Monday, December 13, 2010

How the iPad is Changing Our World

What do eye gaze, iPad applications and the New York Times have in common? Well, in the broadest sense of the words, they are all forms of social communication. Eye gaze is the earliest form of communication a person can have. Every parent remembers the intense staring of their newborn and how it makes you fall in love over and over as the infant learns the power of his gaze and then later his smile while looking at you.
The lack of appropriate eye gaze can be an indication of many neurological disorders including Autism or mental retardation among others. The visual system is a very refined and well developed system that fosters learning from the time of birth onward as we grow. It is integral part of our neurological development. Visual attention is the basic prerequisite for speech, social communication and social engagement. The lack of visual attention or appropriate eye gaze can be disastrous in school. It affects all aspects of school performance from reading to writing to attention.

What I find most intriguing is that children with X and Y chromosome Variations although often accelerated in spatial skills, can be quite deficient in their eye gaze and tracking. The nuances of their visual system are not yet well understood but these subtle differences affect them in many ways. Poor eye gaze in social situations can confound their development of friendships and may be misinterpreted by peers.
The person who stares away in conversation and averts his or her gaze makes people uncomfortable, nervous and at worst suspicious. In my experience I have found that the children with additional X and Y chromosomes have atypical eye gaze because of decreased ocular coordination. It is associated with the developmental dyspraxia that I write about.

How does this all relate to iPad applications and the New York Times? Well I am developing better eye gaze, visual tracking and social engagement in my patients using specific iPad applications... But what is utterly shocking is how easy it is.

Just this week, the New York Times published an article discussing the value of iPad applications for children with impairments in learning and communication. It is an interesting article which reinforces the importance of finding alternative means of communication for our children with special needs. But what is intriguing to me is that children with all sorts of disabilities will engage for longer periods of time, do more rigorous activities and persevere in the most unimaginable ways when it comes to using iPad applications. Throughout my career, the children who perplexed me the most where the kids with low verbal ability. Their parents reported quite consistently that the children knew more than anyone at school realized. The schools often reported frustration with the kids and questioned the parent's beliefs. Yet what I heard from parents was not recognition of their child's deficits but this nagging and powerful belief that there was more there.
Over the years I have been able to demonstrate quite clearly how competent these children were using nonverbal testing but often there was few choices for intervention after I demonstrated their abilities. They were hard to engage, their hand function was poor and most important their eye gaze was fast and fleeting and not well developed. Everyone was stuck and the child often suffered because there were few options to foster his atypical learning style.
In the last four months since I started using my iPad with these patients, I have had spectacular results. I am now developing a library of applications that we have found useful for certain types of patients. What I love about my job is that every single day provides some sort of surprise to me about the brain and how children learn. Over the last several weeks, two children, very different in their diagnosis, their age and their developmental levels shared one common characteristic... they were nearly impossible to assess on standardized protocols. They were believed to be very non compliant and difficult to engage. Levels of function were believed to be low and parents were frustrated. WELL...

We started using iPad applications and compliancy increased, social interactions improved and eye gaze evolved in a more purposeful manner.
Different applications were used but the outcome was the same. One child learned to point purposefully with his index finger, a skill rarely seen prior to the use of applications. The other child would take turns, request and even socialize with the examiner as long as an application was involved.



The lesson learned is that even the impossible can become quite easy if the medium is right.



Like the NYT, I believe that the iPad has changed the world, but even more importantly it has given me the ability to reach what seemed to be the unreachable just a few short months ago... Thanks Steve Jobs for opening another gateway into the minds of those children who are easy to dismiss as unreachable but are reachable with the iPad and its specialty applications.

MORE INFORMATION:
I recommend Cookie Doodle as a great application to initiate socializing and turn-taking.
Interactive books are another way to fully engage children.
10 Revolutionary Apps iPad Apps to Help Autistic Children
Best iPad Apps for Autism and Asperger's Syndrome
Even more useful apps
And of course, some free, fun apps for the holiday season

1 comment:

Ronda said...

This is great information for the Ipad. I am looking forward to geeting names of various applications to use. Thanks so much!