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Your weekly dose of information that keeps you up to date on the latest developments in the field of technology designed to assist people with disabilities and special needs.
Language Acquisition through Motor Planning (LAMP) with John Halloran – Aacandautism.com | AACApps.com
TidBITS: Workflow Is the Next Step for iOS Automation http://buff.ly/1zcXGJS
Ai Squared Releases Window-Eyes 9 Screen Reader | Virtual-Strategy Magazine http://buff.ly/1zcWDJO
Microsoft Office Online gets new accessibility enhancements http://buff.ly/1zcWLJc
App: Step by Step www.BridgingApps.org
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JOHN HALLORAN: Hi, this is John Halloran, and I’m the senior clinical associate at the Center for AAC and Autism, and this is your Assistive Technology Update.
WADE WINGLER: Hi, this is Wade Wingler with the INDATA Project at Easter Seals crossroads in Indiana with your Assistive Technology Update, a weekly dose of information that keeps you up-to-date on the latest developments in the field of technology designed to assist people with disabilities and special needs.
Welcome to episode number 190 of Assistive Technology Update. It’s scheduled to be released on January 16 of 2015.
Today my guest is John Halloran who’s going to talk a little bit about the LAMP communication system; a story about a new app that helps you automate your iPad or your iPhone; interesting stuff coming out of Microsoft and AI Squared about accessibility for their online system; and an app called Step by Step from BridgingApps.
We hope you’ll check out our website at eastersealstech.com, call our listener line at 317-721-7124, or shoot us a note on Twitter at INDATA Project.
I use a lot of Apple products, and I’m very involved in using iOS devices. I use iPads and iPhones and all that kind of stuff. Lately I’ve been paying attention to a new app that sort of was delayed in coming out but now that it’s out, is making a lot of news in the mainstream iOS news cycle. It’s an app called Workflow, and it’s something that has been kind of coming for a while. It’s developed by a company DeskConnect. The app is called workflow. It’s three dollars in the App Store. It’s the closest thing that we found that comes close to Microsoft Automator. It’s a system that lets you pull modules in and automate things in your iOS workflow.
Let’s say you’re constantly handling pictures in a certain way. You’re cropping them or rotating them and putting a filter on them or whatever. Workflow lets you take components and apply them to content on your iOS device, so your iPad or iPhone. It basically lets you program the thing to do some tasks that would normally take several steps. It’s a little more than a macro program and kind of a modular automation system.
I’m looking at a press release here that gives you some ideas for tasks that you might do with it. They talk about you might send somebody the estimated time of arrival based on your map location. You can call Uber for a car to come take you home. You might have a workflow set up to go grab the lyrics of the currently playing song. You might shorten a URL. You might say every time I take a picture, run this workflow and upload a copy to Dropbox or even make it animated GIF image from a series of photos.
I predict that over the next several month and year, you’re going to hear a lot of people finding very creative ways to use this app to automate the daylights out of things on their iOS device. I’m going to pop a link into the Mac Tidbits website where there is a press release there and also a link over to the App Store where you can download and play around with it. Pretty interesting stuff. It’s called Workflow and I’ll be interested to see the impact of this app over the coming weeks and months.
I’ve got a couple of headlines here related to using Microsoft Office if you’re somebody who is a screen reader user. Typically somebody is blind or visually impaired. The first thing is Microsoft has made an announcement recently that they are using web aria stuff to make sure office online is a little more accessible. A lot of the changes seem to have to do with navigation, easier keyboard access to certain features, and even a thing called Tell Me which allows you to instead of spending a lot of time navigating menus to try to find certain functionality, you can type text strings into a text box. The example they give in the article here is if you wanted to figure out how to change your document from portrait to landscape mode, and didn’t want to have to go to lots of menus to figure that out, you would just type the word landscape and this Tell Me text box would take you right to the place where you can make that change. Also talking about a lot of different ways to make drop-down menus more accessible, and a way that you can hit Alt-Shift-A command to get a list of accessibility help pages in Word Online and in the OneNote Online.
And in a similar story, AI Squared, the longtime maker of Zoom Text products and the fairly recent company that has taken over the Window Eyes product line talk to us about the fact that Windows Eyes 9 is now available. A year ago or so we broke the news that Window Eyes was becoming free and you can go to WindowEyesforOffice.com. If you’re a registered Microsoft Office user, you can now download that screen reader and use it for free.
