We” Skills; and Social Problem Solving. The four modules, like a compass that guides North, East, West, and South serve to “steer the child in the right direction” (Charlop-Christy, et al. 2004). Each lesson is composed of eight steps. The materials for each lesson include instructions, a story, a visual support, a read- ing comprehension worksheet, a self-moni- toring data sheet, and a parent follow-up page. These tools help students associate sto- The various parts of the iSoC system. (a) A child could use the ries with visual cues to learn particular socialsystem to identify potential interaction partners. (b) Select an avatar skills. The goal of the lessons and associatedand configure his or her profile (c) Discover social cues when inter- materials is to help students gain a deeperacting with others (d) Consult detailed information associated with understanding of the use of the newlythe social cue learned in the social compass class. learned skill in different social contexts.12 Autism News of Orange County – RW Winter 2011
  13. 13. RESEARCH The iSoC system is a mobile-phone based aug- environment–though the educators and autismmented reality system that supports the Social Compass experts did not use that particular phrasing–for care-curriculum (Tentori and Hayes 2010). Students, both givers to create and to share materials with onethose with ASD and neurotypical, can use it to detect another. As these materials are developed either col-potential interaction partners, get helpful social cues, lectively or within individual schools and greater andand tag memories to reflect later. We will be testing this greater numbers of images and lesson plans areapplication this fall and winter in a school already using included in the systems, another substantial chal-the Social Compass curriculum. lenge arises: how to catalog, search, and browse large A child could use the iSoC system to (a) Identify quantities of media. We leave these challenges openpotential interaction partners (b) Select an avatar and and hope that in the future these tools can incorpo-configure his or her profile (c) Discover social cues rate the best practices and algorithms from the searchwhen interacting with others (d) Consult detailed and collective intelligence research communities.information associated with the social cue learned in Acknowledgmentsthe social compass class. This work was supported by a grant fromConclusion AutismSpeaks, NSF CAREER Award #0846063, Visual supports can enable children with ASD to an equipment donation from Nokia Research Palocommunicate and to learn more easily. Traditional Alto. We thank the participants from across multi-tools, however, are challenging to create, use, and ple Orange County school districts and the Formaintain. Furthermore, they provide little or no OC Kids Neurodevelopmental Center. Thisability to document and monitor use and progress research was conducted as a team effort withover time. Our goal in this work was to understand LouAnne Boyd, Meg Cramer, Sen Hirano,the design space surrounding visual interventions for Gabriela Marcu, Mohamad Monibi, Davidchildren with autism so as to develop new tools that Nguyen, and Monica Tentori.combine the strengths of the analog tools with the For further information please contact:potential for new ubicomp solutions. Gillian R. Hayes Through fieldwork, design activities, and focus Department of Informaticsgroup discussions surrounding these interventions, Donald Bren School of Informationwe have uncovered the ways in which advanced and Computer Sciencesinteractive visual supports can engage students and University of California, Irvinesupport caregivers simultaneously. This focus E-mail: gillianrh@ics.uci.edubrought to the forefront specific design requirements Referencesfor new assistive technologies in this space: flexibil- • Baron-Cohen, S., Precursors to a theory of mind:ity, communication and collaboration capabilities Understanding attention in others. In A. Whiten (Ed.),for both children and caregivers, and caregiver sup- Natural theories of mind: Evolution, development and simula-port for programming and documentation of use. tion of everyday mindreading. Oxford: Basil Blackwell. 