Eye Gaze Communication Review - A Guest Post

1) Just because the concept of eye gaze is simple, reading eye gaze is not necessarily easy. We need practice and experience to become competent partners. Not all kids use the same techniques, in part because the end goal for each child may not look the same (see #2).

2) Eye gaze response procedures should keep in mind technologies to be used in the child's future. If a child will be using a dwell-click with head mouse or eye gaze software, for example, then it is important that they learn to hold their gaze to a choice for a specific length of time. Children who will not be advancing to a head mouse or eye gaze may find it beneficial to confirm their choices with eye contact to the communication partner, especially if they are socially motivated.

3) Similarly, if head mouse use is in the child's future, helping them learn to turn their head along with their eyes will support that technology. This can roughly be considered "nose pointing," although the child is merely directing the nose toward the choice, rather than touching it with the nose. If head mousing is not in the child's future or if you plan to go with eye gaze not head mouse, it's fine to hold the head still and cast long sideways glances with the eyes.

4) Motor ability must be considered. The length of dwell to a choice should be reasonable...five seconds (a standard dwell time expectation in too many IEP goals, sad to say) is WAY (WAY!!!) too long for most children, both in terms of head stability and attention span. Try it...five seconds is an ETERNITY and it slows conversation down to a pathetic pace. At our house, .90 seconds is a good dwell time and doesn't interfere with the flow of communication.

5) Positioning yourself as a receiver is very important. You must be able to see the child's eyes clearly. However, some children fixate on the face of the reader, so you need to be flexible. Head-on (180*) will work for students who do not fixate on faces, but for children who are hyper-fixated on faces, an angle just over 90* may be more appropriate. You learn from the child what they need as far as positioning in relation to the partner.

6) Children with hyper-fixation to faces may benefit from loose symbols held side-by-side in front of the reader's face, then slowly moved apart. The child's eyes will (hopefully!) follow the intended choice as they move.

7) Boards intended for finger-pointing tend to have symbols spaced too closely for all but the most skillful eye gaze readers (and users). Loose symbols allow you to distance the choices at optimal points from the user. These can be held in the hands or affixed to velcro-sensitive boards (I personally like 3"-wide strips of indoor/outdoor carpet mounted to mat board, 15-18" long. Post-It makes poster board that can be cut into strips that holds symbols temporarily as well).

8) Not all days are necessarily the same. Some "off" days may require few choices spaced at farther distances, while other "on" days may allow a child to handle many choices placed closer together.

9) Along these lines of "off" and "on" days, if the child suffers neurological swings, it is imperative to tailor our expectations to the child's ability at the time. This may sound basic, but it is a point often overlooked in our hurry to take data.

10) Some children do very well with fixed frames. These are nice because they free the partner's hands and can often hold many choices. There are directions for some wonderful PVC frames online. There are also commercial e-Tran frames of Plexiglass (Cogain and others). Again, you must keep in mind the child's preferences and tendencies to fixate...

11) The goal of eye gaze communication is COMMUNICATION! It is NOT testing! Kids pick up on the fact that they are being heard or being tested, so make sure you honor what they tell you!!! This is probably the single most important point in all the discussion of eye gaze. For some reason, we tend to doubt eye gaze responses. This is because of our OWN insecurity in reading the answer correctly. If we honor a child's response, they learn to trust us as communication partners. If they indicated what they intended, we validate their answer. If they answered in error, we STILL validate their answer and demonstrate that we honor what they say. The children learn they must change their strategy to communicate the accurate answer and that they must find ways to negotiate to get what they had meant to tell us.

12) When you are unclear of a child's answer, DON'T repeat the same question. Ask it a different way. Try asking it in a way that would require they show a different answer ("Do you need more time?" becomes "Are you all done then?"). Show respect by letting the child know that you are the one having difficulty understanding; it is not the child's fault.

13) Try to keep the same placement of symbols offered for choices. This allows the child to develop motor automaticity. You may start to see eyes heading to a location before a symbol is even offered; this definitely suggests the child has achieved motor automaticity.

