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Wednesday, March 9, 2011

Guest Post: Helping a Child with Tapping Problems use AAC

Guest blogger Barbara Hallahan, SLP is a TapToTalk Service Provider in Ireland. She developed a simple yet effective method for helping a boy whose finger control issues got in the way of using AAC. Here is her story: 

Some kiddos have difficulty controlling their fingers, so it is important to help them develop the skills to tap where they need to as firmly as they need to in order to get the best results. The boy I work with has difficulty isolating a single finger and also has difficulty tapping only once. Despite this problem, there were some items he can consistently press successfully, so I knew he was able but needed support.

When encountering this kind of problem, it helps to break it down and tackle the issues separately.

The first thing I did was isolate the problems:

1. Without resistance he would tap lightly and quickly, but with someone holding his wrist (resistance) he had to push down harder and did not tap repeatedly, he tapped once with more control and force.

2. I found that it worked better to hold his forearm--both because it positioned his hand further away from the screen (better visibility) and because it prevented me from subconsciously directing his finger to the "correct" choice. It is very easy to accidentally make the choice for the child and think he is doing it.

The next thing I did was develop two "warm up" TapToTalk albums for him so he could practice self-calibration--get used to refining his aim and accuracy.

The structure of the warm-ups is as follows:

Basic TapToTalk Warm-up Album

Page 1: Six pictures, with one picture containing a motivating icon (I used a dog) and the other five just plain white squares. Only the dog will bring you to a new page (after barking for you).
Page 2: The new page contains six pictures, five white squares and a fish in a different corner than the dog was on the first page. Pressing the fish gives a new sound and the next set of six pictures.
Page 3: On this page, the "prize" is a cat, and on the next page the "prize" is a frog.
Page 4: When the frog is pressed, a single icon (magic wand) appears and...
Page 5: Pressing it produces "Bravo."

You can substitute any motivating pictures and sounds. It is better to use different ones than all the same, and keep changing the location of the motivating picture among the six.

Advanced TapToTalk Warm-up Album

The second "calibrator"  uses twelve pictures per page instead of six and has five levels. I use the same concept with plain white squares producing no results. Place a star in the upper left corner for the first level, a slightly different one in the upper right corner on the second level, lower left (again just slightly different--colour or size) on third level, lower right (again a bit different) on fourth level. The last page has a single icon and delivers a positive sound message when pressed.

If you use these for a warm up with children who are inconsistent in their responses, you can collect data regarding the number of unsuccessful or incorrect attempts between the first page and the finish. You can also track the time it takes to get from beginning to end. Both of these methods of data collection can be used in outcome reporting and in setting goals.

I also developed a variation on the numbers template so the boy I am working with can practice counting out loud with his fingers. Pressing number one brings him to a page with a single blue box. Pressing the box produces the spoken word "one." Back on the top page, pressing the number two brings us to a page with two blue blocks. Pressing the first produces the spoken word "one." Pressing the second blue box produces the spoken word "two." And so on.

He continues to vocalize more than before he had the tap to talk, and is making more spontaneous attempts to communicate more effectively with and without the DS.

You'll find lots of great pictures to use for this if you explore the various categories in the TapToTalk Picture Library. You can get the white square from the Colors category and magic wand in the Circus-Magic category. You can explore the library in Designer, or on the TapToTalk website's Picture Library page (this page has a nice search feature).

If you have a TapToTalk idea or story you'd like us to share with other TapToTalk users, please email us at blog@taptotalk.com.

The TapToTalk Team
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