From Recipes to Rockets: AAC - Part 2

The process of funding a device, the SLP report, Medicaid applications, etc. can be daunting for some. Put on top of that, the time invested in the trials and matching an appropriate device, and you can be sure that when you see the device in a student's hands it is time for celebration.
I shared in Part 1, how we developed activities to get a middle-school boy using a Dynavox V.
We were discouraged after all our work, having Medicaid deny our claim. I have to say that all through this, the Dynavox team in Pittsburgh held our hand and the area consultant kept us in the loop as they did detective work to find what we needed to fix and re-submit our request for funding. Finally the word came back about August that we didn't do 2 things: the diagnosis for the student had a code number that had a .0 after it - we had not put it down. For example, 2145 would not be good enough. It HAD to be 2145.0! Then, for some reason, the screener of the claim wanted to not only see that there was an AT specilaist (me) overseeing the initial implementation and training, but they wanted the NAME of the AT specilaist in the description.
Past experience on everyone's part never showed that this had been necessary before - but - OK, we re-submitted and waited...
September came and went, October came and went, and then the first of November - at last! The device was approved and would be shipped out. We were ready to go down the next road, which is the set up and implementation piece.
I got a call this week from the family - they had the device and were SO excited. They wanted to know when I could come to help them get it set up. I drove over and met with them for a couple of hours and we built the student's user profile. I showed them how to edit buttons and some beginning strategies to get it up and going. Dad took a picture on his phone of his son with the device to send to the SLP that had done all the hard work of getting this boy this device (He had been transferred to new students in a new community in our region and would no longer be working with this student).
It was so exciting to leave the family with a device up and running so they could help their son express himself with his new voice for Thanksgiving break. I drove away with that great feeling that you get when you know you are in a career with some great rewards that are truly the non-financial and intangible kind. I was truly thankful.
I have another student waiting for his new device as well in another town. His didn't get denied, but we have been puzzle-piecing the funding from various sources and it has also come together in the past week or so - and he will be getting his for Christmas!
All the best to you!
Lon




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From Recipes to Rockets: Building a Fun Foundation for AAC use

One of my biggest thrills is getting to be there when students get their "voice". It is extra special when it happens over the holidays, making them ones to remember. I have been working with a speech pathologist and a family for over a year trialing devices and doing activities to develop skills with a middle school boy in order to have a speech device. We decided on the Dynavox V, and designed activities for him to use coordinating communication boards we designed.
This student had a history of short attention span, getting bored quickly with everything. I had tried working with specialists through elementary years to design a binder, picture exchange systems, use recordable symbol boards like with a Go Talk, but he would refuse an nothing could be developed.
So... last year, in a new school in a new district, we embarked on the Dynavox trials. Our first activity was building a peanut butter and jelly sandwich. Since food is the way to a middle school boy's heart, we graduated to a build a pizza activity as well. As we did these, we had a partner for the student be a helper and we set out all the ingredients. We had a folder in a snacks category that was "Build a Sandwich" or "Build a Pizza". We had all the ingredients pictured and listed with voice output and also had directive buttons labeled and pictured with a sequence of tasks to complete the activity. We went through all the items and directions with the students and checked him out on them by having him show us and "tell" us each button.
Then he used the buttons to tell the partner what to get and what to help him do to finish the recipe and then the reward...eat the finished product.
We video-taped each of these and with permission from the family, showed them to the fellow-SLP's in staff meetings.
Last spring our culminating activity for the year was pretty ambitious. We bought a simple beginner level rocket kit and took digital photos of all the parts and sequences to building it. We built pages in his school/classes/science area and followed the same process of teaching him the parts identification, labeling and sequences to the finished product. We then took him out with his class to the football field to launch the rocket. We even had the countdown and lift-off ready for him to use on the device.
We saw a boy that never would use a device to communicate, begin to get the connection that this could be fun and be used to do things and work together. It went beyond the usual run-of-the-mill buttons we tend to use at school - "I'm thirsty", "I'm done", "when is recess?", "I need to use the bathroom" - with the picture of the toilet on the button - how exciting!
We began the actual funding piece with awesome support from the Dynavox team in Pittsburgh, and our area consultant. We applied to Medicaid, got the SLP report, all essential pieces in the packet and off it went.
About July, we heard back that Medicaid had denied the claim and we were back at square-one having to re-submit the claim. Summer turned to fall and still no device. There had been 9 months of school dedicated to training and trialing, we had all our ducks in a row, but still no device.
Was all our labor in vain? I received emails from the rep and the company that they were trying to find out why Medicaid denied it and we just had to sit tight until we knew what was wrong so we could correct it.
Part 2 is coming up with the end results...

