ASSISTIVE TECHNOLOGY SKILLS PROGRESSION |
| Ian Bean |
Over the last few years, the computer has developed into a valuable resource for teaching children with learning difficulties. Rapid advances in processing power have enabled manufacturers to provide sophisticated hardware and software solutions to the access and learning needs of disabled people. This 'Assistive Technology' was best described by Professor Stephen Hawkin, himself perhaps the most famous assistive technology user, as "A bridge to independence".
Using computers and related assistive technology in educational activities relevant to their needs and interests, children gain self confidence, social skills, communication skills, gross and fine motor skills, problem solving skills and a wide range of abilities and knowledge needed to function in society. Children who will never be able to hold a pencil can use the computers graphics programs for drawing and word processors for writing. Children who are unable to speak can use the computer as a communication tool. For all children, the computer provides topics and incentive for learning at all levels.
The use of Assistive Technology in schools enables pupils to communicate, interact with and control aspects of their environment, often for the first time and gives them opportunities to access the curriculum at every level. As teaching professionals you are invited to explore new and novel ways of working to make effective use of the hardware and software available.
Whilst it is accepted that we would like every pupil at key-stage four to be using a mouse and keyboard, realistically a percentage of our pupils will never be able to access the computer by traditional methods. It is therefore imperative that all pupils be given the opportunity to use as many different input devices as possible bearing in mind any physical difficulties, which may preclude the use of a particular device.
Pupils with PMLD or specific physical and or cognitive difficulties should undergo regular assessment of their assistive technology needs to ensure they are using the device which best meets their particular needs. This information should be recorded together with information relating to positioning, software and prompts to ensure a consistent approach. The availability of this information should avoid the pupil becoming confused by different members of staff adopting different tactics and methods.
It is also important to look at long-term goals for individual pupils, particularly if the pupil would be likely to use an augmentative or alternative communication device. Short and medium term goals should also be identified and activities devised to provide learning opportunities to meet them.
Prior to considering access methods and appropriate software it is important to remember good basic practice when working with children in the ICT room.
It is all too easy to forget these simple considerations, which can severely impact a pupils performance.
There are four main categories of assistive input devices:
Touch Screens
Switches.
Keyboard (including alternatives).
Mouse (including alternatives)
. This document will describe the use of each device, examine the skills required to operate the device competently and suggest activities that can be used at each stage of skills training. This document suggests progression paths to master the skills required to use the access devices,
This is the most direct way of interacting with the screen image, provided the pupil is able to reach out and touch. It is particularly useful when children are developing visual skills and hand to eye co-ordination. Many software programs offer the opportunity to play games involving location, scanning and searching as an integral part of an enjoyable game. As a child's targeting skills improve it is possible to split the screen into many elements providing opportunities for visual discrimination and decision making. Touch screens can be used with a wide range of software covering most curricular areas from basic cause and effect through to word processing with on screen letter or word grids.
As the touch screen emulates the movement and action of the mouse it is possible to use it with programs such as My World, which greatly enhance its use to support learning in other curriculum areas.
There are two different touch screens available for use in school. The first of these detects the child's touch by interrupting a series of infrared beams, which criss-cross the screen. The primary benefit of this system is that the child is not required to apply pressure to activate the screen. This can be very useful when working with children with a limited range of movement. The drawbacks to this system however are that unintentional activation is more common than with pressure activated touch screens and trailing fingers often result in imprecise targeting. Pressure activated screens can alleviate some of these problems but require calibrating before each use, are less robust and often do not activate if the child does not or cannot apply enough pressure.
Both types of touch screen can be configured to activate in a number of different ways although most children should use the 'touch and release' setting unless using a program requiring the use of dragging and dropping.
The following table suggests software that can be used at each stage of touch screen skills development.
| Skill |
Activities |
| Discrete Activation | Teen Tunes (single element) Touch Games Series Clicker (single element grid) Concept Plus (on screen) SENSwitcher |
| Gross targeting | Teen Tunes
(two elements) Touch Games Series Clicker (Two element grid) Concept Plus (on screen) |
| Fine targeting | Teen Tunes (two elements) Touch Games Series Clicker (Two element grid) Concept Plus (on screen) Press to play Animals/Speedy |
| Drag and Drop | Touch Games Series My World Dazzle |
Switches offer a less direct method of accessing the computer and are relatively simple to use. There is a wide range of different switches available to pupils in school ranging from simple button type switches through to adjustable pressure and conductive touch switches. The type of switch and method of activation for pupils with mobility problems and/or PMLD should always match the particular pupils needs following an assessment to find a reliable, consistent and repeatable movement, which the pupil can make comfortably. Successful switch use will involve a range of skills, abilities and understanding and like all motor and cognitive skills best learned from an early age.
