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Visual supports for children with autism. Jordan Clare-Rothe


Image Engine is an online platform to share and improve visual supports for children with autism.


Visual supports for children with autism.

Jordan Clare-Rothe


Š 2012 Jordan Clare-Rothe All Rights reserved Printed and bound by www.blurb.com

No part of this book may be used or reproduced in any manner without written permission from the author, except in the context of reviews. Author and designer: Jordan Clare-Rothe Foreword Author: Nathan Waterhouse

Typography: Bree was designed by Veronika Burian and JosĂŠ Scaglione in 2008 and published by TypeTogether. Chaparral was designed by Carol Twombly in 1997.

This book is part of an MFA thesis at Academy of Art University in San Francisco.


Contents

Foreword

ix

Introduction

1

Part One: The issue Autism

7

Communication

15

Visual Supports

17

Part T wo: The Research Participatory Design Exercises

23

Card Sort

25

Unfocus Group

45

Observation

55

In-Depth Interview

57

Experience Prototype

69

Seven Key Insights

71

Part Three: the response Image Engine is Mobile Application Website

89 93 103

Features and Functionality

111

User Scenarios

119


Foreword Nathan Waterhouse

Since its origins in the 1960s, the internet has successfully transformed almost all aspects of modern society; from how we communicate to how we learn, to how we work and play. The internet is often described as a network of networks and it’s easy when we hear that to think only of the machine nodes within that network. However, today, it’s ever more apparent that the real magic behind those networks lies in the transformation of what people can achieve when we have simple, intuitive ways to connect on a massive scale. When you look back only ten years and think of the technologies that been created and adopted, and then jump forwards ten years from now, the mind boggles with what life might be like. A decade ago there were only a few visionaries that could have predicted Wikipedia might become a more accurate and extensive catalog of human knowledge than The Encyclopedia Britannica. It’s a testament to that phenomenon of how Wikipedia works that even today the size of the full time staff at Wikipedia is still a fraction of that employed by Microsoft to do the same thing with their Encarta product. Rather than paying thousands of researchers to create a digital version of the encyclopedia, something Microsoft did when

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Nathan Waterhouse is a cofounder of OpenIDEO, an open innovation platform. He was an advisor for Image Engine.

first publishing Encarta, Jimmy Wales and Larry Sanger created a way for anyone to contribute to and edit individual articles that were interconnected like a web of human knowledge. They used a technology known as a wiki, a simple collaborative technology that is built on the premise that anyone can edit any page. Wikipedia and technologies like it represent an idea that has become infectious on the internet: that with the right design and insight, communities of volunteers can come together to build things that otherwise would have been impossible or taken years to evolve using non-digital means. Since that time the use of collaborative technologies has been extremely popular in the developer community, but it’s taken longer for the world of designers to adopt and realize its potential to create new value. However, there are many successful examples today of creative platforms and communities which are embracing the idea of openness. To be successful those communities need to balance thoughtful design with a sensitivity to how the community is forming and growing. Jordan’s project exemplifies this kind of approach. In approaching his work he has had to think about how to motivate and engage a community of volunteers to help improve the lives of children with autism. This problem that Jordan set about to improve is not something that either he is an expert in, nor pretends to be. His passion for this area comes from studying politics as an undergraduate and experience working with people with disabilities. Designers don’t need to be deep experts in their project’s domain when they take a human-centered approach. Jordan surrounded himself with experts, users, and the family members of children with Autism to help him understand enough to design the right solution. Image Engine is ingenious in that it attempts to create a service ecosystem that will help continuously improve its own outcomes, rather than trying to design the perfect solution first time. It embraces the ideas of the open source movement and the belief that through opening up parts of the design process, you not only get better informed outcomes, but you create engagement and community which is even more powerful. I was honored to work with Jordan, he is a thoughtful and intelligent designer and I’m excited to see the impact of his ideas, whether for improving the lives of those affected by autism, or for impacting other social issues.

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Introduction

For two years I worked for people with physical and developmental disabilities, assisting them to live in their own homes. My official title was Community Support Facilitator, in part because people with disabilities face so many challenges integrating into the community. I helped people with such tasks as scheduling doctors visits, budgeting, grocery shopping, keeping in touch with family, friends, coaches, landlords, and other significant people in their lives. I also supervised staffs of direct care workers. My organization had two clients I will call Mark and Dave, who were both really great guys in their thirties with severe autism. Mark and Dave lived together in their own apartment in Berkeley. They each had their own staff person with them 24 hours a day to help them meet their daily needs and the long-term goals their parents and others set for them. As part of the team that oversaw their direct care support, and at times supported them directly, this was a tremendous challenge. Neither man spoke more than a handful of words, and their behavior could be unpredictable. Due to sensory issues, Dave only chose to eat Flamin’ Hot Cheetos dipped in Tapatio hot sauce. Helping him to eat enough in any given day was difficult. He was easily agitated and when he was unhappy, he would pinch his care-providers.

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Mark, on the other hand, was generally more even keeled. The two of them lived on one of the busiest streets in Berkeley. Once in a while, and never when I was directly responsible for him, he would run into the fast moving traffic in front of his house. He was a big guy, over 250 pounds, and I was not eager for the task of stopping him if he ever decided to do this on my watch. The great challenge is in communication. Significantly, in the late 1970s, when Mark and Dave were born, one in 2,000 babies were diagnosed with autism. 1 Today, that rate has increased nearly twenty times to one in every 88 babies. It makes me wonder how we keep twenty times the Daves eating a sustainable diet, and how we will keep twenty times the Marks from running into busy streets. I am convinced that integrating People with autism often have sensory issues. A former client of the author preferred to eat Flamin’ Hot Cheetos dipped in hot sauce.

the new boom of autistic people into our society will be a profound test of my generation. This much I know: we cannot wait until they are grown men and women to start. We have to start giving young children with autism the tools they need to communicate with the people in their lives, and we have to start now. This paper will start by discussing autism and its particular challenges, and the visual learning style that provides an opportunity to educate children with autism. The second section will outline a potential solution that will be one piece of the puzzle in helping children with autism grow up to a healthy, fulfilling future. The final section shows the research that led me to this solution.

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A former client of the author would occasionally run into traffic on University avenue, a major thoroughfare in Berkeley.

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Part One

The issue

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“Autism is a life-long, complex developmental disorder that causes impairments in the way that individuals process information� Sheila M. Rao

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Autism

Autism is a developmental disorder that affects individuals throughout their entire lifetimes. The National Institute of Public Health provides a good starting point. It states, “Autism is a neurodevelopmental disorder in the category of pervasive developmental disorders, and is categorized by severe and pervasive impairment.”1 In other words, it is a disorder of the mind, and it is recognized by the way a person behaves, rather than by any physical signs. To be more specific, “Autism is a life-long, complex developmental disorder that causes impairments in the way that individuals process information.” 2 While there are many challenges associated with autism, it is at its core a disorder that hinders the processing of information. CORE CHALLENGES

The core challenges of autism are widely agreed upon by experts. “All of the diagnostic systems commonly used to describe autism agree that there are three main diagnostic features: 1) impairments in social interaction; 2) impairments in communication; and 3) restricted, repetitive, and stereotypical behaviors, interests, and activities.”3 These three features are at the heart of this syndrome, so let us take a closer look at each of them.

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1. Susan E. Levy, MD, Prof, David S. Mandell S.D., Robert T. Schultz, Ph.D., “Autism,” National Institute of Public Health, 7 Nov. 2009, http://www.ncbi.nlm.nih.gov/pmc/articles/ PMC2863325/ (accessed 11 June 2011). 2. Sheila M. Rao, Brenda Gogie, “Learning Through Seeing and Doing,” Teaching Exceptional Children, Vol. 38 No. 6 3. David R. Beukelman, Ph.D. and Pat Mirenda, Ph.D. Augmentative and Alternative Communication. (Baltimore: Paul H. Brooks Publishing Company), 243.

Impaired socialization includes all the social skills that many of us

take for granted. According to the NIH, this can include “impaired use of non-verbal behaviors to regulate interactions” as well as “little to no social reciprocity and absence of social judgement.”4 For example, people with autism can have trouble knowing how far to stand from another person during conversation. They may miss social cues and body language. Or they may have no interest in speaking with another person whatsoever.

