Macworld Feature: iPad therapy The iPad is proving a powerful tool in the treatment of autism conditions Alice Ross | iPad and iPhone User

Macworld Masterclass

Plenty has been written about the way the iPad opens up computing for those who have traditionally struggled with it, such as the elderly. But one of the areas where it‟s really making waves is in helping those who struggle to communicate at all.

This includes those with autism-spectrum conditions, people who have had a stroke, and those who have temporary speech impairment brought on by an illness. “I do think the iPad is revolutionary,” says Dr Sue Fletcher-Watson of Edinburgh University. She is currently involved in a project designing apps to help children with autism.

“Before the iPad, most of the communication tools we had, such as sign languages, were problematic in that the person you were communicating with had to know it as well, which was rather limiting,” she says. With the iPad, however, symbols and gestures can be translated into speech that‟s easily understood by everyone.

An additional advantage is that the iPad has particular appeal for people with autism, Fletcher- Watson adds: “A lot of evidence says that people with autism tend to have real strength when it comes to working with techology; they learn really well in a technological environment.”

Predictable is an intuitive, predictive text-to-speech app with a simple picture-based menu

The iPad‟s simple, responsive interface is also highly suited to young children, who can struggle to master more complex technological systems.

“Young children seem to find it very intuitive – although some children can hold back a bit at first, because they‟ve been told not to touch the TV, so it‟s a little hard for them to learn that this is a screen they can touch,” explains Fletcher-Watson.

She isn‟t alone in seizing on the potential of the iPad – and to a lesser extent the iPhone and iPod touch – as a versatile tool for people with communication difficulties and autistic-spectrum conditions. Many communication specialists have found it to be a flexible and tactile platform that lets them accomplish all kinds of tasks with their charges. Speech therapy

Rebecca Bright is a director of Therapy Box, which makes speech therapy apps. “Speech therapists find the iPad a fun and flexible tool for working with children. Previously, therapists would have carted around flash cards, books and photocopies, so if the tools are suitable on an iPad the therapist would find that convenient,” she enthuses.

Rachel Moore of The Ace Centre, an organisation that helps identify what technologies would best support people‟s communications, adds: “If you can find an app that‟s accessible and appropriate, it can make a enormous difference. The iPad is a mainstream device, it‟s financially accessible, it looks cool – it can be very motivating for people to use. It‟s an attractive platform for a lot of people.” But she adds that it has to be the right platform: “It isn‟t for everybody.” There’s an app for that

One of the advantages of the iPad over dedicated communication-aiding technologies is that you can run a variety of different apps on it, and there are plenty to choose from. The website Apps for AAC (Augmentative and Alternative Communication, appsforaac.net) lists more than 200 tools for helping improve people‟s communication in various ways, and there are more on the iTunes App Store. Apps that help develop speech often use picture-based systems, games and sounds to help children practice forming particular sounds or combinations of sounds.

Meanwhile, with dedicated communication apps, the user can feed in or point to what they want to say, and the iPad will actually speak the words or phrases.

These text-to-speech technologies have been around for a long time – think of Stephen Hawking and his speech-generating computer – but such dedicated tools can be fearsomely expensive, and they don‟t work for everyone. With the iPad, you have a flexible platform where if one solution turns out not to work too well, you can move on and try another.

“There are several ways these text-to-speech systems can work,” says Rachel Moore. “With apps like Predictable (itun.es/ibf4LQ), if someone‟s literate and can spell out a message they can type it on the keyboard, and to speed things up there‟s a predictive element. You can also store whole phrases or sentences.” Such apps can make life significantly easier for people with serious communication difficulties, and can help them gain some independence. Fletcher-Watson explains: “You can get these flash cards, but they can be hard to understand for people who aren‟t used to them, so you might have a picture of a crisp and people can‟t really make out what it‟s meant to be. But with these apps, you press the symbol for crisp and it says „crisp‟.”

