There are now three of us at school who are iPod Touch addicts when it comes to frantically searching for an app that will help free us at least to some extent from the mountain of little picture cards, strips, and communication boards strewn all over our house and car. It’s either that or you never seem to have the ones you need with you in a particular situation. There are numerous great iPod/Phone/Pad apps out there now for picture communication, and my two iPod friends have indeed found a couple they really like. I was certainly impressed with them, too. There’s a lot of creative work going on out there in app developer land.
But here at Chez Flashlight, we have what at first seems like a minor issue, but in the realm of iPod and iPhone communication apps it quickly becomes a much more daunting one. Because the J-Man likes written words and can read many of them, he does remarkably well with pictures as long as they are labeled, and usually the bigger the label the better. We’ve even worked him toward schedule strips with small picture icons and larger written-out words. (See below.) Our more traditional looking picture squares get larger and larger word labels as time goes on. The problem? The iPod and iPhone apps we found so far focus on the picture and much less on the word label.
[Examples of picture strip-based schedules. Follow it like a list. Compare with his aging food choice card below and notice that the pictures above are now just icons with large word labels (or large words with little icon labels). Obviously we now have a zillion disorganized strips that seem to multiply like rabbits in the house.]
[J-Man's food choice card that he's been using forever.]
For the most part, this has been a good ‘problem’ to have. We are all convinced, however, that he has hyperlexia. Hyperlexia is where a child has reading abilities beyond or well beyond age level and often a strong fascination with letters and numbers, but it’s often accompanied by significant difficulties understanding speech. Indications also are that while being able to read at a high level, the child may not actually comprehend much of what he/she is reading. It’s thought that a noticeable percentage of autistic children are hyperlexic, and there’s a theory that children with hyperlexia are usually on the spectrum somewhere. There are cases when, for example, you ask the J-Man to point to a ‘butterfly’ in a book that he points to the word and not the picture. This can make teaching what the word means and how to generalize it more challenging, but we can work with that. The good news is that we believe we can leverage his reading strengths to help him compensate for his verbal communication challenges.
The issue is that so many picture communication tools for his age assume that there’s not much in the way of reading skills there yet, or at least that those skills are secondary to picture recognition. And really, this isn’t unreasonable. The assumption – I think – behind most of the current iPod/iPhone/iPad apps is that the child is picture-visual rather than word-visual (written words are still visual), will become more and more verbal, and between that and pictures will be able to communicate their needs. The problem is, what do you do when the child over time still only minimally talks or doesn’t talk at all, their needs become more and more complex, and you just don’t have enough pictures to capture it all?
Maybe it’s just me and my limited abilities to grasp what to do here, but as the things he wants to communicate become more abstract and nuanced, pictures alone just have a very hard time overcoming a communication barrier with a more verbal world or at least with parents who are struggling to learn a language that best suits him. I know it’s possible to develop a picture-based, visual language, but we have to be able to understand what a visual means to him and he has to be able to get his point across. We have to find someplace to meet in there at least until we build a foundation to work from.
Obviously, this is a complex issue that we can’t do more than scratch the surface of in one post. The main reason I bring this up is that I want to find an app that meets his needs, and I haven’t found it yet. Apps are so expensive, few of them have trial versions, and $35-$200 is a lot to pay just to try something out. There are some very cleverly done apps out there that I’ve tried, and I’ve dabbled with a lot of them, but all of them I’ve looked at focus mostly on pictures and put text as secondary. An app that put pictures and text on more equal footing might get us somewhere. Maybe something like that would address the needs of kids like our J-Man who are either more interested in words for visuals or are just at a level developmentally where they are ready for reading.
The leading contender I’ve found is Proloquo2Go. It’s the only one I’ve seen so far that appears to allow for both picture and text-based communication in such a way that both can be prominent and we can leverage his reading skills. The problem? It’s $190 and has no trial version. That’s a lot of money for something I’m not sure about, but the video tutorials are compelling and its extensibility and customization options put it well above anything I’ve tried so far. In the past, I’ve considered Proloquo2Go more of an app for older kids and adults, but I’m beginning to see the possibilities for our now five-year-old.
