This hospital is creating an autism-friendly Emergency Room

Austism Speaks.jpg

An Orlando children’s hospital is piloting a new program to reduce stress for children with autism when they visit the emergency room.

Nemours Children’s Hospital officials say emergency rooms tend to be overstimulating and can exacerbate symptoms for children with autism.

The program will provide private, quieter waiting areas for families; headphones; eliminate unnecessary loud equipment; and speed up waiting times for medication and tests.

Three research studies are underway to evaluate the pilot. Alfred I. duPont Hospital for Children, a sister hospital in Wilmington, Delaware, is planning a similar program.

Read more about the Orlando program here.

Read about our ATN Emergency Room study here. It’s being used to evaluate the effectiveness of a one-page questionnaire titled, “This Is My Child.” It’s designed to allow a family to provide hospital staff and other healthcare providers with important information about their child’s communication abilities, receptive skills and sensory stressors – all prior to treatment.


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Top Tech Tidbits

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1) The February 2016 issue of AccessWorld hit the web today. The articles within it include: “A Day in the Life: Technology that Assists a Visually Impaired Person Throughout the Day,” “An Overview Survey of Home Appliance Accessibility,” “Reading Remains Fundamental with the Help of NFB-Newsline,” “The AFB Center on Vision Loss: A Showcase of Accessibility and Independence in Daily Living,” “Accessible Personal Finance: ‘Dollars and Sense’ for Blind and Low-Vision Seniors,” “Out of Sight or Out of Sound: There Is Always a Way. Living with a Secondary Hearing Impairment,” “Best Android Apps for People with Low Vision,” “Cruising as a Senior with a Visual Impairment: How to Get the Most Out of Your Adventure,” and “Wrap-up Report from CES 2016.”

2) Chris Hofstader has written an expose about organizations that may be unethically suing businesses in the name of web site accessibility.
(Disclaimer: Flying Blind, LLC neither endorses nor disputes the opinions expressed in this article.)

3) We have a new “Tech Doctor Podcast,” “Apple Accessories Error 53 and New Mac Software:”

4) MAGic version 13.1 offers better localization, support for Microsoft Office 2016, enhanced web browsing and more:

5) BGR brings us “Secret OS X Keyboard Shortcuts That Will Turn Anyone into a Power User:”

6) The release of the first new version of NVDA for 2016 is nearly upon us. The ‘Release Candidate’ is out, demonstrating the new features, such as audio ducking, improvements to Braille output and Braille display support, several significant fixes to Microsoft Office support, and fixes to browse mode in iTunes:

7) Joseph Lee demonstrates the new features (of the ‘Release Candidate’ for the first new version of NVDA for 2016) in version 2016.1, especially audio ducking:

8) AMC, Regal, and Cinemark offer audio description technology at their theaters for first-run movies. Check out ACB’s Audio Description Project for info on audio description at movie theaters and contact your local theater to see if they offer this service:

9) Here you can find listings of DVDs and Blu-ray Discs With Audio Description in 2016:

10) This message from Apple Support explains how to find audio-described content in the iTunes store:

11) Don’t miss Blind Bargains Qast #51:

12) Here’s a list of emoticons and their meaning:

13) Episode 1508 of Eyes on Success introduces us to The Blind Cook:


One Device For All: Designing a revolutionary new voting system for the people of Los Angeles


Designing a revolutionary new voting system for the people of Los Angeles
With nearly 5 million registered voters, Los Angeles County represents the largest voting jurisdiction in the United States. Guaranteeing every citizen the right to an accessible and intuitive voting experience has been the highest priority for the Los Angeles County Registrar-Recorder’s office, which oversees the election process.

To revamp its antiquated voting system that dates back to the 1960s, L.A. County hired IDEO to build its next-generation replacement, a modular system that could adapt over time. And just as importantly, one that would be designed, developed and owned by the county.

Working closely with L.A. County staff, IDEO designers created a voting system that addresses the complexities unique to that voter base, including its vastly diverse population and its myriad election laws and policies. It was imperative for designers to build a system that would be useful and accessible to all types of voters: those who are vision and hearing impaired, in wheelchairs, have learning disabilities, are unfamiliar with technology, speak languages other than English – voters of all ages and backgrounds.