14) Not all children need to demonstrate "scanning of all the options" before making a selection. Motor automaticity may come to play, as well as peripheral vision skills. This does not mean kids aren't expected to know what all the choices are, but it does mean that "scanning" them may not look quite like we expect. An example is this: A teacher offered my child yes/something different/no in the same order each time (hurray! Way to build motor automaticity!) but would not accept the answer until she had gazed at each choice first. This is both unnecessary, slows communication, and discounts motor automaticity).

15) As soon as possible, eye gazers need to have introduced an option to indicate that what they want to say is not among the choices. This can be most anything ("something else," "not here," "different idea," whatever works for you and the child), but it is not fair to force a child into choosing only between choices they don't really want. Otherwise, the only option we give them is to NOT choose...and then we've set them up to be labeled as "non-communicative."

There are usual communication strategies that we can't forget: motivating topics, making the child responsible for sharing information that they alone would know (highly motivating!), respecting the answer, GENUINE conversation...

I hope this helps. Again, it's just what I've learned from walking in the trenches.

Rose-Marie

Where We Stand

I just watched the end of a documentary on NH PBS today called, "Where We Stand: America's Schools in the 21st Century" and was struck by a quote by a principal of a low income school. She said something along the lines of, "If you need your hair combed, we'll comb it. If you need clean clothes, we have them. If you need to eat, we'll feed you."

I have been doing this day in and day out for as long as I have been teaching. No complaints, no arguments, just combing hair, doing laundry and buying lunches so my students can get on with the business of learning. At my last monthly team meeting we discussed taking up a collection to pay for lunches for students who do not bring lunches or lunch money, because no one can learn if they are hungry. I've bought winter coats, toothbrushes and more ponytail holders than I can count.

And those outside the field wonder why the average teacher lasts less than three years?

Imagine if all schools made a commitment, backed by funding from the government, to make sure every child was relatively healthy, clean and fed? And to make sure that every classroom was clean, equipped, and at a comfortable temperature? Surely it is not the child's fault that they are unkempt and/or unfed and certainly it should not fall on the teacher to fix it? A systematic problem deserves a systematic solution.

Adapted You Tube Player

Last weekend my father asked me how to stop a You Tube video once it was playing, a question that may seem obvious to a digital native but certainly isn't obvious to everyone.

The One Switch blog just featured a You Tube player with adapted buttons for those who need them called Easy You Tube. I doubt it will solve school filter issues, but it may solve some usability issues and will certainly make You Tube more accessible to touch screen users.

How You Know...

Back when I did the survey of what people wanted to see on this site lots of people said they wanted more stories about my classroom, so here you go.

I have a student who has highly unintelligible speech, is significantly hearing and visually impaired and is waiting for an AAC device trial, yet she manages to make her point much of the time. One of the ways I know that she LOVES something we have or do in school is that she will say something that sounds like the grown-ups in a Charlie Brown cartoon with the words "in" and "bookbag" very clear in her "sentence". She will then attempt to take whatever it is she adores, put it in the bag on her walker, bring it to her back pack and place it inside.

The punch line: today she attempted to take the computer monitor with the touch screen because she was enjoying the Classroom Suite activity she was doing so much!

(F.Y.I. The activity was Beauty Makeover, which is a brilliant user created activity available in the Classroom Suite Materials exchange. Other words we understood from her speech during her time using Beauty Makeover were, "wow", "ugly", "icky", "roho" (she is an ESOL student) and "brouja").

Visual Scenes - What Do They Mean to Our Students

The big trend right now in AAC is visual scene displays (VSDs). All of the major AAC manufacturers (Dynavox on InterAACt, PRC (PRC calls them context scenes), Boardmaker SDP, low tech VSD devices by Enabling Devices and on the Boardmaker Activity Pad) are offering VSD on their devices, some companies are even offering them to the exclusion of traditional grids of symbols or photos or they are making it very, very difficult to use traditional grids of symbols photos within their software (hours of reprogramming VSDs to grids - this is true on InterAACt on the emerging communicator level).

However many of those involved with the decision when choosing AAC hardware and software do not have any idea what research has been done on VSDs and whether or not they would be beneficial to the individual who will be using the AAC device. Then the device arrives and suddenly there is this huge demand to learn how to use VSDs or reprogram to avoid the VSDs.

