A head pointer can be a light attached to a visor or headband. Or an actual pointer can be connected to head straps made to fit firmly on her forehead or chin and angled so that she can touch pictures, words, letters or a communication device as efficiently as possible. Head pointers can be beneficial for individuals who have relatively accurate head movement, but minimal hand mobility. A head pointer can be utilized in conjunction with a communication board. Communication boards serve as both functional and portable ways to enable access to choices. They can be created out of anything from a manila folder with contact paper, to a foam board with a Velcro strip along its length. They can hold objects velcroed on or placed in pockets, pictures, words, or any combination. It is essential to create them, so she can use her head pointer to request exactly what she desires. These boards can be placed on a lapboard to go with her or placed in strategic locations around the classroom as well as in the home.
A trial with the head pointer and communication board took place. These non-SGD approaches are insufficient to meet Havana’s needs. Communication boards do not provide the auditory feedback she requires to check the accuracy of her message selection. Additionally, she is incapable of directly selecting pictures, therefore the head pointer was mandatory. Havana did not have a successful trial with the head pointer as her frustration was tremendous. Havana’s ability to utilize her head pointer to request wants and needs was less than 50%. Head pointing is a challenge for her because she lacks the motor planning and control to efficiently coordinate these movements. Head pointing is not a viable access mode for her to be a successful communicator.
Proloquo2GO is an AAC application that can provide a voice for those with expressive and receptive language difficulties. This particular application is designed for individuals with an array of disabilities. Proloquo2GO is a complete communication solution providing many natural sounding text-to-speech voices, three complete research-based vocabularies, over 10,000 up-to-date symbols, powerful automatic conjugations, advanced word prediction, multi-user support, ease of use, and the ability to fully customize vocabularies to meet the needs of individual users from beginning symbolic communication to full literacy. The three research-based vocabularies include Basic, Intermediate, and Core or Advanced Core to help create an effective communication system. Basic communication is designed to allow for precise expression at the one and two-word level to promote developmental progression in communication skills. This app is also highly accessible especially individuals with fine motor deficits. Proloquo2GO contains hold duration, scanning, as well as switch control. Switches can be utilized to operate communication devices such as the iPad for simple cause and effect programs and for more complex programs in which require scanning. A pillow switch was trialed during this particular evaluation. It has a smooth and soft foam surface in which makes this switch suitable for head or cheek activation. It easily fastens to a pillow or wheelchair cushion with safety pin and Velcro.
The Proloquo2Go application on the iPad with a pillow switch was trialed with Havana. A switch was trialed because her fine motor skills are not adequate for accessing an SGD with direct selection. Her success with the pillow switch was minimal and she experienced frustration throughout the duration of the trial. Her ability to use switch access was less than 60%. Due to her diagnosis, she is unable to carry out cognitive intent. Havana may intend to move a certain way, but her neurological signal does not effectively reach the correct muscles to maneuver them regularly. When Havana was seated in her chair, the switches were positioned at her head, chin, and cheek. Havana was unable to successfully master the motor plan for a two-switch scanning presented to her. She aimlessly and constantly hit the switches without any communicative intent. In order to utilize a switch, users must master motor plans needed as well as timing components. Additionally, Havana lacks sufficient fine and gross motor movement in which made it extremely difficult for her to successfully activate the switch. Her constant bodily gestures significantly impacted her ability to push the switch. Switch scanning overall is an ineffective access mode for her to be an adequate communicator.
A trial with the TobiiI-12+ with Snap + Core First software was trialed. The Tobii I-12+ is a speech generating device that can be controlled though eye gaze interaction via a built-in eye tracker, as well as direct selection/touch and scanning. This device is intended to provide everyday communication for individuals that have challenges in their ability to speak due to an injury, disability or illness. The Tobii I-12+ is designed primarily for face-to-face communication and additionally for long distance (indirect) communication, computer access, environmental control and on-line social interaction, allowing the user to communicate via text or symbols to generate synthesized (computer voice) or digitized (recorded voice) speech. The Tobii I-12+ allows its users several options of communication through via text message, chat and voice calls via Bluetooth to cellphone, Wi-Fi to Skype, Internet to Email and other third-party applications such as Facebook. While using the Tobii Dynavox Snap + Core First software on an I-Series+ eye tracking device, students have the potential to expand their vocabularies and string new words together. Snap + Core First is a symbol-based communication app enables users to start communicating rapidly and stay engaged as they grow and evolve on their communication journey. This app provides the quickest and most dynamic platform for communication for all users.
Havana is able to successfully use eye gaze to directly access a communication device. She has the ability to activate targets in all quadrants of the screen utilizing her eyes. The Tobii Dynavox I-12+ was considered for Havana and deemed appropriate for her. Havana attended very well to the screen and learned to use the device through adult modeling. It was evident that Havana was making specific choices. Given a variety of options, Havana used the SGD to request what she desired in 80% of opportunities when provided with maximum cueing. The following options were provided to her: Music, eat, drink, say something, do something, play guitar, read a story, go for a walk, lay on the couch, ride your bike. She learned to use DRINK to request a preferred beverage. Shortly after requesting DRINK, she then selected MILK. She also learned to use DO SOMETHING to request certain activities such as riding her bike, laying on the couch, and going for a walk. She would also smile when she chose the desired activity. There was one instance during the evaluation when the clinician asked Havana what she wanted to do, and she responded by saying “I do not want to talk anymore.” This conveys that Havana has the ability to adequately convey her feelings. Overall, Havana appeared to enjoy her communication partners responsiveness to these words as evidenced by her smiling and vocalizations. In a short period of time, Havana displayed that she has the language potential to communicate and continue learning language. However, she requires the necessary means for access.
Havana is able to successfully use eye gaze to directly access a communication device. She has the ability to activate targets in all quadrants of the screen utilizing her eyes. The Tobii Dynavox I-12+ was considered for Havana and deemed appropriate for her. Havana attended very well to the screen and learned to use the device through adult modeling. It was evident that Havana was making specific choices. Given a variety of options, Havana used the SGD to request what she desired in 80% of opportunities when provided with maximum cueing. The following options were provided to her: Music, eat, drink, say something, do something, play guitar, read a story, go for a walk, lay on the couch, ride your bike. She learned to use DRINK to request a preferred beverage. Shortly after requesting DRINK, she then selected MILK. She also learned to use DO SOMETHING to request certain activities such as riding her bike, laying on the couch, and going for a walk. She would also smile when she chose the desired activity. There was one instance during the evaluation when the clinician asked Havana what she wanted to do, and she responded by saying “I do not want to talk anymore.” This conveys that Havana has the ability to adequately convey her feelings. Overall, Havana appeared to enjoy her communication partners responsiveness to these words as evidenced by her smiling and vocalizations. In a short period of time, Havana displayed that she has the language potential to communicate and continue learning language. However, she requires the necessary means for access.