1991.In an iterative process, we developed three prototype • Bondy, A. and Frost, L. A Picture’s Worth: PECS and Other Visual Communication Strategies in Autism. Woodbinevisual interventions that support these goals. House, Bethesda, MD, USA, 2001.Through focus group discussions with autism • Charlop-Christy, M.H., Carpenter, M., Le, L., LeBlanc,experts and educators, we then evaluated the proto- L.A., and Kellet, K. Using the picture exchange communi-types and redesigned them based on this feedback. cation system (PECS) with children with autism: assess- ment of PECS acquisition, speech, social-communicative There are still a multitude of technical challenges behavior, and problem behavior Journal of Applied Behaviorto be considered in this work. A substantial theme Analysis. 35(3), 213-231, 2002.during the focus group discussions centered on the • Cohen, M.J. and Sloan, D.L. Visual Supports for Peopleneed for an end user programming with Autism: A Guide for Parents and Professionals.Winter 2011 Autism News of Orange County – RW 13
  14. 14. RESEARCH Woodbine House, USA, 2007. L.A., Hayes, G.R. vSked: Evaluation of a System to Support • Gray, C.A. Social Stories and Comic Strip Conversations Classroom Activities for Children with Autism. In Proc CHI with Students with Asperger Syndrome and High- 2010. April 12-15, 2010. Atlanta GA USA, 1633-1642. Functioning Autism. Asperger Syndrome or High- • Hodgdon, L. A. Visual strategies for improving visual com- Functioning Autism?, edited by Schopler et al. Plenum munication: Volume I: Practical support for school and home. Press, 1998. Quirk Roberts Publishing, 1999. • Hayes, G.R. and Abowd, G.D. 2006. Tensions in • Hodges, S., Williams, L., Berry, E., Izadi, S., Srinivasan, J., Designing Capture Technologies for an Evidence-Based Butler, A., Smyth, G., Kapur, N. and Wood, K. SenseCam: Care Community. In Proc. CHI 2006, 937–946. A Retrospective Memory Aid. In Proc. UbiComp 2006, • Hayes, G.R., Gardere, L.M., Abowd, G.D. and Truong, Springer, 177-193, 2006. K.N. CareLog: A Selective Archiving Tool for Behavior • McClanahan, L.E., and Krantz, P.J. Activity Schedules for Management in Schools. In Proc CHI 2008, 685-694, 2008. Children with Autism: Teaching Independent Behavior. • Hayes, G.R., Hirano, S., Marcu, G., Monibi, M., Nguyen, Woodbine House, 1999. D.H., and Yeganyan, M. Interactive Visual Supports for • Tentori, M. and Hayes, G.R. Designing for Interaction Children with Autism. Personal and Ubiquitous Immediacy to Enhance Social Skills of Children with Autism. Computing. 14(7): 663-680. 2010. Proc Ubicomp 2010. Copenhagen, Denmark. September • Hayes, G.R., Kientz, J.A., Truong, K.N., White, D.R., 26-29, 2010. 51-60. Abowd, G.D., and Pering, T. Designing Capture Applications to Support the Education of Children with Autism. In Proc. UbiComp 2004, 161-178, 2004. • Hirano, S., Yeganyan, M., Marcu, G., Nguyen, D., Boyd, Cover Artist: Nathaniel Mackin Nathaniel Mackin is an 8-year-old video-game aficionado who enjoys playing Lego Batman and Mario in his spare time. He is also an up-and-com- ing comic book writer, inspired by the book series “Captain Underpants.” He loves writing and draw- ing pictures, especially of the two characters he’s created: “Mechanic Man” and “Fix It Boy”! When Nate isn’t playing video games or drawing, he is on the move, playing soccer and learning how to ride his new skateboard around town. Nate is very excit- ed to see his technology drawing in the newslet- ter…he enjoys drawing almost as much as playing the latest video game with his brother, Jay!14 Autism News of Orange County – RW Winter 2011
  15. 15. RESEARCHIntegrating Information Technology in Therapy and LifeBy Gondy Leroy, Juliette Gutierrez, HyeKyeung Seung & Gianluca De Leo Although ASD receives much attention in the The software mimics PECS use and is intention-media, there is little practical support available to ally very simple so that it can become a steppingfacilitate everyday activities and encourage integra- stone to other software applications and to mobiletion into the community. Existing research projects phones. Similar to PixTalk are Grace apps,and associated funding sources focus chiefly on dis- Look2Learn and other AAC applications in thatcovering genetic causes or evaluating the impact of they facilitate communication using images. Theydrugs, genetics and nutrients. Although these are differ from PixTalk since they use the Apple iPhone,extremely valuable projects, finding a cure is proba- iPod touch and iPad platforms. In addition, PixTalkbly still years away. Parents and children need help allows data tracking and is intended for use by clin-now. Furthermore, most of the existing technology icians who want to systematically review the ongo-interventions are intended for high functioning or ing learning process of multiple children.older children. There is a dearth of support for the Early evaluations