4. Levy, Mandell, and Schultz, “Autism.”

Impaired communication is a way of saying that for a person with

5. Levy, Mandell, and Schultz, “Autism,” http:// www.ncbi.nlm.nih.gov/pmc/articles/ PMC2863325/ (accessed 11 June 2011).

autism, expressing even basic wants and needs presents a challenge. This includes not only spoken language, but also gestures and signs. According to the NIH, impaired communication for people

6. Andy Bondy, Ph.D. and Lori Frost, M.S., CCC SLP, A Pictures Worth: PECS and other Visual Communication Strategies in Autism (Bethesda, MD: Woodbine House Inc., 2011), 20.

with autism includes, “Delay in verbal language without non-verbal

7. Bondy and Frost, A Pictures Worth, 20.

and conversation, and disturbance in pragmatic language use.” 5

8. Levy, Mandell, and Schultz, “Autism.”

Language among children with autism can also include echolalia,

9. Levy, Mandell, and Schultz, “Autism.”

which is the repetition of another’s speech, rather than a response

compensation,” as well as an “impairment in expressive language

to it. For example, if you ask a child with autism, “Would you like to play with the ball?” He may repeat your question rather than respond to the question. Such impaired communication starts from a very young age. Most neutrotypical children, that is, children without developmental disabilities, start “babbling” around six to eight months. By this age they will have started to recognize how their gestures, eyecontact, and body motions influence the adults around them, and by a year have begun saying single words or two word combinations.6 For children with autism, on the other hand, is much more rocky. Bondy and Frost state, “Some children [with autism] are reported to engage in fairly typical babbling and early speech development but then show remarkable regression around their second birthday, often stopping to speak entirely. Other children with autism do not seem to direct their speech to adults or siblings.”7 This is the course for many children with autism. Finally, restricted, stereotypes, and repetitive behavior h as to do

with actions and patterns of actions taken by those with autism. This can include “stereotyped, repetitive motor mannerisms, and self-stimulatory behavior.” 8 In other words, children and

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adults with autism may flap their hands methodically or hum or take part in other behaviors to satisfy themselves. Even as an adult, my autistic client Mark would hum to himself frequently to relieve anxiety. While these behaviors may be disconcerting or uncomfortable to other people, they serve a valuable purpose to the autistic child. They may also have a “preoccupation or fascination with parts of items and unusual visual explorations.”9 There could be a particular object that a child could be drawn to, and he could become quite upset if it is not available to him. In addition to these main three features of autism, other notable features include an over-sensitivity in sight, hearing, touch, smell, or taste.7 This means that, or a person with autism, a regular teeshirt or pants could be too itchy, or a normal restaurant or classroom could be an overwhelming cacophony of sound. Also, people with autism can be highly dependent on predictability and routines, and can become very stressed and agitated if their routines are disturbed. While there are surely other difficulties that fluctuate from person to person, together these make up the core challenges of for people with autism. A Spec trum Disorder

Autism and a few related syndromes are known collectively as autism spectrum disorder. People with autism on often referred to as being “on the autism spectrum,” or simply, “on the spectrum.” This is because one person’s autism can be very different from another person’s autism. According to the Center for Disease Control, “The term “spectrum disorders” is used to indicate that ASDs [autism spectrum disorders] encompass a wide range of behaviorally defined conditions, which are diagnosed through clinical observation and development .”1 This wide range is of pivotal importance on how we

teach and communicate with children with autism. Cognitive Neuroscientist Francesca Happé provides us with a more graphic description. She states, “The manifestations of autism cover a wide spectrum. These range from the child with severe impairments who may be silent, aloof, of a low IQ and locked into rocking and hand flapping, to the high functioning individual with pedantic and verbose communication, an active but odd social approach,

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and rarefied special interests (e.g. registration numbers on lamp posts).”2 Image Engine will serve all but the outliers of this spectrum. However, it is important to remember the great diversity of ability in people with autism. In other words, Speech Language Pathologist David R. Beukelman states, “It is increasingly accepted that autism and a number of related pervasive developmental disorders occur within a spectrum of impairments. On the one end of the spectrum are individuals with autism who also have intellectual disabilities requiring extensive to pervasive support. On the other end are socially eccentric or ’odd’ individuals who may get married, hold down jobs, and are never diagnosed with having a disability.”3 There is a tremendously wide range of people on the autism spectrum. Some have massive personal support needs, while others grow up to lead very “typical” lives, albeit with some social idiosyncrasies. There is an expression within the autism community that “If you know one child with autism, then you know one child with autism,” meaning that one cannot assume that if something is true for one autistic person, then it will be true for another. The wide range of the autism spectrum means that support has to be personalized for each childs individual needs. Savant Skills

A significant percentage of people with autism possess what are known as savant skills. A savant skill is a genius level ability in a very particular area. Again, Francesca Happé states, “Savant skills, in recognized areas such as music, art, calculation and memory, occur in approximately one in 10 people with autism. This makes them a great deal more common in this group than in others with learning disabilities.” In the popular culture, Dustin Hoffman’s Autistic character of Raymond in the 1988 Film Rain Man had savant skills in memory and mathematics. In a perfect world, savants will be able to make the most of their remarkable strengths and not be held back by the challenges associated with their autism. Rising Rates Autism has seen a steep increase over the past decade. In the 1980s, autism was reported at a rate of 1 case per 2,000 children. As of the end of 2009, according to Federal research, that figure jumped to 9 in every

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The core challenges of autism are impaired socialization, impaired communication, and restricted, repetitive behavior.

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10. Catherine Rice, PhD, “Prevalence of Autism Spectrum Disorders,” Center for Disease Control–MMWR Weekly, 18 Dec. 2009, http:// www.cdc.gov/mmwr/preview/mmwrhtml/ ss5810a1.htm (accessed 12 July 2011). 11. Autism Speaks, “What is Autism?” http:// www.autismspeaks.org/what-autism (accessed 16 June, 2011) 12. Alice Park, “Autism Numbers are Rising. The Question is Why?,” Time, 19 Dec. 2009, http://www.time.com/time/printout/0,8816,1948842,00.html (accessed 12 March 2012). 12. Walecia Conrad, “Dealing with the Financial Burden of Autism,” New York Times, 23 January, 2010 13 Perry Klass M.D., “’Environment’ Poses a Knotty Challenge in Autism,” New York Times, 8 August 2011, http://www.nytimes. com/2011/08/09/health/views/09klass. html?_r=1 (accessed 6 August 2011). 14. Roni Caryn Rabin, “Both Parents Ages Linked to Autism Risk,” New York Times, 9 February 2010 (accessed 9June 2011). 15. Dr. Ellen Wright Clayton, “Vaccine Cleared Again Against as Autism Culprit,” New York Times, 25 August, 2011.

1,000, an 1,800 percent increase over three decades. 10 That rate is even higher among boys, who make up three quarters of autism cases. All in all, there are more children with autism than “childhood cancer, juvenile diabetes and pediatric AIDS combined” 11 It is widely believed that the increase is in part related to increased awareness and research methods. According to a Time Magazine report on the issue, “Previous studies looking at a narrower population of youngsters have suggested that as much as 40% of the rise in autism cases might be explained by broader diagnostic definitions and by heightened awareness of the condition. But that still leaves 60% of the increase unaccounted for. “Most scientists believe there is something more than just awareness and a broadening definition that is responsible for the rise,’ says Dr. Gary Goldstein, president of the Kennedy Krieger Institute in Baltimore. ’We are seeing some fraction of the increase that is probably due to more cases of autism.’ ” 11 Whatever fraction can be attributed to heightened awareness and changes in the criteria for diagnosis, it is clear that autism is a strikingly common disorder among boys in this country. In May of 2013, the American Psychiatric Association will release the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — the most important book on mental disorders in American — the DSM-5. This book will have an updated definition of autism, that will more closely circumscribe who is diagnosed with autism. This is controversial in the world of autism and will no doubt result in fewer diagnoses of autism. Never the less, the symptoms that have been leading to increased rates will remain, even if the numbers decrease in coming years. Associated Costs

There are great financial costs for the Families of a child with autism. According to the Harvard school of Pubic Health, “treatment is extremely expensive. Direct medical and non-medical costs can add up to as much as $72,000 a year for someone with an extreme case of the disorder.” 12 Because of this great cost, many families are recommended to visit a financial planner to learn how to afford such high costs.

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Looking on a larger scale, autism has significant financial costs for society as a whole. According to Harvard faculty Michael Ganz, “The lifetime per capita incremental society costs of autism is 3.2 million. Lost productivity and adult care are the largest components of the costs.” When you extrapolate this cost to the increased frequency of autism, it becomes a heavy burden, indeed. Because the bulk of the costs are in lost productivity and adult care, it stands to reason that these costs can be significantly reduced if people with autism are able to become more independent, thereby increasing their productivity and lessening their adult care needs. The goal of this project is to increase communication and thereby independence, which will decrease societal costs. Causes

The causes of autism are not of great importance to this particular project. That being said, it is worthwhile to mention the current status of research into the cause of autism. The causes of autism are mostly unknown. It is widely believed that some combination of environmental factors and genetic factors play a role. Beyond that, there is no consensus on what those factors are. According to the New York Times, “Recent research has taught us more about the complexity of the genetics of autism, but the evidence also has suggested an important role for environmental exposures. It has become a very complicated picture: Genes matter, but we usually can’t tell how. Environmental exposures matter, but we usually don’t know which.” 13 Our best picture of the cause of autism is still very cloudy indeed. Academia has some insights. Older parents have children with autism at a higher rate than younger parents. 14 Also, despite some tenacious if non-academic theories, “The [measles, mumps, rubella) vaccine does not cause autism, and the evidence is overwhelming that it does not.” 15 However, by and large we are far from knowing a direct cause.

