IATP Statewide Conference 2019

Discover the Possibilities

Assistive Technology to Support the Independence of Individuals

with Intellectual Disabilities and/or Autism in Employment

Settings

Toni Van Laarhoven, Northern Illinois University

and

Traci Van Laarhoven-Myers, Indian Prairie School District #204

Purpose of Presentation• The purpose of this presentation is to provide participants with

strategies for identifying appropriate assistive technology (AT) supports for individuals with disabilities in employment settings.

• Participants will be provided with strategies for determining appropriate AT based on the needs of the employee, the employment setting, and requirements of the job.

• Participants will also be given an overview of various low to high tech AT supports that can be used to support and promote independence, communication, and well-being of learners across a variety of jobs and skill sets.

What is Assistive Technology

• The Federal Definition of Assistive Technology

• “any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a child with a disability” (Technology-related Assistance to Individuals with Disabilities Act, 1988).

Questions To Ask

What exactly do we want employee to learn?

What is the targeted outcome?

What are the demands in the environment or actual activity?

Can we have more than one purpose for using the device/adaptation?

Continuum for AT Devices

• AT can fall on a continuum between Low and High Tech

• Low-Tech, Mid-Tech, & High Tech are categories that refer to the degree of technology used in the device/system and the amount of training the learner requires to use it

In most cases, the best solution is the simplest solution.

Which Device To Choose?

• Selecting the Appropriate Assistive Technology Device can mean the difference between Success and Failure.

• It is critical to keep the individual in mind when choosing the device.

• Keep in mind that the newest and most technologically advanced piece of equipment may not be the best fit for the particular individual.

Considerations for Selecting AT

When Selecting AT, it is important to consider:Student /Supported EmployeeEnvironmentTaskTools◼SETT framework was developed by Joy Zabala

www.joyzabala.com

Low Tech Examples✓ Checklists

✓ Line Drawings/Pictures/Visual Supports

✓ Visual Timers

✓ Color Coding

✓ Templates

✓ Pencil Grips/Enlarged Writing Instruments

✓ Special Scissors

✓ Highlighters/Highlighting Tape

✓ Slant Boards/Book Holders

✓ Built-up Handles

✓ Velcro

✓ Non-Slip Materials such as Dycem

✓ Handheld Magnifiers

Mid-Tech Examples

• Voice Recorders or Recording Systems on Phones

• Dictionary/Thesaurus

• Portable Word-Processors

• Reading Pens and Calculators

• Simple AAC Devices

• Switches/Environmental Control

High-Tech Software/Device Examples

• Smart Speaker/Home Devices/Environmental Control• Alexa Echo/Echo show, Google home/Google nest

• Mobile Devices/Tablets/iPads- Hundreds of apps

• Word Prediction- Co-Writer, Read&Write, WordQ

- Text-to-Speech- Texthelp Read&Write, Don Johnston SOLO

• Screen Magnification Software- ZoomText, Zoomtext Fusion (combo of zoomtext & JAWS)

• Screen Readers- JAWS

- Symbol-Based Software- BoardMaker, Writing with Symbols

- Speech Recognition Software- Dragon Naturally Speaking, SpeakQ, Texthelp Read&Write

• Expanded Keyboards- IntelliKeys, Big Keys

Sample Low-Tech Visual Aid

Problem Solving Support Using Color-Coded Visual Aid

Sample Checklist with Embedded Time Management

Other Supports

• Pair employee with seasoned co-worker

• Teach systematic approaches to completing tasks

• Provide assistance in organizing information or supplies

• Establish routine if possible-PredictableMy Weekly Work Schedule:

•Mon. 9-12

•Wed. 9-12

•Fri. 9-12

Other Supports (cont)

• Assist with time management by using schedules, calendars, and timers

• Use assistive devices such as the Watchminder, which is a programmable, vibrating wrist watch

• Recorder to remind of duties

Other Supports (cont)

Using Built-In Features on Cellphones/Tablets as Supports

• Calendar with alerts

• Timer/Clock

Countdown to break

Production rate

Reminders

Self-monitoring

Built-in Features Continued

• Checklists/Notes/To-Do Lists• Text checklists (can use accessibility features to read aloud)

• On Apple products• 1. Go to Settings>Accessibility• 2. Select Speech>Turn on Speak Selection• 3. Press text on note• 4. Select Speak Sentence to read aloud

