For years, different methods of technology have been used to improve the quality of life of people who have various developmental disabilities. However, the varied use of technology for children with autism continues to receive limited attention, despite the fact that technology tends to be a high interest area for many of these children.

This article will discuss how various styles of technology (including technology designed as augmentative communication systems), can be used for children with autism to increase or improve their:

•           Overall understanding of their environment;
•           Expressive communication skills;
•           Social interaction skills;
•           Attention skills;
•           Motivation skills;
•           Organization skills;
•           Academic skills;
•           Self help skills;
•           Overall independent daily functioning skills.

What is Assistive Technology?

According to the Technology-Related Assistance for Individuals with Disabilities Act of 1988 (Public Law 100-407), an assistive technology means any item, piece of equipment, or product system, whether acquired commercially, off-the-shelf, modified or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities. Assistive technology service is any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device.

Typically, children with autism process visual information easier than auditory information. When assistive technology devices are used with these children, it’s giving them information through their strongest processing area (visual). Therefore various types of technology from "low" tech to "high" tech should be incorporated into every aspect of daily living in order to improve the functional capabilities of children with autism.

Visual Representation Systems

It is important to determine which visual representation system is best understood by the child, and in what contexts. Various visual systems, such as objects, photographs, realistic drawings, line drawings, and written words, can be used with assorted modes of technology, as long as the child can readily comprehend the visual representation.

Some children may need different visual representation systems in different situations. This may be dependent upon numerous factors, such as the skill being taught, as well as the unique characteristics of autism: attending, organization, distractibility, etc.

Augmentative Communication Devices

Augmentative communication devices are typically divided into several categories, “no tech,” “low tech,” and “high tech”. It is critical to understand that each category is not exclusive, and a child who uses augmentative ommunication relies on, and should use, a variety of strategies to communicate.

No Tech is the use of natural communication. These strategies include gesturing, eye gaze, and sign language. This communication is usually specific to the child and may require a familiar person such as a caregiver to “interpret” what is being communicated. Working closely with a speech-language pathologist can help caregivers identify what methods the child is currently using and/or can be enhanced.

Low Tech is the use of external materials such as pointing to pictures or the use of digitized speech output systems. High Tech is the use of sophisticated computer-based devices that have a variety of capabilities. They typically use synthesized speech (computer generated) and have an extensive amount of memory. They can also be used to draw and can be programmed to control things in the environment such as turning on the TV, the lights, or access the computer.

Low Tech AAC Devices

One type of low-tech AAC is a communication board. Communication boards can have familiar photographs of people and objects, line drawings, picture symbols, letters, numbers, and/or words pasted or printed on them. These “boards” may look like books, folders, cards, wallets, or lap trays. A child can access these communication boards by touching the pictures with a finger, looking at them with their eyes, or using a pointer stick.

Low tech AAC also encompasses simple speech output systems or VOCAs (Voice Output Communication Aids). With a VOCA, the child makes a choice, usually by pushing a button or a picture on a special keyboard and the device speaks the choice. The child’s language ability can be matched easily by recording simple word combinations. For example, a child can push the button with the picture of an apple on it to have the device say, “Food, please,” or a more complex phrase such as, “Want more food, please.”

Low Tech AAC devices typically use digitized speech which is recorded human speech (like a tape recorder). Digitized speech is very understandable to those who are not familiar with the child. Low-tech systems are easily programmable (usually set by holding a record button). They allow anywhere from 10 seconds to 60 minutes or more of recorded speech depending on the memory of the device and are typically used only for communication.

They use pictures, symbols, letters or words (that can be added or removed) on their "keyboards" to represent spoken messages. "Symbols" or “icons” can represent often-used phrases like, "I want more." or "Help please!" Or they can represent single words like yes, no, he, she, want, get, etc. which the child can combine to make a variety of sentences.

Some common low tech digitized speech systems include single message devices like the BigMac and One Step from Ablenet, and multi message devices such as the Tech/Four, Tech/Talk, and Tech/Scan (AMDi), Easy Talk (Sym Systems), and the Chatbox (Saltillo). These devices can range from $100 to $1,500.

High Tech AAC Devices

Like low-tech devices, high tech AAC devices can be activated by using a pointer stick, a body part, eye gaze or by more advanced methods like using a light-pointing device (infrared). These devices can also be accessed by scanning (moving through choices automatically and sequentially). With scanning, the child hits a switch (a button) to start moving through choices and hits the switch again to select what he/she wants to say. There are a variety of scanning options available. A team evaluation will help determine the most appropriate method.

High tech devices can generate speech by using word-by-word production, or phrases and sentences. These devices typically use synthesized speech which is computer speech that says what the child selects. Synthesized speech can be more difficult to understand than digitized speech to an unfamiliar listener, but current advances are being made to make this speech clearer.

Some common high tech AAC devices include: the DynaMyte, and DynaVox (Sentient Systems); the AlphaTalker (Digital), DeltaTalker, Pathfinder, Vanguard and Vantage (Prentke-Romich); the Parrot and the McCaw (Zygo); System 2000 and Message Mate (Words+); and Speak Easy (AbleNet). With specific software, personal computers (Windows or Macintosh) can also be used as voice output AAC devices. Examples include: Intellikeys/Intellitalk (IntelliTools), Key Largo and Talk: About (Don Johnston, Inc.); Speaking Dynamically (Mayer-Johnson); KeyREP (Prenke-Romich), Talking Screen and EZ Keys (Words+), and GUS (GUS Communications, Inc.)

Most often these products can be set up for pointing directly to choices or scanning. If scanning is needed, some means for plugging in a switch (an interface) is required. High tech AAC systems can range from $1,500 to $9,000 or more.

ACC Evolution

For any caregiver who is considering the use of augmentative communication for their child, the first step is to get a complete team evaluation. The team members include, first and foremost, the child and family including siblings, a favorite cousin, aunts and uncles, grandparents, or anyone else important in the child’s life. In addition, the team can consist of some or all of the following specialists: speech-language pathologist, occupational therapist, physical therapist, audiologist, physician, rehabilitation engineer, social worker, teacher, and psychologist. It’s important to note that in some settings, product vendors are present to set up or demonstrate the device. However, take into consideration that some vendors may not make the most appropriate recommendations given their interest in selling their product. During the evaluation, the team examines the strengths and abilities of the child including physical, language, social, and pre academic skills. Once all information is gathered, the team discusses feasible options, and based on the preferences and characteristics of the child, selects the method(s) and/or device that is most appropriate.

Written by Susan Stokes under a contract with CESA 7 and funded by a discretionary grant from the Wisconsin Department of
Public Instruction. http://www.uchsc.edu/atp/