The Adolescent With Disabilities Can Increase Their Level of Mobility

Transcription

1 Education and Training in Developmental Disabilities, 2005, 40(1), Division on Developmental Disabilities Using a Personal Digital Assistant to Enhance the Independence of an Adolescent with Asperger Syndrome Heather Ferguson, Brenda Smith Myles, and Taku Hagiwara University of Kansas Abstract: The Personal Digital Assistant (PDA), while in use in the mainstream population, is not generally utilized by individuals with disabilities. Using a multiple-baseline design across settings we tested effectiveness of using a PDA to increase the independence of an adolescent with Asperger Syndrome (AS). Results indicated use of the PDA was effective in decreasing the student s reliance on adults to complete tasks at home and at school. According to the Individuals with Disabilities Education Act Amendments of 1997 and the Technology-related Assistance for Individuals with Disabilities Act of 1988 as Amended in 1994, school districts must provide technology and related services to support students with disabilities in the general education curriculum (Mirenda, Wilk, & Carson, 2000). This act introduced assistive technology as a means of helping individuals with disabilities overcome the obstacles that inhibit them from fully taking part in activities at school, home and the community, including enhancing tasks that involve memory and organization skills (Bremer & Rauch, 1998; Bull, Bull, Garofalo, & Harris, 2002; Lewis, 1998, 2000). Assistive technology includes a variety of supports ranging from augmentative communication devices to more commonly used desktop and laptop computers. One device that appears promising for students with disabilities is the PDA (Swan, Swan, & Van Hover, 2002). The PDA, a handheld computer that mainly serves as a personal information organizer, allows data input via an on-screen keyboard or handwriting recognition program using a stylus. With multimedia capabilities, it is capable of playing both sound and video clips. Pictures and other visual representations are Correspondence concerning this article should be addressed to Brenda Smith Myles, Department of Special Education, University of Kansas, Joseph R. Pearson Building, 5 th Floor, 1122 W. Campus Road, Lawrence, KS bmyles@ku.edu vivid and precise due, in part, to the highresolution color screens. In addition, the PDA can be hooked up to a computer to synchronize information and connected to network systems, including the Internet for exchanging s and exploring the World Wide Web. In addition, portable keyboards can connect to the Pocket PC to create a discrete word-processing system, enabling information such as names, addresses, phone numbers, dates, and personal schedules to be stored for easy access and retrieval. Scheduling and time management programs are included as default functions in the PDA (Lewis, 1998; Swan et al.). Despite their use in the mainstream, few studies have been conducted on the impact of PDAs. Nevertheless, the following has been established to date. For individuals without disabilities, the PDA has assisted students in organizing classroom notes and preparing for tests (Norris & Soloway, 2003). PDAs have also been used to support individuals with special needs in career and leisure activities (Furniss et al., 2001) and to increase independence and self-determination (Davies, Stock, & Wehmeyer, 2002). Davies et al. found that persons with disabilities who used PDAs functioned more independently, learned more, and required less assistance from support personnel. The purpose of this study was to add to the literature base on PDA use with students with special needs. Specifically, this study was designed to determine whether a PDA could 60 / Education and Training in Developmental Disabilities-March 2005

2 enhance the independence of an adolescent with AS at home and at school. Method Participant Kent, a Caucasian male in his final year of public middle school in the Midwestern United States was the participant. He was 14- years old, and had a diagnosis of AS made by a medical professional using criterion in the Diagnostic and Statistical Manual of Mental Disorders 4 th Edition (American Psychiatric Association, 1994). Kent s intelligence quotient was in the above average range and his grades were average. He had considerable difficulty with his handwriting, finding it both tiresome and tedious. A Behavior Assessment System for Children (Reynolds & Kamphaus, 1992) was administered to Kent s resource room teacher, his mother, and Kent himself. His teacher reported that Kent was rated At-Risk in Attention Problems, and was identified as Clinically Significant in Anxiety, Atypicality, and Withdrawal. Kent s mother classified him as At-Risk in Hyperactivity, Anxiety, School Problems, Learning Problems, Withdrawal, Adaptive Skills, and Behavioral Symptom Index; he received Clinically Significant scores in Atypicality and Attention Problems. The discrepancy in responses between Kent s teacher and mother appears consistent with other reports by educators and parents addressing the characteristics of a child with AS (Barnhill et al., 2000; Myles, Ferguson, & Hagiwara, 2003). Kent rated himself as At- Risk in Anxiety and Atypicality; other areas fell in Average or above ranges in his report. An Adolescent/Adult Sensory Profile (Brown & Dunn, 2002) was also completed by Kent. This measure indicated that Kent avoided sensation much more than most people, was more sensitive to sensory stimuli than most people, and exhibited registration and sensory seeking behaviors in a manner similar to most people. Setting The study took place in Kent s math and social studies classes, and in his home. Kent s math instruction occurred in the resource room in a small group setting that included two other students, and his social studies class was held in a general education classroom with 20 other students. Target Behavior Kent relied heavily on prompts from his parents and teachers to complete his daily activities. Without multiple prompts from his mother to finish routine daily tasks, for example, Kent would become distracted and stop his routine. In school, Kent s teachers prompted him to gather the appropriate materials before class, pay attention during class, submit his homework, record his homework assignments, and transition to his next class. Kent needed to function more independently to complete routine daily tasks, especially as demands for greater independence increase by age and grade level. Thus, the behavior targeted for this study was to increase Kent s independence during morning home activities, school tasks, and evening home activities by decreasing his dependence on the adults in his life. Instruments A Hewlett Packard Jornada 560 Personal Digital Assistant (Hewlett-Packard, 2001) with Microsoft Windows for Pocket PC Software 2002 (Microsoft, 2002) was introduced to increase Kent s independence when completing early morning, school, and evening tasks. Kent, his mother, and resource room teacher received training on the PDA. In essence, the PDA remained the same as the product available to the general public. The calendar and alarm functions that are a part of the Microsoft Windows for the Pocket PC were used in implementing the intervention. A data collection sheet was designed to outline the four morning tasks and desired times when Kent needed to complete each task every morning in his home. A second data sheet, created using the same format, listed four evening activities. The data collection form listed each task and its start time on the left. Three additional columns on the right allowed Kent s mother to indicate (a) if he completed the task independently, (b) if he com- Pocket PC and Asperger Syndrome / 61