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Although a child may have difficulty associating meaning with verbal instructions, this is not necessarily true of instructions that take a more visual form. c at h e r i n e t i s s o t & R o y E va n s

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Communication

1. Linda Hodgeman M. Ed., “Helpful Visual Strategies Information,” Use Visual Strategies: Meeting Communication Challenges in Autism, http://usevisualstrategies.com/ VisualStrategiesInformation.aspx (accessed 12 August, 2011)

Of the three main challenges associated with autism, the first is communication. And after all, how can a person learn social skills or study skills, or any of the skills one needs to be an independent adult, without being able to communicate. Communication is the key to enabling children with autism to reach their highest possible success in life. Fortunately, there are different forms of communication. When we think of communication we most often think about speaking. One person opens their mouth, those sounds pass into another persons ears and are interpreted as words and sentences, and the meaning is understood. This is the area where children with autism have the most difficulty. Spoken language moves by quickly, and if the child needs more time to process these sounds, there is no record of them to study. Often, if a speaker without awareness of autism realizes they were not understood, they will repeat what they have just said, as in “How was your day?… I said, how was your day?” This only causes the child to start over trying to understand what was said to him or her, making things even more difficult. Seeing Words

Communication can also be visual, written words and images. As it turns out, people with autism face the greatest challenge with auditory communication, but can be much more successful with

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2. Catherine Tissot and Roy Evans, “Visual Strategies for Children with Autism,” Early Childhood Development and Care, 2003. Vol. 173.

visual styles of learning. According to Hodgeman, “Students with

3. Joanne M. Cafiero, Ph.D., Meaningful Exchanges for People with Autism: An Introduction to Augmentative and Alternative Communication (Bethesda, MD: Woodbine House, Inc.) 27.

tory processing is common and pervasive in this population.” She

4. Temple Grandin, Thinking in Pictures: My Life with Autism. (New York: Vintage Books) 3.

autism typically have difficulty processing auditory information. It may not be every student and it may not be all the time. But audicontinues to state, “This is not an auditory acuity problem. They can hear sound. It is an auditory processing problem. When the sound goes in the brain, the child is not able to make meaning from it.” 1 In other words, children with autism can hear just fine. However a part of their disability that their minds have trouble converting that sound into usable data. There is information, however, that is more easily processed by children with autism. “Although a child may have difficulty associating meaning with verbal instructions, this is not necessarily true of instructions that take a more visual form.” 2 For a child with autism, being able to see words, ideas, or concepts is much more meaningful than being able to hear words. According to expert Joanne M. Cafiero, Ph.D., “Most people with ASD have strong visual processing skills and much weaker auditory processing skills. Visual stimuli, like pictures and words, are permanent and not fleeting like sounds and manual signs.” 3 In this way, visuals are a real key to communicating with children with autism. While words pass by quickly and leave no trace, a child can take time to study an image and gather its meaning at their own pace. Temple Grandin While comments from experts is useful in understanding the visual learning style of children with autism, it can be even more helpful to hear it from the mouth of someone with autism. Temple Grandin is a writer with autism who explains what it is like to be a visual learner. She says, “I think in pictures. Words are like a second language to me. I translate both spoken and written words into full color movies, complete with sound, which run like a VCR in my head. When someone speaks to me, his words are immediately translated into pictures.” 4 There you have it. Grandin is fluent in the language of pictures, and uses that understanding to communicate in words. While this is not the case for every single child with autism, it is the case for many, and to reach them, we must communicate with them in their native tongues.

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Visual Supports

The core use of Image Engine is to create visual supports. Visual supports are specific structured combinations of images used to communicate ideas, commands, phrases, schedules, and actions to an autistic person. Visual supports can take several forms, and this site will focus on daily schedules, image exchanges, calendars, checklists, first/ then charts, and task steps. Because children with autism generally struggle with auditory input, and are good at receiving visual input, visual supports can be greatly beneficial in the classroom and at home to provide structure and communicate to children with autism. Six common visual support types are pictured to the right. Visual supports are modular, and the images (indicated by orange squares) can be swapped out depending on the intended message of the support. Calendars There are many types of calendars readily available to teachers and parents that can be used as visual supports. Some are large and represent an entire month. They can be found in dry erase format. Here the day/ date/ month are written into the correct position by hand and then adjusted for the following month. Calendars with pre-printed day/ date/ month are also available. The dates are usually

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Visual supports, used by parents and teachers with children with autism, are modular and take on different forms depending on the need. Illustrated are six common visual support types.

Daily Schedule

Task Steps

4. Marlene J. Cohen, Ed.D., BCBA, Donna L. Sloan, M.A., BCBA, Visual Supports for People with Autism: A Guide for Parents and Professionals. (Bethesda, MD: Woodbine House, Inc. 2007) 10. 5. Cohen and Sloan, 11.

First/ Then

Image Exchange

Check List

Calendar

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A Google image search provides hundreds of thousands of results in fractions of a second, but requires lots of time to find anything appropriate for a child on the autism spectrum. The above is a screen shot of an image search for “share icon”. Note that none of the top images would be appropriate for young children.

attached by Velcro or magnet and can be rearranged monthly. These large calendars are good for indicating important events or holidays and can provide for the individual with a sense of the time that will elapse before a certain event will occur. 1 Daily Schedule Calendars that provide spaces for listing activities by time of day can also be very useful. They can be found formatted one day at a time or one week at a time. This type of calendar can be used to represent a series of activities that are scheduled to occur during a day. In general, this kind of calendar is best suited for older adults and children with some reading skills. You will need to put some thought into considering how much information a particular individual can process at a time. It is best to keep a calendar simple and to gradually increase the amount of information presented at one time. 2 Access Currently there are three main ways for people to get images for visual supports. They can draw their own, they can use Google images, or they purchase from Boardmaker. Each one has draw backs. Drawing requires skills that not everyone has. Google image search requires sorting through many irrelevant (at times inappropriate) images. Boardmaker requires buying CDs of whole categories of images that are poorly rendered and — more importantly ­— cannot be customized to the childs needs.

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Part two

The research

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Autis m a n d pictu r e s

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Participatory Design Exercise Timeline Card sort

Unfocus group

In-depth interview

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Observation

Experience protot ype

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Participatory design exercises

In order to create the blue print for Image Engine, I had to better understand my audience. This is not only the children with autism for whom the visual supports will be used, but also the people whom I intend to attract to the website to build these supports. With this in mind, I did a series of participatory design exercises. While doing these exercises, I was working under the guidance of Nathan Waterhouse, cofounder of OpenIDEO. I used an user-centered approach as laid out in the book User Centered Design, written and released by IDEO.

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User Centered Research Exercise 1

Card Sort

What

The card sort involved making separate cards of each of the many functions I could envision Image Engine serving. I spoke to two educators about what functions would be useful, and had them rank the cards from most important and useful to them to least. This was just a jumping off point, and the real value was in the conversation that the card sort lead to. Why

I wanted to get an idea of what would be useful to the people who would use this site. Generally speaking, people spend approximately 80 percent of their time on any given website using one feature of a website, and only 20 percent on all other features. I wanted to start getting an idea of what this breakdown would be for Image Engine.

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Caitlin Daly Image Engine: Tell me about yourself. Caitlin: I’m a preschool teacher for children with complex communicaWhat is the role of the speech language pathologist? How is work shared between the two parties?

tion needs, mostly because of a physical disability, usually cerebral palsy. I work with a very specific group of students and all of them can’t talk because of their disability. So we work on finding alternative forms of communication. Augmentative and alternative communication. So at the pre-school level, a lot of is not the high tech devices like computers. Most of it is really low tech; picture boards, picture symbols, picture books. And all highly relevant to their community and their world. We are working on skills so that when they are older they will be able to use a more complex high tech device. What kind of skills are you building? Many students do not have the physical dexterity to use a keyboard. So they access the computer through switches. They access it with their elbow, knee, or head.

Is Google the best search structure? Should Image Engine mimic Google images, but with exclusively images geared toward autism?

How did you get into the work that you do? It was a long process. I always knew that I wanted to do something in education. Especially in college. I went abroad for a year and taught English. It was not quite what I wanted to do. I came back and worked as an aide at the Bridge School, and I decided to go back and get my credentials in special education, specifically physical and health impairments, which is the population I work with now. Last year I started as a pre-school teacher at the Bridge School. I really enjoy this more than working in general education. The goal of our school is to get kids prepared to be in general education, they just need the right tools and the right technology to do so. Then they can access general education. My responsibility as a teacher is to provide students with a general education curriculum… The speech language pathologists are really responsible for the technology and the tools. What kinds of websites do you use from day to day? When you log-on, what do you do? I e-mail. I use Google a lot. I use Google images. I also use Youtube for videos and videos with songs. You can find educational tools on Youtube. And cartoons.

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Commonly used system for images.

I use Google images the most. I teach letter sound correspondence, so I make letter books. For example, for the letter A I have different words that have the a sound, for example acrobat, apple. A lot of my students have visual impairments, so when I look for the image I look for an image I look for a very clear picture, without a lot of clutter. Nouns are very easy, but verbs are harder, like run. The verbs can be harder. What else is harder? Prepositions like in, on, under. Those are really hard. Even pronouns are hard, like he, she, and my. What do you use for ’in’? I would probably do something like a Boardmaker symbol at that point, which is like a ball inside a box. I would always explain it with a real object first, so for example I would put a ball into a box, and say, “Now you put the ball in the box.” So at this age they can learn symbols, so long as I’m consistent, so long as I don’t change their in, they can learn that symbol means in. I have to pair that with a real life explanation. Why would you use Google image? What is good about it? I use Google image as opposed to the board maker images because they are real pictures. Also, I use Google images because I try to make my

The substrate could be improved, strengthened. This could be printed from an outside vendor.

pictures as culturally and ethnically diverse as I can. Boardmaker does not have many options for that. Sometimes I like to find images that involve kids, because my students are so young. You know what I wish they had more of is pictures of children or adults with disabilities. I try to find pictures that show a child in a wheel chair to add to the cultural diversity. Sometimes I will use pictures of our actual students.

