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Scenario 2 – Pre-intentional: Reactive

Increased opportunities to participate with other people and interact socially will encourage early understanding of the relationship between cause and effect, or contingency awareness. It is important to note that for most pupils, experiencing social contingency awareness will precede awareness of physical contingencies. In other words, to encourage the pupil’s understanding of cause and effect, begin with people and not with objects.

A study by Phil Schweigert (1989) was one of many to show the power of using switches to interact with people. He showed that a pupil would use a switch to increase social contact, but would be less likely to press a switch if it resulted in non-social contact. A vibrotactile cushion was used. At first the pupil could activate a switch to operate the cushion. The pupil soon showed no interest. Then the cushion produced an auditory signal to a person to come and play with the pupil. Only when someone simultaneously came to play with the pupil did switch presses increase.

Earlier we noted Evans & Ware’s (1987) study which showed that few interactions took place between staff and pupils with severe communication impairment. We also know that the consequences of a severe visual impairment include lack of mutual eye gaze, lack of facial expression and not recognizing facial expressions in other people; we know too that cerebral palsy will result in reduced facial expression; all of which leads to fewer attempts by the pupil to initiate social interactions. What if the pupil could attract staff’s attention?

The various technologies brought together within multi-sensory environments can be adapted so they can be controlled by the pupil. This is an example to show that one type or class of technology can be appropriately used with pupils whose cognitive, sensory, physical and communication abilities are very different.

It is time to focus more on how pupils themselves might activate multi-sensory environment rather than it being operated for them. A balance must be struck. It will be helpful for the pupil to understand that the world of objects can be controlled. But if too much opportunity for control is introduced at one time or no thought is given to why control is being offered to the pupil, technology will offer little advantage and may undo previous hard-won successes. Three useful principles to consider are:

start low

build up slow

make it social!

Because attempts will be made to encourage the pupil to use switches to control events, it is vital to have read and become familiar with the Unit B – Organizing your resources which covers issues of:

seating and positioning Observations, perhaps made in multi-sensory environments, will have given clues about appropriate seating and positioning. Consult with physio and occupational therapists as well as with parents.

Other preparatory steps addressed in Unit 8 – The development of switching skills include:

locating switch Observations (e.g. in multi-sensory environment, feeding situations, physiotherapy etc) will provide hunches about the best site on the body to place a switch. Finger, hand, and arm are optimum but may physically not be possible. Lateral head movement may interfere with eye contact.
type of switch Many factors come into play here. For instance, a contact or target switch requires the pupil to make physical contact, which may be difficult physically to achieve. But because most give feedback on activation, it is often easier to associate contact with effect. Non-contact switches (e.g. mercury tilt switch) may physically be easier to operate but more difficult to understand.
mounting switch Velcro, straps, mounting arms, and clamps for wheelchair trays are just a few of the options to consider to ensure the switch stays in position. Equally important – especially when using mountings near the head and eyes – is to be able to detach them quickly.

Time spent in preparation will be repaid many times over in successful use by the pupil. (But don’t spend so long preparing that you never get started)

Example 2a - Saying "Hey"?
set-up Insert a battery adaptor into a standard battery-powered bell or buzzer, so that an external switch can operate it. (Detailed instructions for fitting battery adaptors are given in Unit 8.)
preparation Refer to the introductory section on ‘Pre-intentional: Reactive’. Begin by showing the pupil how to activate the buzzer; cue a second member of staff to come over when the buzzer sounds. Model the switch activation with the pupil. Staff need to be prepared at first for one of them to drop everything in response to the buzzer.
objective To provide a means of signalling independently to get attention – the response of the staff member is to engage in social interaction
Example 2b – Using loop tapes

Buzzers and bells can attract attention and encourage interaction, but loop tapes can be used to communicate a single thought or idea. A verbal message is a powerful tool for expression. The pupil may not be at a ‘stage’ of using an augmentative communication system in a functional way, but interaction and communication skills can be developed.

set-up Make a loop tape using the tapes for a telephone answering machine. Short tapes are best (10 seconds or so). Record the message, repeating it until the end of tape; press Stop. Next, decide on an appropriate switch to use (see above). Attach the switch to the remote jack of a cassette recorder, or insert a battery adaptor. Press ‘Play’; and with the switch activated the message will be played.
objective Many communication skills can be learned and used with this approach e.g. calling attention, initiating interaction, turn-taking etc. Not all of these skills are appropriate to the ‘Pre-intentional: Reactive’ level of communication. This illustrates that the technology is not important, but the curriculum and preparation are. Sample messages include: “Come over here”, “More please”.

Key skills and equipment

The key skills for the above examples are the ability to:

  • introduce multi-sensory equipment that can be activated by the pupil rather than be operated for them
  • use technology to develop pupils’ interaction with people rather than objects

The key equipment is:

  • battery adaptor(s)
  • battery-powered bell or buzzer
  • switch that pupil can operate
  • additional member of staff to respond to buzzer or loop tape activation in initial stages
  • cassette recorder suitable for loop tape
  • loop tape(s) for telephone answering machine (10-second)
BIGmack single message devicesExample 2c – From loop tapes and buzzers to talking switches

A BIGmack is one example of a ‘talking switch’, a simple yet effective device that brings together physical and social contingencies. By pressing the large top of the switch (giving a satisfyingly loud ‘click’) a pre-recorded message is spoken, such as “Can I have some juice?” or “Jump up and down!”. The teacher decides on the message recorded.

 

preparation Choose a message. Agree that whatever is to happen must take place immediately after the message. Agree who will respond, how to respond and how to end the interaction.
record message If possible, do this within pupil’s sight (or hearing). Press record button; speak message into microphone (you might want to ask a pupil to record the message rather than an adult); release button. Press top of device to check the recording and volume.
position BIGmack It should be made as easy as possible for the pupil to reach and press. Decide if it should be to the right, left or midline and whether it is best to mount it at an angle (using a Maxess mount). Decide if it should be visible – helping pupil understand the effect of actions.
objective Perhaps the message is to attract attention or initiate a conversation: “Come here please”, “Hey, look at me!” ; or requesting something: “More crisps please”, “Do it again”. The last message may be too advanced for this level of communication as it is an example of using a person as an agent for something else rather than for attention and interaction.
other options A remote switch can be attached to the base of the device so the pupil does not need to press the top of the device to activate it. Also a cable can be attached to it so that it operates a battery-powered toy at the same time as a message is played (or without a message). However, this can be confusing – so you might choose not to play a message in this case.

If a switch is to be used as well, to operate mains operated devices or toys, it is helpful to buy these in a different colour. Thus they can be easily distinguished. If the pupil has visual impairment try attaching different materials to the surface of the device.

More examples of using talking switches like the BIGmack are given in the Unit 8 – Developing switching skills. At this level of communication the emphasis is on increasing social interaction.

Key skills and equipment

The key skills for the above example are the ability to:

  • record a short single message on a BIGmack (or equivalent)
  • attach switch to BIGmack for remote activation
  • liaise with other staff member (or parent, or other pupil) to co-ordinate response to message produced by BIGmack
  • adapt BIGmack or switch surfaces to enhance tactile or visual display

The key equipment is:

  • BIGmack or equivalent single message device
  • switch for attaching to BIGmack, if required

 

 

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