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Technology breaks barriers for a special needs child
Susan Hughes tells how she and her team found a unique solution for a child with special needs. By Susan Hughes |
 his is the story
about a young girl who has multiple disabilities and the impact technology has had on her life. Her
accomplishments, paired with the knowledge gained by her teachers and therapists,
could potentially impact many children. I share this with you hoping that others
will become inspired and informed and see the possibilities of using and
individualizing technology for children with and without disabilities.
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 Marie and a friend at the computer. |
 have worked for
two years with this nine-year-old girl in her second grade classroom. Marie has
cerebral palsy and requires much assistance to walk. She began talking at
four-years-old, and at the time I met her, she talked very little. She uses a
wheelchair most of the time to move about; she has minimal functional use of her arms
and legs. She needs help to eat, brush her teeth, and to dress. Marie is legally
blind as the result of retinopathy of prematurity, glaucoma, and a cataract. Reading
material and computer programs must be enlarged in order for her to see it. We
enlarge text to a font size of 100-point, whereas most people see well with a 12- or
14-point font.
Though her disabilities are severely limiting, Marie, like most children, feel a need for some independence from adults. I have worked with consultants, therapists, and teachers to find ways for her to use computer accommodations in any way. Many solutions are simplistic though; they do not take all of her disabilities and needs into account, and they have limited academic use. Individualization was the key in developing solutions for Marie. She was highly motivated to use a computer by herself, probably because she saw other students using computers independently and enjoying themselves. This has been a challenging task for me, her parents, and her therapists: to provide Marie with activities and experiences where she could do anything by herself. We met with limited success in previous attempts to develop a way of using a computer and software she could learn from or have fun with. |
 sing single-switch
software and scanning programs worked for a while, but the software did not
challenge her cognitively; boredom would set in after five to 10 minutes. Due to
her limited vision and hand movement, we attempted to enable her to access the
computer using a Touch Window, a joystick, a
trackball, and Ke-Nx software, among others.
However, anytime she was near a computer,
Marie, who spoke very little, began to say to her family, friends, teachers, and
therapists: "I want to use the mouse." Sometimes this request was met with a gentle
explanation of why it was not possible for her to use the mouse and sometimes she was
simply redirected to use the JellyBean switch.
Marie was polite and tried every alternative we gave her, but her limited movement and
vision, as well as her frequent requests to type and use the mouse, ruled out these
alternatives.
A standard mouse was not an option, however, because her hand and wrist could not move in the necessary angles, and because she could not hold the mouse still and press the button to click. She also could not see most of the on-screen images or text that she needed to click on. For these reasons, Marie used a single switch and preschool or basic level programs for several years to access the computer. Her educational team, including her family, began brainstorming on alternatives. We called manufacturers frequently, and networked among others who worked with persons with disabilities. Funding was clearly an issue though. |
 Working with the mouse on two conventional mousepads. |
 any "solutions"
would have involved spending large amounts of money which wasn't available. In
addition, because of her multiple needs, long term trials were often necessary.
Experience told us that trial and error would also come into play, including frequent
adaptations using unusual items, and lots of imaginative ideas.
The solution we found was a Macintosh 580, several commercial
software programs, programs developed using Hyperstudio, a
mouse, and a home-made mouse pad. After the team had struggled to find this
combination, we watched Marie persist in learning to use the mouse.
She found a way to hold on to it in a way we had never considered before. Her grasp and ability to hold and click at the same time improved dramatically. One problem, however, was that Marie would lose the mouse. It often would roll off a regular mouse pad and she couldn't find it again, because she couldn't see and didn't understand the boundaries of a regular mouse pad. She would also lose it when startled. If someone spoke or moved suddenly, her arms would rise suddenly into the air, and the mouse would fly off the table. |
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experimented
and, with Marie's cooperation and patience, constructed a new mouse pad. I laid two
mouse pads with their widths together. Using 1/4 inch thick sticky backed foam I made
a 3-dimensional frame for the mouse pad. Marie used the new mouse pad with ease: the
mouse would come up to the foam boundary and not fall off the pad or table. The frame
was also a gentle tactile reminder to her to head the mouse in a different direction.
Using this accommodation taught her the boundaries of a mouse pad, and if she was
startled, the mouse would still be within her reach. Her startle response also
decreased dramatically as she learned to concentrate on the computer activity. The
mouse pad now only has one side of foam-frame, on the side closest to the monitor, and
many times she will use a regular pad instead. Marie's motivation in persevering to
learn to use the computer has been, and continues to be, one of her strongest assets.
As might be expected, commercial software programs suited for Marie are largely unavailable. One exception is KidPix by Broderbund. Her classmates frequently used this program and she wanted to as well. She has learned where each tool is located, where the color palette is, how she can save her drawings, deal with error or other messages, and can get a new screen. |
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Individualization is important for children who have a combination of disabilities
which make their needs unique.