Anyone have any suggestions about iPod apps? If you are an app developer and think your app either addresses the above already or you’re working on an app that might, drop me a line.
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{ 13 comments… read them below or add one }
Tim, you raise a *really* excellent point here about assumptions which get made about how all autistic people are visual thinkers or how pictures are the most effective means of communicating for a nonverbal person. GAH! I’m with you in sharing the frustration over the cost of, and lack of trial versions, of the apps which might be useful…if you had a couple hundreed bucks to spare to find out.
Does your state have any sort of assistive technology resource lending program? Maybe they have iPod Touch or iPad with Proloquo2go already loaded which you could try-before-you-buy.
Delaware has an “Assistive Technology Initiative” which is run through our state university’s disability rights program. They have a Assisitive Technology Resource Center (ATRC) in each county. The ATRC is a repository (fully staffed with knowledgeable people) of all kinds of assistive technology devices. I have borrowed a touch screen PC to see if it would work with my son (too high tech for where he is right now) and am now in temporary possession of an iPad. They just got the iPads in so they don’t have a lot of apps yet. (I’ve been downloading lots of free early-learning apps to try w/Nik.)
Since Nik has a Vantage Lite speech device, I haven’t paid much attention (yet) to the other communication programs out there. It’s worth checking out, though.
Feel free to email me if you want more information.
Others are so much more qualified on this topic than me, Tim.
But here’s what I can give quickly – Voice4U is $30. I just checked and the words are above the icons.
Here’s my review w/ several links that might be more helpful.
http://www.therextras.com/therextras/2010/02/iconic-meaning.html
If you find an app that you like, but is more picture-focused, write to the company. These small companies usually love to hear from their customers, and though it may take a while your input could really affect the direction of their products. At least it did at the companies I worked for!
I’ve heard good things about the app you mention, but I’d definitely want to trial it first. Maybe they have (or can give you) a trial version?
These sites might require a bit of looking through to see if anything appeals to you.
http://babieswithipads.blogspot.com/
http://www.bookroomreviews.com/2010/08/16/best-ipad-apps-for-autism-and-aspergers-syndrome/
http://www.happybeingtrevy.com/2010/09/ipad-apps-of-day.html
On this one she has a category you can click on and read just those posts.
http://www.spectronicsinoz.com/blog/new-technologies/2010/07/iphoneipad-apps-for-aac/
Clearly I spend too much time online.
@Niksmom – I had looked up whether we had a local assistive tech place in our city just the other day. It’s actually right by where we did feeding therapy years ago. I contacted them this morning. It sounds like they are low on equipment in general, which I’m sure is a function of all the budget slashing going on. I might be able to get an iPod with Proloquo in a couple of weeks as a loaner. They don’t have any iPads yet. They have other devices to try, but I can’t imagine buying one of those. It’d be like buying a new car in price. They invited me to come down and talk everything over, which I’m going to try to do when they get that iPod back.
What developers don’t seem to get is that these assistive tech centers are in budget hell and can’t buy their stuff either. Sheesh, guys. Send out free coupon codes to all these centers. They are some of your best marketers.
@Barbara – I had looked at Voice4U before. It seemed like the best you could do with it is one picture/label on the screen at any given time. Was I missing something? As far as him communicating with us, we have found that he can handle variations of choice cards (like the food board) up to fields of 9 or more for familiar concepts (food, colors, etc.). That’s what got us thinking about more robust communication apps.
We really have two goals that I realized talking to a couple of moms at school today that I didn’t make clear, mostly because I didn’t know it myself. (Always cool when something I post one day becomes the topic in the parking lot at school the next morning!)
We are trying to meet the following communication goals, which it turns out iDevice-wise are two very different classes of applications.
1. Improve our communication with him.
2. Offer him opportunities to improve and expand his communication options with us.
Conversation is obviously two-way, and I realized that in iLand, apps tend to satisfy one or the other but not really both. There are exceptions, but I’ve not found an app that really does both well. It’s often one done pretty well and the other done at a basic level.