Their goals: to create one device for equal access, to define a voting process that feels familiar to voters, balancing both emotional and functional needs, and to build a system that’s adaptable over time.

[Continue reading]

Purposeful AT Evaluations

January 25, 2016 by Dr. Raymond T. Heipp

Within our classrooms, therapy rooms, and living complexes, we seek to find those devices which enable individuals to live and learn to the best of their abilities. Our hope is to have purposeful AT evaluations that can correctly match an individual to a device. Unfortunately, it is not always that easy. There is so much information and misinformation in the field that the process of a purposeful AT evaluation may seem overwhelming.

Purposeful AT Evaluations: An Historical Look

The Quality Indicators for Assistive Technology (QIAT) Consortium developed seven indicators for quality in purposeful AT evaluations. These indicators include:

  • Indicator #1: Procedures for all aspects of AT assessment are clearly defined and consistently applied.
  • Indicator #2: AT assessments are conducted by a team with the collective knowledge and skills needed to determine possible AT solutions that address the needs and abilities of the student, demands of the customary environments, educational goals and related activities.
  • Indicator #3: All assistive technology assessments include a functional assessment in the student’s customary environments, such as the classroom, lunchroom, playground, home, community setting or work place.
  • Indicator #4: Assistive technology assessments, including trials, are completed within reasonable timelines.
  • Indicator #5: Recommendations from assistive technology assessments are based on data about the student, environment and tasks.
  • Indicator #6: The assessment provides the IEP team with clearly documented recommendations that guide decisions about the selection, acquisition and use of AT devices and services.
  • Indicator #7: Assistive technology needs are reassessed anytime changes in the student, the environments and/or the task result in the student’s needs not being met with current devices and/or services.

Many of you have heard me speak of Joy Zabala and the SETT framework before. Joy is actually part of the leadership team for the QIAT group. As you can see in the language of the indicators, the student or client is the preliminary focus of these purposeful AT evaluations taking in the advice of the SETT framework. Prior to these indicators being developed, states, districts, and even individual buildings determined how the evaluations would take place and how they would be conducted. This led to much confusion and many inconsistencies along the way.

Purposeful AT Evaluations: Addressing Each Individual

One of the lingering characteristics of the old style of evaluation is the myopic view of AT. Unfortunately, some districts view certain pieces of technology as the only solution for some students, without even trying other solutions. Another lingering characteristic is to have a manufacturer’s representative as the only point of contact for a purposeful AT evaluation. These manufacturer’s representatives are experts and do a fantastic job in working with their device and that individual. There is nothing wrong with working with these representatives in theory, but the concern lies within the fact that there might be other tools better for the individual for which that representative might not have access.

For a purposeful AT evaluation, it is best to have someone who can speak to a variety of different devices. Within the context of the evaluation, that person should also have a comfort level in recommending the current device or no device if one is not necessary. We should never rush to suggest a specific device presuming that it will end the evaluation process. The best purposeful AT evaluations are a dynamic process which develops along with the individual.

A purposeful AT evaluation also takes into account all of the environments in which an individual operates. School, work, home, therapy, and any other location where that individual will need to interact must be taken into account. This means a couple of things for the evaluator. First, be willing to speak with all members of the intervention team and the family. Learn from them and see what is necessary for that individual. Second, do not come in with preconceived notions. Go in and observe with an open mind. Ask questions and let the needs of the individual arise for the best recommendation to be made.

I was recently reminded of a purposeful AT evaluation I did a couple of years ago. After reviewing the pre-school age child for a communication device, the parents and the preschool were shocked when I did not recommend any device. They were even more shocked when I shared with them that the biggest issue for the lack of communication for this child was that no one was giving her a chance to communicate. Things were either being done for the child or proper response time was not being given. At that point, the SLP cheered. Part of any purposeful AT evaluation though is also the recommendations as to what to do next. We developed a plan that benefitted that child who made significant progress in communicating and is now using a device. That is because people are now actually listening to the child and viewing her communication differently.

