Saturday, March 8, 2008

Speech Generating Devices, Four--Who Are They For?

Should we buy an expensive (several thousand dollar) device if a child does not spontaneously make requests very often? This is a question that I was asked in the comment section on one of my recent posts.

If a child does not request often, it is likely that good choices (from the child's perspective) have not been offered and the child does not see the point of requesting--requesting is too hard and requesting results in too little gain. I have often been able to get non-requesters to make requests by building in requesting as part of a game or activity that the child likes--as opposed to holding out some item that the child wants--because habitual non-requesters will simply decide that they don't really want the item if someone is going to "make" them request for it. I don't set it up like a drill and I make sure the game is at the right developmental level--which is almost always much younger than people think. Autism is a severe social disability, so social interests are very delayed and socially motivating games are very young as compared to chronological age--but here is the good part, we can all still enjoy a good game that is socially young. Witness how much fun adults have playing with babies. Simple, silly games are fun for anyone in the right mental frame or mood. I have managed to get nonverbal teenage kids to communicate when the routine was simple, fun, and easy, and there was no real demand--just a sincere invitation to play. For example, a button that calls out the monster in Monster, Monster, Please Come Out! is irresistible for some youngsters. Mom or dad roaring out from behind a barrier is too funny and any youngster will push a button to make that happen. Likewise, a button that says Go Away! in a game where family members don masks and move toward each other in a mock scary way is pretty darn hard for a family member of any age to resist. It is hard to ignore dad in a pig nose, and it's fun to tell dad (the wildly snorting pig man) that he should Go Away! If the youngster with autism is playing the pig, the Voice Generating Button is snorting. The Voice Generating Device, even a single button, is an easy means of requesting, protesting, calling, saying funny words, or making funny sounds--requesting is not the only option.

My point in posting these Speech Generating Device games is to encourage people to explore options that are out there because so many more devices are becoming available--so if the simple and inexpensive devices work, then there are options to go to the next level of device. In other words, this communication road is leading somewhere. I also want to inspire people to use a playful creative spirit as the device is introduced to a child, because many unused devices are programed in a way that is, frankly, boring from anyones point of view.

Less expensive devices are worth buying to start a child communicating verbally and an education team or family can experiment without a huge outlay of money. It is true that as soon as you buy one, and a child uses it, the device offers too few messages and feels like it is outgrown immediately. This is OK. You still needs some back up device after you get a higher level device for when that device breaks--which it will, so don't hesitate to buy a less expensive machine and use your initial energy finding a way to motivate your child to use it. The more expensive machines take a lot of support energy in programing and so on--not to discourage you but you might as well learn what your child likes to communicate about before the tech demands of the more expensive machine take all your time.

Get a good evaluation to see if your child can use a more expensive devices before you purchase one--the button size, page size, grid or lack of grid, navigation system, programming demands, machine size and weight all matter and an evaluation will help you not make costly mistakes. On the other hand, as soon as you think a child really can use a more sophisticated speech generating device, start the process of getting one because, unfortunately, the system of funding these devices is very, very, very slow for anyone needing funding--which is most of us. My experience is that this can take months and then learning to use it and training everyone else to use it takes more months. So get started as soon as you are sure.

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