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nitial instruction
involved a lot of hand over hand guidance and repetition. Eventually, verbal cues
such as "Push the mouse forward, away from your body," or "Move the mouse to the left,
towards me," were sufficient and helped her to understand as well as memorize where to
move the mouse for specific commands.
Hyperstudio, a multi-media software authoring tool, has also enabled Marie to
utilize technology for academic work, as well as for entertainment.
Individualization is important for children who have a combination of disabilities
which make their needs unique, and Hyperstudio addresses this need well.
A series of cards or screens are created, known as stacks; each stack presents information that the user can self-navigate through. On each card, the stack author develops buttons which, when activated, cause an action to occur. These buttons could be as small as a penny or as large as the card, and they could be made invisible. I could make two invisible buttons, each of which took up half of the screen, and a different action would occur depending on which half of the screen Marie clicked on. |
 ne of the
first programs I created involved on-screen spelling flash cards. I used a black
background, white letters, and a font size of 100-point, along with two invisible
buttons on each card. I taught Marie that clicking on the top half of the screen would
show her the next card and the next spelling word. When she clicked on the bottom
half of the screen, she could check her answer to the flashcard. For the bottom
button, I tape recorded my voice pronouncing, then spelling, one of her spelling words.
This recording was "encoded" onto the action for the invisible button on the bottom
half of the card. Marie could then independently check her identification of the
written word.
After 10 words, a reward card would appear. Marie enjoyed sounds such as a baby laughing or a piano chord. For her reward page, I placed many visible buttons which made sounds when clicked. Hyperstudio comes with a number of sounds, or you can record your own. She could play a type of concentration game by clicking on pairs of visible buttons with the same encoded sound on each. Having just learned Hyperstudio, it was my first attempt at authoring a stack for her, and it was a great success! |
 Working with the Big Keys keyboard by depressing keys with a modified pencil eraser. |
 hat's better is
that the stacks can be adapted and improved upon as needed as Marie progresses. I can
use scanned photos of family or friends and record her voice or a schoolmate's voice
to individualize a stack as well. Ease of use was an important factor for
her as well as for me. While she is patient most of the time, if she has
quick success in using a program, she will persist in trying it until
she has it mastered, otherwise I hear her say, "What are we doing next?" In
addition, I don't have lots of extra time to learn or to develop new programs for
her. With Hyperstudio, I can quickly make a change in an existing stack in minutes,
or make a new one in a half-hour or less most of the time.
Another piece which has been a key to Marie's success with technology is the use of the Click-it Software, from Intellitools. Click-it allows the creation of hot spots within existing software. The user activates a switch and makes a selection as the choices are scanned. Marie was willing to use a switch as part of a system, when she realized she had more choices for input. In addition, Marie has just begun to use the Big Keys Keyboard, from Greystone Digital. As the name implies, the keys are large: one inch square. The keys are colorful and the letters easier to read than those of a standard keyboard. |
 he uses the Big
Keys Keyboard with a keyguard. Marie also uses an adapted pointer, which she holds in
her right hand. The pointer is a three inch long, 1/2 inch diameter dowel with a
hole drilled through for a pencil, to type with assistance. The keyguard is used
with homemade templates made out of construction paper; these
templates help to increase her accuracy in finding the letters she
wishes to type. For example, for her spelling words, we will make special templates,
like one with the holes above just the letters 'g',
'r', 'e', 'a', and 't' for the word great. As she practices typing her
spelling words, she learns where each letter is located on the keyboard.
We put these accommodations together as we found them, and sometimes designed and made the individual parts ourselves, because no one perfect system was available. In addition, taking the time to try various possibilities enabled the team to more precisely define Marie's needs. We also had budget constraints and we needed to make sure the money was wisely spent. If not, it would be a year or more before new items could be added. Having already spent several frustrating years trying to find a solution for Marie, we knew we had to make careful choices. The choices we made, the Big Keys Keyboard, Hyperstudio and Kid Pix (which were already available to us on the system server, along with other software programs), and Click-it have real growth potential. As Marie progresses academically, the team will be able to continue using these technology pieces. Technology, both high-tech and low-tech has been the dream come true for Marie and her team. |
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echnology has enabled her to meet many goals and has
boosted her self-esteem. It has given her something that no other person, activity
or piece of equipment ever has: independence in learning and in play. Though I believe
we are just beginning to see the possible uses of technology for Marie, we have
already realized its tremendous impact on her academic skills, her social and
emotional growth, and the improvements in her motor abilities. We are excited
about her future uses of technology with children like Marie. Only nine years ago,
Marie's potential was limited, and a life of dependence was almost certain.
Technology has unlocked her future and given her the independence she deserves.
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Look at some interesting sites related to assistive technology!
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A few picks by the SCRTEC staff:
ABLEDATA. A database of more than 20,000 assistive
devices for people with disabilities.
Apple Computer Worldwide Disability Solutions
Group. Provides an extensive database on accommodations for people with disabilities.
IBM National Support Center for Persons with Disabilities. Provides an extensive
database on adaptive computer technology produced by IBM and other companies for people
with disabilities.
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