21 July 2015

Assistive Technology for ADHD and Dyslexia

ASSISTIVE TECHNOLOGY CASE STUDY

Student:            X
School:             Erasmus Middle School
Grade:               7
Learning Need: Attention-Deficit Hyperactivity Disorder (ADHD), Dyslexia
Target areas:     Reading, writing, organisation/notes, auditory
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The Rehabilitation Act of 1973 is where the official or legal use of the term assistive technology (AT) originated (ADHD-Brain.com, 2015). It was designed to ensure that any individual, regardless of disability, would have the right to equal access to education. With the advent of technological changes in the last 30 years, legislation has been updated to include “technologies that would serve to assist students who otherwise might struggle to get their assignments completed” (ADHD-Brain.com, 2015). For students with learning disabilities (LD) such as attention-deficit hyperactivity disorder (ADHD) and dyslexia, the following assistive technologies are recommended as potentially useful:
  • Dictation (speech-to-text) software 
  • Screen reading software (text-to-speech) 
  • Software that corrects grammar and spelling 
  • E-books 
  • Mind-mapping or organisational tools (Nguyen, et al., 2013). 
Choices regarding assistive technology should “support and promote academic success” and allow learners to “acquire the skills and techniques necessary for learning” (Nguyen, et al., 2013). Dyslexic learners have “poorer task-dependent attentional shifting in both auditory and visual modalities” (Hornickel, Zecker, Bradlow, & Kraus, 2012) and technology needs to be “focused on the core symptoms or behaviors that are being seen that interfere with studies, learning and homework” (ADHD-Brain.com, 2015). As dyslexia and ADHD “often occur with physical and sensory disabilities” (Fichten et al., 2006) the AT recommended in this report intends to enhance experiences in auditory and visual aspects of student X’s education. This report recommends that the iSense Micro FM Receiver and iPad Air can offer the required assistive technologies for student X.

Hardware and Software Recommendations

iSense Micro FM Receiver (Phonak AG, N.D.) (see Fig. 1.)

Classrooms are noisy environments. The acoustics of the typical American classroom “do not meet the recommendations from the American Speech-Language-Hearing Association (American Speech Language-Hearing Association, 2005) or the American National Standards Institute (Schafer, et al., 2014). The average classroom therefore poses listening challenges to all children, but for children with learning difficulties, such as ADHD, speech-recognition in noisy environments is “significantly poorer” even if they have “normal pure tone hearing thresholds” (Schafer, et al., 2014).

The iSense Micro offers a solution; it is a “small and stylish behind-the-ear” device that “automatically adjusts the volume in noisy environments, thus ensuring optimum hearing performance” (Phonak AG, N.D.). In a study of twelve children, aged 6-11, Schafer, et al. (2014), found that use of the iSense Micro “significantly improved [the] average speech-in-noise thresholds” for children with ADHD “often to the level of their typically functioning peers” (pp. 194-195). Participants in the Schafer et al. (2014) study “reported significantly improved performance” (p. 204) in the classroom when using the iSense Mirco and overall results concluded that every child in the study “had better performance” using the device, with the benefits “ranging from 26 to 100%” (p. 199).


Figure 1: iSense Micro (Phonak Communications AG, N.D.) 

iPad Air 2 (Apple Inc., 2015)

The iPad Air 2 offers all the features of the iPad Air but with the added features of an “antireflective coating” and “fingerprint identity sensor”, it also offers 10 hours of battery life, all of which help decrease additional worries, distractions or problems (Apple Inc., 2015). The iPad Air 2 is recommended over the smaller iPad Mini 2 or iPad Mini 3 in order to provide optimal screen working space, and the weight difference is minimal (heavier by only 0.23lb or 3.68oz (Apple Inc., 2015)) particularly when taking into account the visual benefits of the extra screen size.

Reading: Text-to-speech Dyslexic learners suffer “reading difficulties in terms of reading accuracy and speed, which results in comprehension difficulties and require technology that has “built-in text-to-speech with a high-quality voice” (Couston, (2006) in Nguyen, et al., (2013)). Apple’s iOS system has a built-in “screen reader called VoiceOver that can read almost anything on screen aloud using text-to-speech” (Meersma, 2015). Dragon Dictation (Nuance Communications Inc., 2015) is an alternative option, offered as a free app.