These are the features she really wants.

So are you bringing a camera to class? We have lots of cameras in class. We take lots of pictures. We take pictures every day for a website that we use to disseminate what we are doing to the public. We use this to teach lesson planning and technology support, things like that. If you had something in mind you would go to Google images first, then Boardmaker, then a photograph taken in the class? If I knew something. For my students I would use Boardmaker last. But for older student Boardmaker would be second.

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Google images is also really easy to use. It’s quick and its fast. And you can refine your search to be really specific, which is very nice. So mostly for the speed I use that. I use Google images first, then our images, then I might go to Boardmaker. But that is also because my students are so young that they really benefit from a real picture. Older students can work better with a line drawing. From a technical standpoint, you use Word, and then print them from a home printer or a school printer? Yes. And then some form of cutting is involved. A lot of my students have visual impairments, so they can see better with a black background. So I will cut it out and paste on a black background. Yellow is a good color, too. Because it makes a high contrast. The contrast helps focus in on the object for students with visual impairments. Does having it in paper work, or is it problematic at all? Yes, a lot of students will touch it and it will get crinkled. If I use it many times, I may laminate it. But laminate is expensive. Sometimes you don’t care if it gets crinkled. Because they like to touch stuff and they should touch stuff. I haven’t noticed a difference with my students in terms of paper or laminate. Would it be helpful to have it on another form, something harder or softer? What I have is fine. Some of the older students have something on foam board, which is really good because the student can pull it off without worrying about it crunching. I’ve also seen it mounted on card stock. Or even mounted on card stock and then laminated. We use felt board sometimes so that things can stick. Are there other assemblages or ways you would put the images together? Yes, last year I did some wall displays. I did letter displays of letters and things that started with those letters. When I taught a letter, I would hang up that letter and related pictures on a wall. I also did one with numbers.

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One thing we do is make communication books. The speech language pathologist does this. The kids bring in pictures of things that happened at home. The family takes pictures of events, like going to the movies. And then they have this tool to communicate with new partners, This is something that the kids really like. We are also going to try the visual displays, which would be a communication board they would need for many events. So for going to the park we would have something that said “swings” and “slide” and then the kids would have something for each time they go to the park. They know that if they want to swing they can look at this visual. I have told you some about this project. The goal is to make a wide library of images free and easy to search and easy to access. Is that something that would be useful to you? Yes! I find Google images very useful, except that there are so many images that are not useful in that search. One thing is that a lot of them are inappropriate, and also you just can’t find what you need sometimes. So I think a set of symbols that are specific to this purpose would be very useful. So the images would be less cluttered than what I find on Google images. So I think that would be very useful. It would be nice even for students to eventually use. We do a writers workshop and pat of that is to pick a topic you want to write about, and you find a picture to go with it. We don’t use Google images for that because we are afraid of what will show up. Do you think that parents would have a use for it? Yes, especially a parent who is involved. We have many parents who are very on-board in making low-tech systems. So we have had parents come in and make their own low tech boards, for things that relate to home. We had one parent come in and she said that she modeled a board after what they were doing in a workshop. This had things you could play at home, things you could eat at home, and what TV shows you can watch. So I do think parents can find it useful, especially the ones who are involved and motivated. I have an activity. I have cards that represent all the things that could be done on a site. Can you put these in order of most important thing, if you could do one thing, all the way down to least important. I like this “account” idea, because then you can

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personalize it. And then you can do things like if the kids were going to access it, you could exclude certain words, like sexual words for a preschooler… That’s very important, to be able to upload your own images…And [mobile devices] are becoming more and more important! We are using the iPad now. My kids can’t because they are too small, but many are using phones. Would this be a group that you join? Yes. Anyone could go on and search and download, but to do certain things then you would need to create an account. And to upload personal images, you can keep those private? Privacy settings.

Would you want to keep those private? If I was uploading a picture, of a students family or of a student, then I would want to keep that private. But if that was not an option, then I would just not put those images up. Right so if it was an option, then you would use it, but if it was an image that was not specific to a person… The image collections, what would that be? Any way that you would group the images. It could be things like, anything that’s for lunch; a sandwich and a milk and an apple. It could be anything that would go on a visual monthly calendar. Or the letter groups? Right! Something for every letter in a collection. Just within my own account, or within the public domain?

Make sure everyone can share. Sharing ideas has to be primary to the website.

What would be more useful? I love other people ideas. I think everyone has different organizational strategies, so the way I might organize something might be different than the way another person would organize it. So I wonder how useful it would be given everyone’s organizational strategies. However, I think if everyone put the letter ’a’ in, that would be wonderful. I think about how I organize my stuff at school, and I make collections, and I am the only one who uses the collection that I have made. And other teachers have made collections. We have a server for our work documents and other things, and I remember one teacher said, “I have

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images for everything! They are all here.” And I never use it, because I don’t know where anything is. It is faster for me to search for it than to search through her folders to try to find something. But it made sense to her! Also, sometimes I like to know all my options before I go. What if you could start with someone else’s alphabet, and go, this is mostly good, but the ’C’ is for “cremation” and I don’t want it to be for cremation. I want it to be for “Cat,” and I could change that. Would that be useful? Sometime it would be good to get ideas, too. I might say “Oh, I didn’t think of that word, or that word is really relevant to my students.” So sometimes it is a good tool for jogging your memory. If they had a letter ’a’ collection, I would probably search it just to get ideas of what words to include. If I could do it on my own, too. Because after my first year it was great to be able to go back and actually have stuff ready to go, saves time. Having access to other peoples would be good, but also being able to create my own. Because I think you are right, it would give me good ideas to be able to see someone else’s. This one, exchanging dialogue, is also very important. I am very lucky that I get to do this at my school, but a lot of people are the only special education teacher on a site. Or they get twenty minutes with the speech language pathologist and that’s it. So this I think is very important, but for me I am very lucky in that I already have that at my school. And also I am very lucky in that my school makes sure that we have access to everything we need. So printing is very easy for me, at school or if I have to go somewhere else, they will pay for it. So I am really very lucky in that regard. Many teachers do not have the materials they need or don’t have access to it. Sometimes their photocopiers don’t work or, it’s bad. So I am very lucky in that regard. So this would be my top. And this [Request an image] is like “do you have a picture of an apple?” I am usually lesson planning the night before, so if it’s not there, I just have to look somewhere else.

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“We have a server for our work documents and other things, and I remember one teacher said, “I have images for everything! They are all here.” And I never use it, because I don’t know where anything is.”

Search and find images

Tag images

Upload images

Download images

“That’s very important, to be able to upload your own images.”

Create image collec tions

Export images to mobile device

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Log-in to personal account

Register a new account

“I like this "account" idea, because then you can personalize it. And then you can do things like if the kids were going to access it, you could exclude certain words, like sexual words for a preschooler.”

“And this [Request an image] is like ‘do you have a picture of an apple?’ I am usually lesson planning the night before, so if it’s not there, I just have to look somewhere else.”

Request additional images

Exchange dialog with others

“This one, exchanging dialogue, is also very important. I am very lucky that I get to do this at my school, but a lot of people are the only special education teacher on a site. Or they get twenty minutes with the speech language pathologist and that’s it.”

Print images

Print on alternate material

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So basically, its either you find it then, or you are moving on. It’s not like you are searching for something that you would use in a week. Yeah. But other teachers plan in advance. I’m still new. I’m still getting there. Do you think that for other teachers that might be ranked higher? Yeah. I like all the stuff about uploading and downloading images. But when you need a new image, it would be nice to ask “Hey, does anybody have a picture of a kid in a wheelchair?” Or some of those harder to find images. But as long as you don’t need them the next day then you are fine! Okay, lets talk about how you might want this to look? How would you want this to be put together? Mostly because this is what I am used to, but the search field front and center. I think any sort of account stuff like login should go up here in the upper right. This would be register new and login account. There would probably be a logout, too. Okay so you would type it in here and then the images would show up. Then what would probably show up would be all the different images here. Much like Google. And then the search field would stay up here, in case that was not what I wanted. So then, I would also find here probably the upload images. Let’s say I want that image, so I click on it. I would want to see a bigger picture of it. There is that big picture, so now I could tag it. I could Caitlin drew prototype web pages to accomplish the objectives of Image Engine.

download it. Would you be able to copy and paste them? How do you mean? Well, for Google images, I can just copy and paste. So you click on the Google image, you hit copy, and open [Microsoft] Word… Yes and you copy into Word. So you could probably do that for this, too. I don’t always download the image. I sometimes just cut and paste it. So you always have Word or another program open as you are searching for images so you can just copy it right in to a file. Yes. Or Boardmaker. And they automatically resize in Boardmaker.