• Add pictures/audio to notes• On Apple products

• 1. Launch Notes• 2. Tap new note• 3. Tap in white space to bring up keyboard• 4. Select Insert Photo or use Microphone to add Audio Note

• Use One Note

Visual Supports Using Camera/Photos

• Take Pictures of Task Sequences

• Take Videos of Tasks

• Have Employee Take Pictures of Work Schedules

Photos of Coolers with Products to Use as Models

Calling/Texting

• Leave Voice Reminders

• Text Audio Reminders

• Text Pictures and/or Short Videos

• Use FaceTime or Skype (more on this later)

• Program “Favorite” Phone Numbers for Work, Transportation, & Job Coach

GPS

• Use Maps or Navigation to Travel to Work

Use of Video Supports• Video Modeling: Review video examples before engaging in tasks at work.

• Video Prompting: Watch short video segments of steps needed to complete task while performing task (watch step- go do; watch next step- go do). This typically requires the use of portable devices.

• Continuous Video Modeling Continuous Video Modeling (CVM) is similar to a procedure called Simultaneous Video Modeling where a video is played while the individual is expected to “follow along” to model the behaviors. With SVM the video is only presented once whereby in CVM the video is played on a loop (Mechling, Ayres, Bryant, & Foster, 2014). The continuous presentation of the video model allows individuals to work “hands-free” and to look at the video as needed and refer back to specific steps while completing the task.

• Video Feedback: Videotape employee as they engage in tasks and have them evaluate performance when watching video.

How Can We Use Video-Based Instruction to Support Employment of Individuals with

Disabilities?

• Use video modeling to have learners watch tasks before going to the employment setting (delayed or rehearsal strategy)

• Use video modeling to have learners watch each task while in the setting (with portable system)

• Use video modeling to maintain skills over breaks or vacations

• Use library of video models for learners to select preferred employment opportunities or activities

• Use video prompting with portable device to show learners steps or chunks of tasks while they are engaged in task in the employment setting

• Fade video prompts to picture/auditory cues

• Fade video prompts to video models

• Use a combination of picture prompts (for acquired skills) and video prompts (for difficult skills)

• Videotape employees in a work setting to create a “video resume”

• Use video feedback for learners to evaluate their own performance or to correct errors

• Use videos to promote self-advocacy

• Use video models to highlight needed supports and to train support staff

• (see example)

Sample Videos to Demonstrate Needed Supports

Link to SV work support video

Needed Supports continued

Link to merrywalker video at work

Use of Mobile Devices and Associated Apps that Support Video

• Several apps can support video-based instruction using either video modeling or video prompting. Some include the following:• Picture Scheduler• Keynote• Video Scheduler• InPromptu• Video Tote• Storykit• Go Talk Now

• All of the above also provide picture and auditory prompts. Additional apps that support picture/auditory prompts include:• Pictello• iPrompts• First-Then

Sample Picture/Auditory Sequence Using Picture Scheduler

Picture Scheduler Beta Version

Developed by Petr Jankuj

Website: http://www.jankuj.com/Picture_Scheduler.html

Cost = $2.99

Sample video of Picture Schedule

Following Schedule

Social Skills

• Video models of social skills or social stories can also be placed on a portable device to provide learners with the opportunity to view positive models of social skills prior to engaging in activities that may be problematic.

Demonstration of How Built-In Video Features of iPad Can be Used to Support Social Skills

• Example: Students with ASD or ID had school jobs where they had to deliver passes throughout the school.

• We compared video models of the task (using a peer model) with video feedback (videotaped student performance on iPad) and measured performance

• See sample

Sample of Video Model Presented on iPad

Sample video of delivering passes

Demonstration of Keynote

• Example: We used Keynote on the iPad to present video prompting sequences to teach high school students daily living/vocational tasks.

• See sample on next slide

Sample of Video Prompting Presented on iPad with Keynote

Loading dishwasher video using keynote app

Demonstration of Go Talk Now

• Example: We used Go Talk Now on the iPad and PowerPoint on HP Slate to present video prompting sequences to teach non-linear vocational tasks to students with ASD and ID.

• Sequences had built-in decision points and branching.

• Screen also had universally-designed features to allow learners to select their own supports

• See sample on next slide

Sample of Go Talk Now App Used as Prompting System

Branching video using Go Talk Now app

Step 1: Pick Clothing Item

Touch picture to play video

Next

Step #2: Check for TJ Maxx tag

Touch picture to play video

Next

Decision Point Yes/NoDoes item have TJ Maxx tag?

