Strategies to Engage
Infants & Toddlers Using
Switches
Nancy Bolden,
Assistive Technology Specialist
North Central A.T. Access Site
ATK: MISSION
 Increase
awareness and knowledge of
Assistive Technology (A.T.) devices and
services for people of all ages and
disabilities
 Help people of all ages and disabilities
acquire the devices they need for
education, employment, living in their
home, and participating in the community
DEVICE LOAN
 ATK
Device Loan
System has an
inventory of devices
appropriate for
infants, toddlers, and
young children with
disabilities
Convaid Carrot –
reclining car seat
Zipzac I (possibly II
also)
ATK Services
 Acquisition
through:


of needed devices and services
Refurbishing donated, lightly used durable
medical equipment to give to Kansans with
disabilities and health conditions
Reviewing possible funding options (public
and private), determining eligibility, and
assembling needed funding justifications
KEE: Device Reuse
 KEE
is funded by
KS Medicaid to
provide
refurbished lightly
used DME
 ATK accepts
other lightly used
devices for reuse
although lacks
refurbishing funds
Otter Bath Chair
Pediatric Commode
Dreamer Stroller
How to Fund Assistive
Technology
 Acquisition
of needed A.T. devices and
services is the priority
 Options vary depending on the device or
service needed
 Medicaid – EPSDT
 Private insurance
 Private funds/charitable supports
 Part C funds
 Part B funds (during transition)
 Financial loan programs
Other Assistive Technology
Services
Call 800 – KAN DO IT (800-526-3648) to
request a device demonstration,
borrow a device,
get a refurbished device,
get help funding a device,
request product information,
learn how to use a device, or
request help in conducting an A.T.
assessment
What is Assistive Technology?


Any item that helps a child actively participate
in an activity or supports their ability to learn in
their daily routines across natural environments.
IDEA 2004:


"any item, piece of equipment, or product
system, whether acquired commercially off the
shelf, modified, or customized, that is used to
increase, maintain, or improve functional
capabilities of a child with a disability. Exception. The term does not include a medical device that
is surgically implanted, or the replacement of such
device.” (§ 602(1)).
"any service that directly assists a child with a
disability in the selection, acquisition, or use of an
assistive technology device." (§ 602(2))
Types of Assistive Technology
Devices




SELF HELP: weighted or
curved spoons,
dressing tools
HEARING: items that
amplify sound, hearing
aids, ear protection
MOTOR: built up grips
on colors, dycem,
switches, trays/slant
boards
LEARNING: built in
switch toys, e-books &
apps, raised pages in a
book
Ear Bandit
Adapted Book
Crayon Rocks
Types of Assistive
Technology Devices
 MOBILITY:
adapted
strollers, walkers,
ride-on toys,
wheelchairs
 POSITIONING:
corner chairs,
positioning harness,
pillows
 VISION: Magnifiers,
color
contrast/textured
items
Embrace seating
system
Boost magnifier
Types of Assistive
Technology Devices



COMPUTER ACCESS:
digital tablets, switches,
adapted keyboards
ENVIRONMENTAL
ACCESS: ramps, remote
controls, van lifts
COMMUNICATION:
picture boards, single
message devices,
electronic
communication devices
New Blue 2 for iPad
Step by Step
Communicator
HOW TO DETERMINE IF Assistive
Technology IS NEEDED
A
comprehensive assessment is typically an
ongoing process that involves input from key
people including the family, caregivers,


Request support from ATK on possible solutions
Examine daily routine – think least intrusive
(environment, how child does it himself, how
child partially participates – assist by peer,
sibling, then adult)
 Trial
use of devices and evaluate its
effectiveness


ATK Device Loan System
Local or national vendors
DOCUMENTING Assistive
Technology ON THE IFSP
 A.T.
can be on a separate sheet of an IFSP or it
can be embedded in existing components of
the IFSP



Present level of development: child currently uses
picture symbols to communicate words and
phrases
Family priorities/concerns: parents want child to sit
at dinner table with family (different chair?
adapted seating system?)
Measurable outcomes: Child will read books
before bed with his sister and participate by
turning pages of cardboard books with page
fluffers.
WHAT DOES Assistive Technology
LOOK LIKE ON THE IFSP
 Outcome
examples across areas of
development and learning will be provided
 Implementation – quality standards

Frequency & length appear adequate for child
and family’s needs
 Outcomes
need to be functional, specific, in
family friendly language and reflecting their
priorities
WHAT DO Assistive Technology
SERVICES LOOK LIKE
 A.T.
is not the goal – how do we
know it works?
 Is it being used?
 Is it still needed?
 Is it helping child learn, be more
independent?
 What are the family’s concerns,
comments?
EXAMPLES OF ASSISTIVE
TECHNOLOGY

The appropriate A.T. solution is often the simplest
one.



Rearrange the environment – move an activity to a
table so the child can be seated and have better use
of his hands
Material selection – use building blocks on a play mat
with better color contrast so the child can see the
individual blocks
Is more support is still needed? Try to find the one
that lets the child participate independently. Peer
and adult help is the next option.
LEGAL RIGHTS & RESPONSIBILITIES
 A.T.
must be provided in natural environments
to meet a child’s needs (34CFR§ 303.13(a)(8)).
 A.T. needs must be addressed during transition
planning conference (34CFR §303.209(c))
and be included on the IEP.
 A.T. services (assessment, recommendations,
teaching use and maintenance) should be
conducted by qualified professionals with
active involvement by the family.