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Is that useful? I don’t use Boardmaker that often. But its really cool because when I use Google sometimes the images come in really big, or sometimes they come in all fuzzy, so you have to pick out another one. Does the image always need to be [about three inches]? Sometime they need to be big. I make them larger if is a child with a visual impairment. Sometimes I have done full page pictures. For example I did a map of California that was a full page. The image came up and it took me a few images before I could find one that could be printed at a full page size. Sometimes when I am teaching I just need something that I can show in front of the whole class. Because it is for the group. So you could tag it, you could download it, you could probably add it to Keep in mind ease of uploading here. She is uploading it is just through a simpler process than saving to a file on her computer. More direct.

an image collection. And there will always be the back button, because I like to use the back button. If you wanted to print from vendor, that means like Shutterfly? So then you would access the Shutterfly account and bring the images in there? It could go that way, or it could work like Amazon where it keeps a cart, so it keeps it all together and order it all at once. Does that sound like the right sequence? Yeah that sounds like a really good idea. I wouldn’t have thought to do it that way. Thank you! I like that. I like the shopping card, too, so you can keep shopping around until you have the whole set you need. That’s really important, because it’s often not just one image that you need. I think on the home page is where I would put the dialog and the requesting. Because you have a home button on each page, is that

File size guidelines

correct? Although I would most likely use the back button. I’m a big back button user. I would keep all the login stuff up here. So the exchange dialog how would that work? Like a chat room, or an e-mail?

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How might it be the most useful to you? Well I guess you would exchange dialog with other people you know. So if I send out an e-mail, then everyone could get it. And if there is a large number of users it could become a barrage of e-mails. But then if it were a chat room then what if no one were in the chat room at that time? I guess I might use either. I wonder how you could filter the e-mails? Another way that could work is that if it were based on one specific image, it could be comments below it. Or it could be like a discussion board with a title thread where people could add comments onto. I like that one the best so far. People actually do write on discussion boards. I mean, I am not one to write on a discussion board, but lots of people do. When I look up things online there are discussion boards that have all kinds of answers on them. Is there something that I am completely missing that I have completely neglected? I will write down copy and paste. That is one that I use a lot. It’s faster to copy and paste than to download and then find it on your computer. But I do think downloading is important because sometimes you do not have internet access and you need it. Would they be able to put on the written label? Because some people like that and some people don’t. For us that is really important, because we are teaching students to be literate, and that can help them to recognize the word. They might recognize the shape of their name or the shape of their friends names. But for some kids that is not important. But we do use the label. Do you want to be able to label an image yourself? Or should it already have a label? Boardmaker has a label. I would say that 50% of the time I am using their label and 50% of the time I am relabeling them. So you are really re-purposing their labels a lot of the time. Yeah, sometimes it makes more sense with a different label. Like if you want to show a wheel, I might use a wheelchair with an arrow to the wheel to draw attention to the wheel. Boardmaker has a wheel image, but using the wheel of the wheelchair image has more context. I also sometime change the font or the size of the label.

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Why? Because that letter a and g in printed form doesn’t look like the ones we teach how to write in school. So I re-do it in either Abc Teacher Font or in Comic Sans. That is why we would change it. So to have a font that looks how you would write it is important? Yes. If you were going to write a fiction 25 years in the future, how do you think the tools in the classroom will be different? I think everything will be much more mobile. And a lot leaner. Right now a lot of the devices are very thick and cumbersome. So a lot of those devises will be a lot more sleek. They will have a smaller foot print. Because when you go into a classroom, you have a wheelchair and your device and a backpack, where some of the other kids have a much smaller footprint. Its really nice when you keep that footprint down so that they can better be in that environment. I also see different ways to access the technology.

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“Teachers may have ten different kids that they see, and they need to have a library for each of those kids, a big database which, depending on what their needs are, they can create special libraries for them� D r . P a m e l a Wo l f b e rg

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Dr. Pamela Wolfberg I spoke to Dr. Pamela Wolfberg, Ph.D., Associate Professor of Special Education at San Francisco State University and expert on social inclusion and autism. We spoke about her iPad, visual schedules, and the zebra room. Dr. Wolf berg: The iPad really has revolutionized education for autism. For children with autism it is so intuitive to use the iPad. Wherever Steve Jobs is, thank you. I have downloaded many apps. The most popular one is Proloquo and Proloquo-to-go. And those images are the same Mayer-Johnson images used with Boardmaker. The same images we used when I was a teacher back in the ‘80s, and we had to photocopy them. They are line drawings, they serve a purpose and they have become very common, but I don’t feel that they are aesthetically pleasing. I think that we can do better. I have found other images that are kind of sweet. Google images that somebody uses that look like real people, but are simple. The images that we designed are really simple, but serve a purpose for what we do. A lot of people are coming out with stuff. I would say that making it accessible is priority number one. And making it really meet the needs of the communicators. Image Engine: I am at the phase to begin designing this website and figuring out what is important to be able to do on it and what is less important. I have an activity for us to do if you do not mind. Of course. These are functions that I think would be useful, and from viewing other websites. Did you make these? Either use different language, or find a way to explain terms.

I did. That’s great! I would like you to put these cards in order of the most important to be able to use to the least important. Okay importance,

Personalize libraries. Base libraries on each child, so you can pull up a child and see all his visual supports right there.

but not logic. Like I am looking at “register a new account.” I would not consider that logically first. How about this: If the site could do one thing, what would that be? Okay I will take a look. That is number one. I would want to find the images before I would want to download them. I am almost doing this more by logic than by importance.

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Create image collections. Yes! That might come first. I guess I want the website to do everything that I want. Upload would be like if I were Various people have to be in contact with each other. Can site facilitate that communication?

drawing an image from like another site? Yes. That could be whether you drew something yourself or if you found something that was open to creative commons that you could put into this. I guess I want the website to do everything that I want! So I was looking that these could be some external activities that could be useful if you could not find what you want. Right? This is for me kind of the outcome, too. And then I would go back and refine my collection. Because I use it for so many different purposes. I like the idea of a personal account, so that I could have my own collection. I don’t know what tag images means. Is that giving it labels?

How could tools be made tougher, but be easier than the lamination machine? Have someone else do it? Like Shutterfly?

That’s a web speak. The most likely place you would have done that is if you have a Facebook account. I don’t. Okay, well just as an example, when people use Facebook, they can look at photographs, and they can say “Oh, that’s my friend John,” and they can tag John. And that way, when anyone is looking at photos of John, that picture of him that you tagged will come up. So in this world, what that could mean is that, if you are putting up an apple, and someone thinks they could use that image in their lesson about lunch, then they could tag that image as “lunch”. And that way, when people search for lunch, that image would be there. Does that make sense? That makes perfect sense, and you know what I am seeing? You know what I think that would just be so powerful? Teachers need this, and I train teachers. When I think about what you just said, what teachers need is, they may have ten different kids that they see, and they need to have a library for each of those kids, a big database which, depending on what their needs are, they may be creating special libraries for them. And for them printing the image would be really important if they are going to be printing a book or putting images on a mobile device. And then dialoguing with their parents, this could be brilliant! Good! Some of this to me would be, you know, you have got to log in and register, request and upload, this would be like additional resources.

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Make site accessible to adults with autism to make their own tools?

So the idea is that you are building this database of images that could be sorted to different ways? Yes. That’s one thing. Would that be the collections? Sorting? I would imagine that some things cross over. I would say that the teacher might be doing a lesson in going out into the community. So they have images for that, but those same images might also be used for at home. So they are cross referenced. Right, so the images could make their way into multiple categories. This is cool! This could go a couple of different ways. They could be printed on a home printer on a piece of paper… One thing is that people want these laminated. And that’s because? When people use a communication system, kids are touching them a lot. So paper gets destroyed very quickly. And I actually think that that is a pain in the butt. I don’t know if there is a machine out there where you could print something and it is laminated. It doesn’t have to be laminated, just something that is about that thick. I don’t know anything about cost or difficulty, but what you see teachers doing is printing things out and then using these old fashioned lamination machines. It’s a lot of work.

This is absolutely key. The site has to serve this function of communication between individuals to collaborate with each other in the service of an individual child.

The other possibility is that you have a book of plastic cases, and they put Velcro on the back. How do you feel about the books? It depends what you are using them for. If it is a communication device, then I really like the mobility of an iPod touch and the iPad. But also teachers and therapists like to have images up on the wall of the classroom on boards, where kids can interact with them tactically. So they might have a schedule of the day, or they might have an activity to do up on the wall. So that’s pretty common in a lot of our classrooms. Everything is very visually oriented. So this could have two outputs.

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Do not focus on the problem behavior, but on keping things running smoothly.

The best thing in the world is when teachers and parents are on the same page and they can really communicate with each other about their child’s communication system. So everyone is consistent, the whole support team. I would say professionals and parents are your main target, most likely. There may be some adults themselves that use icons for themselves, but its probably the more sophisticated individuals. That might be someplace for you to go in the future. How might adults with autism use this? They need to have organizational systems for themselves, and they are very visually oriented. So someone could tell them they need to, for example, sign up for this class this week. And they may forget. So a lot of adults come up with their own systems or get support to make visual systems. And for some pictures are better than the written word. For others, the written word is better. It depends. But that is a whole other avenue because you have to target that other group and find out what their needs are. How else could the images be useful? One thing I was thinking is that quarterbacks in the NFL have an armband with all the plays they could ever call on it. Do you think that something like this with images on the arm could be useful for kids? Some things like that exist as alternative communication devices. That could be very cool. I think it could be very useful if kids forget how to ask another kid how to play with them. And they could look at them like a cheat sheet. It would be so much more natural than carrying around the books. I think they do have some devices like that, such as bubble watches. Another teacher here specializes in Alternative and Augmentative Communication devices. Her name is Gloria Soto. She would know more about devices. I think that would be very nice. I think it would be nice for typical kids to have armbands, too, so they know how to invite kids with autism. It could become a fad! Is there anything that I am leaving out, that could be useful once the site exists? With the image collections, I am thinking maybe there should be categories.