3 pleted the task with prompts, and (c) the time when the task was completed. Kent s mother completed this form. A similar data sheet listing six tasks during social studies and math over a 50-minute period was used in the school setting and was completed by the first author. Figures 1, 2, and 3 present the morning, school, and evening data sheets, respectively. Procedure A multiple-baseline design across settings was used to evaluate the effectiveness of using a PDA to improve the time management and task completion rate of a junior high student with AS. Settings were morning tasks, school tasks, and evening tasks. During the baseline phase, Kent was given a list of tasks and associated times for the following activities: (a) in the morning as he was getting ready for school; (b) at school during math and social studies classes; and (c) in the evening prior to going to bed. A task was considered completed independently if Kent finished the task within two minutes of the time listed on his task list. Each of these tasks were known to Kent prior to the study and had Figure 1. Morning data collection sheet. 62 / Education and Training in Developmental Disabilities-March 2005

4 Figure 2. School data collection sheet. been a part of the expected routine for several months. During the intervention phases, an alarm was set on the PDA to alert Kent to start each of the targeted tasks. The alarm sounded audibly and also flashed visually. Kent s mother recorded the number of morning tasks he completed independently with the support of his PDA, and the number of tasks that she needed to prompt him to complete, along with the time that each task was completed. The first author recorded the number of school tasks Kent completed independently with the support of his PDA, the number of tasks that he required prompts to complete, and the time that each task was completed. The number of tasks Kent completed independently was divided by the total number of tasks to arrive at a percent of tasks completed. Reliability Interobserver reliability, assessed on 20% of data days by Kent s paraprofessional, was 100%. Results As illustrated in Figure 4, during baseline, Kent completed 0% of his morning and Pocket PC and Asperger Syndrome / 63

5 Figure 3. Evening data collection sheet. evening tasks independently, and 63% of his school tasks without prompts. During the intervention phases, using the PDA as a primary prompt, Kent independently completed a mean of: 47% of morning tasks, 87% of school tasks, and 33% of his evening tasks. The study was carried out over a 20-day period. Data were taken for 15 days at school because the school year ended. The break in the data lines during the morning and evening activities on Day 15 represents the transition between the last day of school and the start of summer vacation. Discussion The purpose of this investigation was to determine if a PDA could assist an adolescent in completing home- and school-based tasks independently. Results should be interpreted carefully with limitation considerations given to the length of intervention and use of singlesubject design procedures. Conclusions Results of this study could, in part, be attributed to the novelty of the PDA. This device appeared to appeal to Kent and may have helped to ease the transition into the intervention. He quickly learned how to manipulate the PDA and required reminders to maintain the settings during the intervention phases and not adjust them. While Kent required little training to use the PDA, by comparison, his teacher and mother experienced difficulty learning how to use the technology, even after multiple training sessions. This is significant in that technology use in educational settings can only be successful when adequate support provided (Mirenda et al., 2000). Kent s data indicate that generalization may have occurred across settings. That is, inde- 64 / Education and Training in Developmental Disabilities-March 2005

6 Figure 4. Kent s performance on completing tasks in morning, school, and evening settings. Pocket PC and Asperger Syndrome / 65