Rachel Moore points out that one of the biggest advantages of the iPad is that you can have several apps loaded, each fulfilling a different role. “So for someone with an autistic-spectrum condition you might have a communication app to help them say what they want to say, and a schedule to help them get through the day in a structured way, and then a social stories app,” she explains.

Social stories apps allow people to take a photo and write a brief text for each stage of an activity, such as going to the shops or visiting a respite centre. This gives the user a record of what they‟ve done, and can be used to help them prepare for the time they do that activity.

Recently Fletcher-Watson has been developing a free app, FindMe(Autism), aimed at autistic children – it‟s available at itun.es/ibf4YX. “Our app doesn‟t teach language explicitly: it supports children‟s learning of social skills, such as paying attention and following a finger when someone‟s pointing.”

FindMe(Autism) works as a two-stage game. “In the first part there‟s a character, a little human being, and there are other things on the screen that we call distractors: so if he‟s in a jungle, there will be a lion, or a hippo. You get a verbal trigger, and the right answer is to touch the person. If you do, you get a little reward – it‟s a token, and if you get five, you get an animated sequence.

“In the second part, the character is shopping. They point at things around the shop they want and you have to touch the things they are pointing at.”

Fletcher-Watson points out the app can help children with autism learn how to follow social cues. The response has been pleasing. “There‟s a reduced-scale version on iTunes and we had about 4,000 downloads in the first month,” she says. ‘Not a magical solution’

The Somantics app aims to stimulate interest through touch and gesture input Speech and communication problems can be hugely complex to support, and there‟s no single approach that works for everybody. As Rachel Moore points out, the excitement around the iPad as a communication tool has been so great that there‟s a danger people view it as a miracle solution.

“The buzz around the iPad can give people false expectations,” she says. “One of the drawbacks is that because are so easily available, it‟s very easy for parents to go and get one and download an app – which can be very expensive – and then find out it isn‟t working very well. We would say the starting point isn‟t the iPad but the individual: you need to find the right technology for them.”

Rebecca Bright agrees. “While the iPad is suitable for many children, it‟s not a magical solution for everyone. Sometimes there have been articles in the media which talk about the iPad as treatment for various conditions. This hype needs to be balanced with the standard assessment and advice from trained speech and language therapists.”

The sheer scale of the iPad app market poses an extra problem for therapists, Bright says. “There are so many applications now available that therapists need to work to keep up to date with the latest apps,” she says.

For some autistic people who are used to using their iPad to watch videos or listen to music, it can be a challenge to grasp that they can be used for other purposes, Bright adds.

Another potential drawback is that iPads can be rather fragile – although everyone iPad & iPhone User spoke to pointed out that with the right case, this is much less of a problem. But for the right individual, and with the right support, the iPad can be a fantastically adaptable and appealing tool, and one that can help those with communication difficulties develop their skills and better communicate with the wider world. Communication Skills iPad apps help those affected by autism

ReacTickles Magic “There‟s a great wave of apps that support communication: I‟m not in opposition to that, but we are about allowing the individual to experience the joy of interacting,” explains Dr Wendy Keay-Bright of Cardiff Metropolitan University.

A specialist in inclusive design, Keay-Bright and her team have worked with two groups of young people with autism to create two free apps, ReacTickles Magic (reactickles.org) and Somantics (somantics.org), that are closer to interactive art than developmental tools. Touching the screen on either app produces graphic patterns that change and develop in response to the user‟s interactions.

Many of the people they worked with were profoundly affected by autism. “One group was functioning at the level of a three-year-old, but they were 19 to 22 years old. The future doesn‟t hold a lot of independence for them, and opportunities to be playful and creative are quite slim,” says Keay-Bright.

The iPad‟s tactility and simplicity was important for Keay-Bright and her team. “For young people with autism, delays in processing is a characteristic – this is why social interaction is such a problem,” she explains. “So when you touch something and there‟s an immediate response, it cuts down a lot of cognitive processes. You can reduce the cognitive overload by having the cause and effect in the same motion.”

Source:

http://www.macworld.co.uk/ipad-iphone/masterclass/?articleid=3368528&pagtype=samecat&pn=2