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Posts Tagged ‘AAC’

Hi and welcome to What Works Wednesdays where we share a success story from one of our clinical cases. All names have been changed to preserve the privacy of the child and family. Our intent is to show readers how successful ABA can be.

Today’s post is about a 4-year-old little girl named Nahir who carries a dual diagnosis of Down syndrome and autism. Nahir began receiving early intervention services early in life. She began receiving ABA services shortly after she was diagnosed with autism. She began receiving ABA services from us last year.

Nahir’s parents wanted Nahir to be a community member in her neighborhood and they wanted her to learn alongside other children her age without disabilities. We designed an ABA program that consisted of about 10 hours per week of supported inclusion and 10-15 hours per week of 1:1 ABA instruction. Nahir responded to the intervention and began showing an interest in her peers at school and she began learning many skills at home. She even began using the toilet!

After several months, Nahir’s parents wanted to increase the amount of time in inclusive settings to 20 hours per week combined with 10-15 hours of 1:1 ABA. Nahir began engaging in non-compliant behavior and her rapid learning tapered off. We discussed our concerns about this change in learning with the parents and we encouraged them to consider making a change.

As a result, the family agreed to decrease inclusion time and increase 1:1 ABA time. Watch out! Nahir’s learning took off. She began imitating, her non-compliance decreased, and she started to communicate using her new iPad and Proloquo2go.

You see, inclusion is not all or nothing. Decisions about inclusion should be made individually for each child based on his or her unique situation.

We would love to hear from readers! Share your successful ABA and inclusion stories!

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Hi and welcome to Ask Missy Mondays where I respond to email questions from parents who are having difficulty with their child’s behavior. Today’s question comes from no one in particular but from many parents. Every time we show a parent how effective the iPad is for their child with autism, they instantly want to know how to get one for their child.

While some of our readers may not understand why a family cannot just run out and buy one (we know some families with 3 and 4 iPads!), many of the families with whom we work are struggling financially. So, if you have the finances, then definitely purchase an iPad for your child (and make a donation to the Holly Rod Foundation so more children can have iPads). If you do not have the finances, please read on.

There are several ways to get your device funded so I will carefully review each.

School Funding

First, under the Individuals with Disabilities Education Improvement Act (IDEIA), every child with a communication impairment has the right to an assistive technology (AT) evaluation. Only children with an IEP are eligible for this benefit. If the AT assessment result shows that the child would benefit from services, then the child should receive the device and services at no cost to the family. Training for family members, teachers, and all school staff who interact with your child is also included.

When purchased this way, the device belongs to the school district. Thus, when your child graduates or leaves the school district, the device does not necessarily remain with your child. The IEP team decides TOGETHER if the device should go home with the child each day. Obviously, if a child needs a device at school to communicate, he most likely needs it at home too. However, in some instances, the team may decide against this, especially if your child is prone to throw his device out the school bus window or if you frequently “forget” to send the device back to school.

Your child’s school district is also responsible for the care, maintenance, and repairs of your child’s device. Because the device belongs to the school, they are also ultimately responsible for any apps that are purchased and placed on the device. This means that your child’s app selection may be somewhat limited.

If you already had your IEP meeting, do not fret. Simply write a note to your child’s teacher requesting an additional IEP meeting to discuss AT (and any other thing you would like to talk about). The district must schedule the IEP meeting within a reasonable amount of time. You may have as many IEP meetings each year that are necessary to meet your child’s needs.

If you received an AT assessment and the results suggested that AT was not appropriate for your child, then you need to disagree with the assessment report and ask for an Individualized Educational AT Evaluation. This is known as an IEE and your child may have one IEE at no cost to you if you disagree with the evaluation that was completed by the school team. When your IEE is approved, carefully select an evaluator that will consider the use of an iPad for your child. If a second evaluator decides that an AT device is not necessary then your child will not be eligible for a device from the school district.

Insurance Funding

Your child’s insurance may cover the cost of a device. Coverage for devices varies based on your state of residence, your child’s insurance type, and other factors. Some insurance companies (e.g., Blue Cross and Blue Shield of Illinois) have gone so far as to state that devices like the iPad are not augmentative and alternative communication devices. If this happens to you, connect with your state health care advocate and file an appeal.