Touch picture to play video NoYes

No: Does not have TJ Maxx tag, it goes on the rack.

NextTouch picture to play video

Demonstration of Video Scheduler

• Another app that can be used create video-based sequences is the Video Scheduler

• See sample on next slide

Sample Video Prompt Sequence Created Using Video Scheduler App

Video sample of Video Scheduler app

Demonstration of Educreations

• This is a screen capturing app that can be used to demonstrate academic or other tasks.

• See sample on next slide

Sample of Educreations App with Floor Plan of Restaurant

Video of educreations app with chilis floor plan

Maintaining Vocational Skills

• We conducted three different studies measuring the effectiveness of using video modeling to maintain vocational skills of individuals with ID/ASD 1) over winter break, 2) using video modeling booster sessions following summer break, and 3) comparing VM over break vs. booster sessions.

• Results of all studies indicated that video modeling is an effective strategy for not only maintaining vocational skills, but may also improving performance. Viewing video models over break was associated with higher levels of independence.

Other Apps That Support Video Modeling or Prompting• InPromptu: (a video modeling/prompting app developed by

researchers from Ohio State University) FREE!!!

Apps That Support Video Modeling or Prompting (cont)• Video Tote: An app developed by the Prevention Group

• Cost: $2.99

Using Google Glass

• The purpose of this study was to measure the effectiveness and practical utility of using Google Glass to teach vocational skills to students with intellectual disabilities and/or autism spectrum disorder.

Overview of Study• A multiple probe across participants design was used to

evaluate the effectiveness of using Google Glass to teach vocational skills to three young men with autism and/or intellectual disabilities.

• Instructional trials involved a simultaneous video model presented on the Glass device to teach participants to pack a first aid kit.

• Simultaneous Video Modeling involves having the learner engage in the response while the video is shown.

Video Overview of Google Glass

Link to NIU Google Glass Video

Description of Tasks in Google Glass Study

• The video model had an embedded demonstration of how to use a visual checklist to prompt task completion and the generalized skill of using a visual checklist was also measured with another task (stocking a coffee station).

Results

• Results indicated that all three participants demonstrated an immediate increase with independent correct responding for packing the first aid kit when simultaneous video models were presented on Google Glass.

• In addition two of the three participants demonstrated generalization of visual checklist usage following intervention.

• All participants indicated that they liked using Google Glass and stated they would like to use it again in the future.

Using Picture/Auditory Supports

In addition to using printed picture supports, devices that provide picture and auditory supports are also helpful for some learners.

Mid-Tech AAC systems can be programmed not only for communication, but can also be used as prompting systems.

Apps that Support Picture/Auditory Prompting

• The following slides show some of the features of apps that support picture and auditory prompting.

iPromptsby handholdadaptive

Video

• Website:• http://www.handholdadaptive.com/

• Cost = $49.99

Visual Countdown Timer in iPrompts

• Visual Countdown TimerDisplays an image of the caregiver's choice along with a graphical countdown timer (set to any duration). Useful for demonstrating how much time is left before the next pictured activity begins.

•

Choice Prompts in iPrompts

• Choice PromptsLets caregivers present choices between images, empowering those who cannot vocalize their preferences.

• Multiple sets of choices may be created and saved.

First-Then app

• “First-Then was designed for individuals with communication needs, developmental delays, autism spectrum disorders or anyone who would benefit from a structured environment.” - GoodKarma Apps

• It can be used for daily events, routines, specific steps in an activity and transitioning between activities.

Using the Schedule

• There are three formats for displaying the schedule.

Full Mode Split Mode List Mode

How to use checklists

• First-Then allows users to apply a checklist feature to check off an activity when completed. This has to be activated through the settings menu on your device.

Scroll down to First Then

Switch checklist to “on”

Checklists

• Once an activity is complete, simply click the green checkmark.

Products by Ablelink

• Ablelink is a company that has several mobile, desktop, and cloud based solutions for supporting individuals with intellectual disabilities and TBI. Some of these include:

• Visual Assistant: A multimedia-based prompting system.

• Wayfinder: A GPS-based system to supportindependent travel

They have many other solutions that may be beneficial!

http://www.ablelinktech.com/

App for Note-taking and Annotation

• Skitch by Evernote- Free

• Description: This app allows users to take a picture and add text or annotations. This can be incredibly useful for providing “on-the-spot” visual supports.