7 pendent task completion increased during baseline in the third setting before the PDA was introduced and after the intervention had been introduced in other settings. This finding appears consistent with the investigations by Bock (1994, 1999) who found a similar pattern of generalization when teaching categorization strategies to students with autism spectrum disorders. Kent s mother commented that during the intervention phase Kent checked the time the and announced, Come on! It s time to go [to school]! This was significantly different from his mother s prior reports that she had to continuously cajole and argue with her son to get him to leave the house to go to school on time each morning. In addition, Kent used his PDA to record his appointments and personal information. He also set his PDA so that an alarm sounded and a light at the top of the device flashed. The light and alarm would alert Kent to open the PDA, where his reminder would be displayed visually on the screen. Perhaps, given Kent s sensory issues, the stimulation of multiple senses allowed him to begin his tasks independently (Dunn, Myles, & Orr, 2002). Similar to studies by Davies et al. (2002) and Norris and Soloway (2003), the PDA was effective in addressing a student s target behavior. Although few studies have been conducted with PDAs, cautious optimism exists regarding the use of this technology. In particular, the PDA and similar technology may be a viable tool for individuals with special needs. Positive aspects of palmtop computers include their portability, small size, and increasing popularity among the general public. Thus, the inconspicuous nature of the PDA allows users to support themselves in a variety of settings without calling attention to any additional differences. Use of this type of technology to render assistance to individuals with disabilities, including those with AS, may assist in increased levels of participation in the community (Davies et al.; Norris & Soloway). References American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, 4 th edition (DSM IV). Washington, DC: Author. Barnhill, G. P., Hagiwara, T., Myles, B. S., Simpson, R. L., Brick, M. L., & Griswold, D. E. (2000). Parent, teacher, and self-report of problem and adaptive behaviors in children and adolescents with Asperger Syndrome. Diagnostique, 25, Bock, M. A. (1994). Acquisition, maintenance, and generalization of a categorization strategy by children with autism. Journal of Autism and Developmental Disorders, 24, Bock, M. A. (1999). Sorting laundry: Categorization strategy application to an authentic learning activity by children with autism. Focus on Autism and Other Developmental Disabilities, 14, Bremer, J., & Rauch, P. K. (1998). Children and computers: Risks and benefits. Journal of American Academy of Child and Adolescent Psychiatry, 37, Brown, C., & Dunn, W. L. (2002). Adolescent/Adult Sensory Profile. San Antonio, TX: The Psychological Corporation. Bull, G., Bull, G., Garofalo, J., & Harris, J. (2002). Grand challenges: Preparing for the technological tipping point. Learning and Leading with Technology, 29(8), Davies, D., Stock, S. E., & Wehmeyer, M. (2002). Enhancing independent task performance for individuals with mental retardation through use of a handheld self-directed visual and audio prompting system. Education and Training in Mental Retardation and Developmental Disabilities, 37, Dunn, W., Myles, B. S., & Orr, S. (2002). Sensory processing issues associated with Asperger syndrome: A preliminary investigation. The American Journal of Occupational Therapy, 56, Furniss, F., Lancioni, G., Rocha, N., Cunha, B., Seedhouse, P., & Morato, P. (2001). VICAID: Development and evaluation of a palmtop-based job aid for workers with severe developmental disabilities. British Journal of Educational Technology, 32, Hewlett-Packard. (2001). Jornada 560 Personal Digital Assistant [Portable Computer]. Palo Alto, CA: Author. Individuals With Disabilities Education Act, Amendment, 20 U.S.C et seq. (1997). Lewis, R. B. (1998). Assistive technology and learning disabilities: Today s realities and tomorrow s promises. Journal of Learning Disabilities, 31, Lewis, R. B. (2000). Musings on technology and learning disabilities on the occasion of the new millennium. Journal of Special Education Technology, 15(2), Microsoft Corporation. (2002). Microsoft Pocket PC Software 2002 [Computer Software]. Redmond, WA: Author. 66 / Education and Training in Developmental Disabilities-March 2005

8 Mirenda, P., Wilk, D., & Carson, P. (2000). A retrospective analysis of technology use patterns of students with autism over a five-year period. Journal of Special Education Technology, 15(3), Myles, B. S., Ferguson, H., & Hagiwara, T. (2003). Using a pocket personal computer to improve homework recording in an adolescent with Asperger Syndrome. Manuscript submitted for publication. Norris, C. A., & Soloway, E. M. (2003). The viable alternative: Handhelds. School Administrator, 60(4), Reynolds, C. R., & Kamphaus, R. W. (1992). Behavior Assessment System for Children. Circle Pines, MN: American Guidance Service, Inc. Swan, K. O., Swan, G. M., & Van Hover, S. D. (2002). A novice s guide to handheld computing. Learning and Leading with Technology, 29(8), Technology-related Assistance for Individuals with Disabilities Act, Amendment, Pub. L. No , & (1994). Received: 7 August 2003 Initial Acceptance: 6 October 2003 Final Acceptance: 15 February 2004 Pocket PC and Asperger Syndrome / 67