Case Study 1
A Communication Aid for Minnie
A young child, ‘Minnie’, enters P1. She has cerebral palsy with complex mobility, hand function and eating and drinking difficulties, and no intelligible speech, but she is responsive, sociable and communicative, and appears quite cognitively able. In Nursery, she used a BigMack to tell ‘News’, and had been introduced to basic Mayer Johnson Picture communication Symbols (PCS). She seems to retain this knowledge.
Computer Access - Minnie cannot use a mouse or keyboard or even manage a rollerball or joystick. To access the curriculum and to record her work, she will have to use a single switch with an ‘autoscanning’ cursor (although we will assess whether she can use two switches as this is easier cognitively, less frustrating, and quicker than a single switch). The range of software she will be able to access is severely reduced, compared with classmates. Happily, there are some versatile and powerful ‘flagship’ applications such as Clicker 4 (and now 5) that support switch access. We get her started on simpler ‘single hit’ programs such as SwitchItMaker 2 and PowerPoint, to give her a sense of control, and to motivate her with fun and interesting materials (eg. talking stories) and then ChooseItMaker 2, to teach her to scan and make a selection from a range of options. All of this requires significant staff training and support.
Communication Aid - Concurrently, we consider how Minnie can express herself and participate actively in her education. ‘Wait and see’ is not an option, as she may become passive, but introducing complex and powerful voice output communication aid (VOCA) technology when she is developmentally too young (and when the staff are inexperienced) can be a mistake too. We supply a little symbol communication booklet with pages arranged in topics, and show staff how to do ‘partner assisted scanning’ ie they point to the rows and the symbols and Minnie signals (by smiling and clearly eye-pointing up to her right) when they point to the one she wants. We also suggest to staff a range of quick ways to get Minnie’s answers, eg. pictures, symbols or words, numbers stuck on an ETRAN frame, to which she can eye point. She keeps her BIGMack for home/school news, and gets another one for use in story and game participation. Over the year, we try her out with various scanning VOCAs, such as a TechScan 8, a TechSpeak 32 (which take paper overlays), and a MightyMo (dynamic screen device, with recorded speech). She responds well to the MightyMo which is more complex in some ways (she has to remember how to navigate around from the Top Page to different topic pages) but which can be made to match and develop upon her symbol book, and which has the potential to store more vocabulary (and so to be more interesting and useful). It is relatively easy for staff to program and is a good ‘starter device’ for Minnie who may manage of the most complex VOCAs, later.
All of this is a long term and ongoing process that highlights the need for different equipment loans from CALL, staff training, and continual formative assessment. There is no quick ‘technical fix’.
“ A short note to thank you for the extremely detailed report compiled in respect of the CALL referral made for R. Your report gives lots of reassuring advice in terms of options for supporting him, and I found the reading of the report a very productive learning experience. ”
Educational Psychologist
