by Kathie Harrington, MA, CCC-SLP
Autism Asperger’s Digest | Online Article March 2012
Where was the iPad when my son was young? As a speech language pathologist (SLP), I use this electronic miracle daily as I work with young clients with autism spectrum disorders (ASD). The iPad is portable, affordable, and easy to use. It is colorful, animated, and keeps our children productive and busy on their own. Stop the presses. Keeps our children productive and busy on their own—if that is what an iPad does, then I’d like to rename it a wePad. That is because another person should be using an iPad with children on the spectrum.
I see it all too often, an iPad with a great app is given to a child and there he or she sits, doing the activity all alone. No interaction—other than with the machine itself. Yes, the child can learn the alphabet, colors, numbers, vocabulary, animal sounds, and speaking with rote responses, but personal interaction is lacking. The crux of what children with ASD do not understand is turn taking, how to interact with people, and how to think about what the other person is thinking (Theory of Mind).
Can we use the iPad to teach social skills such as turn taking, answering, requesting, greetings and salutations, choral responses, and eye contact? Yes! When an adult, and eventually another child, interactively engages the child with ASD through the iPad, it becomes a wePad. The following are ideas on how to do just that!
- First of all, the child needs to know that he will be sharing the iPad with another person. Children with ASD are very possessive of the iPad and do not want to share it with anyone. Many children have their own iPad and that makes it even harder for them to understand that they need to share. This can be a major issue at first and one that might involve tears. The parent/caregiver will have to reinforce that they are not taking the iPad away; they are only going to have fun with it together.
One way to do this is to set a kitchen timer for wePad time. Start off with 10–15 minutes and increase it little-by-little. Because the adult is going to make it fun and lively, that increase in time might be more rapid than one would anticipate. Start off with the child’s favorite app. Regardless of what that app is; the adult is going to turn it into a two-person event.
- Because turn taking is the crux of communication—and we now have a wonderful, motivating, communicative device to use—the iPad is perfect for turn taking skills. “It’s your turn. It’s my turn.” Any app can be shared in this manner.
Turn taking is in everything we do and say. It is even built into some apps when the app speaks and the child replies. However, the child is still replying to a machine rather than to a human. Let’s strengthen the concept with the human element by the adult taking his or her turn as well. Here’s how that might look:
Animal App for Vocabulary
(child touches a cat)
Adult: “My turn.”
(adult touches a frog)
Adult: “Frog, I said frog, now it’s your turn.” (The child can now say, “frog.”)
- Because interaction includes thinking about what the other person is thinking—Theory of Mind—the iPad is a perfect place for the adult to interject phrases like, I want to put a blue hat on the teddy bear.
The adult should talk aloud, making simple statements about what he or she is thinking. Do not ask questions at this point. This is a great opportunity for self-talk and parallel-talk. Again, only statements are used by the adult. Self-talk is a short statement about what you are doing. “I’m pointing to the bear.” Parallel-talk is a short statement pertaining to what the child is doing. “You are looking at the horse.”
- Yes/no responses are usually difficult to teach as communication to the young child with ASD, and yet, it is so important for a parent to understand their child’s wants and needs. The iPad is a brilliant, motivating, and cunning device to teach yes/no. There are free apps that have only big buttons with yes/no on them. These are in two different colors and can be changed from a male to a female voice.
The adult needs to ask the child age-appropriate questions to elicit the correct answer. Children want to play around with this first and see what it does. That’s okay. Laugh and have fun as the child hits the buttons. Then limit the hitting to pointing by saying, “Use your pointer.” Always start by asking what the child knows or wants. For example:
Do you want an M&M?
A reward of an M&M is given immediately if the yes button is touched.
Do you want more M&M’s?
Use your pointer and your words.
(Look for pointing to the yes button as well as the child saying “more” or “yes.”)
The pointing to a correct yes/no button will have already been well established before this action/speech combination is requested (depending on the child’s ability level and expressive speech level).
- Choral responses are a part of all classrooms, but children with ASD do not like to respond or sing in unison because they do not interact well in group activities. They tend to shut down and do not join in when a group of children recite The Pledge of Allegiance or sing together. By adding just a few words at a time, the adult, the child, and the iPad soon form a group (choral response). This can be done with the ABCs, counting, songs, and nursery rhymes. Always start with something the child is familiar with and enjoys. Children often respond and speak along with the iPad once they know the activity/song. The adult needs to ease into it with the child. I find that most children know and love “Twinkle, Twinkle Little Star,” which can be found in several app versions on the iPad. They also like “Puff the Magic Dragon” at www.snapps4kids.com.
- Near pointing (with the pointing finger of either hand) is an important concept for all children. Many children want to point with their fist rather than using their pointer. Simply say, “Use your pointer” or use hand-over-hand (the adult taking the child’s hand and forming a pointing finger) to attain a pointer. Point to a single item on the screen to begin—the adult needs to always take his or her own turn or help the child point. Move on to multiple pictures on the screen as soon as possible, naming the picture.
Make it a game: who can point to the top picture first? Bottom picture first? The one that has red in it? Blue in it? (This can involve turn taking, pointing, following directions, prepositions, focus/attention, vocabulary, interaction, self-talk and parallel-talk, fun, and shared laughter!)
- Response-time delay is something I always note with children and adults with ASD but find little written about this in the literature. Many apps provide the opportunity to practice rapid responses that the adult can pair with turn taking. Keep picking up the pace of pointing using any app that is motivating to the child.
Challenge your spectrum child with phrases like, “I’m going to point to the monkey first” or “I can go faster than you.” Just don’t let this get out of hand to where the child starts using a fist response rather than using his or her pointer.
- Of course, there is laughter and fun. What tells us more about language comprehension than moments of shared laughter?
It is okay for children with ASD to have some alone time with their iPad. The iPad can certainly take the place of unwanted stimming time. It can be used as a reward for positive behavior, and it is good as a calming technique. It is also nice to have when a parent is busy getting dinner on the table for the family. Like other “screen time,” the iPad needs limitations. One of the best ways to set boundaries is to use a kitchen timer. When the timer goes off, the activity is over. For individual use with the iPad, I would suggest no more than 20 minutes at a time.
For using the wePad as an interaction tool (practicing turn taking, attention, pointing, rapid responses, vocabulary, expressive, receptive, and pragmatic speech), I recommend unlimited amounts of time interspersed throughout the day. Yes, the iPad is good for children with ASD, but the wePad is better. You, the parent, make it the best!
Kathie is the mother of a grown son with ASD. She is a speech/language pathologist, author, blogger, and international speaker. Learn more about Kathie at her website, www.kathiesworld.com.
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