Podcast Transcription
Hello and welcome to this podcast. I’m Mike Marotta from the Assistive Technology Center at Advancing Opportunities.
This interview was recorded during the 2011 Texas Assistive Technology Network Statewide Conference in Houston.
The title of this session is Developing Switch Access: Cause / Effect and Beyond. The presenter is Ed Hitchcock from the Rehabilitation Institute of Chicago. The session description reads: Students with severe motor disabilities often develop cause / effect switch access skills but are then unable to transition to scanning for communication or computer access. This session will focus on solidifying cause effect activation and then making the transition to scanning to allow participation in curriculum and other activities.
Mike Marotta (MM): All right we are here talking with Ed. We’re talking about his afternoon session at the conference, which is Developing Switch Access: Cause / Effect and Beyond. HI Ed, thanks for sitting down.
EH: Not a problem.
MM: if we could start off by just giving some idea of why do you think so many switch users get stuck at that cause-and-effect level and never make the transition to another level?
EH: This is one of those things where I can only give a message to what I’m doing as a therapist or what I am making available as an educator or I am making available as the person working with this person. I can’t speak to the fact that this person might be cognitively impaired, all that kind of stuff. What I have to do, what my job is, is to develop a motivating activity that they really see – they really want to do – that they can then use the switch for. I will talk about a case study of a kid who I worked with and you know I think the motivation just becomes so important with him because the very first day I saw him, I couldn’t see any motion I couldn’t get him to move a muscle during our evaluation. It’s one of those things that, look I’m wondering if there is anybody in there in a way. You hate to say that about somebody but you start to wonder – okay, what is going on with this kid. I won’t say I’ve got him scanning yet but the difference between where he started and where he is now is pretty big and I’ll be talking about his case a fair amount during the session. I have to say a lot more of it had to do with finding the things that he enjoyed and was motivated by which has to do more with their ability to participate, with their ability to control, with their ability to do things for themselves – ask for things for themselves.
One of the things I share about this kid is that he was using the Big Mac switch and one of the things they did was at the school they would record a message – Connor did so-and-so at school today, he colored in a book, he read a story, blah blah blah. Connor would go home and he would use his elbow site and it would take him like 30 or 40 seconds of somebody sitting there telling him push the switch, push the switch Connor, come on Connor you can do it, push the switch. They get this message that Connor did blah blah blah or I did blah blah blah. Then they would do the same thing at home and send it to school the next day. Hey look I’m not proud, it’s two switch hits and I’ll take them but for one, we’ve theorized with Connor that during that time with somebody sitting there and saying come on Connor you can do it, come on Connor – that is somebody sitting there in interacting with him. What happens when he pushes the switch? That person goes away, he doesn’t get attention anymore. So, I actually theorized that one of the things going on with Connor is that he wasn’t getting the attention and this is an attention play. We reprogrammed that Big Mac to say “more ice cream please” and set it up so that every time Connor wanted a spoonful of ice cream, he had to push a switch. Well guess what? [SWITCH HIT] More ice cream, [SWITCH HIT] More ice cream, [SWITCH HIT] More ice cream, [SWITCH HIT] More ice cream. He really started to – when it was a motivating activity for him – he really started to participate a heck of a lot more than it has to do with that kind of control and so on.
MM: Yeah, it’s very – that’s a great point you’re right. It’s what is being transferred by that switch that has to be motivating for sure. Is there a set pattern of steps you take with someone to move them from cause-and-effect to transition to something else? I know it will be different for each person but is there kind of in overall ……..
EH: Yeah, based on extensive research that’s available in our field, well Mike I can tell you that!!!
MM: Right – step 1, step 2!
EH: The big thing is – you have to get on the switch. I need people to understand that getting on the switch does something. The next thing usually working on is getting off the switch because some people can get on the switch but they can’t get off it again. That becomes an issue when you’re working on using it for scanning. Generally step scanning – using two switches, one switch to advance, the other switch to select – it’s generally considered to be cognitive ability a little easier to handle for a lot of people then automatic scanning which is the more prevalent scanning that is out there. So I will often try to move people through that. That does involve giving two switches, two switch sites but a lot of people, myself included, will tend to say especially if you’ve got somebody where timing is a problem that step scanning will often be a much better option then automatic.
MM: Right and it ends up being faster and people don’t often think that. It’s just they continue to mess with the timing of an automatic scan until it is so slow that someone can finally do it. Then you go to the two switches you realize you can speed it up.
EH: And be a heck of a lot faster. Again the cognitive part of it – it is so much more directed, it is so much more controlled that your patient that does have some cognitive issues is seeing a result for each time. They are less of a passive participant which is obviously what we are shooting for. That’s not to say that when someone gets a good handle on scanning – I don’t have a problem with them progressing to – if you even want to call it progressing which I hesitate to say – but if you want them to do automatic scanning they can do it by all means. But step scanning can be a better option for a lot of those folks.
MM: Now are you seeing people what you’re working with – are they primarily doing switches for communication or are you seeing people use it for computer access and other applications as well?
EH: Most of my clients are towards communication. Then once they get good at it, by extension we’ll start going in the computer access. But it obviously depends on, it all depends – most of the time when you’re talking about switch access, a great majority of the time somebody does not have a voice. So they are using it – you want augmentative communication to be a big part of the goal.
MM: Exactly.
EH: You get them good at their AAC devices, the higher-end ones, they are much much better than they used to be. They offer a lot more computer access options which by no means is perfect and you know there is still a place for a dedicated computer access solution but it is certainly something I would try to progress to.
MM: The newer devices will bridge the gap a little bit more between communication and computer, sure.
EH: Especially as more and more of our communication takes place over the computer, whether it’s social networking or what have you, that’s something that will make it a lot easier especially for these clients who socially speaking are often not able to get out as well, not able to spend as much time in the classroom, not able to go to the museum or go social activities.
MM: Right and just participate. Now people have more questions about the session you doing today the conference, how can they get in touch with you?
EH: Best way to reach me is by e-mail which is ehitchcock@ric.org and hopefully I’m not self fulfilling prophesy zing at this point but I will probably run over this afternoon too, so please feel free to e-mail me and if you put Houston in the subject line I’ll try to get to a lot faster than I otherwise would have!
MM: Excellent. Thank you Ed.
EH: Thank you.
Thanks for listening to this podcast. For more information about the Texas Assistive Technology Network, visit the website at www.texasat.net
For more information about the Assistive Technology Center at Advancing Opportunities, visit the website at www.assistivetechnologycenter.org
The music used in this podcast is by Kevin MacLeod and is used with permission under the Creative Commons License 3.0