Reading: eBooks iBooks is included as part of the iPad package, and Kindle books can be accessed using the free Kindle app; both apps offer eBooks that can be read aloud with VoiceOver (Meersma, 2015).

Writing & Organisation The iPad Air 2 offers a built-in dictation, dictionaries and spell-check in a number of languages. Features such as the Notes and Calendar apps can help with organisation and managing work (The Regents of the University of Michigan, 2015), while apps such as QuickVoice (nFinity Inc., 2014) are free and allow “one-touch recording” for memos such as homework. Mind-mapping apps, such as the low-cost MindNode (IdeasOnCanvas GmbH, 2015) are available along with thousands of other apps, many of which are free, meaning the iPad Air 2 offers plenty of additional support tools that can grow and adapt with the student X.


Classroom integration

AT integration into core subjects needs to be implemented and supported by teachers and administration. Nguyen, et al., (2013) recommend that “students with LD whould be taught how to use specialized ICTs” and that there should be “adequate opportunities and funding for them to learn how to use ICTs” as reseach suggests that “students with LD have more difficulty using ICTs and are less knowledgeable about them than their nondisabled peers”. It is essential that teachers are provided with the necessary support and training to ensure the successful use of the AT by student X. Teachers also need to encourage and allow their use to complete schoolwork and homework. Other provisions mean consultation of core teaches with technology specialiast in order to provide a “comprehensive list of available free and inexpensive ICTs” for each subject (Nguyen, et al., 2013). In addition, there need to be constant review, “communication and collaboration among stakeholders” to ensure the AT used remains appropriate and effective (Nguyen, et al., 2013).

Costs and Funding
Figure 2: Table of AT costs
The total cost of recommended AT for student X is outlined in Fig. 2. For funding purposes, Section 504 of the Rehabilitation Act of 1973, and the Individuals with Disability Education Improvement Act (IDEA) may both offer access to approved AT free of charge. IDEA aims to “guarantee eligible children a free appropriate public education” and specifically covers “students aged 3-21 with a disability that adversely affects that child's performance in school, and/or their ability to learn/benefit from their education” (ATiA, N.D.). It requires the Individualised Education Plan (IEP) to ensure the correct AT is provided, and while “ADHD is not specifically mentioned, students who have symptoms that interfere with their ability to perform at school may be eligible for assistive technology for ADHD” (ADHD-Brain.com, 2015). Section 504 of the Rehabilitation Act does not require an IEP and works to remove obstacles that may “prevent students with disabilities from participating fully” as well as provide “support and auxiliary aides” to ensure they can access the curriculum fully within the mainstream classroom (ADHD-Brain.com, 2015).

As student X’s LDs are impacting upon their learning at school, they may qualify for assistance through one or both of these federally sponsored regulations. As there is no specific source of federal or state funds for assistive technology, student X’s local education agency (LEA) must “either re-direct their IDEA monies or dip into general operating funds to purchase or lease such equipment” (National Center for Technology Innovation, 2015). Erasmus Middle School should work with the parent(s) to submit an inquiry/request for approval through one of these acts.

ASSISTIVE TECHNOLOGY INTERVIEW


Due to the time of year and most schools being finished for the summer, along with my location in the world, interviews were conducted via survey (see Appendix and online). I included a video embedded into the start of the survey to ensure that those completing it were aware of what AT was (PACER, 2010) and ensure responses were focused on AT, as I was not able to clarify this face-to-face. I designed it to collect a variety of responses – both from those who were experienced in using AT and those who were not. Depending on the response to the question about their experience, they were directed to different pages. This is interpreted in terms of being directed to certain questions, as shown in the printed version included in the Appendix.


Fifteen educators responded with varying teaching experience (see Fig. 3), however the majority (80%, Fig. 3) had been teaching for at least five years or more. Eleven of the teachers who responded (73.3%, Fig. 4) had direct experience using AT in their classrooms, ranging from “computers”, “iPads” and “laptops”, to “voice enhancers” and “weighted vests”, “translators”, and “Braille computers”.