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What kind of category system would be the most useful? I’m not sure. That’s what I think you should ask my students. But when I think of kids with autism, they have three main issues: communication, socialization, and, related to behaviors, I don’t call them negative behaviors, but behavioral issues related to sensory issues and related Visuals are easier to understand because you can take your time to understand them.

to their different way of thinking. So I like the idea of everyday life as one of the categories, because then its not artificial that you are looking at the problem, but you are looking at how does this person address these three areas in within getting up in the morning, getting ready for school, routines in life. And then new routines. That is how I used to do it. I used to make a lot of things. Before it became popular, when I was a special education teacher, I intuitively knew that the kids needed visuals. I used to draw a lot of things on the spot. Things would come up like, a bus did not come, now my child is having a complete breakdown. So I would draw an image for him to sit down, drink some water, calming kinds of things, and bus later. I actually went through a whole funeral sequence for a boy for his father’s funeral. It was just real life. Sometimes I worry that teachers get too caught up in academics and teaching what a symbol is rather than what it really means. So I am really big on routines. Schedules are big, and when something new happens. I don’t think that this is just for kids, because this is for kids who are visually driven, who may be very intelligent, and it will help guide them. But there are the non-verbal kids who rely on visual communication, so that in itself is a little bit more tailored to, how do you more actively initiate something? So if they are non-verbal they have to be able to ask for things, whereas for kids who are verbal, its more about the things that you said, communication, social, and behavioral routines. Yes, so there is also a part that is expressive, and there is also a part that is using the visuals as an internal guide for people.

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Can you give me an example? Yes. For example I had a student who is very verbal and can read, but she had a really hard time carrying our her plan and ending it, and carrying out her goals. So we would create visuals that would show her the steps. In some cases they were kind of like cue cards. Like “Stand up and move to the door,” “Line up with the other kids.” These kinds of things. And then after a while you start to fade them out, but it just gives them a jump start. She would say them out loud. We have a lot of kids like that. Part of the theory behind it is that it takes them a long time to process and auditory information moves too quick. It takes them a long time to process, and people are very impatient so people keep repeating it. And every time they repeat it the child has to start over. But something that is visual is not transitory like the spoken words. And most of them are very good visual processors. Is there any app that you think needs to be done, that you would like to see? I think that Proloquo is done very well. It just uses the wrong symbols. The big thing that relates to what you are doing is it creates that predictability for kids are very anxious without it. That is why visuals are so important for kids with autism. And routines are so important to them, and they don’t like to break their routines. If they go to a playground for the first time it’s scary for them. So they might have visuals that say, “this is what this structure looks like,” “This is where this many kids might come.” Just a thought! So then you are designing a space to make it accessible. To me the visuals are just so important. I learned it a long time ago, before I even started working with kids with autism, how aesthetic it could be. I worked in an international school in Germany, where they had Molas, which are beautiful animal designs from Peru that are very colorful. So children could find their Mola that linked to their classroom, and there was a theme that linked everything together. So they had diff​e rent classroom for each classroom. No one ever said to me go to room seven. They said go to the zebra room. And they had maps and you could find it easily. That is how I am envisioning the playground. And every school.

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User Centered Research Exercise 2

Unfocus Group

What

I visited a graduate level course at San Francisco State University on the topic of teaching children with autism, taught by Kathy M. Small. Most of the graduate students in this course were also special education teachers in classrooms and taught children with autism. Why

I wanted to see how teachers would categorize the images in order to maximize the usefulness of the search functions on Image Engine. Ultimately, users of the site will be asked to tag images to improve their searchability. I needed know how they would search for what they were seeking.

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Group 1

Group 2

> Iris (preschool) > Renee (K-5) > Dirya

> Jennifer H. (18 months-12 years) > Jennifer G. (3-15 years) > Sungmoon Y

Medication thermometer, asthma inhaler, syringe, pills, ice pack, syrup

Safety Wheelchair, helmet, floaties (swim), Seat belt, band aid, stop/ go, wait, nurse, help, hospital

Hygiene shower, shave armpits Body parts back, scents, heel, feet, mouth Relationships romance, sister, brother, family, husband, wife, grandparents, baby, aunt, uncle, nephew, niece Holidays and Celebrations Jack-o-lantern, gift, Christmas day, pumpkin pie, birthday card, balloon, New Years sign, Chinese new year, dragon, valentine, heart, Easter, eggs, bunny, July 4, flag, fireworks, St. Patrick’s day, green shamrock, hall owe en, thanksgiving, turkey, Santa, Hanukkah

Image Engine

Places Bank, Amusement park, church, School, Home, Park, Mall, grocery store, restaurant Activities Puzzle, fast (run) Swimming, ride bikes, baseball, sports, video games, reading books, computer People/ Occupations Old person, speech language pathologist, singer, teacher, doctor, dentist, mail man, police

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Group 3

Group 4

> Julia (Elementary) > Rachel (Grades 4-6) > Vera HS / FL (9-12)

> Matt (High school) > Scott (High School) > Adam (Pre-school)

Morning routines in bathroom shave, brush teeth, shower, blow dry hair, brush hair, wash face, take bath, towel, soap, wash cloth, tooth paste

Food Refrigerator, salt, store, utensils, actual food, people eating

Medical Devices thermometer, asthma inhaler, syringe, stethoscope, blood pressure, scale, ear checker Body Parts heel, mouth

People with Jobs dishwasher, teacher, mail carrier, garbage carrier, police man, fire fighter, CPS employee, Bat man Health/ Hygiene asthma inhaler, shave armpits, rash, doctor, washing hands, showering, nurse, Brushing teeth Nature woman, goldfish bowel, earth, exercise, class pet

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Group 5

Christy Teaches 3-5 year olds in a special day class.

Julie Leads film group for 10-18 year olds.

Michelle Behavioral aide for 3-23 year olds.

Shirley Teaches 13-18 year olds at Special Day/ Resource High School

Household items Also sink toilet, bed, TV, couch, toilet paper, towel, toothbrush, chair, table, kitchen, living room, bedroom, garage, toaster, stove, microwave, stairs, garage, mailbox, video game, computer

sports and recreation

self help Also Dressing, food preparation, sequencing events such as hand washing, washing hair, Daily living sequencing: laundry, cooking, tooth brushing

jobs

greetings Also speech bubble “hi”, two people conversing (speech bubble), person listening (cupping ear), “Good bye” (turned around waving), *appropriate spacing when conversing

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Group 6

Group 8

> Kate > Melissa > Maria (pre-K 4-5 years)

> > > >

Danger cigarette, fireworks, bonfire hot, cold, poison, crossing street, community signs Things in a home scoop, earth, salt shaker, candle, table, door, bedrooms, kitchen, TV, stuffed animals Health asthma inhaler, crutches, first aid cross, objects specific to disabilities, wheelchair

Nia (pre-school) Dayan (elementary) Emil (high school) Stephanie (elementary 3-5)

Directions left hand, no-speaking, hello, men’s toilet, time to go home, schedule, listening, bus Self-help money, check book, wheel chair, helmet, raised hand Things to do pepper, fast, puzzle, singer, Computer time, recess, books State of being lost, good, sweating

Community garbage collector, mail delivery, church, store, community helpers, places (parks, grocery store, police station)

Group 7 > Monica (pre-school) > Kate (K-2) > Hanaadi (infants and toddlers) Food Drink Thirsty, pancakes Hygiene/ Self-Help Getting Dressed, "I need help," clean up, wash hands Unlabeled Right hand, first place, full, stain, clean dishes, clouds Transportation car, travel, school bus, fire truck, bicycles, tricycles, boats, ambulance, police car Sports/ Recreation basketball, bowling Instructions/ Directions/ Commands Sit down, stand up, come to circle, stop

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54

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r T h e RCehsaept a rech

U n f o cus g r o up

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User Centered Research Exercise 3

Observation

What

I visited three schools in the course of my research. The first was The Anova Center for Education in Santa Rosa, where I observed a classroom of fifth graders and a classroom of high schoolers. The second was an elementary school in Richmond, where I visited a pre-kindergarten class, ad the third was another Richmond Elementary school where I observed a third grade class. Why

I wanted to observe classrooms in action. I wanted to see just how supports were being used with autistic students across all age groups.

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User Centered Research Exercise 4

In-Depth interview What

Scott is a graduate student at San Francisco State University. He is an advocate for students with autism, leading a weekly meeting group. He is also on the autism spectrum. I met with Scott on a windy morning at San Francisco State to talk about his experience growing up and finding success. Why

I wanted to learn more about the childhood experience of a person with autism, and see if he had any insight as to how I could make the site and the visual supports useful for children on the spectrum. Image Engine: To start off, will you tell me about yourself? Scott: Okay. I’m a 29 year old masters student in special education here at [San Francisco] State [University]. I am also on the autism spectrum, diagnosed at the age of three. I had a little bit of turbulence in elementary school, which was tough. But with accommodations I was able to become a college student. Eventually I graduated college. I took the seven year track, but I made it. Where did you go to school for under grad? Here at SF State.

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Do visual tools serve a role here?

