Technology Update

It seems like there isn't a long stretch in the year when we are bored.  Right now we have lots of school activities, communion parties, softball games, etc.  We are also working on Emma's kindergarten placement and it seems like we have an agreed upon placement for her in the Fall.  I'll tell more about that later once we update her IEP because I'm afraid announcing it on this little ole blog might jinx us.  Better safe than sorry in my book!  Especially when it comes to IEPs....sigh.

Emma has been making a lot of progress using Evie at home.  She has a new SLP at school who hasn't been trained on her device yet but she is working with it as best she can and Emma is starting to show her what she can do with it a bit more.  We had an IEP meeting today to increase her Speech session from 2x 30 min sessions/week to 2x 45 min sessions/week based on input from her prior and current SLP.  Emma just gets warmed up and in her groove at the 30 min. mark when it's time to end and they want more time with her.  So that was agreed and added to the IEP.  Also, we'll add training time for her current SLP to the IEP and hopefully she'll get it ASAP.  Lastly, we added in some wording that lesson plan words will be programmed into Evie prior to the start of the unit.  Right now I do all the programming but once her SLP is trained she will take over that responsibility.

I spent a lot of time on the PRC website (the training tab at the top of the screen is where I went) and AAC Language Lab lately taking the self paced study courses and I've learn a ton!  The resources they have posted are wonderful and if you are using a PRC device I recommend checking them out.  They have lesson plans for how to teach core words and ideas to incorporate the core words into your everyday life.  I printed out many of the lessons for the Stage 2 communicators and plan to use them at home with Emma.  I'm thinking I'll plan to dedicate 2 sessions/week at home working on the lesson plans over the summer.  That seems about right for us.  We also plan to add in outside school Speech sessions with her device over the summer with the AAC expert at our hospital.  My hope is to build on the momentum Emma has with Evie lately and have her start Kindergarten with a more functional use of the device.

Emma continues to love playing with her iPad and it really gets her to open her hands nicely.  We decided to purchase the iPad attachment for the mount (Mount'n Mover) she uses with her talker.  The iPad attachment can be used with both her table top holder and the wheelchair holder.  The iPad attachement is the new one with a bungee cord to keep the iPad secure.  We can also use it to hold a mirror (my girl LOVES to look at herself) or other items instead of the iPad.  It was an investment in the attachment but so far it's been hugely successful.  Here is a brief video of Emma playing the Peeping Musicians app that is put out by the people at Helpkidzlearn.  In case you aren't familiar with them, it's a website with many fun switch activated computer games Emma enjoys playing.

Overview of our current iPad Apps

We have been using the iPad with Emma for about 5 months now and she still LOVES it!  In fact, we all love the iPad and are happy when Emma decides to share it or when she goes to sleep and it's up for grabs.

We bought the iPad for both communication and entertainment use and I have to say we are 100% satisfied with the purchase.  The iPad opened up a whole new world to Emma.  She can use it to communicate, watch movies, flip through books, play music, learn her alphabet, play games - it almost feels like there is very little this handy device can't do!

I've had several people ask me for app recommendations for the iPad so I decided to share the programs we have loaded.  I am going to do a separate post on how we use the iPad for communication and focus this post on our iPad set up and non-communication apps.

With the new operating software we gained the ability to put the apps into folders.  This cleaned up the desktop significantly so now I can find her apps by the skill we want to work on.  I left our communication programs - Yes/No, Proloquo2Go, and TapSpeak Sequence on the desktop for easy access while I put most of her other apps into categories.  The categories I created are:  Books, Music Apps, Listening Fun, Pointing Fun, Educational Games and Flash Cards.

Our favorite books are the Dr. Seuss books, The Monster at the End of the Book (Grover Monster), and Toy Story.  They highlight the words as they are reading, have fantastic graphics, and include interactive options.  The Dr. Seuss and Toy Story (a free app!) books include the feature to auto read which I love!  She can also scroll through the pages on her own and is getting really good at flipping through her iPad books in a way that she can't do with her actual books.

Both girls really love the music apps we have loaded.  Emma loves to play the Virtuoso piano on her own but needs a bit of help on the others.  Julia is more than happy to play the music apps along with Emma so she gets to play these apps a lot even if I am doing something else.  I highly recommend the Old Mac and Itsy Bitsy apps shown below.  The Toddler JukeBox app is great, but I wish they made something like that where you could put your own music from iTunes along with a coordinating picture (sort of like in Prolo or TapSpeak) into the boxes and customize it for your child.  Anyone know of a program that does that?  Any app developers out there?

