Electronic Devices Help Nonverbal Kids Find Their Voice
WASHINGTON, Ill. — Selah isn’t ready to work yet.
Carrie Kerr asks, “Do you want a drink?”
Selah grabs a bright pink iPad programmed with more than 3,000 words and matching pictures, including a skunk for a fun kid word like “fart.” Pronouns in yellow-colored boxes, adjectives in blue, nouns in white, verbs in green with different shades for past tense and other conjugations.
Advertisement - Continue Reading Below
Selah taps an icon for drink, taps another for water.
Symbols for drinking water appear on the screen and a girl’s version of Siri’s voice says “drink water.”
Selah Oelschlager is 6 years old and learning to talk.
“It’s hard for her to find the words verbally, but easy for her to find them here,” says Kerr, a speech pathologist, referring to the electronic device she calls Selah’s “talker.”
Once Selah finds the matching symbols and words on her talker, Kerr adds, “it’s easier for her to learn them verbally.”
The scene isn’t quite the breakthrough moment of Helen Keller’s discovery of the sign-language meaning of water from the movie, “The Miracle Worker.” It is a child who is nonverbal and has autism stalling the start of a therapy session, the way young children find excuses to put off bedtime.
They are at Child’s Nature, Kerr’s new pediatric therapy center. The scene may not be high drama, but it is a picture of the higher technology of alternative communication systems. Until about a year ago, Kerr and Selah’s mother, Tiffanie Oelschlager, say the exchange might have ended on less agreeable terms.
“The breakthrough was when she didn’t have to use behavior to communicate,” Kerr says. “Before, she would have gotten up and brought the water to us, or bolted, or screamed because we had no idea what she wanted. Now, she can tell us.”
In private life, Kerr worries about the widespread attachment to electronic devices. “It drives me insane.” Her professional life is just the opposite.
“I want that child so invested in their device that it’s not seen as work,” she says of her therapy sessions for children with alternative communication devices. “It’s where their power is. It should be about their freedom, their ideas, their wants and needs. It’s simply their voice.”
She wants the children she works with to use their devices at home, school, the grocery story, at the park or during meals. They do. For instance, varying types of assisted communication technology are evident at many schools, including Peoria Public Schools, where Selah is in a life skills class at Kellar Primary School.
The love affair with electronic devices has an upside for the children Kerr works with. The stigma attached to earlier, clunkier versions of alternative communication devices is disappearing, she says. “Almost all kids are carrying screens around now.”
Kerr works in a specialized field of speech pathology, augmentative and alternative communications, or AAC.
“It’s a whole world in and of itself,” says Jim Runyon, executive vice president of Easterseals Central Illinois. “But they can be a life-changing experience for families with a child they’ve never been able to communicate with and who has never been able to communicate with them.”
Runyon serves on the board of the Peoria Regional Society for Autism, which offers mini-grants to help families purchase devices if they’re not covered by insurance. Selah’s family received a grant from the group.
Kerr formerly worked at Easterseals. Runyon says she came up with the idea for Easterseals AAC Clinic, which assesses a child’s need for an alternative communication device. Easterseals has two speech pathologists trained in the field.
“There’s not a lot of people with that training,” he says.
But, according to Kerr, there are many children who need the technology and not a lot of places for them to go.
She works with children from about 18 months to 12 years old, all of them nonverbal or with limited verbal skills. She visits some at their home. Others come from as far as the Quad Cities, Normal and Canton. Most have autism. Others have a wide range of genetic disorders.
“Speech is not the only problem most of them have,” Kerr says. “They have a lot of specialists, and I’m just one. I spend a lot of time talking to their other specialists.”
Alternative and augmentative communications can be as low-tech as picture cards or sign language. Or as sophisticated as the text-to-speech generated voice box Stephen Hawking operates by twitching cheek muscles.
The difference between Hawking and the children Kerr works with is he knew how to talk, read and write before he lost the ability to communicate.
Eye-gaze technology opens a computer screen to nonverbal children who can only move their eyes. There is technology designed for children who can’t tap an icon with their fingers or grasp a stylus. There are devices suited to children who are nonverbal and blind. Voice-generated elements can be customized for a girl’s voice, a boy’s, a man’s or a woman’s. Voices can come with dialects or switch languages for nonverbal children in bilingual families.
Assisted-communication apps are available for iPhones and other electronic devices. Some units, like Selah’s, are solely for communication. No games, no YouTube videos, no texting.
Selah’s verbal skills were close to non-existent until about two years ago, her mother says. Selah started speech therapy at about 18 months. She went to Easterseals Autism Learning Center until she turned 6.
Selah recently began extensive behavioral therapy. At Kellar, she continues to receive weekly speech therapy sessions. But Selah’s mother still pulls her out of school one morning a week for an additional hourlong session with Kerr. Selah’s school therapist and Kerr collaborate, often texting back and forth with questions.
“I really fought against getting the device,” Oelschlager says. “Other therapists had mentioned it but my biggest fear was she would never talk, she would just depend on the device. It’s been just the opposite.”
Kerr says that’s one of the biggest misconceptions about the technology.
The typical child learns to talk by hearing other people talk. “Selah’s learning pattern is different. It’s not enough just for her to hear language.”
She has to see it, touch it, feel it, move to it.
The sensations are built into the word-system app, LAMP Words for Life, on Selah’s iPad and into Kerr’s therapy sessions.
The play, running, dancing, swinging, singing and other activities in the sessions are designed to keep Selah engaged — but also to help her make the connections between nouns and verbs of daily speech and the icons on her iPad.
Selah’s mother says changing the word-system app on the iPad would be like suddenly switching to a new language. Families must learn the Words for Life system so they can model its use for children, just as families model speech. Oelschlager took a daylong training class, then practiced nonstop when Selah first got the device. Other family members, including Selah’s 8-year-old sister, also know how to use it.
As Kerr explains it, children learning to use the device mirror children learning to speak. Young children babble. They tend to babble electronically when they begin learning to use alternative communication devices.
Then Kerr moves to core language, the common words and thoughts young children use most.
It’s one thing for a child to learn the term for orange juice, Kerr explains, but what does that mean?
So she focuses less on nouns and objects than verbs, because they’re versatile, and terms like more, all done, mine, yours, “and all those words that surround orange juice.”
From there, they go to two-word phrases, then sentences.
“I don’t want her just to communicate, I want her to grow in language skills,” Kerr says. “Even if she doesn’t fully communicate, she’ll be able to write papers at her age level.”
Selah caught on to the mechanics of the device faster than her mother did.
“I thought she’d let it do the talking. But once she heard the words, she started to repeat them. Then it spiraled. The more words she learned on the device, the more she could say.”
Her once-common tantrums are now rare, her mother adds. Then Oelschlager mentions Selah’s journey toward finding a device-assisted voice.
“That’s the most amazing thing when you haven’t had one.”
© 2017 the Journal Star
Distributed by Tribune Content Agency, LLC