showed that PixTalk can be ayoung children and those with severe autism. We digital communication enabler. So far, five caseaim to address this gap by focusing on an immediate studies have been conducted with teachers and ther-technological solution for these children. apists in Southern California and in North Autism is a devastating diagnosis. It is something Carolina. The studies showed how children who arenobody is ready for. Caring for children with autism able to use PECS are also able to use PixTalk whencan be overwhelming and sometimes frustrating. This taught by the teacher. In other cases, where a childis what a group of information technologists is learning did not yet communicate, the teacher adaptedas they work with parents and teachers on better infor- PixTalk to be used as a choice board. Figure 2 showsmation technology for children with autism. Gondy a sentence that was displayed by a child whileLeroy (Claremont Graduate University) and Gianluca PixTalk was being used in his public school class-De Leo (Old Dominion University) developed PixTalk, room. The device was kept in the classroom or wassoftware for communicating for use on mobile devices worn by the teacher and anytime the child wanted(see Figure 1). PixTalk’s development was funded by to use it, he could get it from the teacher. PixTalkMicrosoft Research and it is available free of charge usage data was collected every time the child usedat More than 400 the device.images can be downloaded free of charge and free of water thank you morecopyright from the website. PixTalk can be used in asimilar fashion as a paper-based Picture ExchangeCommunication Systems (PECS) but it eliminates the Cookies pretzelsneed to print, cut, or laminate. Children choose images Figure 2: Sentence displayed by child using PixTalkby touching them on the mobile device. Sentences canbe built, which convey a message (Figure 1a & 1b). Gondy Leroy (Claremont Graduate University) together with HyeKyeung Seung (California State University at Fullerton) and two graduate students, Juliette Gutierrez and Shannon Schow, are evaluat- ing how such mobile devices can be integrated in therapy and everyday life. Dr. Seung leads autismFigure 1a: Operational mode. Figure 1b: Display mode. research with young children who are non-verbal orSelection of image/images Visualization of image of sentences produce few functional words.Figure 1: PixTalk used to Communicate MessagesWinter 2011 Autism News of Orange County – RW 15
  16. 16. RESEARCH The potential advantages of using a digital Uploading and downloading files, cropping orcommunication approach such as PixTalk are enor- improving images, and synchronizing a computermous and diverse. For example, concrete images can with mobile devices are often new skills to bebe used, frequently changed and shared without the learned. Parents who are trying to cope with every-need for printing or laminating. In future it will be day demands often are overwhelmed by learning andpossible to systematically collect data from many training with PixTalk. Similarly, therapists andchildren. Based on these data therapists could fine- teachers often do not have the time to devote totune their intervention and test or develop alterna- learning new technology. And the device hardwaretive systems. The digital images used in PixTalk are itself also adds obstacles: keeping batteries chargedconcrete, but they could also be dynamic or adjust- and avoiding damage to mobile devices proved hard-ed automatically over time. A digital media provides er than options to therapy that are impossible with a Funding by the Allergan Foundation is bring-paper-based approach. And finally, an application ing the group closer to offering solutions. After asuch as PixTalk can be integrated with other local short pilot study with one mother and her daughter,approaches, such as the visual scheduling work by the group is now working with another parent andGillian Hayes at the University of California, Irvine her son and evaluating how the training and consis-(see article on pg. 30). tent use of a new device can Even though success has be best integrated in every- While the Picture Exchangebeen achieved in pilot stud- day life and in therapy. Theies, there are still obstacles to Communication Systems (PECS) is in computing skills required bybe conquered. The case wide use, there exists significant con- clinicians are being evaluat-studies show that limited troversy about its use in language ed and the lessons learnedtechnological knowledge learning. Linguists often have