Our friend Jeremy Curry is the director of product development over at AI squared, and formerly of GW Micro the originating company of window eyes, and Jeremy says that “This major release has received rave reviews from screen reader users who have helped us develop this product. Window Eyes 9 further embodies our philosophy of innovation, ease-of-use, and wider compatibility with third-party PC software.” That’s the end of Jeremy’s quote there.
Some of the key points they make in the press release is that there are some new web reading improvements that make browsing easier, more descriptive, and more accurate. There are some new smart algorithms that help ensure accurate screen reading, getting the right stuff in the right order and also to make reading web tables a little bit easier. They talk about the fact that there is a new convenience feature, and is called the What You See Is What You Hear capability. It’s a new tool that helps with selecting text, copying and formatting, those kind of things. They also talk about Window Eyes 9 has wide support for things like Microsoft Office Online, Microsoft Office 365 Pro Plus, Outlook, QuickBooks for Windows, Google Docs, Google Slides, Google Charts, and some other kind of stuff. Even a teaser about some upcoming support for Windows 10. A whole lot of stuff going on in the world of Microsoft as well as Window 9 nine. I’m going to pop a couple of things in the show notes over to those articles and you can check out the details for yourself.
Each week, one of our partners tells us what’s happening in the ever-changing world of apps, so here’s an app worth mentioning.
AMY BARRY: This is Amy Barry with BridgingApps, and this is an app worth mentioning. Today’s app is called Step by Step.
Step by Step is an app designed to evaluate and facilitate sequencing skills. It was a signed by an occupational therapist and can be used with both adults and children. It is appropriate for users of all ages with impaired or developing cognitive skills.
Once the app is downloaded, the user creates an account with a password as well as a profile. Using the app is simple. Select the category, adult or kids, and select the sequence. Written directions instruct the user to arrange the sequences in order from left to right. Simply tracking the square depicting the activity moves the sequence. Once finished, a user touches the continue button to see how many steps were completed correctly. The user then has a choice to try again or to see the results. Results indicate name, date, sequence, accuracy, and time to complete. Multiple users can easily be added to keep data on different clients.
Initial purchase comes with four free sequences: two adults and two kids. The free sequences in the adult category are getting dressed, which is eight steps, and flower planting, which is six steps. The free sequences in the kids category are teeth brushing, four steps, and pumpkin carving, six steps. The user can purchase all 24 kid sequences for $9.99, and all 28 adult sequences for $9.99.
Some examples of the sequences available for purchase for kids include the following: going down a slide, painting a picture, putting on socks and shoes, and washing hands. Examples of sequences available for purchase for adults include the following: baking a cake, ordering a cup of coffee, transfer into a car, and using an ATM. The sequences range from 3 to 10 steps.
This app can be used with a variety of diagnoses such as dementia, stroke, traumatic brain injury, and developmental delay. It’s a wonderful tool that parents, teachers, and therapists will find useful.
We trialed this app with a young boy diagnosed with traumatic brain injury who attended a special-needs preschool class. The child initially needed total verbal and physical assistance to wash and dry his hands. The sequence used was four steps: turn on the water, squirt soap, wash hands, dry hands. Over the period of a week, the child used the app on a daily basis with exposures throughout the day. He initially correctly identified zero out of four steps, but by the end of the week, he was able to identify four out of four steps in the sequence as well as perform the actual task with only supervision by the teacher.
This is a very versatile app that is helpful to assist in teaching sequencing. It can be used for both adults and children and has a variety of clearly illustrated sequences with a varying number of steps. This app is available at the iTunes Store and it can be used on iOS devices. From information on this app and others like it, visit BridgingApps.org.
WADE WINGLER: Everybody needs to communicate, and a lot of folks who have disabilities use augmentative and alternative communication systems. That is not something new for the people who listen to the show. We talk about AAC a lot. Something we haven’t had a chance to talk about however, specifically anyway, is the LAMP system. I’m excited to have John Halloran here today who is a senior clinical associate at the Center for AAC and Autism and we are going to take a little bit under the hood about the LAMP system. First of all, John, thank you so much for carving some time out of your busy day to talk to us.
JOHN HALLORAN: Thank you, Wade. I’m honored to get the chance.