I think #1 is the easier to fix after talking to the moms at school today. They helped me figure that out. I started out with the second goal being the one I was really focused on, but realized we need to address both.
I think I found some apps for #1 and will let you all know if they work. The second is where I’m still cogitating.
Thanks for the links!
@Jen – I follow a few of those companies on Facebook and like you have found they are often very receptive to input. It’s interesting and heartening to watch them struggle with how to address everyone’s needs and do so with a real passion for their work and the people they seek to help.
Talking to the iPod Moms at school today, we identified another issue. Though some developers are responding by adding new features, we all still spend inordinate amounts of time trying to customize apps to meet our needs (or see if they can meet them). I think this is where developers are hitting a huge wall with their customer base. We all need something a little different, and how do you balance meeting people’s needs with customizability with avoiding making the app a time-consuming mess for people to set up? It’s a tough quandary, and I know a lot of devs are struggling with it. They seem to be erring on the side of more and more customization options, which for us personally has turned out to surprisingly be a pain in the butt.
We seem to be the oddballs out compared to a lot of the feedback I’ve read from users on Facebook and Twitter.
But we rather like being odd. 
@no one in particular – I’ve worked in and around software development for a long time. In fairness to app developers, creating trial versions is a lot harder than it looks, particularly with Apple’s restrictions. Apple doesn’t allow apps to just expire at the end of a trial period, so developers have to create ‘lite’ versions with reduced functionality that are then replaced with the full version if the user buys it. These lite versions are total pains to make because of all the extra programming you have to do to turn features off.
I have been using iPrompts from Handheld Adaptive for about a year now. You can use your own photos, edit captions, and download pics or photos for it. It can be used for schedules or social stories, has a visual timer, and a choice board.
@Mette – Thanks for mentioning iPrompts. I spent a long time looking at it over the past few months. As a communication device, it felt too limited for our purpose. I can definitely see its usefulness for social stories and schedules. Ultimately the cost ($50) felt too high for what I thought we’d get from it, particularly when there are more apps coming out that when combined with another app might give you the same functionality for a lot less. A year ago, this definitely wasn’t the case, though. There were a lot fewer options in the app store then.
I heard an interview a while back with the people who make iPrompts, and they definitely are a smart bunch. Just looking at it from a cost-feature perspective, to this point I haven’t felt like I can justify the $50 for it, though. I do think it quite possible, however, that they will improve it over time such that I’ll see its value differently. I’m always willing to be persuaded to change my opinion, though.
We’re actually only using the time function currently as my son mostly prefers his laminated copies of social stories and file folder schedules right now (he’s 6). Hopefully he will appreciate the coolness of using the iPod (or maybe someday an iPad!) to house all of his visuals. His preferences are always changing.
There was also talk of adding a video library of social skills.
Mette – While all the laminated parts of our lives are working pretty well in and of themselves, we’re both drowning in them and feel like he could communicate more if we had the right visuals with us at the moment he wants them without having to hunt through all our laminated stuff. At school, his folders, schedules, stories, etc. are working great for him, too. We just can’t seem to keep it organized here at home and especially when we’re out in public. It’s like we can’t ever get it together enough to handle this complex system. We hope the iDevice approach works, though no doubt we’ll still have laminated stuff around for a long time. It’ll probably be a hybrid system for at least some time. It’ll be a huge leap for the J-Man, but like you said, preferences are always changing and some things like this can slot right in if the planets align right.
Model Me Going Places is a cool little free app with some slideshow-based social stories. They’re preprogrammed so no customization, but I bet this sort of thing with options to make your own stories will become more available. I like their interface. There are lots of ways you can go with videos. It’ll be interesting to see what people develop for that.
I don’t have that many laminated copies of things. We are lucky that we can write things down with a dry erase marker and that suffices. I know I can’t begin to imagine having to organize pictures for so many things. I hope you find the app you’re looking for as it would make things more efficient for you. Do you have too many to tuck into a binder of sheets of trading card pockets? Maybe that’s not a realistic solution.