One thing we really like about the iPad is that we can use it to reinforce Emma's listening skills in a fun way.  She does not really enjoy her listening or speech therapy sessions, but is totally tuned in to listen when I incorporate the speech and listening into games.  The iPad has so many fun games for listening!  Our go to favorite games are Peekaboo Barn and Peekaboo Wild.  LOVE them!  For Peekaboo Barn the barn door shakes and you hear the sound the animal in the barn makes until you tap the screen (anywhere!  perfect for our kids with little finger pointing!) and the barn doors open and the animal is shown and a child says the animal name.  Then you tap the screen again and you get a closed barn door with the animal noise to play again.  The one thing that would make this program better is if the animal sound was louder - it would really make it a better listening game but as is we still love to play it.  We were lucky to get a free code for Peekaboo Forest to add to the collection and are happy to hear that a Peekaboo Fridge is in the works.  Sparkabilities Babies 2 is also a favorite in this house (we did have a couple problems with the app and the developers were very good at responding to my emails and then follow-up on the resolution).

We've seen that the iPad has brought out Emma's pointer finger a lot.  She is less fisted and more open handed when using the iPad and we are even seeing her pointer finger emerging to play some of the games.  I've collected a few games, many of them free, to promote the increased use of her pointer finger.  Emma loves these games, especially the Fireworks, Glow Draw and Koi Pond app.  I love how much fun she has with these games, that she can play them independently, and that she is working on her fine motor skills without even realizing it!

I downloaded a lot of ABA Flashcards when they were giving them out for free last year.  Emma loves to flip through the flash cards and can do this activity independently but I often choose to play with the flash cards when we are working together.  I like to reinforce the vocabulary and talk about each item and love that they are on a plain white background.  We don't use the Flash Cards as much as the other apps because I have touch and feel real flash cards at home that I use more, but I think we will use these more as Emma gets older.

Here is a screen shot of our desktop.  As you can see there are other apps. I haven't covered here including 123 Color HD.  I've left that one on the desktop because it is our most used app.  Both girls love coloring with it and it updates the coloring sheets for the changing seasons.  I think this app is free and is on my must have list.

There you have it - an in-depth looks at what is on Emma's iPad.  I've underlined the apps that I'd put on my Top 10 list and many of them are free or a very good value for your money.  We were able to use many of the iTunes gift cards Emma received to buy them, so if you have an iPad and want to buy some apps for your child you might want to let people know that an iTunes card for birthdays and holidays would make for a great gift.

Stay tuned for Part 2 - How we use the iPad for Communication.  I hope to have that post completed shortly.  Let me know if you have any questions on any of the apps we use.

iPad - Week One Impressions

We've been using the iPad for a week now with great success. We are mostly using the Yes No program and a few games and books. We plan to introduce a more comprehensive communication program - Proloquo2go - soon. I am downloading that program today and will be learning how it works so I have it all set up how we want it before we introduce it to Emma.

I'm very happy with the way we are introducing the iPad to Emma. We are starting out simple and learning the best positions, adapatations, and type of interactions that make the iPad most useful for Emma.

For positioning, we've tested out various positions and found that Emma is most successful in making her choices when the iPad is positioned at an angle off to her right. This allows her right hand to easily choose between the Yes and No buttons and also to move through screens on her books and games. We also purchased an iPad cover that has multiple viewing angles built into the stand. It is working pretty good, but the iPad doesn't "catch" in the notches in the cover at the various viewing angles as much as I would like.

For adaptations, Emma sometimes wants to hit a button and her motor skills don't quite get her to that button without assistance. So, to make this easier for her, I purchased a different iPad cover that was ~$3 including the shipping on Amazon (reviews said it didn't fit the iPad great) and flipped it over so that the part that would cover the back was now covering the front. Then, I cut two square holes in it so that Emma could only see the Yes and No buttons. This way, when Emma is trying to select a choice she does not see the Options button which she loves to hit or the 1x/2x button which she hits a lot by mistake (moving these two buttons to the top of the screen is one of two requests I put into the developer!) since her motor skills have her going towards the bottom instead of the middle of the screen. The cut out gives a tactile feedback to Emma since it is raised from the screen and we have seen an improvement with using this adaptation for the Yes No program.

