Tuesday, July 30, 2013

Universal Design for Learning (UDL) and Assistive Technology for learners with Autism

Typically, a curriculum is written to meet national, state, county or district goals. Curriculum designs and teacher effectiveness can affect the overall scores students and schools achieve locally, and nationally.  It is therefore the responsibility of curriculum writers to create content which takes different learning styles into consideration. A teacher’s responsibility is then to use effective teaching methods which ensure that every child meets those goals. Classrooms, however, do not consist of a heterogeneous group of students who learn the same way. Meeting the needs of all students led to the development of the Universal Design for Learning (UDL).

Universal Design for Learning is a research-based framework for designing curricula — that is, educational goals, methods, materials, and assessments — that enable all individuals to gain knowledge, skills, and enthusiasm for learning. It is described in the Higher Education Opportunity Act of 2008 as a “scientifically valid framework for guiding educational practice”. UDL additionally “supports teachers’ efforts to meet the challenge of diversity by providing flexibility and varied means (differentiation) when it comes to representation and expression of the teaching material”. The provision of these flexible approaches, which allow for customization and adjustment for individual needs, additionally provides higher levels of engagement of students (see Table 1).

Table 1: The three principles of UDL, as well as the brain networks they directly relate to. A successful curriculum integrates all three of these, via multiple methods/means.   

These principles can be used to identify the barriers that students face. Such barriers are found within the curriculum itself, as opposed to focusing solely on the student’s needs. The CAST Curriculum Barriers Tool outlines this in further detail. In addition to evaluating barriers, the needs of the student have to be assessed, and appropriate reachable goals need to be defined. These goals can then be used to develop Individualized Education Programs (IEPs), and thus the modifications and accommodations required by the student can be implemented.

Since Universal Design for Learning promotes engagement and better, more effective, learning, it greatly benefits students who have autism. Such students usually use assistive technology tools to help them overcome any learning barriers in their environments. Using assistive technology tools alone, however, is limiting. By using the UDL framework, learning environments have reduced barriers to begin with, which potentially decreases the need for assistive technology tools in the classroom.

In so doing, the opportunities to learn increase. It is important to note that the need for assistive technology is not eliminated altogether, however. Developers of educational software and hardware should therefore take into consideration UDL principles as they generate learning materials. Educators, on the other hand, need to be aware of UDL and select “inherently flexible” tools for their students.

AutisMate fits into both of these criteria. It is an assistive technology tool that compliments Universal Design for Learning given the fact that it is highly customizable. This particular app can be used with children with autism or any other disability where contextual based environments, visual schedules and video modeling are needed.

1. CAST. (n.d.). Retrieved from http://www.cast.org/teachingeverystudent/tools/curriculumbarrierstool.cfm
2. (n.d.). Retrieved from http://www.udlcenter.org/aboutudl/whatisudl
3. Ralabate, P. K. (n.d.). Retrieved from http://www.asha.org/Publications/leader/2011/110830/Universal-Design-for-Learning--Meeting-the-Needs-of-All-Students/
4. Retrieved from http://www.udlcenter.org/advocacy/referencestoUDL/HEOA
5. Retrieved from
6. Retrieved from http://www.cast.org/teachingeverystudent/ideas/tes/chapter4_4.cfm#at

Thursday, July 18, 2013

Using the SETT Framework to make Assistive Technology Decisions

No two people on the autism spectrum are alike. Just because they may share the same characteristics – such as age, gender, IQ, medication use, even the autism diagnosis itself – does not imply that they will both respond similarly to the same methods, tools or treatments1. This demonstrates the need for personalization.  One field embracing personalization is the field of Assistive Technology. Given the wide range of assistive technologies available for those on the spectrum (see the CTG Resource Directory2, a database of tools), this personalization process might seem daunting, and only possible through trial and error. Fortunately, this does not have to be the case. The SETT Framework, a four part model, can be used to assist IEP teams in making more informed assistive technology decisions that are based on the specific needs of each learner.  

The SETT Framework enables those teams to simultaneously consider the Student, his/her Environments, and the Tasks the student needs assistance with, to eventually select appropriate Tools3. Once the abilities, interests, and needs of the Student, the details of the usual Environments he/she spends time in, and the Tasks demanded of the student in those environments in order to participate actively in them, have been determined, effective assistive technology tools can be identified for that student that address those factors4. The following figure summarizes the framework and its use:

Effective implementation of assistive technology needs to be the result of thorough planning because it has such a direct impact on the student’s progress. Using the proper tools enhances the student’s existing strengths and supplements the areas he/she needs help in.  Some other areas to consider are a student’s intrinsic motivation and levels of support at home. A fully engaged student is more likely to participate fully and productively in his/her environment5.