For any purposeful AT evaluation, look at that individual first and what is happening around them. Seek out someone or some group that will take the time to observe and listen before making decisions and be strong enough or not financially tied to a group so that the option for no device or the current device is there. The bottom line is that a purposeful AT evaluation is one that is done for the sake of an individual and enables them to live a purposeful life!

Autism and Bullying

February 1, 2016 by Dr. Raymond T. Heipp

Autism and Bullying is an issue that we continue to face in our society, and more specifically, in our classrooms every day. We find that the source of this bullying is a lack of understanding and common misconceptions from people. However, this lack of understanding does not excuse or eliminate the pain associated with autism and bullying. How can we strive to reduce this issue and bring a better understanding to those outside of the autism community is a question that needs to be answered.

Autism and Bullying: Source of the lack of understanding

Autism and bullying tend to arise in the school settings because of the students not understanding why some of their peers might not interact with them in a way that they interact with others. It might also stem from the lack of understanding of what “stimming” is and how all of us actually have some form of “stimming,” but do it in what is perceived to be a “socially appropriate” manner. A lack of understanding differentiates students and, therefore, distinguishes them for the rest of their peers. So how do we teach students about each other?

I witnessed a program a couple of years ago at a district who had experienced a significant rise in the number of students with autism. They found that most of these students were in inclusive classrooms and they wanted to address “stimming” to reduce any potential autism and bullying issues. They invited a teacher who was also a mother of a child on the spectrum to conduct lessons in each elementary classroom about everyone’s “stimming.” The critical piece was that she was able to address this issue in a pedagogical manner from both a teaching and a mother’s point of view. The lessons worked extremely well as students began to identify what they did along with what others were doing. These lessons created an understanding of “stimming” in a manner that all of the students could understand. Hence, the focus was not autism. The result was that autism and bullying incidencies declined.

Autism and Bullying: Parental Knowledge

With some cases of bullying, the root arises from the parental viewpoints of the bully. Parents may have views that are limited and see certain groups in ways that do not promote diversity or understanding. This root has arisen in some cases of autism and bullying. It still amazes me that in this day and age, parents presume things about autism that are simply not true. The most outrageous belief lies in the parents who believe that autism is “contagious.” These are the parents who tell their children to stay away from children on the spectrum. They also paint the picture of anyone with autism having set characteristics and not being able to function in real life, which is completely inaccurate!

How do we better inform the parents in an effort to eliminate that as a potential cause for autism and bullying? That is a question which does not have a simple plan. The unfortunate thing is that so much of the information on autism shared with the general public come from news stories or tabloids that focus on specific stories and not always the facts. In my travels throughout the country, I have not found any strong parental programs in the discussion of autism in our public or private schools, except those schools focused on students with differing abilities. This is not the fault of the schools, but an issue with which they must contend.

Autism and Bullying: Next steps

As I speak at various conferences, I listen to presentations on and am asked questions about autism and bullying. There is not an easy answer as bullying is something that all schools deal with and they often have to fight the fact that the root of it may come from outside of the school walls. The first step must be a program for students in the early elementary years recognizing the beauty of each of them and all of their peers. We must operate in a grass roots format so that the students become better equipped to understand any difference between them and their peers. We must be supportive of their learning of these differences and tolerant to the idea that some of their inaccurate beliefs may be supported at home.

We cannot and must not stop supporting our students who are bullied. Autism and bullying should not go hand-in-hand in schools. Our students who are on the autism spectrum must be given all of the respect any other student would be given. We must lead the way, serve as role models, and do what we do best, teach! Through our educative practices we can begin to diminish the rates of autism and bullying. We must also strive to educate the outside world to the beauty of every individual no matter what their abilities might be!

Learning to Speak AACtion Plan

Posted on January 31, 2016 by Heidi LoStracco, MS, CCC-SLP

“Success is the sum of small efforts, repeated day in and day out.”

~Robert Collier

Screen reads “I like hug” in the message window of Speak for Yourself.

We are beginning Week 4 of the Learning to Speak AACtion Plan, and if you’ve been following along and completing the challenge, we are hearing from a lot of you that it’s making a difference and you’re seeing results! I shared some of my experience from this week on our Facebook page, and I’ll share it here as well.

