Diagnosis: Primary disability: Autism, Secondary disability: Speech and Language impairment
Miss J.T is a student at a SDC classroom, classified as Autism class at a County program in California. With two parents and one older sibling, J.T has an appropriate stimulating environment. She loves Disney land and different fun activities. She loves music, trying different food items. She remembers almost everything and corrects others in her surroundings. She loves making schedules, reminders and notes on her and school calendar. She loves reading and writing books.
Present skills:
J.T finishes her assigned school work with little help in terms of reminders to stay on the task. She also needs reminders and cues, sometimes physical prompts to stay back at her seat. She can follow instructions to do different activities.
Language skills: J.T has very good receptive or comprehensive language skills, including understanding before-after, cause-effect, sequences of events, associations etc. She can point to appropriate pictures in response to when, who, what, why etc. She can also arrange the sequence of events, with pictures or only written descriptions.
J.T initiates conversations including greetings, needs, answers, descriptions, opinions etc, but limited to single words or 2 word phrases followed by a word expression “okay ya”, everytime without fail. She can extend her answers in response to questions, such as-
Clinician asks- what does the boy have?
J.T answers- “book okay ya”
Clinician asks- what book does he have?
J.T answers- “Red book okay ya”
When motivated and modelled or with some cues few utterances are longer than phrases.
Her speech is intelligible to familiar adults, except sometimes when context is unknown.
Cognitive skills: She has excellent cognitive skills, she can solve puzzles, calculate on her own, remember and arrange the cabinets how it was, replicate any patterns using blocks and very small pieces.
Symbol use: She could recognize pictures and symbols for almost all objects, family members, animals, verbs etc. She can categorize, make small sentences using 2-3 icons while testing. She could either pick to arrange sentence or just point, although pointing needed reminders to stay on the task.
Access: She could use fast and precise pointing and picking skills.
Literacy skills: She has good reading, writing, spelling, mathematics skills.
Objective of this referral and assessment:
Parents needed her to be more intelligible and express faster and appropriately.
First trial: J.T was tried with Touch chat HD. She did great work in the first 3-4 sessions, with 60, 80 and 108 icons word power. She started using a combination of icons and typing and after the generated voice, she would repeat uttering the same. Slowly, it became her favourite activity to type in small stories from her book using the app based keypad.
So, we tried co-writer us and predictable app with her, she was initially confused without the icons. But she slowly understood the idea of prediction.
We could motivate her to speak with the device and remove extra words like “okay ya” slowly.
At present:
J.T is an expert user of the app predictable now. However, she prefers to use it when she wants to talk about all day activities or stories etc. She has gained a lot of control on her verbal vocal expressive skills, but prefers to carry her iPad with predictable loaded on it.
It is also used during redirecting her to assigned task or analysing when she does anything unwarranted or when she has an error in her academic tasks.
Advantages:
More independence
Less verbal cues, physical prompts for redirection
Less exhausting
More extensive generation of utterances
Faster and accurate
Less frustrating
Intelligible expression and serves as good model for natural utterance generation
Disadvantages:
Sometimes she does not let it go as she feels more confident to hold it in her hand, wherever she goes.
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