The research on VSDs seems to be primarily done on older (elderly) AAC users who have aphasia and secondarily done on those with autism spectrum disorders. There is some theroretical writing about VSDs and young children, but not much research. There is little research on VSDs in other populations (cerebral palsy, brain injury, Down Syndrome, Fragile X, etc.), nor is there any research on VSDs when the access method is not some kind of direct selection (i.e. for those who use auto- or step-scanning). Where there is research, i.e. this study for small children, the sample size is small (n=5) or the research focuses on personally relevant VSDs (photos of a person's actual surroundings as opposed to abstract drawings). This leaves decision makers in a void of information and presents a challenge when working with individuals outside of the areas that have been researched (everyone except young children, those with ASD and those with aphasia).

There is an assumption that visual scene displays reduce cognitive load, but this likely varies by individual (i.e. some individuals may find VSDs easier, but others may find traditional grids with no questions as to what is selectable vs. what isn't easier. If you are a PC user think about whether or not you like to view folders in thumbnail, icon, list or another format. This varies from person to person and task to task. The need for VSD may also change based on the persons style of learning - highly visual people, like most people with ASD may prefer the VSDs while others may prefer traditional grids). There is also an assumption that visual scenes will act as a visual cue to prompt conversation, but while this is possible it is also possible that a VSD can act as a distractor and lead away from the point that needed to be made (think about how often we write in IEPs to decrease visual distraction as an accomodation).

In short we don't know what visual scenes mean to our students. We are left where we are often left when teaching those with low incidence multiple or severe disabilities: direct trials and data collection is the only way to determine what will work and what won't. That means in the current trend of VSDs it is even more important than previously to rent an AAC devices for an extended period of time and run trials of the different types of software (with VSDs like InterACCt software and without VSDs like Gateway software) before you order. Additionally it is imperative that trials be done on the most current software available because if the software has changed the ability to access it may also change.


Bibliography of VSD research and presentations:

• Beukelman, D., Deitz, A., Hux, K., McKelvey, M., & Weissling, K. (2005). Performance in chronic aphasia using visual scenes interface with AAC. The ASHA Leader, 139.
• Beukelman, D., Dietz, D., Hux, K., McKelvey, M. Weissling, K. (2005). Visual scenes: An AAC prototype for people with aphasia. The ASHA Leader, 139.
• Dietz, K, McKelvey, M, & Beukelman, D (2006). Visual scene displays (VSD): New AAC interfaces for persons with aphasia. Perspectives on Augmentative and Alternative Communication, 15, 13-17.
• McKelvey, M., Dietz, A., Hux, K., Weissling, K, & Beukelman, D. (2007). Performance of a person with chronic aphasia using personal and contextual pictures in a visual scene display prototype. Journal of Medical Speech Language Pathology, 15, 305-317.
• Shane, H. (2006). Using Visual Displays to Improve Communication and Communication Instruction in Persons with Autism Spectrum Disorder. Perspectives on Augmentative and Alternative Communication. 15:1, 7-13.
  
• Ongoing Research

The AAC run down on visual scenes

• CallTalk (runs on BM/SDP, The Grid) - traditional grids
• Chailey Communication System (runs on Mind Express) - traditional grids
  
• Communicate 4 (BM/SDP, it originally ran on DV4s) - traditional grids
  
• Dynavox InterAACt - default visual scenes, elimiating is difficult
  
• Dynavox Gateway - traditional grids
• Express Talk (runs on Mind Express) - traditional grids
• Ingfield Express (runs on Mind Express) - traditional grids
• PRC Lite Devices - visual context scenes (not sure if default or optional)
• PRC Devices - Unity/Minspeak on a traditional grid, some have "learning scenes" option
• Point to Pictures (JR Cooper devices) - traditional grid
  
• Symbol Chat (runs on The Grid) - traditional grids
  
• Talking Screen - traditional grids
  
• TALK Boards (runs on BM/SDP) -traditional grids, text based, not for emergent communicators
  
• Velocity (runs on DV, SM/SDP) -traditional grids
• WordPower (runs on DV, PRC, BM/SDP, The Grid) - traditional grids, not for emergent communicators

Hardware/Software Mentioned (what board sets above run on)

• Dynavox
• PRC
• Boardmaker Speaking Dynamically Pro (aka BM/SDP)
• The Grid
• Mind Express
• Talking Screen
  

Our Room

These pictures show materials pertaining to everything from sensory, communication, positioning, life skills and functional academics. Perhaps 30% or more of the items in the photos came from grants from Donors Choose. All of the sensory materials came from Donors Choose donors. All of the oral motor items. Everything that is laminated and/or bound on the comb binder was made with our laminator and comb binding machine from a Donors Choose grant. The blue and white cart and the materials in it is from the generous folks who sponsored our grant at Donors Choose. Donors Choose philanthropists have made the difference in our room and we appreciate them every day.

