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One of the most well known methods for working with students who are non-verbal is the Picture Exchange Communication System, or PECS.  According to the PECS website, “PECS was developed in 1985 as a unique augmentative/alternative communication intervention package for individuals with autism spectrum disorder and related developmental disabilities.”  As the name suggest, PECS begins by having students exchange pictures to request a desired item from a communication partner.

Recently a meta-analysis was conducted by Flippin, Reszka and Watson (see full citation below) to examine the effectiveness of PECS for students with autism spectrum disorders.  Overall they found that “ Results indicated that PECS is a promising but not yet established evidence-based intervention for facilitating communication in children with ASD ages 1–11 years.”  Specifically, here are a few things I took away from the article:

• The publication mentions several reports that suggest that PECS has increased functional communication in students with ASD in a relatively short time period.  While this is good to note, the article makes the point that while positive, these reports lack evidence.
• There are enough articles mentioned throughout the publication that will keep any researcher busy for some time, but the most common outcome from referenced studies was the success in increasing students’ ability to request items.  While this is far from what one would  consider to be proficient communication skills, it is never the less a positive result that data clearly indicates is capable with PECS.
• Some studies referenced did demonstrate an increase in communication.  Some of these were said to have treatment fidelity (meaning that it was clearly demonstrated that PECS was implemented correctly) while others did not.
• Data is limited for the maintenance phase (ability to continue effectively using PECS after training) and the generalization phase (using PECS effectively in other settings).

Anyone using PECS or working with students with ASD and communication delays should read this article.  It is titled “Effectiveness of the Picture Exchange Communication System (PECS) on Communication and Speech for Children With Autism Spectrum Disorders: A Meta-Analysis” by Flippin, Reszka and Watson in the American Journal of Speech-Language Pathology, May 2010.

It is important that classroom teachers as well as AT specialists and other related service providers are familiar with what the research says.  While this article demonstrates the effectiveness of PECS for requesting items, it gives concern for having expectations past this, or for assuming that a student will maintain progress once training stops.

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I’m really in to data based decision making.  I know this term gets thrown around quite a bit, but I think it’s importance is often overlooked, especially when we get into the AAC field.  Let me start with an example that involves communication, just the wrong kind.

A colleague of mine is a behavior consultant.  He gets called in on some cases you wouldn’t believe.  One interesting case he shared with me concerned a young student who spell curses.  Without getting into the details of how this all got started, I want to focus on what happened after my colleague visited the classroom.  Keep in mind that this student was probably spell cursing over 50 times a day.  My colleague observed the classroom and made a few recommendations and followed up a few weeks later.

Now, here’s where the data collection piece comes in.  If you are being cursed at (spelling or otherwise) 50 times a day every day and the student reduces their cursing to 40 times a day you are not going to notice the difference.  However, if this occurs after implementing a new strategy for a few days, this is actually huge difference!  Basically, in less than a week’s time, you were able to reduce the negative behavior by 20%.  Just think of what could happen over a few weeks of implementing this and other strategies.  Unfortunately, if you are like most of us, you would not have collected data on every curse word thrown at you every day, so you would not have noticed the 20% reduction, therefore causing you to believe the strategy was worthless and abandoning it.

Let’s carry this example back to the world of AAC.  Many times I see an AAC device purchased or borrowed and simply sat in front of student waiting for it to magically increase communication for the student.  Unfortunately, it doesn’t work this way.  Strategies must be used with the student using the device just like reading strategies are used with students learning to read.  So how do we know if the device is going to work?  You guessed it… with data!

If you thought the example above was tough to collect data on, imagine collecting data on a student who has over 300 opportunities to respond in any given day.  I’m not saying it is easy, but we have to figure out a way to collect data to determine if a device is increasing the student’s ability to independently respond when an opportunity arises.  One easy way to start this process is with rubber bands.  Put a bunch around your wrist and before introducing a new strategy or device, throw one of the bands in a jar every time the student independently responds.  Do this for a week, then repeat after a device and/or strategy is introduced.  If the jar started after the AAC was introduced has more bands, improvement has been made.  Train all of those working with the student to collect data as well so you have a more accurate picture of how the device or strategy is working throughout the day.

In addition to tracking the number of independent vs. prompt dependent communication attempts, you may also consider tracking the amount of time it takes a student to respond after a prompt is given.  In this case, the shorter the time the better.

As the title suggests, this short post is on the importance of collecting data.  There is much more to successful AAC implementation than just collecting data however.  I’ll throw out some ideas on how to make the process easier soon.

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I’ve been saying for sometime now that the iPad and iPod Touch may fix many of the problems with Augmentative and Alternative Communication (AAC) device abandonment we see so much in schools.  I mean let’s be honest, even though some devices cost upwards of $5,000, kids do not want to carry these dedicated communication devices everywhere they go.  Sure they can be used for other things like turning a TV or the lights on, but they just don’t have the “cool” factor that some of the Apple devices have.  With an iPad or iPod Touch, not only can students access communication applications, but they can also access games, the internet and thousands of apps that could be useful.  And at a fraction of the cost ($499 for an iPad, $199 for an iPod Touch, plus under $200 for a pretty good communication app).

