What is assistive technology?

Assistive technology is any kind of technology and/or tool that can be used to enhance the functional independence of a person with a disability. Often, for people with disabilities, accomplishing daily tasks such as communicating with others, going to school or work, or participating in activities can be a challenge. Assistive Technology (AT) devices are tools to help overcome those challenges and enable people living with disabilities to enhance and have access to a quality of life, that may otherwise not be known, and lead more independent lives.

Monday

Choice Making with Complex Communication Challenges




Students need options. They need many opportunities to make choices about numerous aspects of their lives throughout their day, every day, even when they have complex communication challenges.





Active participation can be difficult for children who face severe multiple disabilities. As Linda Burkhart says, "They cruise through the day as a passive passenger, never needing to pay attention to the road or even helping with navigation of where they are headed. (Guided Tour vs. Following a Map)" They are cared for and entertained regardless of their participation level. Continuously providing opportunities for making choices, enables the child to feel in control. Making choices helps to increase cognitive engagement and reduce passivity.

Choice making from an early age creates a foundation for critical thinking, increased problem solving abilities, and increasing independence.Creating opportunities to make choices is an important component to teaching communication. Choice making can easily be built into many activities. Choices can be offered around how things are done, when they are done, with whom, or with what materials. Through choices, the student then has some degree of control over their life with all its built-in rewards, risks and consequences. In addition, if the choice making is built into all classroom activities, then all the students in the class can have their own feeling of power along with the ability to model the behavior.

As Linda Burkhart states in: Engineer Choices and Control for the Child

  • Active participation is increased by providing opportunities for control and making choices that will affect the child’s experiences.
  • Provide opportunities for control, by setting up child-directed activities and following the child’s lead.
  • While children cannot often have control or choice about the sequence of the daily routine, there can be opportunities within routines that affect them. (For example, deciding who will be their peer buddy for an activity, selecting the book for story time, or competing with friends in an adapted game that reinforces concepts just learned in a lesson.)
  • Continuously provide opportunities for making choices - enable the child to feel "In Control".    
  • Provide choices that matter and choices that are easy to discriminate.
  • Provide adapted methods of choice making for individual needs:
    • eye-gaze
    • reaching
    • pointing
    • talking switches
    • partner listing
    • two hand choices
    • touch points cues
    • choice boards
  •  Making choices helps to increase cognitive engagement and reduce passivity .
  •  Set up choices for who, what when, where, how, and how many - within any activity.
  •  Provide multiple opportunities for meaningful choices throughout the day.
  •  Engineer communication opportunities.
Making our own choices is a key part of personal development, self-determination, self-esteem, and judgment. Students with severe communication and/or physical impairments do not automatically have access to choice making opportunities. They cannot easily go to get an item or call out a request, therefore opportunities for choice making need to be structured and intentionally presented in the same contexts as they would be with typically developing children.

Choice making is important in developing personal autonomy which defines who we are and what we value as individuals. Choice making for a student with special needs provides, among other things, power and control.

As communication partners, we are responsible for creating opportunities for choice making by offering choices directly and coaching others (e.g., peers) to offer the student choices. For students just getting the concept of making a choice, try selecting a preferred object and a non-preferred object to choose between. We must all be intentional about giving the opportunity to make choices.

For nonverbal students, having a voice opens the door to participation, inclusion, independence, and fun.

When asking a question, make sure that it isn’t rhetorical, and that you show that you expect some type of response! Be sure to provide time for them to respond. If a response is not quickly provided and wait time has been given, repeat the question, letting them know you are waiting, you care, you want to know.

Make sure you are really creating an opportunity for choice making. Choice making increases attention. It empowers and motivates the student. Be sure to provide multiple opportunities throughout the day, every day, all day.

Providing opportunities for the student to make choices helps to alleviate learned helplessness. A child with a communication impairment is at risk for learned helplessness. Because adults do not expect the child to inform them of his or her needs and wants, they anticipate, and often misinterpret, the child's needs. As a result, the child may relinquish any attempt to make his or her desires known and become extremely passive.

Brwon, Appel, Carsi and Wenig (1993) identified 7 types of choices available within the context of most activities and routines:

  1. Choice within an activity
  2. Choice between two or more activities
  3. Deciding when to do an activity
  4. Selecting the individual with whom to participate in an activity
  5. Selecting where to do an activity
  6. Refusing to do an activity
  7. Choosing to terminate an activity at a self-selected time. 
That can add up to a lot of choice making throughout the day!

Some possible topics for providing choices throughout the day may include:
  • what to have for snack
  • what color of candy treat they want
  • what to wear
  • who to play with
  • how to wear their hair
  • where they want to go on their walk
  • what order they want their schedule to be
  • when to take a break
  • what to say to grandma on the phone
  • how to compose an email to a friend
  • where to go on the weekend
  • what to do after school
  • what story to tell their classmates
Try presenting choices of actions instead of objects for increased motivation and more natural repetition. Offer choices for frequent short activities, or choices within an activity instead of choosing an activity.

Choices may be presented via objects, environmental cues, icons/pictures, hands, fingers, or verbally.

Here are some important elements of choice making:

  • Present choices clearly and without unnecessary verbiage
  • Consider the student’s receptive vocabulary and use appropriate language when presenting choices
  • Allow the option of “something else” or “I don’t know”
  • Consider how many choices to present at a time: 1 selection is NOT a choice; 2 may not be enough; 5 may be too many at one time
  • Consider visual issues and placement of tangible choices
  • Know how long to wait for the student to initiate a response
  • Know when and how to confirm choices with the student
  • Don’t give a choice with which you cannot follow through
A personal challenge for all of the staff working with the child: how many choices can you provide today. Have a choice making poster and every day have staff post the choices they provided throughout the school day. Review it as a team at the end of the day until it becomes a natural part of the school day.