If you are lucky enough to have the right type of insurance, you will have to work closely with your child’s speech and language pathologist as well as your child’s primary care physician in order to get a device approved. The process will be time-consuming but when you use this option, the device belongs to your child. You will be responsible for its care, maintenance, and repairs. You will be responsible for purchasing any new applications.

When the device is purchased with insurance funds, the device is serving as a mode of communication. It should not be used as a toy.

Grants

There are many non-profits and foundations out there that are focused on helping provide iPads to children with autism and other disabilities. My favorite is the Holly Rod Foundation. My brother was a recipient of one of their iPads and he uses it to Skype our Dad and to Face Time me. One of my clients also received an iPad from the Holly Rod Foundation. We cannot thank the Foundation enough. Get on their mailing list so you will know when the next round of iPads will be given away.

If you live in Texas, the state has a program called STAP grants that are available to individuals who need to be able to communicate with others. Your child’s speech and language pathologist must complete the application on your behalf. Similar to insurance funding, the device must be used for communication purposes and not for games. This device will belong to your child and you will be responsible for its care and maintenance.

We have recently been made aware of other groups that are giving away iPads. We have not had any experience with these groups so use caution before providing them with information such as your social security number.

Babies with iPads is hoping to give away 4 iPads per year. Their website is here: http://babieswithipads.blogspot.com/

Snapps4kids is also giving away iPads. They recently merged with Easter Seals. Their website is here: http://www.snapps4kids.com/funding-sources-directory/

Have you had success getting a device for your child? Please share so that we may celebrate with you.

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Lately, I have begun paying attention to the ways people parent when they are on community outings. Many times, I see toddler tantrums that make me laugh. Why do I laugh? Well, if the parent is laughing, then the parent understands why the toddler is throwing such a fit.

You see, many parents understand that toddlers are going to tantrum. Many parents also know why their toddlers throw tantrums. Toddler tantrums are really just words that the toddler has not yet acquired.

“I want _______”

“I don’t want __________”

“_______ is mine”

This is true and there is even a shirt about it. This is a shirt showing the toddler tantrum yoga poses. See? Parents know their children’s tantrums!

You know what else? Pet owners often understand what their pets are trying to tell them.

“I’m hungry”

“Let’s play fetch”

“Let’s go outside”

“I have to potty”

“I’m tired and can’t walk anymore. Carry me.”

Pet owners know what their dog is saying, even though they cannot speak.

What I have never understood, however, is why people don’t understand (or don’t even try to understand) the tantrums exhibited by individuals with autism. Individuals with autism who are non-verbal have tantrums because they, too, have not yet acquired the words. Yet, when they have a tantrum, people are not laughing. Whey they have a tantrum, people get mad. When they have a tantrum, they get restrained, punished, or yelled at.

What we, as behavior analysts have learned over the years, is that individuals with autism are using their behaviors to communicate. A behavior analyst’s job is to assess what the individual with autism is trying to say with his tantrum.

“I want ________”

“I don’t want ______”

“I need help ________”

“I am all done”

That assessment is called a functional behavioral assessment. After the assessment, the behavior analyst designs a communication intervention program to teach the individual to communicate instead of tantrumming. You’ve heard the old saying, “Use your words”. When an individual is non-verbal, she does not have words. So, behavior analysts teach augmentative and alternative communication strategies or AAC. Individuals can learn to sign. They can learn to use pictures to express their wants. Or they can use an iPad equipped with proloquo2go. The options are endless.

So, next time you are out in public and you see an individual with autism throwing a tantrum, think about your toddler and her tantrums. Know that the individual is trying to tell us something. We just need to stop and listen.

Addendum

This is one of our favorite posts. We are hoping to share it with others today as we link up with Ado over at the Momalog as she celebrates her blog’s first birthday. Hop on over there and check out the other bloggers’ favorite posts.
Blog Bash

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Dear Steve,

You left us too soon. You left us before you could possibly know what your work has done for us. The iPad combined with many, many different applications, including the Proloquo2go software has helped us and our loved ones tremendously. Children have learned to communicate that they want to eat, children have learned to communicate when they are upset, children have learned to communicate when they are scared.

Thank you for being brave enough to think differently. Thank you for making a difference for our children with autism who also think differently.

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