Great! Yeah, actually I started at Santa Rosa Junior College and transferred here after three years. I ended up a geography major, but I was interested in a lot of things. I like foreign language. I was good in Spanish. I though for a while in my high school years that I might be a translator or something, or maybe something in the travel field. I also had other interests. I was interested in Political science. That was my undergraduate degree. Yeah. And I entered here as an international relations major. Ultimately I settled on geography because it nicely combined the physical sciences with the social sciences. I was always really interested in not only places but how places interact. I also considered the psychology major, so I was all over the place. I was always concerned that I would not be good enough at something, so I would try something else. Ultimately I settled on Geography. Borders are interesting because there are so many factors and so much history to those lines. One of my most fascinating classes was geographies of health. Where you study not only health care in different countries but also health issues in different countries and what factors cause that. What are the geographical factors, what are the social factors that cause that. Ultimately I suppose I could have found something in that field, but I was so frustrated, I just wanted to find something to graduate with. And at the time I had been in contact with Dr. Wolfberg and also Kathy Small. I’ve always been an advocate over the years, for myself and others. As part of my undergraduate I chose a cluster of courses in disability, which I thought was appropriate. I really liked those classes very much, and I felt a sense of community, and I ended up embracing it and I decided to pursue special education for my Master’s [Degree]. I also got a minor in Special Education. So you have studied Special Education, some as an undergraduate and now as a Master’s student. What can you tell me about how kids with autism are taught? Very good question. It varies depending on the individual, and of course the age. So if you are looking at very early pre-school, for example, you really only kind of know what that students abilities are going to be. So you try to stimulate their environment as best you can.

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Just doing well on tests will not ensure classroom success. Social skills are as important to teach as anything else.

What do you mean by “stimulate their environment?” What I mean by that is you try to engage them and find what their interests are. It is very difficult because of course they do not tell you, and they are of course off in their own little world. So you are playing a game of detective, essentially. It’s through those moments that you find a path in. It’s very worthwhile. What my mother did with me was, I was diagnosed with autism as a little boy. There was no way to know at the time that I would become the person that I am now. Back then my mother made a point to always take me wherever she went. She took me on all her errands. So I was in the car a lot. Even when it was difficult and I was having my tantrums, it would have been easier to have someone else watch me. She wanted me to be in those situations, so contextually I learned this. My mom didn’t come from any educational background, but she did a lot of research, and in the last couple of years I’ve read some of her notes and saw that, gosh, she really did her homework. It was very fortunate that we found a private pre-school—and back then autism was not very well known. They said they could handle all different issues and deal with [my having autism]. So I was very fortunate there. I had a lot of good support. My dad is a doctor and through his connections I wound up getting a diagnosis from UCLA. I entered special education in Kindergarten. I was in what was called a kindergarten transition class. There were about 15 students in the class with various disabilities. There was a lot of intensive intervention. I do not remember what it was, but whatever it was I did alright to the point where I transferred to another special education class in first grade that was closer to my home district. And actually I did very well academically. I was off the charts in terms of percentiles, and the aid there called me Mr. One Hundred Percent. So the issue back then was “Oh, he doesn’t need any help whatsoever. He can go to a regular class next year in second grade. So I did that and it was a total disaster. I ended up acting up because there were 26 kids and one teacher and so I got lost in the shuffle, so-to-speak. So I started to act out, and it almost became a learned behavior. I had issues where I would be sent to the principal’s office. It got the point where I was suspended a few days a week.

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You say it was a learned behavior because you…Well I think eventually I would say okay, I’m not liking the situation, and I can toss a fit and I’ll go home. What kid wouldn’t like that! Makes sense. Right. They never really wised up to that, so the school administrators were like, “what do we do now?” And their solution was to toss me out of the district. They sent me to a county run class for emotionally disturbed students. This was back in 1991, ’92, thereabouts. Still we have issues today, but the attitudes back then [were really extreme]. How much change has there been since you were a kid? Dramatic! Dramatic. Remember to avoid things that make a child seem more different. How can visual tools “fit in” to what other kids are doing?

I’m dragging my feet here, but in third grade, I struggled. In fourth grade I moved into the Severely Emotionally disturbed class run by the County. Eventually I did very well and ended up being transferred back to my home district. I went through the fifth grade twice, and the second time was in a regular education class. It was the first time I was in what I would consider an ideal situation for anyone on the spectrum which is to be in a regular class where possible with one-on-one attention. And that aid can also help other students as well. That way it was not as stigmatizing or labeling. I was in all regular education in sixth grade and ever since with varying levels with an aide. In Junior high school I had one period with the aide one-on-one where we would talk about what was making me stressed out. I would worry about very little things that were not really important to worry about. So that was helpful to meet with the aide? Yeah, absolutely. It sort of grounded me. At the time social skills were

Social skills are challenge for many people with autism.

not a strong point. At the time I had gotten myself isolated. In the past I had gotten some ridicule, what-have-you. So it was my defense mechanism to avoid other people. Eventually I became more acutely aware of social issues and more interested in addressing them. When I was in middle school I did very well [academically]. I thought of myself as an academic and I was almost disdainful of other peers and really did not understand the social aspect of it.

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By tenth grade I really started exploring what does it mean to interact with others. That’s not to say that I didn’t have some friends. But were they very close friends? In Junior High School, probably not. By 12th grade I had no aide. It was a staffing issue, but also I did very well, to the point where I transferred to Community College. I graduated High School in 2002 and started Santa Rosa Community College that same year. There was tremendous growth in Junior High School. By growth do you mean personal growth? Personal growth and also the ability to handle certain situations and to learn social reciprocity. So what does it mean to have a conversation? How do you understand that someone else is interested? How do you start a conversation and not just talk about something that interests you. Not purposefully, but not even knowing that the other person might not be interested. Did that come to you at that point, or were you studying it in some way? No, it didn’t. Actually I had one aide who was particularly helpful, and he wrote a couple of short two-page essays, and I give him credit. I had learned some things over time on my own and with my parents and other aides. But a couple documents he wrote about how to make a friend and how to be a good friend were really interesting. It was stuff that was obvious, but it was like, aha! that is how it works. Okay now how do I go about this? So that was really eye opening. And to be able to sit down and read it. Right! That too. That is a good point. You can go back, read it, read it again, think it over. Whereas if someone is telling you these things it is more like “Yeah, Scott improved his understanding of social skills by studying a written document.

yeah, okay. Oh, what did he say?” So you raise a good point about visual notes that are with you or even audio recorded notes in this case. So that was sort of an Aha! moment for me. Going back to growth, that is both growth in being able to handle stressful situations and being able to understand social situations. Those have all been works in progress and I still have my occasional slip-ups. But don’t we all!

He had to learn social reciprocity in different ways

I had an apartment down here [in San Francisco] for three years, so I did live independently for sometime. So that was useful. Also I could not have commuted here [from Santa Rosa] five days a week.

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How did you like having your own place down here? It was very nice. I found a very nice sense of independence. I was not the best cook, was another issue. I didn’t cook, I would prepare. But I guess that is like most college students. I know that at any point if I were ready to go back out on my own it would be no issue. For a lot of people on the spectrum there is no guarantee that will ever be the case. So you are out of school, you are doing well, you are in graduate school. What skills would you say are important for kids on the spectrum to acquire before they reach adulthood? That can be kids who are academically stronger like you were, or ones who struggled more. I think in any case, universally, is the ability to cope with stressful situations. People on the spectrum by nature do not like unpredictability. But let’s face it, life is full of unpredictability. There is no avoiding it. I just hope that whoever is struggling they do not Routines make things predictable. Routines are super important.

have a meltdown situation that could put them in danger. For example being in public and running out into traffic. Or heaven forbid someone gets in trouble with the police. Or someone gets stressed out about what someone else said at a high school or college class. So how do you handle stuff, because there is going to be things that upset you. How do you deal with that? How do you deal with those emotions, which are already difficult? And try to deal with concepts such as “internalize," “take something personally," “not take something personally.” I mean, that is very, very loaded. And if you are someone who has more of a deficit, how do you deal with that? I do not have the answer. What I mean to say is, knowing that stressful situations are going to come up, how do you approach them? In a positive meaningful way. I think that is the number one universal skill. I can remember times when I first started college that I saw problems and did not know what the heck to do and freaking out. I remember my first English class. Oh gosh! We had to read a chapter and then talk in front of the whole class of 25 students. Oh my goodness, I went off the roof! I did not want to talk and they would call on me and I would say “Later, later!” And I would walk out of the room. The obvious distress was there. But I was so fortunate to have what was one of my favorite

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instructors. When I arranged to go to his office hours to give him my accommodation letter, he was very welcoming and he said I know this is very stressful. There are ways we can work with this. You are able to do much more than you think. He set me up with an academic tutor. I think for English it is especially important to have this. There is very symbolic language. For example, “hold your tongue” as opposed to “don’t talk.” That kind of symbolic language is very challenging [for people on the spectrum] and I think for me more than others. Does symbolic language need a visual representation of its own? Is this a category to itself?

Now for me, I had trouble really seeing creative pictures, and that is why art seems like the most unlikely subject for me. Some others like Temple Grandin do very well in a picture focused way. What did your teacher help you do in order to talk in front of the whole class like that? Even when I was doing well academically in High School [public speaking] was never something I liked to do. I still don’t like to do it, but I do it. It’s something that I didn’t get used to until later in

Then one goal has to be to make unpredictable situations more easy to predict.

college. I’ve practiced it and I’ve gotten so much better in the special education department. Even though talking about autism can be a very difficult and complex thing, it’s just something I’ve gotten used to over time. You told me you lead a student group here at SF State. Can you tell me about that? Yeah. I had been working on my Master’s project here and my goal is to create a field manual for incoming student to point out the resources and challenges that students might face. And at the same time to provide information for disabilities specialists who may not know much about autism. There are so many disabilities, they deal with everything from deaf and blindness to mobility. They may not understand that when someone is coming in for their intake interview that if they are looking down and pointing out “Oh, I like this little clock you have here. Do you know what the gears are made of?” And they are like, what is this person’s deal? And that would be a sign. Right, and there might be cues that they can use.