concerns are shared with new teacherprevents teachers, clinicians about the way this system is meant to credential programs, suchand parents from using scaffold language (see also page 30). as the new programPixTalk to its full potential. at Claremont Graduate University, or with those in charge of training the next genera- tion clinicians, such as at California State University, Fullerton. For further information please contact: Gondy Leroy Claremont Graduate University E-mail: WE STILL NEED YOUR SUPPORT Juliette Gutierrez Claremont Graduate University To continue our newsletter, we need your support. HyeKyeung Seung Please make a donation to our newsletter California State University, Fullerton so we can continue to spread the word in our community! E-mail: For more information, please visit us at: Gianluca De Leo or e-mail Old Dominion University16 Autism News of Orange County – RW Winter 2011
  17. 17. E D U C AT I O N / T H E R A P YEffectiveness of a Computer-Assisted Instructional Program forChildren with AutismBy Christina Whalen & Laura Lara-BradyComputer-Assisted Instruction (CAI) 1) Language Development; CAI refers to instruction or remediation on the com- 2) Social and Emotional Skills;puter to support therapies or education. Results show that 3) Adaptive Skills;CAI has great potential as an effective intervention for 4) Cognitive Skills;students with ASD supporting pre-academic and acade- 5) Language Arts; andmic skills, as well as acquisition of vocabulary or even 6) Mathematics.skills in Theory of Mind or Social Problem Solving Each domain has 5 levels: 1) Toddler; 2)Research on CAI is not new (e.g., Panyan, 1984), yet Preschool; 3) Pre-K; 4) Kindergarten and 5) Grade 1.there has been a surge of studies in the past decade Upon enrollment, the teacher completes a ranking(e.g., Bernard-Opitz, Sriram, & Nakhoda-Sapuan, questionnaire regarding the student’s current perfor-2001; Coleman-Martin, Wolff Hellar, Cihak, & mance that places each student at a starting rank (i.e.Irvine, 2005; Moore & Calvert, 2000; Swettenham, level) for each domain. The curriculum is then depen-2006; Williams, Wright, Callaghan, & Coughlan, dent on student performance and is adjusted for each2002). Some of this research indicates that CAI may student. Teachers can customize the curriculum tobe more effective than other methods in teaching cer- meet IEP goals, and to best suit the needs of each stu-tain skills to students with ASD such as vocabulary dent.and other language skills (e.g., Moore & Calvert,2000; Williams, et al, 2002). Furthermore, computer- ABA (Applied Behavior Analysis)ized techniques are showing promise in social under- Teaching Approachstanding (e.g., Sansosti & Powell-Smith, 2008; Silver The instructional methodologies in the& Oakes, 2001; Simpson, Langone, & Ayres, 2004), TeachTown: Basics program incorporate common tech-and there is evidence that information learned via CAI niques in ABA. Specifically, Discrete Trial instruc-can generalize to the natural environment(e.g., Bosseler & Massaro, 2003;Hetzroni & Shalem, 2005).A CAI Program Based on EffectiveInterventions TeachTown: Basics is a CAI programthat includes the following features:Curriculum The program includes a comprehen-sive curriculum that aligns to standard-ized measures (e.g., The Assessment ofBasic Language and Learning Skills-Revised–ABLLS-R, Partington, 2008)and state content standards (e.g.,California). The program was designed for students tion and Pivotal Response Training (PRT) are com-with Autism Spectrum Disorders (ASD) between the bined as follows: The program presents objectives indevelopmental ages of 2 and 7 years. The curriculum discrete tasks and guides learning through promptingincludes the following learning domains: and reinforcement (e.g., Lovaas, 1987). The studentWinter 2011 Autism News of Orange County – RW 17
  18. 18. E D U C AT I O N / T H E R A P Ychooses and starts a lesson by clicking on a building in images). Gradually introducing distracters at the stu-the town scene, which has lessons targeting the specif- dent’s pace maximizes learning and minimizes errorsic location (e.g., farm building, includes animals). that help the student discriminate stimuli (Perez-Child-choice keeps motivation and attention to task Gonzalez & Williams, 2002).high (e.g., Koegel, O’Dell, & Koegel, 1987). ReinforcementDepending on the student’s previous history with the Correct answers are reinforced on a variable ratiolesson, a pre-test, learning exercise, or post-test is pre- schedule with rewards available approximately every 