All the best,
Lon

In the News: Kids Use Nintendo Wii to Learn Skills - Video

Yesterday KEPR TV and KVEW TV came and taped for a news clip. The students had fun showing what they could do. Although a lot ended up on the cutting floor, there are some interesting pieces. It gives you a rough idea of what we are doing. As promised, here is the link to the KEPR article and segment. They have the link to the video there as well:

Kids Use Nintendo Wii to Learn Skills

All the best,

Lon

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Wii Therapy: Findings in Motor Integration/planning and Sensory Systems

Can observing children using theWii help us learn more about their weaknesses and develop strategies to use the Wii to augment traditional therapy and educational practice?

The Wii mat for Outdoor Challenge is pictured above, along with the pipleslider game the students play when sitting on the mat. By leaning left or right and patting their hands, the can steer themselves down the slide.

My question at the top is quite a mouthful! We are struggling to get valid results from observing students using the Wii and find ways to use it to support their goals. They love to play the Wii and it can be a real motivating factor. Whether we are looking at social interaction and systems that students work in with autism, or orthopedic issues in motor integration and planning, our efforts are showing some positive results as we have used the Wii in several situations this fall.

I have been working with a PT/OT and a early childhood specialist in an early childhood program. We have been bringing students in from the morning and afternoon sessions to "play". They have more speech and social goals than orthopedic ones. We have used the Outdoor Challenge game mat to play games like Mole Stomper, Pipe Slider and Timber Trail. All of these involve skills like running in place, foot/eye coordination, left/right orientation, balance, anticipation and developing problem solving systems, etc.

It has been enlightening to see how these young children develop better skills through trial and error, but we have also been able to pinpoint certain deficiencies in age-appropriate developmental skills within the motor planning, fine motor and right/left skills. We have also noticed that the students that have speech issues do not necessarily have motor planning issues as well when using the Wii, but most everyone has some area of deficiency when using the Wii that we can monitor and work on skill strengthening.

We have 2 TV stations coming out to the classroom tomorrow to tape the students and our therapists and myself on the pilot program. If we get a video clip of the piece to share online, I will link to it.

Since we have developed this program, we have been able to use it for some high school age students with autism as well. The thing we are noticing with them is that when they have to do something out of their sensory system - something that cause them to have to adjust and "tweek" their receptive sense, there can be some learning and higher tolerance as an outcome. For example, if we ask a student to take off their shoes and stand on the Wii Fit Board to play a balance game, they might refuse or have a hard time dealing with doing something in their sock feet. The lure of the game and the motivational factor there might be the ticket to get them to comply and give it a try. When this happens, the door can open to new sensations and willingness to try. We have had similar instances with sitting on a mat on the floor, being in sock feet on the mat and putting the strap on the Wii remote around a wrist.

We have just purchased the components for a second system that will go into a student autism group in a high school to work on social and sensory developmental goals. We also have a fourth grade deaf boy who is in a wheelchair and will be using the Wii therapy to do some eye/hand coordination and integration of a speech device with game symbols and basic communication to play with the teacher and a peer.

This has been an interesting journey. I have actually been so busy that I have had to focus on other directions and let this go. In spite of my negligence at times, the teachers and specialists have owned the program and run with it. They have been sharing results and ideas, and proposing new ways to apply the games to student needs. It is taking on a life of its' own!

We have a goal to develop improved data collection forms and develop some tutorials and helps for specialists and teachers to integrate games. We are a long way from that yet - but things are definitely taking shape.

More to come as things develop.

Note: The Wii is not used for official diagnosis, evaluation or screening. It is only used as another tool to see what students can and cannot do and give them a fun and motivating way to develop and achieve goals - approaching them from a different angle.

All the best,

Lon

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Is it a Mystery? Self-accommodation Needs Information and Self-Awareness

Assistive technology has been a unfamiliar concept for many living in my rural Eastern Oregon region, but in the past 5 years I have been working on building a program, and this fall we have begun to see the efforts pay off. I have been literally overwhelmed with new requests for evaluations, observations, new students, personal development trainings, involvement in accessible instructional materials directions state-wide (not to mention spending every waking minute not at work, spent underneath our home built in 1897, excavating and leveling and putting in new beams - and shutting 'er up before the snow flies - I live high in the mountains).

I am FINALLY at a place where I can sit by the crackling fire in the wood stove this evening, after my son practiced his fiddle tunes and his spelling words, to play some cards and then write on my blog - a dear friend I have missed but have been much too preoccupied this past few months.