Responses indicated that the great majority of teachers have to rely on themselves or other educators to find out about relevant ATs. Only one educator stated that their “school district provided the hardware and training and fit it to the student”. In terms of accessing AT, five of the fourteen teachers gain access to resources through the special needs or learning support programs or departments, one via their EdTech support, while one stated that they had to find their own. Two teachers replied that there is no process for accessing AT in their schools; one stated it would be “helpful”, while the other gave the reason that the school has “given itself the designation of a 'mainstream' school therefore it doesn't have to provide these sort of requirements”.

Teachers who had used AT suggested that it did indeed help learners with LD to be part of the mainstream. One teacher, who taught a learner who struggled to write physically, was still able to contribute and share his ideas through “apps like Tellegami and voice recorder”. Another teacher, who taught a learner suffering from cerebral palsy and ADHD, said that the student “responded positively to pressure on him as it helped to calm him”. It was recommended that “he wear a weighted vest” and use “a necklace he could bite” to aid in curbing aggression. Other teachers of bilingual, multilingual or learners new to English, used iPads and Google Translate to support these children. One teachers suggested that “any tech helps the reluctant participant”, whether LD or not, and in particular, said that “dragon dictation has been handy”. Overall, it seems the best technology – for assisting all learners – needs to be “interactive and able to be used easily by child [such as an] iPad”. We also need to ensure we listen to and learn from our learners because, as one teacher stated, “students have their own apps/sites that help them in class, most of the students show me them.”

ASSISTIVE TECHNOLOGY LEARNING & INTEGRATION


I completed the Case Study section of this assignment whilst the results from the online survey were being collected. What is most interesting to me is that some of the tools I recommended in the Case Study – namely the iPad and Dragon Dictation – were repeatedly mentioned and recommended by the responders. Hearing devices were also listed, but not specifically the iSense Micro recommended in my Case Study, and those that were used were done so for hearing issues rather than for ADHD learners. Indeed, I have never heard of listening devices being used for ADHD learners before, but, having taught a great number of both diagnosed and un-diagnosed ADHD children (as well as being the mother of one), I can, with hindsight and experience, see that it could make a difference. In the 1:1 school I taught in, the acoustics of the room were quite dreadful and the climate necessitated constant air-conditioning. I noticed an improvement in work and engagement levels of all children once I installed sofas, beanbags and rugs in my room. These soft furnishings helped a great deal with acoustics and with the ability for us all to be able to hear each other. My own daughter is diagnosed with ADHD. After reading research by Hornickel, Zecker, Bradlow, & Kraus (2012) and particularly Schafer, et al. (2014), I can see how her hearing may have been affected. In fact, we had her hearing tested on a number of occasions when she was at pre-school age, believing she might have hearing issues – she doesn’t and her hearing is normal. However, her speech developed very early but her words were mispronounced and hard to understand.

The results of the survey also confirmed my belief that iPads are the tool of choice, particularly in the ever-changing world of technology (Fig.5). No one can dispute that iPads are a costly solution, but ensuring that the correct AT is being used throughout the educational career of a child means choosing a tool that is adaptable. The iPad can grow and change with the learner – all for little cost when using free or low-cost apps and it’s true value becomes that “the interface changes with the needs of the users” (Holt, 2014). In my current school, I believe that iPads would be beneficial on many levels as, after the initial outlay, they can operate as “keyboards”, “cameras”, “camcorder”, “document camera”, “musical instrument”, “full set of artist’s tools”, “microscope” – the list goes on (Holt, 2014). Funding is not something that is of relevance to my particular setting, as the school or parents would be expected to foot the cost and there is no national stipulation or recognition to support children with LDs. However, the benefits to ALL children having access to iPads in the classroom is something I intend to explore in more detail, along with the use of Dragon Dictation and other speech-to-text tools, which I think will benefit the English as an Additional Language (EAL) learners at my school. 


Bibliography


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Appendix

Google Form Survey.