Strategies to Engage Infants & Toddlers Using SwitchesNancy Bolden,Assistive Technology SpecialistNorth Central A.T. Access Site
ATK: MISSION Increase awareness and knowledge of
Assistive Technology (A.T.) devices and services for people of all ages and disabilities
Help people of all ages and disabilities acquire the devices they need for education, employment, living in their home, and participating in the community
DEVICE LOAN ATK Device Loan
System has an inventory of devices appropriate for infants, toddlers, and young children with disabilities
Convaid Carrot – reclining car seat
Zipzac I (possibly II also)
ATK Services Acquisition of needed devices and
services through: Refurbishing donated, lightly used durable
medical equipment to give to Kansans with disabilities and health conditions
Reviewing possible funding options (public and private), determining eligibility, and assembling needed funding justifications
KEE is funded by KS Medicaid to provide refurbished lightly used DME
ATK accepts other lightly used devices for reuse although lacks refurbishing funds
Otter Bath Chair
Pediatric Commode
Dreamer Stroller
KEE: Device Reuse
How to Fund Assistive Technology
Acquisition of needed A.T. devices and services is the priority
Options vary depending on the device or service needed Medicaid – EPSDT Private insurance Private funds/charitable supports Part C funds Part B funds (during transition) Financial loan programs
Other Assistive Technology Services
Call 800 – KAN DO IT (800-526-3648) to request a device demonstration, borrow a device, get a refurbished device, get help funding a device, request product information, learn how to use a device, or request help in conducting an A.T. assessment
What is Assistive Technology?
Any item that helps a child actively participate in an activity or supports their ability to learn in their daily routines across natural environments.
IDEA 2004: "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 a child with a disability. Exception. - The term does not include a medical device that is surgically implanted, or the replacement of such device.” (§ 602(1)).
"any service that directly assists a child with a disability in the selection, acquisition, or use of an assistive technology device." (§ 602(2))
Types of Assistive Technology Devices SELF HELP: weighted
or curved spoons, dressing tools
HEARING: items that amplify sound, hearing aids, ear protection
MOTOR: built up grips on colors, dycem, switches, trays/slant boards
LEARNING: built in switch toys, e-books & apps, raised pages in a book
Ear Bandit
Adapted Book
Crayon Rocks
Types of Assistive Technology Devices
MOBILITY: adapted strollers, walkers, ride-on toys, wheelchairs
POSITIONING: corner chairs, positioning harness, pillows
VISION: Magnifiers, color contrast/textured items
Embrace seating system
Boost magnifier
Types of Assistive Technology Devices
COMPUTER ACCESS: digital tablets, switches, adapted keyboards
ENVIRONMENTAL ACCESS: ramps, remote controls, van lifts
COMMUNICATION: picture boards, single message devices, electronic communication devices
New Blue 2 for iPad
Step by Step Communicator
HOW TO DETERMINE IF Assistive Technology IS NEEDED
A comprehensive assessment is typically an ongoing process that involves input from key people including the family, caregivers, Request support from ATK on possible solutions Examine daily routine – think least intrusive
(environment, how child does it himself, how child partially participates – assist by peer, sibling, then adult)
Trial use of devices and evaluate its effectiveness ATK Device Loan System Local or national vendors
DOCUMENTING Assistive Technology ON THE IFSP A.T. can be on a separate sheet of an IFSP or
it can be embedded in existing components of the IFSP Present level of development: child currently
uses picture symbols to communicate words and phrases
Family priorities/concerns: parents want child to sit at dinner table with family (different chair? adapted seating system?)
Measurable outcomes: Child will read books before bed with his sister and participate by turning pages of cardboard books with page fluffers.
WHAT DOES Assistive Technology LOOK LIKE ON THE IFSP
Outcome examples across areas of development and learning will be provided
Implementation – quality standards Frequency & length appear adequate for child
and family’s needs Outcomes need to be functional, specific, in
family friendly language and reflecting their priorities
WHAT DO Assistive Technology SERVICES LOOK LIKE
A.T. is not the goal – how do we know it works? Is it being used? Is it still needed? Is it helping child learn, be more
independent? What are the family’s concerns,
comments?
EXAMPLES OF ASSISTIVE TECHNOLOGY
The appropriate A.T. solution is often the simplest one. Rearrange the environment – move an activity to a
table so the child can be seated and have better use of his hands
Material selection – use building blocks on a play mat with better color contrast so the child can see the individual blocks
Is more support is still needed? Try to find the one that lets the child participate independently. Peer and adult help is the next option.
LEGAL RIGHTS & RESPONSIBILITIES
A.T. must be provided in natural environments to meet a child’s needs (34CFR§ 303.13(a)(8)).
A.T. needs must be addressed during transition planning conference (34CFR §303.209(c)) and be included on the IEP.
A.T. services (assessment, recommendations, teaching use and maintenance) should be conducted by qualified professionals with active involvement by the family. Family members have unique information about
the child’s strengths and abilities, interests, daily routines, environments, and family priorities.
A.T. needs to meet the needs of child and family.