Family members have unique information about
the child’s strengths and abilities, interests, daily
routines, environments, and family priorities.
A.T. needs to meet the needs of child and family.
Why we teach switch use to
young children with
disabilities:
 To
help a child understand that they are
able to extend influence and control over
their immediate environment
 As a foundation for future learning
 For children with severe physical
disabilities, as a way to interact with the
world (may be their only access method)
Assistive technology for young
children: Evidence-based
practice
o
o
o
o
o
Campbell, P., Milbourne, S., Dugan, L., & Wilcox, M. J (2006). A
Review of Evidence on Practices for Teaching Young Children to Use
Assistive Technology Devices, Topics in Early Childhood Special
Education, 26(1), 3-13.
Reviewed articles about assistive technology published between
1980 and 2004 focusing on children birth through 6 years of age
The largest number of empirical articles were published more than 15
years ago
12 studies focused on teaching switch activation use to young
children with disabilities
Strong evidence that children younger than a year old with
disabilities may be successfully taught to operate switches to
activate toys
Assistive technology for young
children: Evidence-based
practice
Light, J. (1993). Teaching automatic linear scanning for computer
access: A case study of a preschooler with severe physical and
communication disabilities. Journal of Special Education
Technology, 12, 125-134.
o A single case study of an instructional protocol to teach
automatic linear scanning for computer access to a child with
severe communication and physical disabilities (cerebral palsy).
The child was successful in learning to scan using the experimental
protocol.
o Several empirical studies have been published investigating the
instruction of single and two-switch scanning in older children with
physical disabilities.
o
How I Know My Child Can Use
a Switch To Make Things
Happen:
I
have identified a reliable, repeatable and
consistent movement that my child uses to
activate their switch
 I know what position works best for my child’s
body and for their switch
 My child is pro-active and engaged in what is
happening when the switch is activated
Resources for Beginning
Switch Users
The child’s physical and occupational therapists
 Switch Progression Road Map by Inclusive
Technologies (free)
www.inclusive.co.uk/articles/switch-progression-roadmap
 Utilizing Switch Interfaces with Children who are
Severely Physically Challenged (Goossens’ and Crain,
1992)
 Different kinds of switches and switch mounts
available from Assistive Technology for Kansans
equipment loan library (785-827-9383)

Different Ways to
Use a Single Switch
 Press
and hold (direct)
 Press and let go (timer)
 Press it again (switch building,
sequencing)
 Turn things on and off
(latched)
Switch Latch and Timer
for Battery Operated Items
Switches with Built In Latch
and Timed Features
Powerlink Switch Interface
for Electric Items
When Wires Are a Problem
Ablenet Jelly Beamer Switch
Adding Speech Output to
Switch Activation
Plug that extra little wire into the toy/appliance jack . . .
Strategies for Extending Single Switch Use
After the Child Has Learned
Cause/Effect:




Activate many things across the day
 60 Things to do with a Switch and a Battery
Interrupter (Kate Ahern)
 Ideas on How to Use the PowerLink at Home
and at School (Northcott)
Use familiar adapted toys in new ways
 25 Things to Do with a Switch Activated Pouring
Cup (Kate Ahern)
 Fifty Fun Ideas for Simple Switch or Low Tech
Activities (Molly Shannon)
Build opportunities into the curriculum
 Ablenet Play and Learn preschool curriculum
Increase control of the environment
 Electric toothbrushes, hair driers, personal fans,
night lights and lamps, TV remotes
Using Two Switches


Start and Stop
 One switch starts
activity
 Other switch stops
This or That
 One switch activates
one option
 Second switch does
something else
Using the Switch with a
Computer
Wireless Computer Interfaces
Super Switch
IntelliSwitch
QuizWorks
Using a Switch with the iPad





There are switch interfaces for iDevices
(Ablenet Blue2, RJ Cooper Bluetooth
interface and more)
At this time there is no full scanning and
switch access option available that
works with all Apps
Scanning is available within individual
Apps only
Not all AAC apps will scan (Sounding
Board, Predictable, TapSpeak Choice);
more are coming
Switch apps list from Helpkidzlearn.com,
enablingdevices.com, janefarrall.com
and others
How Scanning Works
 One
switch
 Auto Scanning
 Software/hardware determines speed
 Two switch
 Step Scanning
 Child controls the speed
One Switch Scanning
Positional
 Scan
moves across
row – left to right, top
to bottom
 Each item is
highlighted in
sequence
 Child presses switch
when desired item is
highlighted
One Switch Scanning
Popup
 Child
responds to
on screen cue
 Timing can be a
challenge
 May cause a
startle
Two Switch Scanning
 Move


and Choose
1 switch moves through options
1 switch selects
 http://www.bltt.org/switch/ani_tss.htm
Introducing Formal Scanning
 Introducing
the colored box to highlight
on-screen choices
 Use a “real” scan box
 Choose a color that the child can easily see
 Making choices with no wrong answer
 The child chooses from 3 or more onscreen
options
 Whatever the child chooses, they receive
the reward of activating that option
Choosing Independently
 Nothing
here
 Choosing from a row with empty cells
 “finding” activities
 Finishing a sequence
 Can involve empty or filled cells
 Find the right one
 Choose the answer to the questions or
requests
Resources for Switch
Activities on the Computer


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





www.helpkidzlearn.com
www.papunet.net
www.northerngrid.org/index.php/component
/content/article/81-sen/271-sen-switcher
www.priorywoods.middlesbrough.sch.uk
www.lburkhart.com/hand2sw4s.htm
www.cricksoft.com
www.rjcooper.com
www.switchintime.com
www.judylynn.com
HOW TO CONTACT US?
 ASSISTIVE


1-800-KAN-DOIT
1-800-526-3648
 OCCK,



TECHNOLOGY FOR KANSANS
Inc., Solution Outreach Center
Nancy Bolden
785-827-9393
1-800-526-3648