"I want to go potty." This may not sound like much, but for Jordan, it's a milestone.
One year ago, 8-year-old Jordan, who has autism, could hardly speak a word. But with a specialized educational program, a lot of family support, and an electronic tablet, Jordan has learned to communicate. So when he recently spoke these words to two friends while swimming, his mother was ecstatic.
"We were hoping technology would bridge the gap between his inability to tell us what he wants to some way of communicating," says his mother Gail, who withheld her last name to protect Jordan's privacy. She's convinced the multisensory approach of the tablet (visual and auditory cues paired with physical touch) and its consistent, paced output "triggered something." Jordan now has what is known as "emerging speech," delayed, but nevertheless communication with intent. He also is beginning to read kindergarten books.
CAN Sponsors Autism Study
Jordan is part of a small group of young children with autism who are participating in a research study conducted by AARTI, Inc., a not-for-profit corporation established to commercialize technology created by the Archimedes Project at Stanford University's Center for the Study of Language and Information. Autism is a serious neurological disorder that usually strikes in the first two years of life and can cause severe impairment in language, cognition, and communication. The Cure Autism Now (CAN) Foundation contracted AARTI with the task of creating a device that would allow these children to communicate, explains Lead Researcher Dan Gillette. So, believing that "software does not drive accessibility—hardware does," Gillette and his team sought an appropriate computer.
They considered a PDA (personal digital assistant), but decided "the real estate is too small. You need a bigger screen," says Neil Scott, Vice President of Engineering for AARTI and Director of the Archimedes Project.
So because of "ruggedness" of the tablet and its relatively large screen and portability, they chose the tablet. The first proof-of-concept version of the tablet communication device, or VOCA (voice output communication assistant), runs with standard Windows software. A second version, using the Linux operating system, is now under development. "Our goal is to significantly improve performance while, at the same time, eliminating unnecessary display and control functions that distract the user," Scott says. The communication functions are defined by Perl scripts, which create interactive movies that are presented to the user by a Flash viewer. The user interacts with screens displaying six to nine photos or cartoon-like drawings of each child's environment, sorted by category, such as foods, people, and places. When the child touches one of the pictures, it grows larger and rotates 45 degrees to confirm selection and speaks. Individual pictures can be dragged to a staging area at the top of the screen to build complete sentences, which are then spoken aloud by the VOCA.
Regaining Speech
"This has been a wonderful opportunity" for 7-year-old Ariane who originally had speech, then lost both her communication and eye contact, says her mother Denise. "I knew her when she could say words, so I always knew the potential was in her. The dilemma was 'How do we tap it?'" Just recently, Ariane, who has autism, has begun to demonstrate spontaneous, appropriate speech. Denise estimates she now has a working vocabulary of 100 words. She attributes the spark to Ariane's emerging speech to the VOCA.
Ariane, who has difficulty pointing and discriminating visual cues, liked the "clear, simple language" spoken by the tablet. "When the tablet started talking, she came," Gillette says. Ariane's VOCA uses a natural, spoken voice and photos taken by her mom.
After Ariane learned how to point with a variety of custom-designed pointers such as a reshaped guitar finger pick, she began experimenting with the tablet. The slow pace of the device and its consistent speech was perfect for Ariane who needs a longer period to alert to a social interaction and who responds slowly. She began to attempt to speak the words spoken by her VOCA. Even her caregivers began to mimic the slow, quiet, patient cueing of the tablet. With this "one link, her growth became exponential," says Denise happily. Her social interaction, visual discrimination, and attention have all improved and she is demonstrating limited contextual speech paired with sign language.
Beyond the Tablets
Jordan prefers using a desktop computer with his VOCA vocabulary because he is more comfortable using a mouse. Ariane will bring her tablet to her general education 2nd-grade class at Highland School in San Mateo, but she may rely more on her signs and speech.
"I don't care if she ever speaks through the device. We want her to communicate," Gillette says referring to Ariane. "Although technically we are creating a communication tool, I've always seen this as an educational tool," he explains.
The Archimedes Project is more interested in ensuring that all people have access to and use of information and control of their environment. Scott and two other researchers created the Archimedes Project in 1992 to make information technology accessible to all people—aging, those with disabilities, and those with limited literacy. "The idea was to use technology as leverage for people who can't otherwise do things. Put the person in the middle and create the technology to allow access and control to occur. Archimedes said, 'Give me a lever and a place to stand and I will move the world.' If you give people the right technology, it can be the lever that moves their world."
But universal access, although talked about a lot, is rare. And "it's not by a recipe," Scott points out. "We are trying to find solutions that are long term, universal, and can be mixed and matched to suit a particular person at any given time."
So, while Ariane and Jordan may be moving beyond their tablets at this point in time, the technology gave them access to information and the beginning of control over their environment. Both are continuing in the CAN-sponsored project, and both moms agree technology will continue to be a part of their lives.
"We don't know what the future holds for Jordan. If only you could find a little Palm Pilot that you could talk with and walk around with," says Gail. Who knows? That may not be so far off in the future. (See Access Factory)