Once tools have been tried and determined the next step is developing an effective implementation plan. An implementation plan avoids unnecessary frustrations parents/caregivers/teachers may face, in terms of using the newly selected tool.  Lack of training and implementing assistance by qualified personnel produces higher levels of tools and product dissatisfaction.  One implication of poor planning and implementation strategies is increased rates of product abandonment6. Regular use of decision making Frameworks such as SETT is more time and cost efficient7.

Such Frameworks also allow for personalization, and personalized technology seems to work best for those with autism8. Studies propose that there is a reduction of reduced anxiety, improved motivation, and deeper understandings of self and surroundings may be observed when treatments are personalized9. Personalization allows for empowerment because of its tailored support. This is exactly what AutisMate does. It focuses on both communication and life skills, not just one or the other. Autismate can be modified to meet the student, exactly where he/she is.

Finding the right assistive technology tools for students with autism does not have to be a challenge. By using the SETT Framework, the needs of the student can be determined more systematically. This lends itself to personalizing the student’s experience for a better outcome from the beginning.

Tuesday, July 9, 2013

What do we know about autism?

What do we know about autism?

What do we know about autism epidemiologically?

The most current statistics about autism are as follows:
  • A review published in 2012 states that the current median global prevalence of autism is 62/10,000.
  • In the U.S., the Centers for Disease Control and Prevention recently claimed that 1 in 50 children are affected by autism, compared to the previous estimate of 1 in 88.
  • 1 in 54 boys are diagnosed with having autism, versus 1 in 252 girls, indicating that boys are nearly five times more likely to have autism compared to girls.

Comparing these numbers to those of previous years indicate that autism prevalence is increasing. However, it is important to note that it is not the amount of people being born with autism that is necessarily on the rise, but rather, the amount of diagnoses – better methods to do so have been developed over the past few years, resulting in more people being properly identified as having autism. 

In terms of autism therapy, there are currently three acknowledged and widely used forms of therapy, into which assistive technology is incorporated. Assistive technology for those with autism ranges from PECs all the way to AAC apps, and focus on different skills such as autism communication, socialization, and integration.

What do we know about autism scientifically?

Autism is a lifelong neurological, developmental condition resulting in cognitive impairment that can be identified as early as 6 months; children with autism are formally diagnosed as early as 18 months. Though it appears to be a genetic condition, there have been no putative genes found, and thus there is no known direct cause of autism. Rare mutations and rare multigene interactions have been found to contribute to the condition, however. Biomarkers have also been identified, which may bring researchers closer to finding pathways and eventually genes involved in autism. Finally, the influence of environmental factors is being studied to determine their role in autism, and recent findings presented at the annual International Society for Autism Research conference reinforced the belief that environmental influences in the womb are more meaningful in terms of autism risk.

What do we know about autism behaviorally?

Autism consists of a spectrum of diseases, ranging from high functioning Asperger’s syndrome to childhood disintegrative disorder, which is considered the most severe and rarest form found in children with autism. Of those on the spectrum, 30-50% are non-verbal and lack daily communication needs. Because they have trouble expressing themselves, children with autism exhibit atypical behaviors, such as arm flapping, failing to maintain eye contact, and rocking. In addition to behavioral and communicative skills, individuals with autism also have trouble developing life skills. Because of their differences, there is a stigma created against people with autism and they may therefore face exclusion. Thus there is a need to raise awareness in order to increase acceptance.

What do we know about autism therapeutically?

Because there is no direct cause of autism, there is currently no pharmaceutical therapy available, but there are numerous forms of autism treatment. Perhaps the three major types of clinical autism therapy available to an individual with autism are:
  • Speech and language therapy – such therapists focus on improving communication skills.
  • Applied behavior analysis (ABA) – this is considered the most scientific form of therapy. It entails a process of instruction via repetition, using incentives/rewards, and aims to improve behavioral and emotional skills.
  • Occupational/physical therapy – this targets both fine and gross motor actions, seeking to improve coordination. 

In addition to such therapists, educators (who can be actual clinicians, or special education teachers and teacher aides) and caregivers/parents have pivotal roles to play. These two groups have to adapt to the needs of their student/child with autism, reinforcing everything covered in therapy sessions as well as providing a safe and nurturing environment.  

There are also a handful of new therapies being researched, and sensory-focused autism therapy has been in the headlines lately. This form of therapy entails exposing the individual to various sensory signals in addition to regular therapy. The recent study showed that those who interacted with these sensory signals performed much better. It will be interesting to see how this supplemental therapy progresses, since previous promising attempts have not proven effective. 

One of the most effective supplements for autism therapy is the implementation of assistive technology, including various autism apps.  By using assistive technology, therapists are able to improve autism communication and like skills, which encompasses social skills, socialization, peer engagement, and behavioral skills.

What do we know about autism legally?

