Cheryl Digney
Using the Apple iPad as a Communication Device for Children with Autism and Developmental
Disabilities: An Annotated Bibliography
Children with autism and other developmental delays may have verbal difficulties, including
single word utterances or lack of speech overall. Traditional assistive and augmentative
communication has been used with great success; specifically the picture exchange
communication system (PECS) is empirically effective. With the advent of emerging
technologies, the ability to use an iPad with this population enables a less stigmatizing, cheaper,
and more compact method of speech generation and communication. Mostly following
behavioral learning theories, these journal entries investigate the effectiveness and suitability of
the iPad for communication purposes for students with autism and developmental delays.
Boyd, T., Barnett, J. E. H., & More, C. M. (2015). Evaluating iPad technology for enhancing
communication skills of children with autism spectrum disorders. Intervention in School
& Clinic. doi: 10.1177/1053451215577476
Previous studies have found that the use of augmentative and assistive devices by
students with autism impacts communication and social skills. The iPad is a comparatively less
expensive device with many customizable applications. However, the desire to shift to this
technology must be evaluated on a case-by-case basis founded upon five criteria described by the
authors. A rubric is provided for a simple explanation of these criteria. This study details the
benefits of the iPad for communication but also warns that it is not a suitable method for all
students. Due to limited research in this specific area, it is necessary for educators to investigate
all modes of augmentative communication before they select iPad intervention.
Flores, M., Musgrove, K., Renner, S., Hinton, V., Strozier, S., Franklin, S., & Hil, D. (2012). A
comparison of communication using the apple iPad and a picture-based system.
Augmentative & Alternative Communication, 28(2), 74-84. doi:
10.3109/07434618.2011.644579
The use of an iPad as a communication system for five children with autism spectrum
disorders and developmental disabilities was investigated. These children were previously using
picture cards to communicate. At the time of this study, the iPad was not yet available for
commercial use and an application was specifically designed for this study. Thus the mixed
findings may be a result of a lack of familiarity with an iPad, use of different symbols, and
software design. Additionally, these students had already mastered communicating via picture
symbols so the benefits of using the iPad to actually learn those skills is undetermined.
Hill, D. A., & Flores, M. M. (2014). Comparing the picture exchange communication system and
the iPad™ for communication of students with autism spectrum disorder and
developmental delay. TechTrends: Linking Research and Practice to Improve Learning,
58(3), 45-53. doi: 10.1007/s11528-014-0751-8
The picture exchange communication system (PECS) is a low-tech method of teaching
students with autism and other developmental delays to make requests. This study investigates
the ability of the iPad to perform the same function. Of the five student participants, one had
limited exposure using PECS while the others had no exposure at all. Alternating both methods,
researchers found mixed results. While this can be attributed to study limitations, it also
demonstrates that the selection of assistive and augmentative communication devices must be
determined based on the preferences and skills of the individual child. The authors suggest that
progressive teaching beginning with PECS followed by the iPad may be the way to build a
foundation of communication skills.
King, M., Takeguchi, K., Barry, S. E., Rehfeldt, R. A., Boyer, V. E., & Mathews, T. L. (2014).
Evaluation of the iPad in the acquisition of requesting skills for children with autism
spectrum disorder. Research in Autism Spectrum Disorders, 8(9), 1107-1120. doi:
10.1016/j.rasd.2014.05.011
The Proloquo2Go application on the iPad is used as a speech generating device. Three
preschoolers with autism spectrum disorder participated in this study to determine whether they
could learn requesting skills with an iPad. All students had knowledge of the picture exchange
communication system. This study adapted that system using Proloquo2Go to assess whether the
students were able to transfer that knowledge to the iPad. All students were able to use the iPad
for requests, and there was also a vocal increase in all students to different degrees. However,
there were iPad use difficulties, variances in data, and inability to complete all phases. Future
research in this area can determine whether successful adaptations of traditional materials via
technology can significantly change the field of assistive and augmentative communication.
Lorah, E., Karnes, A., & Speight, D. R. (2015). The acquisition of intraverbal responding using
a speech generating device in school aged children with autism. Journal of
Developmental & Physical Disabilities, 27(4), 557-568. doi: 10.1007/s10882-015-9436-2
Most studies involving autism and the use of iPads revolve around generating requests.
Lorah et al. instead examined the use of iPads as speech generating devices enabling the students
to respond to three specific questions. The iPad use was effective, with rapid acquisition and
continued maintenance. However, the answers to those questions were not open-ended which can
mean the communication was not truly intraverbal. Furthermore, there was no measure for
generalization of skills outside of the study setting. As more research is conducted in this area
the use of an iPad for this purpose will be more thorough.
Lorah, E. R., Crouser, J., Gilroy, S. P., Tincani, M., & Hantula, D. (2014). Within stimulus
prompting to teach symbol discrimination using an iPad® speech generating device.
Journal of Developmental & Physical Disabilities, 26, 3335-346. doi: 10.1007/s10882014-9369-1
Using an iPad as a speech generating device requires students to be able to discriminate
between pictures on a screen. Four autistic children were given iPads with progressively more
pictures per page throughout the duration of this study. The students were rated on both
accuracy and independence. All students demonstrated increased performance. However, there
were a limited number of preferred stimuli in a controlled setting with no socialization or
communication with the instructor. Therefore picture discrimination in a natural setting is
unknown. This study is in agreement with previous research in its determination of
effectiveness, but more research post-study needs to take place before proclaiming the success
of this method.
Lorah, E. R., Tincani, M., Dodge, J., Gilroy, S., Hickey, A., & Hantula, D. (2013). Evaluating
picture exchange and the iPad™ as a speech generating device to teach communication to
young children with autism. Journal of Developmental & Physical Disabilities, 25, 637649. doi: 10.1007/s10882-013-9337-1
The use of a picture exchange system and an iPad as a speech generating device were
compared in regard to teaching mands to five male autistic preschoolers. The results of the rate
of independent manding were mixed, with the iPad attaining slightly faster rates of acquisition.
This finding contradicts previous research indicating picture exchange systems were learned
faster. This difference may be attributed to the specifications of teaching methods. The
preference for the iPad was clear for four of the five children, which also matched the method
with which they had more success. However, picture discrimination was not necessary, which
thwarts the effect of the iPad as a speech generating device. Additional research is needed to
investigate that aspect.