Why we teach switch use to young children with disabilities:To help a child understand that they are
able to extend influence and control over their immediate environment
As a foundation for future learningFor children with severe physical
disabilities, as a way to interact with the world (may be their only access method)
Assistive technology for young children: Evidence-based practice
o Campbell, P., Milbourne, S., Dugan, L., & Wilcox, M. J (2006). A Review of Evidence on Practices for Teaching Young Children to Use Assistive Technology Devices, Topics in Early Childhood Special Education, 26(1), 3-13.
o Reviewed articles about assistive technology published between 1980 and 2004 focusing on children birth through 6 years of age
o The largest number of empirical articles were published more than 15 years ago
o 12 studies focused on teaching switch activation use to young children with disabilities
o Strong evidence that children younger than a year old with disabilities may be successfully taught to operate switches to activate toys
o Light, J. (1993). Teaching automatic linear scanning for computer access: A case study of a preschooler with severe physical and communication disabilities. Journal of Special Education Technology, 12, 125-134.
o A single case study of an instructional protocol to teach automatic linear scanning for computer access to a child with severe communication and physical disabilities (cerebral palsy). The child was successful in learning to scan using the experimental protocol.
o Several empirical studies have been published investigating the instruction of single and two-switch scanning in older children with physical disabilities.
Assistive technology for young children: Evidence-based practice
How I Know My Child Can Use a Switch To Make Things Happen:
I have identified a reliable, repeatable and consistent movement that my child uses to activate their switch
I know what position works best for my child’s body and for their switch
My child is pro-active and engaged in what is happening when the switch is activated
Resources for Beginning Switch Users
The child’s physical and occupational therapists Switch Progression Road Map by Inclusive
Technologies (free) www.inclusive.co.uk/articles/switch-progression-road-map
Utilizing Switch Interfaces with Children who are Severely Physically Challenged (Goossens’ and Crain, 1992)
Different kinds of switches and switch mounts available from Assistive Technology for Kansans equipment loan library (785-827-9383)
Different Ways to Use a Single Switch
Press and hold (direct) Press and let go (timer) Press it again (switch
building, sequencing) Turn things on and off
(latched)
Switch Latch and Timerfor Battery Operated Items
Switches with Built In Latch and Timed Features
Powerlink Switch Interfacefor Electric Items
When Wires Are a Problem
Ablenet Jelly Beamer Switch
Adding Speech Output toSwitch Activation
Plug that extra little wire into the toy/appliance jack . . .
Strategies for Extending Single Switch Use After the Child Has Learned Cause/Effect:
Activate many things across the day 60 Things to do with a Switch and a Battery
Interrupter (Kate Ahern) Ideas on How to Use the PowerLink at Home
and at School (Northcott) Use familiar adapted toys in new ways
25 Things to Do with a Switch Activated Pouring Cup (Kate Ahern)
Fifty Fun Ideas for Simple Switch or Low Tech Activities (Molly Shannon)
Build opportunities into the curriculum Ablenet Play and Learn preschool curriculum
Increase control of the environment Electric toothbrushes, hair driers, personal
fans, night lights and lamps, TV remotes
Using Two Switches
Start and Stop One switch starts
activity Other switch stops
This or That One switch activates
one option Second switch does
something else
Using the Switch with a Computer
Wireless Computer Interfaces
Super Switch
IntelliSwitch
QuizWorks
Using a Switch with the iPad There are switch interfaces for iDevices
(Ablenet Blue2, RJ Cooper Bluetooth interface and more)
At this time there is no full scanning and switch access option available that works with all Apps
Scanning is available within individual Apps only
Not all AAC apps will scan (Sounding Board, Predictable, TapSpeak Choice); more are coming
Switch apps list from Helpkidzlearn.com, enablingdevices.com, janefarrall.com and others
How Scanning Works
One switch Auto Scanning Software/hardware determines speed
Two switch Step Scanning Child controls the speed
One Switch Scanning Positional Scan moves across
row – left to right, top to bottom
Each item is highlighted in sequence
Child presses switch when desired item is highlighted
One Switch Scanning Popup
Child responds to on screen cue Timing can be a
challenge May cause a
startle
Two Switch Scanning
Move and Choose 1 switch moves through options 1 switch selects
http://www.bltt.org/switch/ani_tss.htm
Introducing Formal Scanning
Introducing the colored box to highlight on-screen choices Use a “real” scan box Choose a color that the child can easily
see Making choices with no wrong answer
The child chooses from 3 or more onscreen options
Whatever the child chooses, they receive the reward of activating that option
Choosing IndependentlyNothing here
Choosing from a row with empty cells
“finding” activitiesFinishing a sequence
Can involve empty or filled cellsFind the right one
Choose the answer to the questions or requests
Resources for Switch Activities on the Computer
www.helpkidzlearn.com www.papunet.net www.northerngrid.org/index.php/
component/content/article/81-sen/271-sen-switcher
www.priorywoods.middlesbrough.sch.uk www.lburkhart.com/hand2sw4s.htm www.cricksoft.com www.rjcooper.com www.switchintime.com www.judylynn.com
HOW TO CONTACT US? ASSISTIVE TECHNOLOGY FOR KANSANS
1-800-KAN-DOIT 1-800-526-3648
OCCK, Inc., Solution Outreach Center Nancy Bolden 785-827-9393 1-800-526-3648