Vanessa A. Green

Using iPods(®) and iPads(®) in teaching programs for individuals with developmental disabilities: a systematic review.

We conducted a systematic review of studies that involved iPods(®), iPads(®), and related devices (e.g., iPhones(®)) in teaching programs for individuals with developmental disabilities. The search yielded 15 studies covering five domains: (a) academic, (b) communication, (c) employment, (d) leisure, and (e) transitioning across school settings. The 15 studies reported outcomes for 47 participants, who ranged from 4 to 27 years of age and had a diagnosis of autism spectrum disorder (ASD) and/or intellectual disability. Most studies involved the use of iPods(®) or iPads(®) and aimed to either (a) deliver instructional prompts via the iPod Touch(®) or iPad(®), or (b) teach the person to operate an iPod Touch(®) or iPad(®) to access preferred stimuli. The latter also included operating an iPod Touch(®) or an iPad(®) as a speech-generating device (SGD) to request preferred stimuli. The results of these 15 studies were largely positive, suggesting that iPods(®), iPod Touch(®), iPads(®), and related devices are viable technological aids for individuals with developmental disabilities.

Behavioral Intervention Promotes Successful Use of an iPod-Based Communication Device by an Adolescent With Autism:

Individuals with autism and limited speech are candidates for speech-generating devices (SGDs), but some individuals might experience difficulty in operating these devices. We describe the case of Steven, a 17-year-old adolescent with autism who used an iPod-based SGD, but had difficulty activating the speech output feature of this device. His difficulties were initially interpreted as motor control problems, suggesting the need to abandon this technology, prescribe a different SGD, or adapt his existing device. An alternative conceptualization was that the existing intervention procedures had failed to shape more effective response topographies. Along these lines, a behavioral intervention, involving differential reinforcement and delayed prompting, proved effective in shaping response topographies that enabled Steven to be more successful in activating the speech output function of his iPod-based SGD. The results suggest that behavioral intervention may provide an alternative to the more costly and involved process of replacing or modifying the person’s SGD.

Teaching Functional Use of an iPod-Based Speech-Generating Device to Individuals with Developmental Disabilities

Anecdotal reports suggest that individuals with developmental disabilities who lack speech may be enabled to communicate through the use of a new iPod-based communication device. However, there appear to be limited empirical data demonstrating successful use of this new device by such individuals. This study was designed to provide empirical evidence on acquisition and functional use of an iPod-based communication device. Three individuals with developmental disabilities participated in baseline, acquisition-training, post-training, and follow-up phases that were staggered in a multiple-probe across participants design. Acquisition-training focused on teaching participants to request snacks, or snacks and toys, by selecting graphic symbols on an iPod Touch® with Proloquo2Go™ software. Graduated guidance, time delay, and differential reinforcement procedures were successful in teaching functional use of the iPod-based system to two of the three participants. These preliminary results support the use of this new iPod-based communication system for some individuals with developmental disabilities.

A Comparison of Picture Exchange and Speech-Generating Devices: Acquisition, Preference, and Effects on Social Interaction

Augmentative and alternative communication (AAC) includes picture exchange (PE) and speech-generating devices (SGD), but these two systems have rarely been compared. We therefore conducted three studies comparing PE and SGD for an adolescent boy with a developmental disability. Study 1 compared acquisition of a PE- and SGD-based requesting response and monitored the effects on social interaction. For Study 2, both communication modes were made simultaneously available and the child could choose to use either PE or the SGD. For Study 3, only PE intervention continued, with the distance between the child and trainer systematically increased to prompt social interaction. The results showed equally rapid acquisition of the PE- and SGD-based requesting response, but only the distancing manipulation had any positive effect on social interaction. We conclude that PE and SGD are equally viable modes of communication, but acquisition of an initial PE- or SGD-based requesting response may not be sufficient to promote social interaction.

Assessing Behavioral Flexibility in Individuals With Developmental Disabilities

Researchers associate an insistence on sameness or lack of behavioral flexibility With autism and Asperger syndrome, but feW studies have sought to identify specific situations in Which individuals insist on sameness. Along these lines, We developed the Behavioral Flexibility Rating Scale (BFRS) and conducted an Internet survey of parents of individuals With autism, Asperger syndrome, and DoWn syndrome. A total of 726 respondents submitted usable returns during the 3-month survey period. Parent report indicated that individuals With Asperger syndrome shoWed the most problems in relation to the insistence on sameness as measured by the BFRS, folloWed by individuals With autism and DoWn syndrome, respectively. When diagnosis Was controlled, there Were no gender or age differences. This preliminary investigation suggests that the BFRS may be useful in identifying specific situations associated With an insistence on sameness. Identifying specific situations in Which individuals insist on sameness or shoW a lack of behavioral flexibility may be useful in planning interventions focused on promoting greater behavioral flexibility.