One of the things that we love is that we get to work clinically with students who use AAC. We believe strongly that this is a large part of Speak for Yourself’s success. We are able to see first hand what our clients are doing and use that to improve SfY as a tool. 

Since the beginning of the Learning to Speak AACtion Plan, the way that I’ve been using it is to focus modeling for the students I see to target that vocabulary each week. 

As a clinician, there are a lot of times where you work towards something with very little reinforcement or “proof” that it’s working. Modeling can sometimes be that way. You do it because in all of your education, experience, and evidence-based research, you know that it’s beneficial. You do it with the expectation that the students are paying attention and your job is exposure. You expose them to useful language so they know they have access to useful language. 

And if you stick with it long enough and look for them to be successful, you get to see it click for them. 

Yesterday was that kind of day for me. 

When I went in to see one student, she had independently started using “please” when asking for something (Please was a Week 1 word). Her aide said that it’s much harder to say “no” or tell her to wait when she says “please.” (Guess who figured that out really quickly…the student with extra trampoline, music, and swing time:) While being polite isn’t necessarily a priority when a child is having a hard time expressing wants, needs, ideas, and feelings, this little girl has figured out that the word “please” has power. 

I spent the session with another little girl, modeling “like_______”  and saying “I like apples too” as she was requesting snacks. After a little while, she looked at me, used the app to say “like hug” and hugged me. It was a heart melting kind of day. 

If you’re participating in the Learning to Speak AACtion Plan or you’ve just been modeling and you’re wondering if it’s working, keep going. You’ll be glad you did in that moment when you see it click for that child.

I had dinner after that post with an AAC user in her early 20s who told me she “enjoys shrimp” and that “ice cream (is her) favorite.” Her mom has been modeling around her and making sure she has the words open. It’s working, and some of your children/clients are validating your efforts.

But some are not. If your child/client isn’t eagerly showing you that they can use the new words you’re learning, keep learning and keep exposing them to the vocabulary. If you’re following along and learning your child’s augmentative and alternative communication (AAC) system, and you haven’t seen any tangible evidence that it’s “working,” keep going and celebrate any success.

Of course the end goal of learning the location of the vocabulary is to model for the AAC user(s) in your life. If your child/client doesn’t seem to be attending to modeling, my advice is to find a measure of success that depends entirely on YOU, which is where this plan originated. YOU can complete these practice lessons in 5-7 minutes each day, and count it as success that you have done something to focus on communication. YOU can decide to do the practice lessons in front of your child or choose a word that you are going to model 5 times every day this week. Decide to do something that you can commit to and count it as a success.

When I look at the survey results each week, here is what I know: People who are following this plan are doing SOMETHING. You are working towards your children’s AAC success. What you may not realize is that they are noticing.

This week, we are adding the word “to” because it is one of the words that I notice children seem to pick up on pretty quickly. Also, for such a tiny word, it has a lot of function in English…we say it A LOT! We use it to form the “to-infinitive” verb tense (to play), the negative infinitive (he asked me not to go), and as a preposition (to school). It provides intention (I need something to drink), and as grammar gets more complex, the to-infiitive expands its role.

I’ve also seen children use it as a homophone that in context changes the meaning to “too” or “two.” My advice is to go with it. As children become readers and spellers, they figure out the difference between the “to, too, and two,” but for early language learners, the context supplies the meaning. If your child says “I want to pretzels,” by all means, give him two pretzels. If she says, “I play to,” let her play too. For verbal children, we don’t have the visual transcript of everything they say, so we acknowledge their context dependent language. Do the same for your student’s using AAC…listen for their intent.

So here are the words for week 4:

Week 4 Learning to Speak AACtion Plan words

Here are the Practice Lessons:

Learning to Speak AACtion Plan practice lessons

The text only Master List is updated:

Learning to Speak AACtion Plan Master list through week 4.

If you haven’t completed the Week 3 survey, please do!! It will be available until tonight at 11:59 pm EST.

If you are going to be at ATIA 2016 in Orlando this week, please stop and see us! We will be in Booth 704 and we will also be presenting on Friday afternoon from 2:20-3:20.

Finally, here is the link to the site for the Rafflecopter Giveaway:

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