Computer use for people with autism

World Autism Orgnisation Congres, Melbourne Nov. 2002

Paul Tréhin

 

"What type of computer program could I use for my autistic son/girl education?"

This question always embarrasses me a lot. It is almost like asking a cabinet maker "What could I do with a combined Jointer-planner-vertical shaper to build some furniture for my son's bedroom?"

Like many powerful tools the computer is still just a tool. As such, it can do a lot if we know what we want to do, but  even then it will only do certain things and gets is usefulness from the combination with other tools, some as powerful, some much more basic... If we want to take really advantage of the power of the computer or for that matter of any powerful tool, it is necessary to take the subject in a diagonally opposed way.

One must start with the person that is in the end concerned by our endeavor. In our present case we want to provide some support to an autistic person. We must start with that person's needs and what we want to achieve in order to satisfy them. Then we may ask ourselves or some computer specialist(s) if using a computer might not help us achieve the goals that we have selected.

Karl Popper called the computer "a glorified pencil".

IDENTIFYING THE NEEDS

Identifying the needs of a specific autistic person and prioritizing them is hence the first step of a meaningful approach. This in itself could justify a whole paper, it involves parents preferences, professionals recommendations and whenever possible and to the maximum extent, the concerned person's direct expression of requirements. We talk here of final needs, such as expressed by parents, professionals and autistic persons themselves.

Some goals can be extremely basic such as: "We would like to improve hand-eye coordination", "We would like to enhance the attention level/span". These are more likely to be expressed by the professionals in charge than by the parents or the autistic person.

Goals can also be pretty much in line with some academic or pre-academic skills developments such as "I'd like my child to learn the colors", "I'd like him/her to be able to read", or the child himself may have expressed or made us understand: "I want to play music".

Another domain concerns social skills: "I would like my child to learn how to recognize the household objects", "I would like him/her to learn the rules of a game", "my son expressed the desire to go by himself to the local toy store to buy toys on his own".

Without going in detail into the definition of individual needs, all the above needs can be organized in three major domains:

1/ Helping the person with basic functional skills acquisitions.

 2/ Development of elementary or higher academic skills.

 3/ Development of social skills, for work or for leisure.

This broad categorisation of the needs corresponds to the classification of the World Health Organisation (W.H.O.) that was introduced in 1980 (Wood 1980) which distinguishes three levels[1]:

       1/ IMPAIRMENT: a functional trouble in a body part or system function

       2/ DISABILITY: the difficulty in achieving basic performance resulting from an impairment

       3/ HANDICAP:   The difficulty in achieving social activity  resulting from the disability

 

     ------------

     !          !   CAUSES

     !IMPAIRMENT!-------------

     !          !            !

     ------------            !

                             V

                        ------------

                        !          !    INCREASES

                        !DISABILITY!<----------------

                        !          !                !

                        ------------                !

                             !               --------------

                             !  GENERATES    !            !

                             !-------------->! HANDICAP   !

                                             !            !

                                             --------------

 In order to respond to those needs we will try to segment the approach of the problems in a corresponding frame(Tréhin 1988):

 1/ Devising specific exercices to try to work on brain plasticity

 2/ Finding appropriate methods to teach basic academic skills

 3/ Developping activities fostering social skills acquisition

       ----------------------------------------------------------------

      !                    !                    !                    !

      !   IMPAIRMENT       !   DISABILITY       !    HANDICAP        !

      !                    !                    !                    !

      !--------------------!--------------------!--------------------!

      !                    !                    !                    !

      !     MEDICAL        !   MAINSTREAMING    !  ENVIROMNMENT      !

      !                    !                    !   AND PERSON       !

      !   INTERVENTION     !   PREPARATION      !   ADAPTATION       !

      !                    !                    !                    !

      !--------------------!--------------------!--------------------!

      !                    !                    !                    !

      !  BASIC BRAIN       !  ADAPTED           ! TEACHING SOCIAL    !

      !                    !                    !  SKILLS FOR        !

      !  FUNCTIONS         ! EDUCATION, BASIC   ! MAXIMUM LEVEL OF   !

      !                    !                    !    AUTONOMY        !

      !  EXERCICES         ! KNOWLEDGE ACQUIS.  !                    !

      !                    !                    !                    !

      ----------------------------------------------------------------

 

This is not really specific to autism, even though identifying the needs may require some pretty good knowledge of the person as well as what autism is, I mean what we do know so far about the specific learning difficulties linked to autism...