A Harvard study estimates that it costs $3.2 million for autism therapy over a lifetime, ranging from $40,000 to $50,000 a year for children, depending on the length and frequency of each therapy session. This excludes the services provided in schools via the Individuals with Disabilities Education Act, which may not suffice for some individuals. The Combating Autism Act of 2006 made $950 million available for screening, diagnosis, and intervention, as well as biomedical research, but most of the funds are being used for the latter. And unfortunately, autism therapy is covered by insurance in 32 states only.

This is why there has been a significant push for autism reform across the nation, so as to require insurance companies to include autism treatments, including assistive technology, in their plans. One of the most notable cases is Ava’s Law in Georgia. Ava Bullard, who is now 8 years old, was diagnosed with autism at around 2. After being subject to intense therapy 40 hours a week, Ava is now independent and fully integrated at school. However, this cost her family about $50,000 a year, which made them use up their savings and borrow from family. Ava’s mom, Anna, is working on getting Ava’s Law (House Bill 309) passed in Georgia in order to save the state’s 30,000 diagnosed kids’ families from these exorbitant costs. Currently, Ava’s Law has been put in mandate committee, and will get a hearing next month.

There is hope for a positive outcome. Rep. Chuck McGrady recently got a Bill that would provide such coverage passed in North Carolina’s House. Its exact provisions: $36,000 a year for behavioral treatments, up to the age of 23. The next step is to get it passed by the state’s Senate. In order to do so, McGrady recommends reaching out to the Senate Insurance Committee, whose members along with their email addresses are listed below.

What do YOU know about autism professionally?

Share with us your professional and even personal stories regarding autism, we would love to hear them!

List of Members of the N.C. Senate Insurance Committee

Tom Apodaca, Insurance Committee Co-Chair: Tom.Apodaca@ncleg.net
Wesley Meredith, Insurance Committee Co-Chair: Wesley.Meredith@ncleg.net
Norman Sanderson, Insurance Committee Vice-Chair: Norman.Sanderson@ncleg.net
Austin Allran, Insurance Committee Member: Austin.Allran@ncleg.net 
Jim Davis, Insurance Committee Member: Jim.Davis@ncleg.net
Joel Ford, Insurance Committee Member: Joel.Ford@ncleg.net
Rick Gunn, Insurance Committee Member: Rick.Gunn@ncleg.net
Ralph Hise, Insurance Committee Member: Ralph.Hise@ncleg.net
Floyd McKissick, Insurance Committee Member: Floyd.McKissick@ncleg.net
Gene McLaurin, Insurance Committee Member: Gene.McLaurin@ncleg.net
Bob Rucho, Insurance Committee Member: Bob.Rucho@ncleg.net
Michael Walters, Insurance Committee Member: Michael.Walters@ncleg.net

Monday, June 24, 2013

Early Identification and Intervention, Video Modeling and Children With Autism

Research tells us that early identification and intervention are critical elements for successful outcomes in therapy for children with Autism.  One of the targeted skill areas to improve during early intervention are functional life skills.  Teaching life skills to children with Autism often requires the use of visual cues, verbal prompting and hand over hand activities.

One method of teaching children with Autism the life skills they need is through the use of Video Modeling. Video modeling is a form of observational learning in which desired behaviors are learned by watching a video demonstration and then imitating the behavior of the model. Video modeling can be used to teach social skills, multi-step tasks, and behavior expectations, to name a few. Types of video modeling include: 

• Basic video modeling 
• Video self-modeling
• Point-of-view video modeling
• Video prompting 

Basic video modeling involves recording someone other than the learner engaging in the target behavior or skill (i.e., models). The video is then viewed by the learner at a later time. In video self-modeling (VSM), individuals observe themselves performing a target skill/behavior successfully on a pre-recorded video, and then imitate it later. Point-of-view video modeling is when the target behavior or skill is recorded from the perspective of the learner. Video prompting involves breaking the behavior skill into steps and recording each step with incorporated pauses during which the learner may attempt the step before viewing subsequent steps. Video prompting may be done with either the learner or someone else acting as a model.

Video modeling is viewed as an effective tool for use with children with Autism because children with Autism are “visual learners”. Children with Autism are inherently challenged by the presentation of the receptive language components required when teaching tasks verbally. The provision of video to assist with task completion removes the auditory & language component which challenges them and focuses on the visual stimuli representing the same components.

Video modeling is viewed as an effective tool for use with children with Autism because children with Autism are “visual learners”.  Children with Autism are inherently challenged by the presentation of the receptive language components required when teaching tasks verbally.  The provision of video to assist with task completion removes the auditory & language component which challenges them and focuses on the visual stimuli representing the same components.

The use of video modeling as well as other visual supports such as social stories and visual schedules can complement Augmentative Communication systems because they remove the components that are challenging to children with Autism and focus on their relative strengths. Video modeling studies in different life situations including conversational turn-taking, social initiation, play behaviors, and grocery shopping showed an improvement in these skills when video modeling was implemented.