iPads & Communication

iPads & Communication

Teachers who work with students with autism are constantly looking for strategies to improve communication skills, especially for students who are nonverbal. In the past, we have used sign language, Picture Exchange Communication System (PECS), and incredibly expensive augmentative devices to promote communication. So the advent of the iPad appears to be a godsend in terms of communication. You can buy apps that are designed specifically for being used as a communication system for our nonverbal students, the iPad is typically highly motivating for students, and communication apps range in price from $150-$250. That’s a steal compared to the thousands of dollars once spent on devices in a pre-iPad world.

Before going on, I think it is important to clear up a misconception about introducing sign, PECS, or an augmentative device to help a student communicate. Introducing one of these systems is not equivalent to giving up on the student’s potential for language. Instead, it is providing the student with a means of communication which frequently leads to a decrease in self-injurious behavior, tantrums, and other maladaptive behaviors. And, in many cases, introducing one of these systems can lead to speech. In my own practice, I have worked with one student who began speaking a few weeks after being introduced to sign and many students who began speaking after being introduced to PECS. (It should be noted, I have only had two students that we used sign with, while I’ve had about 40 who have used PECS. So my results listed above are not indicative of one system being better than another.)

So, back to the iPad. Because the iPad has been so successfully marketed as a tool for education, there are many schools and programs that have bought apps to use for a communication device. I’ve visited many locations that rely solely on ProLoQuo2Go, an app that enables people to “talk” using symbols or typed text in a voice that suits their age and personality. While many educators I have met have had success with ProLoQuo2Go, I actually prefer Speak for Yourself, which is thoughtfully designed so that no one thing you want to say requires more than 2 taps, develops grammatical structure, and is highly customizable based on your student’s current levels of receptive and expressive language. You should consult with a Speech Language Pathologist for further information.

Multiple studies are coming out now about using the iPad as a communication device for students with autism. What I’ve noticed time and again is that the studies are completed in isolated environments. It makes sense to begin these studies with students in clinical or school settings. But is the iPad really the easy solution for your student in all environments, outside of the clinical or school setting?  Below are some questions to ask before implementing the iPad as a communication system for a child.

  • Have I assessed? As is stated in many places on this blog, everything must start with assessment. I prefer the use of the VB-MAPP for students who are displaying serious deficits in communication. The VB-MAPP provides a wealth of information about your student’s current skill levels, assesses the student’s barriers to learning, assesses their ability to transition to a less restrictive environment, AND it provides suggestions for teaching strategies and IEP goals. It does all that, then goes a step further. Based on your student’s results, it can help you determine what type of communication system might be best for your student. So if you assess, then read the materials provided with the VB-MAPP, and it suggests that sign language would be most beneficial for your student; you should not start with the iPad. There are many details that go into choosing an appropriate communication system, but assessment of the student’s abilities and needs should be the foundation for the final decision.
  • Does the student use the iPad for multiple functions? This is quite possibly the most difficult aspect in terms of using the iPad as a communication device. Many of our students have been conditioned to see the iPad as a purveyor of games and youtube videos. If the child is already unmotivated to communicate, you may be setting yourself up for failure by trying to change the function of one of his/her favorite items. If you feel the iPad is the best option for communication, you have two possibilities: (1) have one iPad for fun and the other for communication, or (2) clearly mark that the iPad is only for communication and use the accessibility features to lock the iPad into the communication app you have chosen. (You can lock the app by using guided access, as detailed in this post.) If you are not able to do one or both of these two things, you are unlikely to experience success because many of our students are more motivated to engage with the iPad in other ways than to use it as a tool for communication.
  • Are the parents trained in how to promote appropriate use of the iPad for their child? Addressing the problems detailed in the last paragraph is already difficult as a trained professional whose time with the child is focused solely on that child. If you are implementing the iPad as a communication device, parent training is key. When the student is with the parent, that parent is doing many things we as teachers NEVER have to do when with the student: cooking dinner, cleaning the house, taking care of other children who are home, accepting phone calls from family members, running errands, etc. There are far too many opportunities for the child to use the iPad for other functions instead of as a tool when he/she is in this setting. Be thoughtful about the particular obstacles that are present for that child, for that child’s parents, and in the home environment. Help the parent implement practical plans for addressing those obstacles if you have decided that an iPad app is the best tool for communication for that student.
  • Does the student always have access to the iPad? If the iPad is only available in one environment, it is not a very useful language tool for our students. It is unfair and unethical to allow the student access to language in only one environment or only around specific people. This is one of the pros for using sign language: it’s a mode of language that is always accessible to the student. If the iPad is not always accessible to the student, it should not be their mode of communication.

You may have asked yourself all of these questions and arrived at the answer that the iPad is, in fact, the best tool for your student. Your next step is to research the different apps available and choose the one that is most appropriate for your student. Utilize speech therapists and ABA therapists or other educators to help you make this decision. I do believe that the iPad has huge potential as a communication tool (and I have never seen any device designed as well as the aforementioned Speak for Yourself app.) But the key here, just like with everything else we discuss at this site, is to implement thoughtful instruction. Do not implement a communication system on the iPad simply because the iPad is there. Implement a communication system based on your answers to the questions above.

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5 Comments

  1. You have made some very good points but something very important to remember is that an licensed SLP specializing in AAC is the one who should do the AAC assessment to determine if an iPad with communication app vs. a dedicated device vs. static display picture boards vs. PECS vs. sign language is appropriate. This assessment should of course include feedback and information from all team members. It should never be on the parents to have to make this decision on their own but a licensed speech and language pathologist specializing in AAC needs to be involved in the assessment.

  2. I agree with your article but have a couple of comments. When assessing a person for a communication system, it is important that a licensed speech and language pathologist specializing in AAC does the assessment. This assessment should of course input and feedback from all team members. An SLP specializing in AAC is a necessary part of the team as they can help to determine the correct language representation system that the person needs as well as developing a plan to help the person learn and develop language following normal language acquisition. A parent should never have to make this decision on their own but an SLP should be there to help with the process. Additionally, if it is decided that a more traditional voice output device is necessary, an SLP has to write the funding report for insurance and Medicare funding.

    • I absolutely agree that an SLP specializing in AAC should be the person doing the assessment. And I have had the good fortune to work with several SLPs who are fantastic and have trained the whole team of people working with the student on how to correctly implement the AAC that has been chosen.
      However, two problems frequently arise. (1) I have been on many cases where an SLP was not available. In some cases, a speech therapist, though mandated on the IEP, was not available. There is such high demand for speech therapists in my area, that it is difficult to fulfill the mandate, especially if the child lives in a low-income area. (2) I have seen many cases where an in-home teacher (for preschool-aged children who are not yet in school) haphazardly implements AAC, usually with some sort of picture exchange system or with the iPad because it’s readily accessible.
      I’d love to hear any resources or suggestions for managing those two situations.

  3. Great article! I am a speech-language pathologist specializing in AAC. I have thought about the same questions. One of my biggest challenges is that teachers and parents push for the iPad because it is socially acceptable even though it is often not appropriate. They are not very loud, they are not durable, and they are a waste of money if the individual cannot initiate communication. So often I see individuals with devices who require complete hand over hand assistance to use it but can independently use a PECS book.

    • I don’t think that the communication systems are a waste of money if the client/student does not initiate. I prefer to see initiation, of course. But if someone has a way even just to respond to questions, they have a way, then, to demonstrate competence. Expectations get raised.

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