4sented. Maintenance tasks are interspersed through- correct (or prompted) responses (VR-4). This inter-out the exercises and occur for 20% of the trials. These mittent schedule of reinforcement has been effectivetasks help the student preserve previously learned for keeping responses high, particularly on the com-skills and keep him motivated and on task (Koegel, et puter (e.g., Neef & Lutz, 2001). To access a rewardal, 1989). Each trial follows the discrete trial model (i.e. reinforcer), the student chooses from 6 options(Lovaas, 1987; Smith, Groen, & Wynn, 2000) where that include a variety of casual video games andthe discriminative stimulus is presented (i.e. the brief cartoons. The student can play or watch forinstructional cue requiring student response) by pre- only 10-20 seconds and then returns to the next trial.senting one or more images (e.g., a happy, sad, andangry face) with a vocal instruction (e.g., “Find the Automatic Data Collection and Reportingperson that is happy”). Next, the student responds by The program contains data tracking and report-selecting one of the images (e.g., clicks or touches ing to allow for student progress reports. Data is syn-[touch screen] the happy face). A correct response elic-its a positive statement (e.g., “You did it!”) followed bya brief (3 second) pause between trials, and the nexttrial is presented. An incorrect response elicits an iso-lated lingering correct answer. Due to earlier findings,negative feedback is not included because of rein-forcement potential. Students in the pilot phaseseemed to choose the incorrect images deliberatelyand repeatedly to hear the “negative” feedback (e.g.,“Try again”). For pre and post-tests, 25 trials are pre-sented including 4 different concepts (e.g., happy, sad,angry, confused). For learning trials, 15 trials are pre-sented (with 3 maintenance trials) targeting at least 2concepts (e.g., happy and sad). The standard masterycriterion is 80% correct (Lovaas, 1987; Smith, Groen, chronized using a hosted data server and encrypted& Wynn, 2000). The TeachTown: Basics program also Internet communication allowing student usage onrequires 80% correct. All responses are coded and pre- any computer. Such synchronization allows for con-sented graphically. sistent programming and allows for school adminis- trators to remotely track classrooms district-wide.Prompting Trial difficulty is controlled by within-stimulus Generalizationprompting which has been shown to result in better Studies have shown that motivating teaching tech-discrimination, generalization, and independence (i.e. niques can result in generalization (Koegel, Camarata,prompt fading) in 1:1 trials (Schreibman, 1975) and Valdez-Menchaca, & Koegel, 1998). Additionally,using the computer (Panyan, 1984). When necessary, research indicates that the use of multiple exemplars isa least to most prompting strategy is utilized, where critical (Stokes & Baer, 1977; Jahr, 2001; Reeve, Reeve,stimuli are introduced in a weak (i.e. faded images) Townsend, & Poulson, 2007), specifically varying theform and gradually strengthened (i.e. saturated instructions and stimuli can result in better acquisition,18 Autism News of Orange County – RW Winter 2011
  19. 19. E D U C AT I O N / T H E R A P Ymotivation, and generalization (Dunlap & Koegel,1980). In addition to providing a motivating platform Students made more spontaneousfor students, the program addresses generalization in comments, showed more positive affect,many ways. Concepts are taught through several teach- and more joint attention modules including receptive identification (e.g.,“Find the blue bird”) or identical and non-identical 105% increase in language and social behaviors onmatching (e.g., “Match the tiger” or “Match the color to the computer compared to a play condition with theirthe object”). Varied instructions (e.g., Trial 1 “Do you parent. Students also made more spontaneous com-see an airplane?”; Trial 2 “Which one is an airplane?”) ments (e.g., “Look, a rocket ship!”), showed moreand multiple exemplars (currently over 15,000 images positive affect, and more joint attention behaviorsand sounds) including photographs, drawn images, and (e.g., coordinated gaze). Inappropriate behaviorsanimation (e.g., actions), are presented throughout the decreased both on and off the computer (61%program. The stimuli in exercise trials are different from decrease on computer and 44% decrease in off-com-pre and post-tests to ensure concept learning rather than puter activities compared to baseline play activities).memorization. Generalization