App to Support Reading

• Prizmo- $9.99

• Description

• Prizmo is a universal photo-based scanner app that lets you scan and recognize text documents, business cards, and images, and then export them as PDF/Text, vCard, or JPEG/PNG

• Prizmo's quick capture mode provides a fast path from picture to speech synthesis for an improved workflow, and it provides a high-quality voice reader (individual voices available as in-app purchases).

VoCal Voice Reminder

• VoCal Voice Reminder by Gzero ltd.: Cost $.99

• Description: Is a voice calendar and sends alerts with recorded messages. Can be used for reminders and as ‘to-do’ lists. Has echo feature that will continue giving prompts until completed.

• 1. Tap the record icon, record a reminder using your voice ✔2. Set time/date for the reminder to alert you ✔3. Tap save and close the app ✔

Reminder with Voice Reminders

Reminder: Free with in-app purchases

DescriptionAida Reminder lets you create reminders very easily and quickly. Recurring reminders are fully supported, you can set hourly, daily, weekly, monthly and yearly reminders, or even days of the week or month. It also has a wake-up alarm with custom snooze time.

Use your own voice recordings or pick a song from your music library and set it as the reminder sound. They will play when the reminder is due.

Apps for Communication

• iConverse by Xcellent creations, Inc. $9.99

• iConverse is an Augmentative Alternative Communication (AAC)application for the iPhone and iPod Touch.

• It assists learners with basic communicative functions.

• There are 6 “common buttons” that display icons representing basic needs (bathroom, drink, food, sick, break, and help).

• Users can also create their own icons by using “my buttons” and taking pictures or using pictures in the camera roll.

• Speech can be added using text to speech (speaks typed message) or creating recorded messages.

Go Talk Now

• Go Talk Now by Attainment Company- $79.99

• Description: This app is a communication device that is available for iPads.

• Caregivers can create personalized communication pages using recording and text-to-speech capabilities.

• The app has the benefit of blending videos, pictures, and music to create pages.

• It also has the ability to jump between different pages and can be organized by categories.

Proloquo2go

(See Video Intro Above)

Overview of Proloquo2go app video

Cost = $249.99

Overview of Proloquo2Go

**Refer to the manual: (http://www.proloquo2go.com/Manual/article/downloadable-manual) and click on Full Proloquo2go 1.3 Manual for more detailed tutorials on the extra features of this program (Such as changing voice and display settings).

Touch Chat

• TouchChat HD - AAC

• TouchChat HD for iPad/iPod/iPhone ($299.99 USD + tax) is a full-featured communication solution for individuals who have difficulty using their natural voice. TouchChat is designed for individuals with Autism, Down Syndrome, ALS, apraxia, stroke, or other conditions that affect a person’s ability to use natural speech.

Apps that Translate Pictures into Text Messages

• TippyTalk is a free app that allows a person with a verbal disability to communicate by translating pictures into text messages, which are then sent to a family member or care givers phone or tablet.

• This allows the person who is non-verbal to communicate and express a desire, want, need or feeling.

• Are developing a two-way communication version that could be a game changer!

Learning

Guided Access for Apple Users: (THIS IS A LIFESAVER)!!

▪ Keeps the device in a single app and allows you to control which features are available for the user. To start guided access, triple click the home button in the app you want to use (may have to go to settings to turn on).

▪ Passcode Settings▪ Set the passcode used when guided access is enabled

▪ Time Limits▪ Set an alarm for when the guided access time is done.

▪ Accessibility Shortcut▪ Triple click of the home button

Covert Audio Coaching (CAC) or Bug-in-Ear (BIE) Technology

• Covert audio coaching involves a teacher, paraprofessional, job coach, supervisor, or another individual delivering immediate feedback to a person performing a skill via a two-way radio or walkie-talkie and an earbud speaker (Bennett, 2013).

• Feedback often includes antecedent prompting, praise statements, and/or corrective feedback to increase the likelihood of correct performance.

• Increasing the distance between job coach and employee may assist with fading dependency on adult support.

Wearable Devices and Apps to Reduce Anxiety

• The presence of anxiety can often cause difficulties for supported employees in work situations. Particularly in the following situations:• Unfamiliar tasks to perform

• Changes in schedule/routine

• New or unfamiliar coworkers

• Problem-Solving Situations• Missing materials

• Broken equipment

• Unexpected Change in how task is performed

What is Spire Device?

• Spire is a small, wearable device that monitors breathing to help user’s manage stress and can be worn on waist band or bra.