Our last several grants have gone unfunded, however we have two grants that are partially funded. Please consider making a difference to use by donating:

• AAC Device Grant
• Hearing Impairment Grant

Weekly Reader Ablenet Edition

Recently I had an opportunity to sample Weekly Reader Ablenet Edition. Like News-2-You it is an adapted newsletter, however, unlike News-2-You it supports inclusion in that it goes along with the standard Weekly Reader that is mailed out 32 times a year to classrooms all over the country for the past 100+ years. This way students are doing the same topics with differentiationin instruction. Here is a sample.

Also like News-2-You you go online to download most of the content, however you do receive the regular, unadapted Weekly Readers in the mail each week (and an e-mail telling you when the adapted content is available).

The content of Ablenet Edition Weekly Reader is differentiated on three levels:

1. The first level is very basic, for learners somewhere between cause and effect and emerging conceptual/linguistic knowledge. It has full literacy symbol report and the selections on the page are large and uncluttered.
2. The second level is for students with some concept knowledge and working on beginning emerging literacy.
3. The third level is for learners who need a high interest-low readability text (about mid first to late second grade level).

In addition you recieve a teacher's guide with lessons for sensory, literacy and "day-fillers" (okay they need a better name than "day-fillers", especially since the activities are not busy work and areapproproiate thematic activities - perhaps they could be renamed "thematic activities"). Themeatic activities include lessons for community based instruction, recipes, games, interviews, surveys, web links and more. If you want to view the themes for each weekly reader you can download them from Weekly Reader. It would be possible knowing the Weekly Reader themes ahead of time to plan your curriculum with the Weekly Reader topics as a base.

It appears as if the Weekly Reader Edition 2 (second grade) and the Weekly Reader Senior Edition are available from Ablenet, however most of the themes of the are the same across all of the elementary levels (K-3) so you should be able to use the Weekly Reader Edition 2 from Ablenet with any of the Weekly Reader elementary editions for inclusion. Use the link above to check the Edition 2 themes against other additions to be sure. The elementary edition comes our 32 times a year and the senior addition comes out 25 times a year.

Both News-2-You and Weekly Reader Ablenet Edition offer support for assistive technology and AAC. Ablenet comes with guidelines for using technology such as a Big Mac, a Step-by-Step, All Turn it Spinner, iTalk2, Power Link and a Super Talker with the Weekly Reader content. (I wish I had all of those things, just last week on of the teacher I mentor asked to borrow my All Turn It Spinner and i had to tell her that not only do I not have one, I have never had one. I don't have a Super Talker in the room either.) These guidlines are super for teachers new in the intensive field and have no idea what a switch is or what to do with it. The advantage that News-2-You has is the Classroom Suite Activties that can be downloaded for each newsletter. Here's hoping that Ablnet adds Clicker 5 or Boardmaker Plus, or even Classroom Suite support to their offerings.

Like News-2-You, Weekly Reader Ablnet Edition aligns to state standards and allows you to easily match standards to activties and take data for Alternative Assessment purposed. With so many similarities the major difference between Weekly Reader and News-2-You is the normalization and inclusion factor. I read Weekly Reader in elementary school, my elementary aged family members read Weekly Reader, Weekly Reader has been a staple in American schools for years and now our students can take part too. (Note: there has been some online banter on listservs that Weekly Reader is not available outside the USA, including in Canada. I would call and check before ordering outside of the USA.)

A word about the symbol support. Ablenet uses JupiterImages and News-2-You uses Symbol Stix. The free newspaper (UK based) ELive from Symbol World uses Widget Symbols. As far as I know there is not an adapted newsletter using Mayer-Johnson Picture Communication Symbols. On my wishlist is for someone, maybe Ablenet, to produce an adapted newspaper with Mayer-Johnson Picture Communication Symbols and Boardmaker Plus content.