Dear Ms. Kelly,
We applaud you for updating your readers on the uses and application of tablet technology to teach individuals with autism (“Using tablets to reach kids with autism,” April 10, 2014). It is wonderful to see how the use of technology—specifically the use of tablets and the development of a variety of apps—have extended to use within the autism community. As you pointed out, when the iPad was initially released in 2010, it was quickly hailed as a “miracle” device for children with autism. Thankfully, that fad has diminished, and a more realistic perspective on its utility has taken hold among parents and educators alike.
You mention that technology is used primarily as a teaching tool, not a cure, in autism treatment and this is a noteworthy point. We appreciate that the application (app) developers as you stated, “had time to discover what works best for kids…the uses vary from child to child.” It is critical to consider that fact as it applies to individuals with autism in order that they may receive the best treatment possible by considering the varying skills, needs and capacities of each individual. Numerous articles have been published related to teaching children with autism a variety of skills using tablets and apps, including: picture naming (1), numeracy skills (8), academic engagement (13), imitation skills (2), requesting and social communication skills (van der Meer, et al., 2013), generalized matching skills (11), requesting additional time to play (14), increasing play dialogue (12), and communicating snack preferences (4).
In your article, a number of examples of teaching scenarios involving apps are mentioned; in some cases, further investigation and interview with an expert in the use of apps for children with autism might have uncovered the fact that many of these teaching procedures have their roots in behavior analytic principles. This supports our view of integrating appropriately selected technology with other behavior-based methods. For example, the methods of video modeling and behavior rehearsal are present in speech therapist Jordan Sadler’s Puppet Pals app that “restaged the scenario as a movie…using the app to show an instant replay … (to) identify what went wrong” and work on areas of improvement.
Task analysis is also alluded to with one woman’s child “now 13, to think visually, to interact with content directly…and it breaks complex concepts up into more easily understandable chunks.” Activity schedules are referenced with one child, Leo, able to “use the iPad on his own and have a good time independently,” whereas he used to find it difficult without someone else structuring his day. This also allows for more autonomy for the child. The access to reinforcement is also noted with “Rosa, though, like many parents, is careful about letting her son have too much screen time.”
While the use of tablets may be helpful in teaching specific skills to individuals with autism, the individual needs of each child must always be considered. Not every child will be most compatible with computer devices, and the medium chosen to teach each child should be one that will be both functional and effective in meeting his or her needs. One child may be attracted to using the tablet, whereas another may show more progress using PECS or sign language. In the article comparing iPad use and picture-based systems, M. Flores et al. found that “the results were mixed; communication behaviors either increased when using the iPad or remained the same as when using picture cards,” and that preference for a device “appears to be individual to the student” (4). There are also potential motor limitations that would prove difficult for using a tablet for some children.
Your article also points to the fact that tablets are a more affordable option for parents/educators and a replacement for older methods. While compared with devices that are $6-8,000.00 this is true; however, other, older options such as signing and PECS, are even more affordable, and may be the better option for a particular child. The M. Flores et al. study previously mentioned also cautions against prematurely investing in iPads because they may prove “more costly in the end if they do not result in effective and efficient communication” (4). There is a great potential with tablets in autism treatment; with this potential is the need to proceed with caution and to support further empirical research through scientifically-based studies.
Technology has already assisted parents and professionals to teach individuals with autism, and will no doubt continue to evolve and develop. Articles such as yours inform parents and educators of the current uses of tablet and other computer devices. In the future, we would encourage you to combine the wonderful interview and accounts you wrote about with input from researchers in the field of autism who have conducted investigations about specific uses and their effectiveness. Including information about current research and expert recommendations will allow your readers to be more savvy consumers of autism treatment and technology.
Sincerely,
Emily S. Walkup, B.A. and Barbara Jamison, B.A.
Association for Science in Autism Treatment
References
Alexander, J. L., Ayres, K. M., Smith, K. A., Shepley, S. B., & Mataras, T. K. (2013). Using video modeling on an iPad to teach generalized matching on a sorting mail task to adolescents with autism. Research in Autism Spectrum Disorders, 7(11), 1346-1357.
Cardon, T., & Azuma, T. (2012). Visual attending preferences in children with autism spectrum disorders: A comparison between live and video presentation modes. Research in Autism Spectrum Disorders, 6(3), 1061-1067.
Cardon, T. A. (2012). Teaching caregivers to implement video modeling imitation training via iPad for their children with autism. Research in Autism Spectrum Disorders, 6(4), 1389-1400.
Flores, M., Musgrove, K., Renner, S., Hinton, V., Strozier, S., Franklin, S., et al. (2012). A Comparison of Communication Using the Apple iPad and a Picture-based System. Augmentative and Alternative Communication, 28(2), 74-84.
Gevarter, C., O’Reilly, M. F., Rojeski, L., Sammarco, N., Sigafoos, J., Lancioni, G. E., et al. (2014). Comparing Acquisition of AAC-Based Mands in Three Young Children with Autism Spectrum Disorder Using iPad® Applications with Different Display and Design Elements. Journal of Autism and Developmental Disorders, 3(6).
Hill, D. A., Belcher, L., Brigman, H. E., Renner, S., & Stephens, B. (2013). The Apple iPad as an Innovative Employment Support for Young Adults with Autism Spectrum Disorder and Other Developmental Disabilities. Journal of Applied Rehabilitation Counseling, 44(1), 28-37.
Hill, D. A., & Flores, M. M. (2014). Comparing the Picture Exchange Communication System and the iPad for Communication of Students with Autism Spectrum Disorder and Developmental Delay. TechTrends, 58(3), 45-53.
Jowett, E. L., Moore, D. W., & Anderson, A. (2012). Using an iPad-based video modelling package to teach numeracy skills to a child with an autism spectrum disorder. Developmental Neurorehabilitation, 15(4), 304-312.
Kagohara, D. M., Marschik, P. B., Lang, R., Sutherland, D., Lancioni, G. E., O’Reilly, M. F., et al. (2012). Teaching picture naming to two adolescents with autism spectrum disorders using systematic instruction and speech-generating devices. Research in Autism Spectrum Disorders, 6(3), 1224-1233.
Meer, L. V., Sutherland, D., O”Reilly, M. F., Lancioni, G. E., & Sigafoos, J. (2012). A further comparison of manual signing, picture exchange, and speech-generating devices as communication modes for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 6(4), 1247-1257.
Meer, L. V., Marschik, P. B., Lancioni, G. E., O’Reilly, M. F., Green, V. A., Balandin, S., et al. (2013). Teaching Multi-Step Requesting and Social Communication to Two Children with Autism Spectrum Disorders with Three AAC Options. Augmentative and Alternative Communication, 29(3), 222-234.
Murdock, L. C., Ganz, J., & Crittendon, J. (2013). Use of an iPad Play Story to Increase Play Dialogue of Preschoolers with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 43(9), 2174-2189.
Neely, L., Rispoli, M., Camargo, S., Davis, H., & Boles, M. (2013). The effect of instructional use of an iPad on challenging behavior and academic engagement for two students with autism. Research in Autism Spectrum Disorders, 7(4), 509-516.
Sigafoos, J., Hodis, F., Achmadi, D., O’Reilly, M. F., Lancioni, G. E., Green, V. A., et al. (2013). Teaching two boys with autism spectrum disorders to request the continuation of toy play using an iPad®-based speech-generating device. Research in Autism Spectrum Disorders, 7(8), 923-930.