There are differences among devices however, and I really liked this post on the ATMac blog discussing some information provided by RJ Cooper.  In the end, I think that if a student has the physical and cognitive ability to use a high tech dynamic display device that systems similar to the iPad are the future.  Don’t get me wrong, we still have a ways to go with helping educators be able to integrate these devices in all settings, but that’s always going to be an issue.  There’s also the issue of these devices currently being designed for business users instead of emerging student communicators.  Because of this, don’t expect an iPad to work for every student who needs a high tech communication device.  But do expect similar devices that function better for students with fine motor and other disabilities to be coming soon.

And last but not least, keep in mind that you will probably need to find a way to attach speakers if you plan to use an iPad or iPod touch in situations with background noise.  I know iMango sells some for the iPod Touch that I like, and RJ Cooper has rigged something up for the iPad, but I have yet to find a good case that includes speakers for the iPad.  Please pass along a link if you know where one can be found.

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Ran across this post on an AT blog from the Virginia Department of Education about iPad orientation locking.  iPads are becoming more and more popular in the classroom setting.  However, I see some students struggle when it comes to holding them.  If tilted just a little too much in one direction or the other, the orientation changes (this is super frustrating if you have ever tried using one while laying down).   To change this setting, simply flip the screen orientation lock switch on the side of the device by the volume button see image below (from tothepc.com).

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I’ve been on the road quite a bit this week and last, so not much time for posts.  I did run across a set of speakers for the iPhone or iPod touch however that I think will work great with the Proloquo2Go software I highlighted last week.

iMainGo

The speakers pictured to the left are from iMainGo.  They fit snugly around your iPhone or iPod touch, which not only looks  nice, but gives your device some extra protection as well.

I havent’ personally used the speakers, but the reviews I’ve seen are excellent.  This will give your device the extra volume it needs to become a very legitimate communication device.

I’m sure there are more options out there, so be sure to send me an email or comment if you have recommendations.

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If you haven’t already heard, there is an App in the apple application store for iPhone and iPod Touches that can turn your iPod into an Augmentative and Alternative Communication (AAC) device.  If you’re not familiar with AAC devices, they help people who are unable to speak communicate with others… they give you a voice.  The app is called Proloquo2Go and is priced at $199, but can currently be purchased for $149.  This may sound expensive for an application, but considering the alternative is a $1,200 – $8,000 device, I consider the price very reasonable.

Porloquo2Go.com

In addition to the low price, there are a few other things I like:

• Unlike some software, it comes with some standard vocabulary that makes it usable as soon as it is downloaded.
• You can add new messages at any time.  This includes symbols, or just snap a picture with your iPhone or iPod touch and make a custom button
• You can type a message at any time and have it read aloud
• There is a button that allows you to re-read something you said 15 minutes, 30 minutes, an hour, or longer ago instead of having to re-type the message.
• You can put beginner to advanced vocabulary sets and change the size of the symbols (which of course will cause less symbols to be displayed on the screen).

The only thing I am not to excited about is the volume.  This has nothing to do with the software itself, but if you are in a crowded area there’s not much of a chance that your communication partner will hear you (you could always show them what you are saying I suppose).  I know there are external speakers you can buy for the iPhone, but not sure if there are any that are portable enough to stay connected to the iPhone with a power source for long period of time.  If they do not exist yet, I imagine someone will be coming out with them soon.

A final thing I would like to note is that this could be the tool to end much of the abandonment of AAC devices we see all to often.  There aren’t too many non-verbal students that get excited about carrying around an AAC device everywhere they go.  Even if it is a smaller device, it is still different.  This changes everything however.  I can pick up an iPod touch for under $200 on ebay ($229 new for the 8GB version from Apple) and be using the same device to communicate that others are using for a variety of purposes.

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I had an opportunity to take a look at a new communication device at the Assistive Technology Industry Association (ATIA) Conference in January.  It is called the ProxTalker and is a bit different from other devices on the market.

As you can see, the ProxTalker’s design is one that fits in well with students who use systems such as PECS (picture exchange communication system).  Meaning that the pictures can actually be taken off the device and used as a low tech communication system, an exchange system or for an activity.  I think this is great because most students begin using symbols and symbol activities at an early age with programs like Boardmaker.   This system just provides students a gateway to move to a more advanced system without a major shift in ability.

The basics on how ProxTalker works is simple.  You just purchase the device and it comes with a hundred or so plastic “sound tags” that are used as the communication aides.  Here’s what the website has to say:

Each Sound Tag is encoded with a unique radio frequency identification code. When the Sound tag is place on the zone button and pressed, the ProxTalker detects the tag and then it speaks the word associated with the it. There are five word zone buttons so a complete sentence can be formed. Sound Tags are included with the device and are also available to add to a system. Specially designed binders and accessories are available for added convenience. Multiple real human voices and multiple languages are available. There is no programming involved.

I have been looking for a device that goes beyond the GoTalk and CheapTalk types of mid-tech devices, but are simpler than the dynamic display devices for some time.  In my short time experimenting with this device, it seems to fit the bill.