Switch use can start before reception level giving children the opportunity to experience cause and effect by controlling a number of devices connected to a switch. Tape recorders, battery operated toys, lights, fans etc. can all be connected to switches offering 'off computer' learning situations.
Talking switches like the Big Mack, which store up to twenty seconds of recorded speech are a useful tool to aid the inclusion of non-speakers into classroom activities. A child could join in with stories or songs using repeated phrases, answer their name, or give instructions to others, all at a moments notice. Big Mack switches can be interfaced with any battery operated equipment or the computer allowing for audio feedback specific to the equipment used or the likes of the child.
Audio feedback devices like the Big Mack switch can also be a useful assessment tool as children can demonstrate their understanding of a story by joining in at an appropriate moment.
As pupils become more proficient with the use of switches they can be used with the computer to enable them to access a range of software covering all curricular areas and levels. In school we use a very sophisticated switch control program which will allow almost any software to be operated by one or more switches irrespective of whether the program was originally designed for switch access. Scanning systems speed up the input process for single switch users enabling them to interact with more complex software with the minimum of switch presses.
| Skill |
Activities |
| Continuous Activation | Battery
Operated Toys Tape Players Lighting Equipment |
| Discrete Activation | Big Mack Talking
Switch Battery Toys (via latch or timer) Tape Player (via latch or timer) Teen Tunes Blob 1 and 2 SENSwitcher Clicker Switch IT |
| Multiple Switch | Mains devices (via an interface) Blob 1 and Two Clicker |
| Row Scanning | Teen Tunes Press to Play Animals / Speedy Clicker Switch On Original |
| Column Row Scanning | Press to Play Clicker |
It can be quite difficult to ascertain fully whether a child has grasped the concept of cause and effect. For example, a child may be observed pressing the switch and then looking up at the screen and listening to the reward. This may not always mean that they have fully established in their mind that they are causing this reward to happen; it may be that they quite like pressing the switch as an activity, then, when there is something nice happening on the screen, or they hear a nice sound they also like watching that.
Careful observation and a sound knowledge of the child and how they function
in other circumstances may be necessary to ensure they have fully developed
the concept of cause and effect. Before moving on to more complex software,
give the child time to develop their switch skills to a point where they
become reasonably automatic, so that they are able to concentrate their
thoughts and efforts on the results of their presses, not on their switching.
Concept keyboards can be used as an additional or alternative to the standard keyboard. They are available in school in both A3 and A4 sizes. They have a flat surface and are commonly used with prepared paper overlays, which indicate what will be sent to the computer when the board is pressed. The boards have a grid of touch sensitive areas, which can function as individual keys or combined to provide larger keys. All concept keyboards used in the ICT room transmit information by infrared so there are no wires connecting the board to the computer.
Concept keyboards are very flexible when it comes to the kind of information that can be sent to the computer when any of the board area is pressed. Text, in the form of letters, whole words or sentences, Symbols and graphics, including photographs, speech and sounds, and control codes to move the mouse or run external programs.
Concept keyboards can be used to support work across the curriculum and at every level. The strength of this device lies in the flexibility of the overlay design program, which allows overlays to be created tailored to a pupil's particular needs. Overlays can be made using photographs or symbols which children can use to communicate wants and needs, out of sequence story pages or rhymes to support literacy, large calculator type numbers and operators to support numeracy and even controls for the computers CD player.
Concept keyboards can provide both audio and speech feedback when used with word processors and overlays used to represent QWERTY style keyboards, colour coding vowels etc. This function makes for an easy crossover to an adapted large key keyboard such as the Big Keys.
Most computer software is designed to be used by controlling an on screen pointer with a mouse. Using a mouse appropriately requires a high degree of manual dexterity and hand to eye co-ordination. It can take a considerable time for children to master the skills required and it must be remembered that our pupils often have other impediments such as visual, perceptual or motor difficulties, which can affect the child's ability to learn.
When teaching children to use a mouse it is very important to ensure that the child can comfortably reach the mouse and there is sufficient space to move the mouse around the desk. Consider if the child may need additional support for arms or wrists and that the size and velocity of the mouse pointer are set at a level the child can manage. Mouse adapters such as SEMERCS 'Mouser' are available in school, which allow you to customise the actions of the mouse buttons even turning them off if required.