is also planned by teach- This study offered promising results for using theing several concepts at a time instead of a common mass program by means of parent implementation.trial teaching strategy. The program also includes off-computer activities that encourage the application ofcomputer learned skills, enhance understanding, andteach additional skills (e.g., communication, play, social,and motor skills).Off-Computer Activities Research indicates that structured teaching andnaturalistic approaches may positively affect a varietyof students (Bernard-Opitz, Ing, & Kong, 2004). Toprovide a program that is likely to benefit differentstudents, TeachTown: Basics includes a structured In a recent study, 47 preschool and K-1 students inapproach (the computer program) and a naturalistic ASD classrooms participated in a randomized efficacyapproach (the off-computer activities). All computer study in the Los Angeles Unified School Districtlessons are tied to off-computer activities. Although (LAUSD) (Whalen, et al, 2010). Students were random-PRT (Koegel, 1989) and other naturalistic approaches ized by classroom with the treatment group receiving the(e.g., McGee, Daly, & Jacobs, 1994; Rogers & intervention for 3 months while the control groupDawson, 2010) are the recommended instructional remained in baseline (their regular educational pro-methodology, the activities are written for caregivers gram). Teachers in the treatment group had students useand teachers. There are approximately 300 activities in the computer program for 20-minutes and do an off-the current manual that cover both learning domains computer activity for 20-minutes per school day.and developmental levels. Compared to the students in the control group, theResearch on TeachTown: Basics treatment group showed more improvement overall on In a parent implementation study, a multiple- language and cognitive-developmental measures. Inbaseline design (2-5 weeks) was used with eight stu- addition, students who used the program demonstrateddents (4 with ASD and 4 with Down Syndrome) significant gains on standardized measures compared tousing the program for 2 months (Whalen, et al., students who used the program less. These findings offer2006). Results showed a significant change from possibilities for improving early school-age skills for stu-pre to post-test scores (53% increase) for students dents with ASD in a classroom setting and offer hope forwho used the intervention. Collateral effects were a successful program that can be teacher implemented.observed where students with ASD demonstrated aWinter 2011 Autism News of Orange County – RW 19
  20. 20. E D U C AT I O N / T H E R A P YFor further information please contact: Christina Whalen, PhD, BCBA-D We are grateful for the Co-Founder and Chief Science Officer support of this newsletter by E-mail: the following organizations: Laura Lara-Brady, PhD Research Scientist E-mail: lbrady@teachtown.comDr. Whalen and Dr. Lara-Brady are full-time employeesof TeachTown, Inc. Dr. Whalen is also a shareholder inthe company.References • For the following references, please click here. Thank You Rita Eagle Kelly McKinnon & Assoc. For Your Support! Pacific Child & Family Assoc. Rick & Helen Park The following donations for ANOC Carol & Ralph Clayman have been received. We very much Recent Donations appreciate all the support! Valerie de Martino Supporter ($1,000-$2,999) David Monkarsh Christina McReynolds Announcements of Support REACT Foundation Pacific Child & Family Assoc. Contributor ($500-$999) Newport Language Speech Audio Center Vera Bernard-Opitz Kelly McKinnon & Assoc. Friend ($25-$499) Joseph DeCarlo, JD Property Management Janis White Helena Johnson & Alexander Gantman: David Monkarsh Peers Program Michael & Suzanne Pugsley Joe Donnelly: For OC Kids Joseph DeCarlo, JD Property Management Rethink Autism Newport Language Speech Audio Center Vizzle Christopher & Christine Soriano Autism Asperger Publishing Company (AAPC) Anonymous Job Announcement Stuart Krassner Toufic Jeiroudi Geeta Grover Your support is urgently needed to help Dr. William H. Murphey, III ANOC continue. Please visit our website at Wiltrud & Gotfried Luderer S.H. for more information. Annabel Chen Madyson Park Thank you!20 Autism News of Orange County – RW Winter 2011