ASSESSMENT OF LEARNING CAPABILITIES

One very specific aspects of autistic people is the fact that not only are there inter individual differences but for a same person there can be considerable differences in the various domains of development: capabilities can be close to or at chronological age level in some areas and quite bellow age level in other areas(Frith 1990).

This entails the second step which is an IN DEPTH ASSESSMENT OF THE CAPABILITIES of that autistic person in all the domains of motor development, of cognitive development as well as in the social adaptation areas (Schopler 1988). This will tell us at what level, in each developmental domain, we can start to propose teaching activities that will lead us in the direction of the goal that we established in step one.

ESTABLISH A TEACHING STRATEGY

Step Three is to ESTABLISH AN APPROPRIATE TEACHING STRATEGY. For that we will use a "palette" of educational activities that are as much as possible adapted to the present level of the autistic person and his/her preferences. There may be the place to establish sub goals that may be necessary to achieve the final goal.

The implementation of exercises can be based upon some known, tested education strategies for autistic children (Schopler, trad Française 1988/1993). Other exercices can be adapted to computer assisted education and used for people with autism (Feuerstein 1994)

Games can often be used for incidental learning. While ordinary games have been rather well scaled for developmental age, this is a little more difficult with computer games. This remains one of the main obstacles to the use of computers games with people with autism.

REMEMBER THAT THE PERSON IS AUTISTIC

It is important to have a thorough understanding of autism in general (Gilberg, Peeters 1995, Jordan 1997). If it is true that there are enormous inter personal differences between autistic persons, there are nevertheless many striking common elements shared by many of them, albeit each with quite different levels of intensity. In most cases, visual educational material and strategies will be more efficient (Hodgdon 1996).

At least in the early phases of learning, use one sensory modality at a time, don't overload the main topic being learned by too much context, given the problems encoutered by people with autism at the sensory level (Grandin 1991), this may come at a later time when the generalization of knowledge will be mature. Context can be reintroduced progressively as the person acquires more advanced cognitive skills.

SPECIFIC QUALITIES OF COMPUTER WITH AUTISTIC PEOPLE

Now that we have approached the needs and the emerging capabilities as they should be, it is about time that we come to the use of computers with autistic children or adults.

Among the many tools that could be used to help us achieve the goals we have setup according to the level of the person and given the type of activities that would benefit the person, the computer technology can indeed bring some very specific exercises that can really be well suited for autistic people specific learning style:

1/ A computer does not react like a person : I believe that the difficulties of the autistic child with persons and animals lies in their unpredictable behavior. A computer has very consistent reactions to the same actions.

2/ A computer can be programmed to create very stable pictures of simple objects and respond consistently to the child interactions. Once the basic concept acquired, the next step could be to try

progressively building a more complex categorization of objects by introducing small variations on the objects images, progressively adding more and more complex context.

3/ The usage of a speech synthesizer could allow a similar strategy for the acquisition of verbal language. The words for the same simple objects would be pronounced by the synthesizer in a very stable auditory stimulus in simultaneity with the picture. Once the acquisition of a concept is definitive, variations in the voice can be introduced in the pitch, in the speed, in the intensity, in the

various parameters that differentiate speakers voices. Here too add contextual sounds progressively.

4/ The multiple input/output devices that can be used will enable interactions adapted to the progress of the child. Multimedia programs would be the almost perfect tool as they allow starting with real pictures of familiar objects, people, situations, etc... and progressively introduce variations around them, later introduce drawings, and more and more symbolic representations. Multimedia would allow the introduction of sound contexts to a picture and vice versa. This can be extremely useful when teaching social skills since it permits the progressive introduction of more and more complex social situations.

5/ The computer has one very specific quality that is not often mentioned: the computer is a means of  communication[2]. For some of the children who will not develop a spoken language, this possibility will constitute a realistic alternative. One can think of portable devices, but also about the emerging home computer networks, enabling a very rich communication.

All these positive aspects of computer use with autistic people only take their full power when integrated in a comprehensive strategy that will call upon many other teaching tools other than computers, and in particular moving from the computer environment to the real world...

I have stressed here the Learning situations since it is the one most often encountered by parents. With people with autism, even games have to be learned (Hogan 1997)... Leisure use of computers can be interesting too. But here too, we must think first about the autistic person, her needs, her capabilities and see that the computer program  corresponds to them. As often mentioned, there are risks too with some computer based activities. People with autism may get so immersed in the interactions with a computer that they will fail to become more socialized. The support here will consist in trying to diversify the activities in order to offer a choice to the person.