WADE WINGLER: We are happy that you’re here. I thought it might help a little bit before we jump into LAMP to learn a little bit about you. Can you tell me a little bit about your background and how you kind of landed where you are in your career right now?
JOHN HALLORAN: My background is in speech pathology. About 25 years ago or so, I worked at a Easter Seals Center probably similar to yours. I really enjoyed working with assistive technology down there. It used to be the Touch Talker at the time. I like talker. They had other products out there, but those were the main two at the time. At one time someone from Prentke Romich Company came on and asked me if I wanted to work for them, and I enjoyed that opportunity.
Probably most significant to LAMP is my wife is an occupational therapist. She opened a private practice called Integrated Therapy for Kids. Together we worked with lots of kids who are both on the spectrum or have multiple disabilities who needed communication devices. Really about 15 or 20 years ago, we started presenting based on watching the children in the clinic and how some of them performed, those children who did well we tried to identify what made some children do better than others and made those the principal elements that you see now and the formalized LAMP approach.
WADE WINGLER: I’m always excited when I meet former Easter Seals alumni. It’s always great to know that we have that in common. LAMP, Language Acquisition through Motor Planning. Tell me a little bit about what that is.
JOHN HALLORAN: it was important that we got the word acquisition through the motor plan into the description. Not every child has language in a receptive way and are just finding a way to say it with some symbol or through a picture. Some children are actually acquiring language.
There’s five key elements or components to LAMP. The first one is that they are at an appropriate readiness to learn. A lot of people talk about readiness to learn. Maybe they talk about brushing or a tent or something they go to or a sensory diet. One of the components we added to readiness to learn was that we are giving the child to where they wished they could say when they want to say it. In other words, vocabulary selection is critical to readiness to learn.
Just quickly, the other components are making sure that when they do learn to say something, that that movement of the hand or gesture is consistent with that sound. You can imagine if I was teaching a child the word “more” and they put their fingers together, they really wouldn’t understand why putting their fingers together to bounce them means more, but they could learn that. As long as that motor movement and change or say something else — so you can imagine if they didn’t put their fingers together and made the sign for more, I think most people know what the sign is. If it said more today and it said hello tomorrow, then it wouldn’t have a consistent motor pattern.
The next component was we’re trying to make sure the machine provided or the device provides an immediate auditory signal. Early devices, especially in the iPad world, had an auditory delay. So when you touch something, the auditory can always come out immediately. We wanted an immediate auditory signal. Then we wanted a visual reaction to that. What we are really after is multisensory convergence where you have a motor movement treating your hand as if it’s your mouth, and immediate auditory signal, and you see something happen. When those three sensory systems are used together, you get convergence. Those neurons fire.
The last component that’s important is what we call shared engagement or moment of joy. That act of committee getting has to be reinforcing at that moment so that that become something that’s generalized and used across the environments.
WADE WINGLER: I can’t tell you the last time someone was describing assistive technology and talked about a moment of joy. You made me smile when you say that. It makes sense.
JOHN HALLORAN: It’s a critical moment. If you’re teaching someone to communicate — to sound corny when I say it — it’s critical that there is happiness and joy and love in the activity. Otherwise those neurotransmitters aren’t released which makes those neurons that were just used together become a memory. That component is critical.
WADE WINGLER: John, tell me a little bit why this is different to other approaches to communication and learning language?
JOHN HALLORAN: There’s a lot of things that make it different. Many people might say that they keep a motor plan the same, but — and I’m not being ugly when I say this — they don’t do that. We study all the systems out there, and they’ll say they do but they don’t. Keeping a motor plan consistent so that the first movement of your hand, it could start as one-hit, one message, and that would grow into the same word. Motor plan can grow. It cannot change. We want the words to be word based. We believe words are the atom with which we communicate. If you want spontaneous utterances, you need to be teaching children words and not phrases.
We don’t like carrier phrases or don’t believe that people should be putting carrier phrases in front of words, like “I want” and up would come mommy. The best way to describe that is if I was teaching you a foreign language like Spanish, and I said the word “comer” is eat, and “galleta” is cookie, and I put the two together, comer galleta, you might think that “comer galleta” is cookie or “comer galleta” is one word, but really “comer galleta” our two words. So we teach words independent of each other. We start a follow-up development of language. But this parity to keeping a motor plan the same where one motor movement has a unique sound attached to meanings across environments is critical to us. We don’t start to play with it where on one page the corner one says hello and on another page the corner one says I love you. Each word is treated like the hand is an articulator.