Communication in Individuals with Rett Syndrome: an Assessment of Forms and Functions

In the present study we assessed the forms and functions of prelinguistic communicative behaviors for 120 children and adults with Rett syndrome using the Inventory of Potential Communicative Acts (IPCA) (Sigafoos et al. Communication Disorders Quarterly 21:77–86, 2000a). Informants completed the IPCA and the results were analysed to provide a systematic inventory and objective description of the communicative forms and functions present in each individual’s repertoire. Results show that respondents reported a wide variety of communicative forms and functions. By far most girls used prelinguistic communicative behaviors of which eye contact/gazing was the most common form. The most often endorsed communicative functions were social convention, commenting, answering, requesting and choice-making. Problematic topographies (e.g., self-injury, screaming, non-compliance) were being used for communicative purposes in 10 to 41% of the sample. Exploratory analyses revealed that several communicative forms and functions were related to living environment, presence/absence of epilepsy, and age. That is, higher percentages of girls who showed some forms/functions were found in those who lived at home, who had no epilepsy and who were relatively young.

Issues in the use of visual supports to promote communication in individuals with autism spectrum disorder

Purpose. Visual supports are widely used and generally regarded as an effective resource for intervention with individuals who function on the autism spectrum. More cross-contextual research into their efficacy is required. Method and outcomes. In this article, we selectively review the research literature around visual supports based on an original conceptual model that highlights their contribution in the interpersonal social and communicative milieu of classrooms, homes and other daily living contexts. Attention is drawn to a range of practical and research issues and challenges in the use of visual supports as well as evidence of their effectiveness in enhancing participation, learning and social membership in this population. Conclusions. Areas for further research relating to the introduction and use of visual supports with the autism spectrum disorder population are identified.

Teaching multi-step requesting and social communication to two children with autism spectrum disorders with three AAC options.

Abstract The present study involved comparing the acquisition of multi-step requesting and social communication across three AAC options: manual signing (MS), picture exchange (PE), and speech-generating devices (SGDs). Preference for each option was also assessed. The participants were two children with autism spectrum disorders (ASD) who had previously been taught to use each option to request preferred items. Intervention was implemented in an alternating-treatments design. During baseline, participants demonstrated low levels of correct communicative responding. With intervention, both participants learned the target responses (two- and three-step requesting responses, greetings, answering questions, and social etiquette responses) to varying levels of proficiency with each communication option. One participant demonstrated a preference for using the SGD and the other preferred PE. The importance of examining preferences for using one AAC option over others is discussed.

Transferring AAC intervention to the home.

Purpose: To evaluate the acquisition of AAC skills during an initial clinical trial and assess subsequent transfer of the training to the home setting. Method: A 12-year-old male with autism was first seen in a clinical setting to establish the use of a voice-output communication device. After learning to use the device to request access to preferred objects in the clinical trial, the intervention was transferred to the home. Follow-up with the parent was conducted via e-mail and telephone. Videotapes were made of initial home-based sessions to enable evaluation of the participants progress. Results: The programme was successful in teaching the participant to use a portable AAC device to make requests during the clinical trial and then in two home-based activities. Conclusion: An initial clinical trial with follow-up support for parents may be an efficient method for beginning AAC intervention and transferring the training procedures to the home setting.

Behavioural flexibility in individuals with Angelman syndrome, Down syndrome, non-specific intellectual disability and Autism spectrum disorder

BACKGROUND Little is known about behavioural flexibility in children and adults with Angelman syndrome and whether people with this syndrome have more or less problems in being behaviourally flexible as compared with other people. METHOD Behavioural flexibility scores were assessed in 129 individuals with Angelman syndrome using 11 items from the Behavioural Flexibility Rating Scale-Revised (Green et al. 2007). Level of behavioural flexibility scores in individuals with Angelman syndrome (N = 129) was compared with that of people with non-specific intellectual disability (ID) (N = 90), Down syndrome (N = 398) and Autism spectrum disorder (N = 235). RESULTS Comparative analyses show that individuals with Angelman syndrome were more flexible than those with non-specific ID (P < 0.001) and those with Autism spectrum disorder (P < 0.01). There were no differences in behavioural flexibility scores between individuals with Angelman syndrome and those with Down syndrome (P = 0.94). CONCLUSION It is concluded that individuals with Angelman syndrome are comparatively flexible in their behaviour.