Using Assistive Technology to Promote Children's Participation

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Deana Buck
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Pip Campbell VA Webinar September 2010 http://tnt.asu.edu http://jeffline.jefferson.edu/cfsrp 1

Lets Get Started!

Today’s Presenter
Deana Buck

Hi Pip!
Pip Campbell


Using Assistive Technology To Promote
Children’s Participation

Pip Campbell VA Webinar September 2010 http://tnt.asu.edu http://jeffline.jefferson.edu/cfsrp
3

What Will You Learn About in this
Webinar?
• What is Assistive Technology & how can it be used
as an intervention with infants & toddlers?
• What are the differences between participation
and skill learning?
• In what ways can adaptations and AT be used to
help children participate and to perform
functional skills?
• How can I make adaptations/AT that can be used
successfully by caregivers to help children?


Adaptations & Assistive Technology (AT) are not an
end in themselves – But are a means to promote,
enhance, and enable successful participation


What is the difference between skill
performance and participation ?


Skill performance means ---
• Ability to do
something well
• Competence
• Excellence in
execution


Participation Means --the fact of taking part


Children are included when they are able to
participate in typical activities and routines


Name the routine that
providers most frequently use
with infants and toddlers?


What are the 2 most frequent
routines that caregivers do
with infants and toddlers?


Activities & Routines At Home
• Activities – things that families do together like
outings, errands, chores, outdoor play, etc.
• Routines – things that occur regularly each day
like morning and evening (bedtime) routines,
mealtimes, indoor play/activity
• Some routines/activities
go well, some not.


What are activities and routines
that occur in child care?

Name at least one


Activities and Routines
in Child Care

• Activities – things that occur at the early care and
education setting like literacy, art, learning centers,
outdoor play, etc.
• Routines – every day occurrences like naps, snack,
lunch, transitions, bathroom, arrival and leaving, etc.
• Some activities/routines go well, some not.


So – how do we ensure participation
for each person/child?

Embed adaptation &
Assistive Technology (AT)
interventions into Activities
& Routines

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Think about ---Who is most
likely to have the most
information about a child’s
participation?


First Step in Embedding:
Assess Activity & Routine
Participation

What strategies do you find useful in
gathering information from “first
hand” reporters?

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EXPECTATIONS SATISFACTION

Occasional

Somewhat
ly Meets
Does not
ROUTINE/ACTIVITY COMMENTS

Exceeds

Did Not
Meets

Is OK
meet

Very

Not

Ask
EVENING ROUTINE
(getting ready for bed,
going to bed, sleeping)
MEALTIMES (appetite,
level of assistance)

PLAYING INDOORS

PHYSICAL ACTIVITIES
(riding a bike, playing
outside, playing on
playground equipment,
swimming)
AT HOME CHORES
(cleaning, preparing
meals, watching TV,
caring for pets, etc.)
LEAVING THE HOUSE
TO GO SOMEWHERE
RUNNING ERRANDS
(grocery store,
mall/store shopping,
banking, wash/cleaners)
OUTINGS (visit a
friend/relative, eat at a
restaurant/fast food, go
to museums, amusement
parks, zoo, etc.)


Application in Child Care Settings for Preschoolers
Available through DEC at
http://www.dec-sped.org/index.aspx/Store/Additional_Resources


What can you learn?
• Adults’ (e.g., caregivers, teachers, parents,
etc.) perspectives
• What goes well (is pleasurable or functions ok)
AND
• What does not go well
• What happens when something is
pleasurable? Or when something is not going
well?
• What would the adult like to have happen?
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How Do We Embed Adaptation & Assistive
Technology (AT) Interventions Into
Activities & Routines?


Second Step in Embedding:
Identify the activity or routine in
where embedding will take place.
• Will adaptations/AT make an activity or
routine go better?
• Can adaptations/AT be embedded into a
activity or routine that goes well so
learning may occur?
• Which activities/routines will be
targeted?
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Think about types of
interventions—
What are some examples
where intervention is
specifically directed to the
child?