  21. 21. E D U C AT I O N / T H E R A P YKeeping up with TechnologyBy Hiroka Yamada & Debbie Ferrante Stein Education Center is a nonpublic school in the more familiar,San Diego, which serves a wide range of students and considerablywith autism or significant communication deficits. more expensiveThe speech department, in conjunction with the AAC devices his-entire education team, has always searched for the torically availablemost efficient methods of facilitating communica- to the special edu-tion opportunities for the pre-verbal and significant- cation communi-ly unintelligible population. Low-tech methods, such ty, students needas picture communication, serve the needs of many to be able to “tog-students who mainly communicate to request. gle” betweenHowever, our population also includes many higher numerous “pages”functioning students whose verbal deficits will always to make this pro-curtail the spoken word as a modality for meeting gram an appropriate choice for communication facil-communication needs. Sign language is an important itation. The Proloquo2Go touch-screen format allowsadjunct for many students but is not readily under- the student to scroll through various pages to formu-stood by persons outside of the special education late statements. It should be noted that this scrollingcommunity and can prove to feature has proved to be a “differen-be problematic when formu- tial diagnostic element” for devicelating complex expressive selection, in that some students dooutput. Previously, appropri- not possess the fine motor controlate electronic augmentative needed to accurately scroll throughdevices, useful for the higher page options.functioning population, have In addition, Proloquo2Go pro-always been associated with a vides a default vocabulary set ofconsiderable price tag. For a over 7000 items, across a variety ofspecific sector of the current categories. One can adjust thespecial education population, vocabulary size by adding or delet-technology has recently closed ing the words applicable to eachthe gap between the need for student. Digital photos can becomplex augmentative com- added and interface features can bemunication formats and pro- altered (e.g., the number of itemsviding technology at an on a screen, item size, color, oraffordable price. voice output) in order to best The speech department accommodate the user’s ability.has recently explored the use In addition to the Proloquo2Goof “Proloquo2GO” as an program we also use several com-effective “picture to speech” augmentative program munication applications. Several parents at our centerfor higher functioning students. Proloquo2Go is an have applied current technology to their students in aAlternative Augmentative Communication (AAC) different format using their iPhone potential. Theseapplication for the iPod, iPhone, or iPad, which uses parents, in consult with school needs, have down-the Mayer-Johnson Boardmaker symbols. Just as with loaded photos of persons in their student’s environ-Winter 2011 Autism News of Orange County – RW 21
  22. 22. E D U C AT I O N / T H E R A P Yment as well as places that are fre- students this may be a “goodquently visited by their students idea” for a big birthday present.(e.g., doctor offices, stores). Theseimages are used as a digital sched- For further information pleaseule to help the student understand contact:what is going to occur in his or her Hiroka Yamadaday. An explanation of activities Stein Education Centerthat are about to occur can never E-mail: hyamada@vistahill.orgbe underestimated as a proactive Debbie Ferrantebehavioral strategy. E-mail: If already in possession of aniPod, iPhone, or iPad, one can * There is no affiliationpurchase this “app” for less than between the Stein Education$200. This device is extremely Center and the productsaffordable, as compared to the described in this article.other popular AAC devices,whose prices range from about$3000 to $7000. For some of our Kelly McKinnon & Associates is proud to support the Autism News of Orange County & the Rest of the World www.kellymckinnonassociates.com22 Autism News of Orange County – RW Winter 2011