The types of interactions we've used the iPad for varied throughout the week. All of her therapists were so happy to have the Yes No and incorporated it into each of her sessions. Some examples of what Emma would respond to:

• Do you want to keep playing with the X,Y, Z toy - Yes and No were both answered depending on the toy and what she wanted at that time
• Someone asked Emma Do you have a brother - Emma said No
• Do you want to go home when at the playground - No
• When a therapy session was over - Do you want to continue playing with Therapist's Name Here - No. Do you want to go home - Yes.
• While at the Children's Museum I asked Emma if she was having fun - Yes. And, if she wanted to go home - No. For this one, I asked her this in the bathroom after I changed her diaper. She would not attend to the iPad when we were in the exhibits because there were loads of children running around. I don't blame her one bit for that!
• Showed her a cow and asked her if it was a sheep - No. Asked her if it was a cow - Yes. Her auditory verbal therapist did this for several items and Emma QUICKLY lost interest in that game - there was no What's in it for me for Emma so she moved on to a game. She just wanted to see how Emma would respond and she was 100% accurate in her responses. I don't think we'll be re-visiting this "game." :-)

The Yes No program is limiting our interactions with Emma to Yes and No responses, but it was a great way to start getting Emma familiar with the iPad and learning about positioning. We are now looking forward to incorporating the First Then Visual Schedule app that I downloaded along with adding the Proloquo2go program for more in depth conversations with Emma.

These are exciting times for us!

Can you give us a Yes or No?

Emma had an apt. with the Augmentative Communication (AC) group at the hospital in April (Good Friday, to be exact!) and I've followed through with a few of the suggestions. One main suggestion that I've sort of been on again, off again focusing on is giving Emma a way to express Yes and No. The reason I'm so wishy washy on this is that it's HARD. Emma isn't all that interested in learning Yes and No and the way we were teaching it to her - eyes up to say yes, shake head for no - didn't seem to capture her interest at all and so I wound up exhausted by a lot of the Yes No teaching efforts and pretty much gave it a rest for a while.

But, we really want to reduce the frustration Emma has in communication until she starts talking and I think a Yes No response is a great start and I know that we really need to bring our AC efforts up a level. To do this without losing our sanity and buying loads of one function AC equipment we decided to get an iPad. Truth is, I've wanted to get one for Emma ever since the announcement of the iPad launch but we wanted to wait for the 1st gen. kinks to get worked out and buy one next year. You know, we wanted to be a bit more practical than rushing out and buying the iPad right away.

And then we came to a realization.

As we were waiting and being practical time was slipping away from us. Time that we could use to get Emma up and running with a communication system that she responds to - she loves electronics, switches not so much! - and will help reduce her frustration on our not-always-so-accurate guessing what she is trying to tell us. So, we decided to just take the plunge and get her an iPad since there are so many great AC apps available for it. Once we made the decision I was ready to go full force and we set out to the Apple store for a family outing only to come out empty handed. Apparently everyone wants an iPad so they were sold out and so I ordered it online and had to wait.......for a couple of weeks to get it. I wish I could say I waited patiently, but Chris would call my bluff for that statement!

The iPad finally arrived last night and I got it all set up for Emma. I bought the Answers: Yes No application from the iTunes store and thought this is just what I needed to help Emma learn a Yes and No response. This morning we started out with the Yes No app by asking Emma a couple of questions. She told me:

• YES she was happy to see Courtney, the babysitter, this morning
• No she did not enjoy her PT session at the hospital
• Yes she wanted to go home and play with Julia

The great thing about this app is that it is EASY to use and implement. Emma is interested in using the iPad and selecting her choice. So, we incorporated it into her speech therapy this morning. She independently chose a Yes No response 3 times and needed hand over hand assistance 3 times. This is and INCREDIBLE response from Emma. My previous attempts at Yes No responses from her would maybe, just maybe have her respond to me once.

Courtney used the Yes No to ask if Emma was done eating and wanted her bottle and also to ask her if she was ready for her nap. She was clearly making a choice and happy that she was communicating it. This evening we asked Emma if she was done eating and if she wanted her bottle. She was a bit more tired but still made a choice.

ANYONE can do this with Emma. It's easy and almost effortless on our part and it took me less than a minute to show it to Courtney and her therapist. That alone is priceless to me!

We have a lot of other apps on the iPad that we can use with Emma. Many of them reinforce the auditory input she needs. She really seems to love everything it does including watching home videos and reading Dr. Seuss books, but for now we have decided to use the iPad mostly for the Yes No application before we move on to all the other fun apps. We don't want to throw too much at her all at once.

After Emma masters the Yes No, we think the next step would be to introduce the Proloquo2go application.

I'm really excited about Emma's response to the iPad so far!