Two Categories of Child Interventions
Directed to the Child by Adaptations/AT Directed
Another person to the Environment
(e.g., caregiver, another adult-
provider, child, sibling)


Directed to the Child By Another Person

CUSTOM
Specialized,
Individualized

DIFFERENTIATED

Needed for
Some but not
all Children

UNIVERSAL
Used with ALL
Infants
&Toddlers


Adaptations/AT Directed to the Environment

CUSTOM
Specialized,
Individualized

DIFFERENTIATED

Needed for
Some but not
all Children

UNIVERSAL
Used with ALL
Infants
&Toddlers


What does Adaptation mean?
• Change in behavior of an individual or group
in adjustment to new or modified
surroundings is an adaptation.

• Something that is changed or changes so as to
become suitable to a new or special use or
individual situation is an adaptation.


Adaptations as Interventions
• Environments, activities & routines, have social
and physical expectations for participation
• Adaptations, including assistive technology allow
participation in typical family routines and
activities
• Adaptations function as a mediator to make a
bridge between the child’s abilities and the
“demands” or expectations of the environment
• By promoting participation, opportunities for
learning are increased


Tier 1: Universal Adaptations/AT

Are things that we might all use
with any infant or toddler

• What are some examples?

Pip Campbell VA Webinar July 2010 http://tnt.asu.edu http://jeffline.jefferson.edu/cfsrp

Tier 1: Universal Adaptations/AT
– Things that we might all use with infants and
toddlers
• Placing toys outside reach of child to promote
movement
• Safety plugs in outlets
• Bath seat
• Toys with large grips or safe to chew
• Rewards (i.e., preferred activity) after
doing something that is difficult
• Break multi-step directions into single
step (e.g., Go to the kitchen and get
the napkin” becomes 2 separate directions.)


Tier 2: Differentiated Adaptations/AT

Interventions we might use to enable children to do
something that they are unable to do and may not be
able to do for a while
– Bath seat for 18 month old
– Velcro on bottom of bowl so a 24 month old child
can learn to scoop
– Push play toy (e.g., baby stroller, shopping cart)
– Providing a more active child with a toy to
manipulate during circle time
– Schedule picture board


Tier 3: Customized Adaptations/AT
Child Specific/Custom Interventions allow a child to do
something they cannot otherwise do

– Communication board for social interaction with
siblings and cousins
– Specialized positioning equipment so that a child
may sit up at a table to play, sit on the floor for
circle time, sit and swing, stand at the sink
– Motorized mobility device to get around from place
to place
– Switch to activate something that is part of an
activity/routine


Low Tech --------------------------------------High Tech
General; Readily Available Targeted; Specialized
General market Small market


The 3 YES Conditions of AT

Does the child have
a disability or a
significant delay in
Is
the area of
development ?
YES

Is this a device or Can the child perform
adapted material? the skill only with the
Can
device or adapted material?
YES YES

38

A word about Assistive Technology (AT) and
Augmentative & Alternative Communication
(AAC)
AT AAC
Socialization Sign
Communication Picture Exchange
Getting Around Picture Board
Use of Arms & Hands Single Switch Voice
Output


Pip Campbell VA Webinar September
2010 http://tnt.asu.edu 40
http://jeffline.jefferson.edu/cfsrp

Adaptation/AT
An Intervention to promote participation
This child is participating in
toy play by reaching &
hitting the switch to
activate a toy -- without
adult assistance & through
use of adaptations and AT
•Child chair – modified
with foam
•Motivating/engaging toy
that moves
•Simple switch


Facilitating Children’s Participation
and Learning
Environmental Accommodations
Adapt Room Set-Up
Adapt/Select Child Equipment
Equipment/Adaptations for Positioning
Adapt Schedule
Select or Adapt Activity
Adapt Materials
Adapt Requirements or Instructions
Have Another Child Help --
Peer Assistance/Tutoring
Cooperative Learning
Have an Individual Child Do Something Different
Have an Adult Help a Child Do the Activity
Have an Individual Child Do Something Outside
of the Room (with an Adult)


Continuum:
Adaptations to the Environment
• Adaptations to the environment change the setting.
For example:
• Rearrange the furniture in the room so that a child in a
wheelchair can move about freely.
• Adapt or add equipment (e.g.,
use a slant board to help
a child participate in coloring
activities, use wedge
to provide supportive seating
during circle activities).