Care should be taken that the child understands the association between what they are doing with the mouse and what is happening on the computer screen especially in the early stages.
| Skill |
Activities |
| Button Control | Custom
grids (Clicker) Press to Play Animals / Speedy single element Teen Tunes single element Blob 1 and 2 Concept Plus (on screen) |
| Simple Targeting | Press
to Play two elements |
| Complex targeting and button control | Talking Storybooks Teen Tunes two elements Talking Storybooks Clicker Concept Plus (on screen) |
It is important to remember that for children and young adults with profound and multiple learning difficulties the focus of early ICT teaching should be experiential. Children should be given the opportunity to experience and respond to stimuli produced by ICT equipment without the additional cognitive load of having to control it for themselves.
Priory Woods programme of study, together with the Equals ICT scheme of work for people with PMLD set out a clear progression path for experiential ICT teaching, which will give our children the prerequisite skills they need before attempting to teach control.
Assistive technology devices have a role during this phase of learning. Children become familiar with the devices by seeing them being operated by staff, increasing the likelihood that they will more readily accept positioning of the equipment in relation to their bodies.
Accurate assessment will be required to find a reliable, consistent and repeatable movement that the child will be able to make comfortably from his normal seating position. Several points need to be considered.
Active involvement of the occupational therapist at this stage would be beneficial.
Once a reliable movement has been identified together with an appropriate method of access, the child should start to learn about continuous pressing. Continuous pressing is defined as the act of pressing and holding a switch active to achieve a desired effect. This could mean a child holding down a switch connected to an electronic toy, the toy only being activated while the switch is being pressed.
This action helps to reinforce the action / reaction bond giving a child the opportunity to experience cause and effect using a number of different devices connected to a switch.
This skill has real world applications in wheelchair and environmental control, 'dragging and dropping' (pressing, holding whilst moving and releasing) using a mouse amongst others. Continuous pressing is the cornerstone of all switch access and the skill should be generalised before moving on to other methods of activation.
Children should be encouraged to activate switches in response to cues from the program or equipment used. It is therefore important that the child attends to the screen for as long a period as possible. Responding to program cues will enable an easier transition to scanning systems for switch users. Useful programs to facilitate this learning are the 'Press to play' series by Don Johnson Software all of which allow for direct program controlled verbal cues to press the button, switch or touch screen. Children should work from "Wait, Press" through to "Wait, Wait, Wait, Press". Other software includes 'BLOB' and 'Teen Tunes', all of which are available in school.
Scanning is best described as an indirect method of computer access requiring an individual to activate a switch and make a succession of choices that leads to the desired input. These choices are usually made via a switch or switches, some other type of keyboard emulator or even voice. Scanning systems are a very important time saver for single switch users There are two main forms of scanning systems:
 |
Row scans work by scanning sequentially left to right through a number of on screen elements. Each element is scanned and highlighted in turn usually accompanied by an auditory cue. The user of a row scanning system will activate the switch when the element they require is highlighted. Most programs allow for the speed of the scan to be altered to suit the needs of the user
These systems although slow and often frustrating enable single switch users to access some quite sophisticated software. The word processor used in school allows for this method of input using word / picture grids and even on screen dynamic QWERTY layout keyboards. The only limit to the number of choices available to users of this system is the relative slow speed of access.
 |
Column row scanning is faster and therefore much less frustrating than row scanning especially as the system can be tailored to scan the most frequently used elements first. This system can also be used with two switches, the user moving the scan with one of the switches and selecting elements with the other. Other scanning systems do exist but their complexity would make them difficult for our pupils to operate.
Column row scanning is used extensively with AAC devices such as the Dynavox and many environment controllers.
Using a switch connected to a tape recorder a child could control their classmates in a game of musical statues, get adults to dance to music, initiate sing-along sessions and play stories for the rest of the class.
Moving toys connected to a switch can be used to knock down piles of bricks, send a toy over the edge of the table and watch people try to catch it. In group situations the toy could be sent to a chosen individual.
Mains controllers allow a switch to be used with a blender to create milk shakes, mixers and microwave ovens to enable participation in cookery lessons. Lights, bubble tubes, fans and mains powered audio devices (not CD players) can all be controlled from a switch.
Talking switches like the Big Mack are especially useful with children who are more interested in people than things. A child could use it to take messages to another class, answer their name, instruct adults to do silly things like dance, hop or jump, and use it to join in with songs and stories. Stored audio can be changed in seconds making the opportunities to use this device in the classroom almost endless.
Ian Bean
Priory Woods School
ianbean@ntlworld