  23. 23. E D U C AT I O N / T H E R A P YTouch2Learn ProgramBy Bill Thompson The Orange County Department of Education touch. The “exchange” becomes sharing pictures on(OCDE) Special Schools and Program Division the device instead of handing a picture icon to thecontinues to implement the Touch2Learn (T2L) communicative partner.program, which uses mobile devices to enhance In most instances, students carry their device inlearning, in its special education classes. a “fanny pack” or in Over the past several months, numerous publica- their pocket. Sometions, including The Wall Street Journal and the San students with ASDFrancisco Gate, have discussed how the Apple iPod appreciate the con-touch and iPad may improve education for students crete nature of thewith Autism Spectrum Disorders (ASD). These arti- device as well as itscles continue to support what has been observed at portability. The pre-OCDE over the past two years. dictability of the The Touch2Learn program at OCDE uses over drawings also appears60 iPod touch devices with students with multiple to benefit the largedisabilities. In addition, piloted programs are also number of caregiversbeing reviewed that implement the use of the iPad and educators in thefor instructional purposes. Based on preliminary student’s life. Theresults, these devices appear appropriate for several device may aid in cre-target areas. ating a uniform method of use, whichCommunicating with the iPod touch helps promote con- The most common teaching target is picture sistency and higherexchange method communication. Rather than learning.using paper-based drawings or photographs (i.e., pic- iConverse displays 6 different In addition to the icons that represent a person’sture icons) the pictures are formatted on the iPod increased educational basic needs. gains, staff and par- ents have reported social benefits. These benefits include other peers showing interest in what the stu- dent is doing. This social quality has also been observed in the community. Assessing behavioral data on the iPod touch Most recently, benefits associated with T2L have also been observed in areas beyond communication. In some pilot classes, behavioral data is collected on either an iPad or iPod touch. Many data applica- tions allow for easy methods of collecting informa- tion. Once collected, graphs and charts can be extracted which facilitates discerning behavioral pat-A student participating in OCDEs Touch2Learn project shows terns in students. Such information is essential foroff his iPod touch to communiciate. improving challenging behaviors.Winter 2011 Autism News of Orange County – RW 23
  24. 24. E D U C AT I O N / T H E R A P Y the number of autism-specific applications contin- ues to increase. For example, a recent search on iTunes for iPhone applications with the word “autism” yielded over 225 applications. Individualizing strategies While its benefits cannot be disputed, the Touch2Learn group has been quick to note that this strategy may not be recommended for all students. Some students show varying degrees of attending skills to the device. In addition, communicationLook2Learn allows 2 word sentences from devices and programs may require a number of cog-several categories nitive and behavioral prerequisites. The tendency may be to immediately use this “cool, sociallyOther applications for the iPod touch accepted” device; however, it simply may not be the While the educational benefit and interest in the best fit for the student at the moment. IEP teamsstudent has been paramount, staff has reported that throughout Orange County are continuing to exam-mobile devices have supplanted other resources in ine the appropriateness.ease of use and implementation. For example, rather While the results are preliminary, it’s clear thatthan carrying a large visual timer when out in the there have been numerous positive outcomes fromcommunity, staff can now use the iPod touch to the use of these mobile devices within the Orange show the student County Department of Education and the how much time is TOP TEN APPS in Touch2Learn Program. As these devices become remaining with a Touch2Learn more prevalent, the benefits appear to be far-reach- visual timer appli- • Behavior Tracker Pro ing, including greatly aiding students with Autism cation. The dif- • Stories2Learn Spectrum Disorders. ference in cost has • iEarned That also been noted as For further information, contact • Look2Learn visual timers can Bill Thompson • iConverse cost upwards of School Psychologist • iPrompts $40 while a com- Orange County Department of Education, • Answers: Yes No parable applica- Special Schools and Programs • Proloquo 2 Go tion on the iPod is E-mail: • iWrite Words typically less than • SoundingBoard $2. In addition, mobile devices aresubstantially cheaper than traditional “high end”Augmentative and Alternative Communication(AAC) devices. While mobile devices certainly have a “cool fac-tor,” perhaps their greatest asset is the ease withwhich these devices can be individualized. Somestudents may use it as a timer, some for communica-tion. Well-researched concepts such as “video mod-eling” now appear easier than ever to implement and24 Autism News of Orange County – RW Winter 2011