• The app that accompanies device shows breathing patterns and indicates whether breathing is Calm, Focused, Tense, or Neutral (or active).

• When Spire senses a change in breathing rate or pattern, it sends a notification to phone/device through an app to alert user.

• The app can also be set to send “notifications” to users through vibrations on the device if they are tense or haven’t taken a breath in a while.

• The free app has several "Boosts“, which are audio exercises that guide breathing.

• Spire is also an activity tracker that will count individual footsteps throughout the day and calculate calories while wearing the device.

Spire Stone Wearable Devices

• Use of Visually-Based Breathing app (Breath Guide/Green Dot Exercise on Spire Device) to produce calm.

What is Empatica Device?

• It’s like a fit bit on steroids!!!

The E4 doesn’t tell time but it measures…..

• Heart rate

• Heart rate variability

• Motion / activity

• Electrodermal activity (GSR)

• Skin temperature

Apps to Produce Calm

• Calm: Meditation and Sleep Stories Calm.com

• Free

App for Calm that Can be Paired with Apple Watch

• Breathe2Relax: National Center for Telehealth & Technology

• Free

• Description

• Breathe2Relax is a portable stress management tool which provides instructions and practice exercises to help users learn the stress management skill called diaphragmatic breathing.

• Breathe2Relax can be used as a stand-alone stress reduction tool, or can be used in tandem with clinical care directed by a healthcare worker.

• Breathe2Relax now uses HealthKit and your Apple Watch device to measure your heart rate throughout your breathing exercise to help provide an even more complete picture of the relaxation experienced.

Other Considerations• Cost of Device/Service

• Protecting Device(s)

• Size of Device

• Maintaining/Programming Device

• Training individual/caregiver/professionals to use device

• Technology must match environment and task

• Hands-free Considerations

• Wearable Considerations (what will learner tolerate and what will be the least cumbersome)

• Service availability (wifi and cell)

• Privacy and security using technology

• Technology may interrupt work flow

• Technology doesn’t replace teaching

• Some strategies are packaged with other interventions

Resources for Other Apps

• https://autismapps.wikispaces.com/Resources+and+More+Links

• A great list of apps was created by Eric Sailers and that can be found at:• http://www.scribd.com/doc/24470331/iPhone-iPad-and-iPod-touch-Apps-

for-Special-Education

• http://ericsailers.com/iresources.html

• Another great list by Therese Willkomm:• https://iod.unh.edu/sites/default/files/media/AssistiveTechnology/bestapp

sselectedbytheresewillkomm.pdf

Additional Resources for Considering AT

• Websites

• Georgia Project for Assistive Technology: www.gpat.org

• GPAT has developed numerous resources to assist educators and families in providing assistive technology services to students with disabilities. These resources are organized by various process topics including narrative documents, PowerPoint presentations, forms, on-line videos, and web links.

• OCALI Assistive Technology Training Module: www.atinternetmodules.org

• This module assists educational professionals and IEP team members in considering and determining student need for assistive technology.

• Oregon Technology Access Project: www.otap-oregon.org

• The Oregon Technology Access Program (OTAP) provides training, information, technical assistance and resources regarding the uses of technology for children with disabilities.

• Quality Indicators of Assistive Technology: www.qiat.org

• The QIAT Consortium, a nationwide grassroots group, provides input into the ongoing process of identifying, disseminating, and implementing a set of widely-applicable Quality Indicators for Assistive Technology Services in School Settings that can be used as a tool to support school districts, assistive technology service providers, consumers, universities and professional developers, and policy makers.

• Texas Assistive Technology Network: www.texasat.net

• TATN has numerous resources to support the use of assistive technology in the state of Texas. Training modules include: consideration, legal, administration, evaluation and reading.

• Wisconsin Assistive Technology Initiative: www.wati.org

• Sponsored by the Wisconsin Department of Public Instruction, this site offers process and downloadable forms to support the assistive technology assessment process.

PEAT - Accessible technology action steps

• http://peatworks.org/action-steps

Customized employment and assistive technologyunderstanding the relationship

• http://www.worksupport.com/documents/workplace_supports.pdf

Questions?

• Any other ideas???

• Thank you for attending the presentation! To obtain more information, please feel free to contact:

Toni Van Laarhoven Traci Van Laarhoven-Myers

tvanlaar@niu.edu t_vanlaarhovenmyers@ipsd.org

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