45

Continuum:
Adaptations to Activities and Routines
An activity or routine may be adapted to accommodate special
needs. For example:
• Add periodic movement activities to a story time activity to
help children who have difficulty paying attention.
• Do the initial pieces of a routine for a child & let them do the
end parts – e.g., dress a child up to the point of pulling up long
pants
• Start dinner earlier for a child who needs longer to eat than the
rest of the family.
• Allow a child to “walk” to mealtimes by being a duck so that
the child is on task


Continuum:
Adaptations to Materials
Materials used in an activity or routine, when adapted, may
help a child participate. For example:
• Make the pencil thicker by putting a foam curler around it or
by wrapping the pencil with play dough or silly putty to help
a child who has problems gripping pencils/crayons.
• Use assistive technology—
as in the case of using
a simple switch interface
to help a child with motor
difficulties activate a toy.


Ideas to Share

Pip Campbell VA Webinar September
2010 http://tnt.asu.edu 51
http://jeffline.jefferson.edu/cfsrp

Look Up By --
• Functional Skill • Activity or Routine
• Errands
– Communication • Chores
• Outings
– Socialization
• Mealtimes
– Mobility • Indoor Play
• Bathtime
– Arms and Hands • Morning
• Evening
• Outdoor Play (Physical)


Communication


activities
Beach or bath

Bathtime


Errands


Continuum:
Requirements and Instruction
Changing the requirements of an activity or a routine, or
the way you provide instruction can enable a child to
participate.
For example:
• Use photographs to show each step rather than simply
speaking the instructions.
• Reduce the number of steps a child is expected to
perform to change requirements.


http://www.challengingbehavior.org/do/resources/teaching_tools/ttyc.htm


Hand Washing Sequence


Circle Time Sequence
Beginning view of Turn over picture as Hand the child the picture of
circle mini schedule activities are completed the next place to go

Lentini, R., Vaughn, B. J., & Fox, L. (2005). Teaching Tools for Young Children
with Challenging Behavior. Tampa, Florida: University of South Florida,
Early Intervention Positive Behavior Support.
http://www.challengingbehavior.org/do/resources/teaching_tools/ttyc.htm


Continuum:
Assistance
• Providing assistance is the most intrusive form of
adaptation because it involves another child or adult
actually helping the child do the activity or routine,
rather than allowing the child to do it independently.
Always try to have a peer provide the assistance first
before using an adult.

• Provide assistance only
when other adaptations
have not worked, and
only as a last resort.


Adaptations/AT Planning
What’s happening now? & Brainstorming
What would you like to see happen?

Environmental Modifications
Equipment for Positioning
(Room, Child Equipment)
Adapt/Modify Schedule

Adapt Activity
Adapt Materials
Adapt Requirements
Expected Outcome

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It is hard to remember ---but
ADAPTATIONS & AT are NOT about
the “STUFF”


ADAPTATIONS & AT ARE ----
• INTERVENTIONS
• To help children participate in activities and
routines to the maximal extent possible
• To increase opportunities for incidental (or
unplanned) learning opportunities
• To increase functional skill performance across
activities/routines for children with significant
disabilities


ADAPTATIONS & AT ARE ----
Strategies /Interventions/Methods used by
professionals and family members for the
purpose of influencing

Child Participation & Learning

Use Resources
http://tnt.asu.edu

66

Next Steps
• Attend Regional Training Sessions
– October 12 Tidewater
– October 13 Northern Virginia

• Registration information will be
emailed in the next few weeks


68

Using Assistive Technology to Promote Children's Participation

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