WADE WINGLER: That makes a ton of sense. As we’re sitting here talking, I’m kind of envisioning the communication process. I’m envisioning the people I know who have used AugCom systems over the years, but that probably means I’m making some assumptions that may not be fair. Tell me a little bit about who uses the LAMP system, aybe the age of the person, the kind of disabilities were talking about, who is using this stuff?
JOHN HALLORAN: When we first developed LAMP, we really envisioned it for the children and adults were having the most difficulty learning to communicate. Our focus was on kids working on their first 10 words but wanted to go to 20 and 40 and 50 and then had no limit to where they could end up.
I don’t know if I’m disappointed in this or shocked or how to describe it, but LAMP is being used by a wide spectrum of people, but kids and adults who have very good cognition and are using it to communicate very spontaneously and generally. Maybe in some ways I feel like we’ve become the approach for them when we were always intended to be for the kid who’s tried everything. He’s tried five years of sign language and three years of PECS and he’s had page based systems and none of those things have stuck. He’s been in years of ABA therapy and he still isn’t communicating. And then we were hoping that they would give something new to try where they actually treated the hand with that motor movement has a gestural movement with sound attached. For some children — not every child, but for some children, that seems to work when nothing else did. We were meant to primarily be for the children and adults most language impaired. Usually they are aggressive and biting and hitting and having a hard time. They tried almost everything else. That’s what we were intending to design the approach for. It’s used by a wide spectrum of people and people with different disabilities. We have lots of people with cerebral palsy and Down syndrome and different disabilities using the LAMP method now.
WADE WINGLER: when you talk about the LAMP method, is this tied to a particular kind of equipment? Is it cross-platform? Is it broader than that? Talk the technology part to me.
JOHN HALLORAN: We made another mistake, I think, when working with PRC, we allowed the LAMP app to be called LAMP Words for Life. LAMP Words for Life is a vocabulary. It can be on the iPad. It can be on the Prentke Romich Company’s products, and then it can be on Sawtillo’s [phonetic]. Sawtillo is an associate of Prentke Romich Company. So they are all related. That’s all one company’s product.
LAMP, the method, could be applied to anybody’s product. But because we developed a LAMP vocabulary, LAMP Words for Life, then it works for us, it works very fluidly and follows the rules very well. There are other approaches out there that have tried to say we follow the principal elements of LAMP, and again, not trying to be ugly, they don’t do it well. You can be following the LAMP methodology on any company’s product. You just have to make lots of meditation to make sure it actually follows the rules of LAMP. Does it really have a motor plan that grows and doesn’t change? does it end up having morphological endings that are rule-based? The “-ing” sound always comes from the same location. Does it keep the visual field where it knows that more buttons means easier so it starts with the maximum number of cells? Even though you could go down to larger buttons? There’s a lot of components that have to be thought of when going into it. They may take a piece or two of it and run on that, but to actually follow all of the rules to make it something that follows the principal elements of LAMP is actually quite difficult.
WADE WINGLER: I have friends and colleagues who said they were going to get some LAMP training. Who are the people who are teaching this method, using this method? Is there certification or training for professionals related to the LAMP system?
JOHN HALLORAN: My wife is the founder and I am the senior clinical associate, so it starts with us at the Center for AAC and Autism. And then we have five other LAMP trainers who are all speech pathologists to work in the field who actually treat or have in the past treated lots of children with autism with AAC or communication devices. So we put together a team of highly qualified people for doing the training. That’s what a LAMP trainer is. When you go to a LAMP training, it would be one of us providing that training.
And there are LAMP certified professionals. Those are people who go to the training, are inspired, want to learn more about LAMP, and then they go through a certification process where they submit videos, they write a paper. For example, they write a paper on how would you use LAMP with low tech or on another product. So we are seeing that they actually understand the methodology. They didn’t just get fired up about it. It sounds kind of funny. They don’t just believe in LAMP. They understand it. We’re looking for those people who really understand how the method works and how to apply it.
WADE WINGLER: That makes sense because enthusiasm does not an AT professional make. I’ve learned that in the 20+ years I’ve done this.
