First a disclaimer: I don’t work with patients with autism, in fact I haven’t done so since grad school, and even then I only worked with the population sparingly. iPads on the other hand, are awesome, and I use mine daily (much to my wife’s chagrin) for nearly everything (including this post) besides treatment (unless you count documentation, for which I use an iPod Touch), and that’s only because it doesn’t make much sense for my setting, not yet anyways (this is the point where I stop making parenthetical statements). But I am a speech pathologist and I do know a thing or two about communication, and that’s why I watched last Sunday’s 60 Minute segment, Apps for Autism, with much anticipation and excitement. I generally have respect for the show, but at the end, I just felt ‘meh’ about the whole piece. And let me tell you why.
When you watched the segment, did you notice the peeps with autism struggling and ultimately failing to use paper letter boards to communicate, which was immediately followed by the same person using the iPad exceptionally well to convey their message? This scenario was shown a few times throughout the piece and it felt like an As Seen On TV infomercial. Besides that, it completely ignored the decades worth of research and development that has been done in the field of Augmentative and Alternative Communication (AAC). It’s as if the Lightwriter, Dynavox, Prentke Romich, Tobii-along with a host of other companies-devices have never existed. That the idea of using technology to help people communicate is one that is original to the iPad. And that, of course, is rubbish.
It also seemed to prescribe the iPad as a panacea for autism treatment, you know, just give the kid an iPad and he’ll be on his way to communicating and that it’ll unlock an new and undiscovered portal into their minds that we never knew existed. Forget the fact that the successful use of AAC devices require training, especially for those with cognitive deficits, and forget that speech pathologists and special education teachers are needed to foster language development and literacy skills in order for the iPad to even be a viable option. A Twitter friend, @JohnduBois, said it right: “I felt it ignored the point that AAC is a tool and requires proficient users and teachers-too much “Apple magic”. Indeed sir, indeed.
And what was with that lady doing hand-over-hand assistance with the kid who had no apparent interest in the task? It was way too reminiscent of facilitated communication, and we evidence-based practitioners do no want to go there. Most likely, and hopefully, she was simply providing cues and trying to engage the kid in activity, but I cringe at even the slightest hint of FC.
For all of 60 Minute’s shortcomings, it must be said that the iPad is most definitely an inspiring piece of technology, and it is capable of capturing the attention of of children and adults alike with its boundless applications. But we need to be mindful that when teaching social skills to children, we teach them to use turn-taking skills, theory mind and what have you with people and not machines. If a child is captivated by the iPad and is able to direct their attention to something purposeful and meaningful, that’s great, but its all for naught if those skills do not generalize to the world at large.
The iPad is a wonderful and powerful tool, and has numerous applications for autism treatment, and the broader speech pathology and special education fields as well. But let’s place our focus on the end goal and not the bright and shiny gadgets that serve to facilitate such goals, lest we become victims of the latest fad and fail to view the iPad for what it is: a tool.
(This post originally appeared on slowdog)
Adam Slota M.A., CCC-SLP is a speech pathologist working in long term care and long term acute care settings, primarily with tracheostomy and ventilator dependent patients. He is also the author of the blog slowdog where he writes about various topics in speech pathology and beer, among other frisky and/or mundane missives.