Some of the preferences for repetitive patterns, may happen. Providing that they don't occupy all the time, these can be considered as autistic personality preferences and aren't different from other repetitive activities. Some place and some time should be reserved for those activities too, it is not because we don't understand them that we should try to eliminate them... Don't we all have preferences that a number of people would not understand? These we keep to ourselves, and in general we try to reserve a time and a space for enjoying them. Autistic people should be taught to do the same with their favorite activities. That goes also for a computer program preference...

It is also necessary to establish a link between the activities on the computer and those in real life. For example to learn the rules of a game in a simulated environment in order to be ready later on when getting in a real social environment. This is important for people with autism as in most cases they have severe difficulties with grasping the rules by simple observation. Learning in the safe context of a computer game avoid the failure of learning in social context at first and hence avoids rejection by the social group.

Computers can be fun too with all forms of artistic expression. Drawing, music, even writing stories, if necessary through using pictures. This expression can really enhance the potential for sharing experiences, it allows one to create a document recounting an experience such as a trip to the sea, or a visit in a zoo, even if one doesn't know how to read and write. It is now easy to include sounds, images and even videos clips in a multimedia document that can then be shared with friends or more openly on a web site(Noyes 2002).

For people with more limited skills, there is still a possibility for creativity by using combinations of ready made "building blocks", writing a story in pictures, drawing with ready made elements, mixing pieces of music, etc...

Computers have one additional fantastic characteristic not often mentioned: they let you erase mistakes... Most programs have an "UNDO" feature which enables you to cancel the very last action that you did with your computer and just have to remake the last bit you did wrong. In the case of autism, where some fine motor skills can be subject to "parasite movements" this is a tremendous capability. This goes for writing texts, drawing pictures or even playing music.

But regardless of all these possibilities, remember that computers must remain a tool for developing real life activities and that they must be combined with many other tools to become really efficient.

 

Paul Trehin

Melbourne 2002

Bibliographie

 R. Feuerstein, Y. Rand, J.E. Rynders, "Dont accept me as I am, Helping,'Retarded' people to excell", Plenum Publishing Corporation,  NY 1994 (First published in 1988).

U. Frith, "Autism and Asperger syndrome" Cambridge University Press, Cambridge 1991

C.  Gillberg, T. Peeters, "L'autisme, aspects éducatifs et médicaux", 1995

T. Grandin, " Sensory Problems in Autism", Proceedings, 1991 Conference of the Autism Society of America

L. Hodgdon, "Visual Strategies for Improving Communication, Practical Supports for school and Home", Quirk Roberts Publishing, 1996

K. Hogan, "Pensée non verbale, communication, imitation et compétences de jeu : une perspective développementale", TEACCH Program Home Page, 1997, Traduction Evelyne ARTI-VARTAYAN, avec l'autorisation de l’auteur. E.D.I. Formation 1998 Titre original : "Nonverbal Thinking, Communication, Imitation, and PlaySkills From a Developmental Perspective"

R. Jordan,  " Education of Children and young people with autism ", Guides for Special Needs Education number 10, UNESCO, Paris 1997

P. Noyes, “Iconic Solutions – how a multi media package engaged a young autistic man & changed his family’s life”, World Autism Orgnisation Congres, Melbourne Nov. 2002 

E. Schopler, G. Mesibov, "Diagnostic and assessment in Autism", Plenum press 1988

E. Schopler, M. Lansing, M. Reichler, L. Marcus, "Stratégies éducatives de l'autisme", Traduction C. Milcent, Masson 1988 (4ème tirage 1995)

E. Schopler, M. Lansing, M. Reichler, L. Marcus, "Activités d'enseignement pour enfants autistes", Traduction M.D. Hemptinne et G. Van Hecke, Masson Paris 1993

P. Tréhin, "Déficience, Incapacité, Handicap et Education  assistée par  Ordinateur"  Colloque  De  Lons  le  Saunier, 17 Octobre 1987,  UNAPEI 1988

P.  Wood, "Appreciating the consequences of disease: The International Classification of Impairements, Disabilities and Handicap", W.H.O. chronicle 1980, (World Health Organisation).

 

[1] Note that there is a new classification used now by the World Health Organisation. However, I think that this one gives a clear vision of the relationship between the process leading to a handicap.

[2] I am not speaking here of a technique called "Facilitated Communication". This technique has been abundantly publicized causing a lot of controversy among parents of autistic people, professionals working with autistic people and often between the two groups.