JOHN HALLORAN: We need both. I wasn’t putting down enthusiasm, but there is a difference between someone who believes in a method or believes in something and someone who understands why it clinically works.
WADE WINGLER: You really need both. When somebody is using LAMP for communication, what does it look like? What does it sound like?
JOHN HALLORAN: am my describing the method or am I describing the app, the Words for Life vocabulary? If you are following the method, an example would be teaching words and those words would most likely be core words that cross more environments. You see the person generalizing the vocabulary in session, so if the child said go, you would see them teaching the car to go, and you might also see them telling the fan to go, and you might see them tell someone to go away. You see them being very child centered and following the child’s lead. You see them keeping the child at an arousal level. I say if you hear the child grumbling too much, you are sabotaging too much. They are ending on a positive note. They are modeling a motor plan correctly. They know the vocabulary well enough to model it themselves. They use peers to model the vocabulary. It’s about 10 pages of LAMP treatment integrity. It’s a lot. Once you sort of know it, you know it. When you watch someone in therapy, you know they are following the method.
More technical, when they taught the child the word, do they have a plan for how that was going to stay in that consistent, unique motor pattern? If they are on a page, they are using bubbles, and use a word in a corner where there is no architecture for how that word is going to stay there, then you see them on another page, another activity and there’s a different word at that location. You now know that they are not following that principle of keeping the motor plan the same. You’ve heard of carrier phrases. That’s the message. I did it randomly. It would be a much longer list than that.
Now if you talk about Words for Life, you would see a child or an adult on a vocabulary that has lots of cells. It could be they only have two cells working. You can have two buttons in a grade of 84. You are still on 84 locations even though only two of them are showing. The word would be core. The words could potentially be color-coded. The therapist would know how to hide and show, or the app would hide and show very quickly, keeping the visual down but keeping the ability to learn the motor plan.
There’s another unique thing that you’ll see in the LAMP vocabulary, the Words for Life vocabulary, is the icons that are likely to be taught together are spaced farther apart. If I was going to teach the child Mommy and Daddy, expert and I have a button I hit to take me to names. Mommy and Daddy wouldn’t be next to each other because we would know that the father, more unique the motor plan, the easier it is for the child or adult to learn. That’s sort of in a nutshell the two things, although it would take days to go through all of it.
WADE WINGLER: Thanks for helping paint the picture. That gives me more understanding. We only have about a minute left in the interview. And the amount of time, tell me a story about somebody’s life who’s been impacted by LAMP.
JOHN HALLORAN: This is going to be kind of ironic, but I want to tell a story about a little girl in Iowa, a young lady in Iowa who is a senior this year. She had been on every system you can imagine. I’m going to use her first name because I have permission to. Her name is Lydia. My grandmother and her great-grandmother were best friends.
Lydia had tried everything. With the Words for Life app, I gave it to her and her school to try. She has taken off with it and has now started training other children herself. I find that most amazing that she seeks out other children, one little guy with down syndrome, another girl in her school is maybe five or six, and she has become the mentor teaching other people how to communicate on the app and with the device. So I find that community of people who get the app to be the most powerful part about the method. There are all sorts of people out there clamoring about evidence, evidence, but the evidence lives in the human beings whose lives are being improved by using the app and using the words for life program and the method.
WADE WINGLER: I think that’s why we are all in the business, is for the stories and to touch lives in a real and meaningful way. As we wrap up here, tell us where folks can learn more. Is there a website? What kind of contact information?
JOHN HALLORAN: There are two places they can go. If you just type in “AAC and autism” you’ll see that we come up at AACandAutism.com. Another place to learn about the words for life vocabulary is AACapps.com.
WADE WINGLER: John Halloran is the senior clinical associate at the Center for AAC and Autism. John, thank you so much for being with us today. Switcher thank you, Wade.
WADE WINGLER: Do you have a question about assistive technology? Do you have a suggestion for someone we should interview on Assistive Technology Update? Call our listener line at 317-721-7124. Looking for show notes from today’s show? Head on over to EasterSealstech.com. Shoot us a note on Twitter @INDATAProject, or check us out on Facebook. That was your Assistance Technology Update. I’m Wade Wingler with the INDATA Project at Easter Seals Crossroads in Indiana.