I haven't meant to neglect my AT writing but there has been too much going on in life lately to chronicle. I think I have been on overload. It is like walking through a buffet line and not knowing what to try first. There have been many students and many ideas and new relationships built.

I wanted to share about a high school girl I drove to see way out in the boondocks in a small community who has central auditory processing issues and has low grades as an eighth grader. I was asked to come and observe and do an evaluation based on her needing support to write and get her ideas down. I observed her in a language arts class, write an essay on the computer. She could write on the fly and use the spell checker and word prediction well. She could do the mechanics, but the teacher spent a lot of time with her trying to get her to flesh out the main ideas and words that emphasized the major points. She wasn't quite getting that.

I visited with her afterward and explained that I was there to help her with some ways to write and organize her thoughts. I asked her:

"The papers in your file say that you have a central auditory processing disorder. Do you know what that is?" I asked.

She shook her head "No".

"It's like this," I said, "Do you ever feel like your brain is like a radio and you hear what people tell you but you can't tune in the station clear enough so later you can't remember what you were supposed to do?"

Her eyes got big and she nodded, "yes".

I started to share ideas, "What if we were to work on finding some tools, maybe a voice recorder to help you remember. You can have teachers say directions, instructions - maybe even record a class where they tell everyone a lot of important information for a test. You can use this to help you get it again."

I shared how we could set up a special binder with pockets to hold cards that tell her what the big picture ideas are in a class or steps to a project. We are going to have the staff that work with her in for a meeting and talk about low and mid tech and what might best support her.

I think the "take home" for me was that I was talking to an eighth grader who had never been told what her learning disorder was or how to accommodate for it.

In order to be successful, students with disabilities need to know what they have going on and what tools best will give them the life skills they need to succeed independently in life.
Let's take the mystery out of the issues our students face. Let's help them understand how things can be different and they can begin to have power over what they can read study and write. Empowerment and independence is what it is all about!

All the best,

Lon

Free OCR Programs for Print Disabilities

I have been using OCR (Optical Character Recognition) software for quite some time to work on ways to accommodate student learning and help students be able to access printed text when they have print disabilities. I wrote a review of Top OCR and Access Apps last spring and I have been demonstrating Top OCR to sped teachers, assistants and SLP's to use with their students.
I have grappled with all the intricate issues of copyright but I just show teachers the tools, advised them on what is within reasonable limits of the law balanced with what we are mandated to provide in AIM, and leave interpretations up to individual teachers, administrators and districts.
I have used Access Apps in several downloadable versions (it installs on a jump drive). The line up has changed as far as the tools RSC has included over the past year. I was disappointed to find Top OCR was gone. I had referred a parent to it after an inquiry on text to speech tools that were supportive with scanned text. I recommended Kurzweil 3000, but cautioned on the price. If a person is willing to give up some of the cadillac luxuries, a lot can be said for free open source tools.
I stumbled across a great review on the Top 5 Free OCR Softwares and thought I would pass it on. Hope it helps some of you as you sort your way through the many options for those with print disabilities.
All the best to you!
Lon



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Wii Therapy, AIM, AAC and Everything in Between: Welcome Back!

I have taken a huge bit of the summer to be offline and rest, spend time with family, etc. I am excited to get back to writing and bring posts that will encourage and stimulate your creative juices. We just returned from a great trip to Toronto and now - back to it!

With Labor Day is behind us, it is time for gearing up towards goals for children and for me, pressing onwards to new goals in my knowledge and professional development. I know that we are being told that stimulus funds are available for AT and I am writing and developing recommendations for items for Autism and AT for our districts. I will have to share them and get your feedback.
I am on a state AIM committee that is working on our implementation of print diability materials in a timely manner and will be developing our protcols for requests and connecting teachers and students with materials, knowing qualifications for access, etc.
My biggest surprise in the projects I have been involved in has been the interest in the Wii as therapy. We tested it out last spring and it seemed very successful. I am going to an ECSE classroom today to work with some children for their motor skill activity time. We have two local TV networks that are working on stories on what we are doing and we are continuing to develop our data collection sheets this fall and fine-tune things. I am working on developing some overlays with speech devices to incorporate with the Wii therapy so we can develop some communication goal work alongside the motor work as well.
I stumbled across some new successes using neuro-feedback for dyslexia with great results. The doctor that has been doing this work has agreed to an interview and so I will be writing about this and setting up a time this fall for him to share what they are doing with you.
There is so much to do and so little time. Just take a deep breath and remember to pursue the things that give you joy. Those will being about your greatest success...
Have a great fall and do great things out there!

All the best to you,
Lon



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