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The group itself has been very interesting. We have about six students so far. We meet every Monday from twelve to one and we talk about different things that we find interesting or that are bothering us or different challenges or different things that we have seen in the new that are interesting. Today we actually had academic technology come in to show us a new pen that is really cool. I’m very encouraged by technology, and encouraged by other projects such as the one you are doing. We don’t know what it will all lead to, but its all very worthwhile stuff to experiment with when you see what works and what doesn’t. What works for one student is not necessarily going to work for another. That is why autism is so interesting. No one kid like any other. I mean, yeah they all have some basic characteristics in common. They have trouble with social interaction. They have trouble with stereotypical behavior, they have trouble with certain [obsessive] interests. But the similarities virtually end there. They all have their different interests. Some desperately want to have friendships, but don’t know how. Others don’t want anything to do with it. Some never learn to talk, and some not only learn to talk, they can go on and on. Some are savants, and can calculate up to ten or twenty digits. I can’t do anything near that. I am just your average person. In terms of someone on the spectrum, on the very high end. Probably 98th, 99th percentile. But again, trying to find something that works for a student, it is the most frustrating thing, because no one thing works for all students. You know, that is something that I have run into time and again with this project. Yeah, and it’s like, how can you call this the same disorder or the same condition? That is kind of how I got to this project as it stands was realizing that everyone needs such different things, that maybe the best thing would be to have all of these tools in one place. And of course for someone who is not visually inclined, it is not going to be useful. But for those who read, for example, you could make words out of those pictures. So that might be another way to adapt this project, perhaps for a portable device.

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I n - D e pth I n t e r vi e w

Another thing that happens in particular to those who are higher functioning, they are acutely aware that something is different about Address what is in common, customize for the differences.

them. They don’t know how it is they can change or if they can change. People get depressed when things are not working out well for them, right? So depression is a common coexisting issue that will come up for many – usually higher functioning – people on the spectrum. So social work and social networks and having a psychologist to see once a month, is really very important. So would the terms surrounding going to see a therapist — and I am trying to apply this to what I am doing — would there be a purpose to having images to make those terms more clear? To help people talk about their feelings? Depending on the person, possibly. I don’t know that I would find it useful, but that is different. I have also found that situation very useful to think about social skills in my head. To think “why are these issues happening? Is this about me? No, its not about me.” To imagine what someone else is thinking and dealing with. You kind of put this together to know that you can only do so much.

This is interesting. Should this address depression in some way? Should people connect to their psychologist over Image Engine?

Temple Grandin considers herself a visual learner, and I know that you said that does not describe you. I’m more linear. Good. So what kind of learning techniques have worked well for you? Taking systematic notes, recording things, and playing certain things back where it is not clear. Writing things down and reading. When I have the time to read, I do very well. When I am not distracted listening I also do well. But the pressure of having to get it in one shot is enough to shut anybody down. So do you bring a recorder to every class? Not so much anymore, because I am in a lot of discussions now where a recorder would not be that helpful. But yes especially for a lot of my undergraduate courses I did, and then to a lesser extent in grad school. So yeah, making it linear and visual. I think math is one area that can be particularly interesting to look at. Especially if you look at math and geometry. They take two different skill sets. Algebra: I’m great at. Geometry: I don’t have a chance.

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Because geometry is about…Geometry is about certain spatial relationships. You can draw a cube, and I don’t see a cube. I see lines. I know the cube is there, but to see something that is flat as 3D is a little harder for me. I’m the opposite. I was great in geometry and weak in algebra. And someone else on the spectrum might have the complete opposite situation. Similar to you. So I think math is something than can give clues about a person’s learning style. Scott is at a big advantage over people on the spectrum because of his great reading skills.

Well it is interesting that you found your way to geography, because that seems to be so much about spatial relationships. Well it is spacial, but it does not have to be. You can talk about social geography as a particular area. You could talk about the social geography of the Philippines. English and figurative language were never strong ares for me, but I am a great writer. But I’ve gotten better at it. I used to write very literal papers. Then I worked on being more symbolic. I still don’t use much symbolism. I have some reflection in there, but it is mostly factual. Imagine a teacher who is just getting a student with autism for the first time in her class. Is there advise you would give to someone ho is new to this? Yeah, a couple of things, One is that your patience is going to be tested more than you ever thought that it could. And that different strategies are going to work on different days. And you are going to have to have as positive an attitude as you

Image Engine can do this. It can link people together to facilitate communication.

can. And be willing to try different things. Definitely talk with other people. Collaboration is essential. Just because something goes wrong one day doesn’t mean it will go wrong again. If you see a pattern that is consistent, you may not want to do something anymore. Like for example finger painting. I am very tactile-ly averse. I would hate to paint with my fingers, it would drive me nuts. Other kids might love that, even though they are on the spectrum. So if you were to take me in kindergarten and tell me we were going to go finger painting. I would say “No I don’t want to!” You start to see a pattern there. You would want to say yeah, we should give him a paintbrush.

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I n - D e pth I n t e r vi e w

Another person in this case would be a classroom aide.

Know that the student is going to need a lot of one on one time. Probably more one on one time than you have. If you have the support of another person that is ideal. But if you don’t, well then gosh, my heart goes out to you! That’s reassuring. Yeah, your patience is going to be tested. You are going to want to build structure for any student who is on the spectrum. Most important to them is not playing a guessing game about what they are going to be doing that day. To some degree that is unavoidable. They don’t like surprises, they don’t like thinking they

Reliability ad predictability. Make these easy to show, visually.

are going to be doing one thing and doing another. They don’t like particular assignments where the idea is “I’m not going to help you, let’s see how much of this you are going to figure out.” With that you are probably going to have a few students on the spectrum melt down under that circumstance. That’s not to say you can’t do that, but if you do you had better have some supports around.

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User Centered Research Exercise 5

Experience prototype What

The “Experience Prototype” was a group I created on the photo-sharing website Flickr. This website allowed me to upload images and share them with other members of the group. Why

I wanted to get an impression of how people would use the Image Engine website. Would people want to share with each other? Would they upload images used in their visual supports for others to use? Would they “tag” images with search terms? I wanted to begin with a basic prototype to see how users may use the site.

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Seven Key Insights In order to make Image Engine effective for the end user, I did extensive research with teachers and parents of children with autism. I refined my research into seven key insights that drive and inspire the shape and functionality of the Image Engine project, across its various touch points. The following pages show the seven insights.

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1

Every child is different. There is a common expression in

others prefer line drawings.

For this reason, visual supports

autism circles that goes, “If you

Some favor the color red, while

must be customizable to the

know one child with autism, then

others may be distracted by any

needs of the child. The people

you know one child with autism.�

color at all. Some can read and

closest to the child must be

This is because every child with

understand common symbols,

able to have control over the

autism is different, a fact that

others cannot. For this reason,

substance and the appearance of

even pertains to their response

the visual supports must be

the visual support, ensuring that

to visual supports. Some children

different for every child.

the support matches up with the

respond better to photographs,

individual needs of the child.

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2

Just the necessities.

Sensory issues are one of the

For this reason, classrooms are

For this reason, extraneous

core issues of autism, which

decorated in a way that minimizes

information will be eliminated

means that people with autism

bright flashy images, especially

from the visual supports used

can be very easily distracted and

characters from known movies

in Image Engine. Images will be

overwhelmed. According to a

or cartoons. Many children and

culled so that they only display

man with autism who I heard at a

adults with autism wear strong

the information that is essential.

conference, “Neurotypical people

noise-blocking headphones to

This will limit possible distrac-

can handle the bandwidth. We

drown out distracting noise.

tions which could interfere with

can’t.”

the visual supports.

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3

Must be easy to use. Parents and teachers of children

Parents of young children are

Essentially, the site will be

with disabilities may be among

busy in general, and those who

built so that every action can be

the most busy people on the

have a child with a disability such

achieved while their is a child

planet. Every potential action

as autism are even more thinly-

having a tantrum in the room.

must be achievable within the

stretched. Users must never be

This may be the only time Image

fewest number of clicks possible.

asked to read long bodies of text,

Engine gets from its users and

and it will be assumed that they

that will be just fine.

may be partially distracted when using the site.

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4

Consistency, consistency, consistency. The most important aspect of

His teacher tried an experiment.

Alex’s teacher made additional

using visual supports is that there

She printed an illustration of a

copies of the “no vacuum” symbol

are used consistently. The symbol

vacuum with the universal no

for Alex’s parents to use in the

for going to the park, for example,

symbol (a red circle with a line

house, where they had the same

must always be the same. It cannot

crossed through it) over it, making

problem. Because the symbol was

be a picture of a slide one day and

a symbol for “no vacuum”. She

the same, Alex understood that

a picture of a swing the next. To

attached Velcro to the back and

the vacuum in his home would also

illustrate this point, consider a child

attached it to the vacuum cleaner

not be used, and so he did not have

I came across named “Alex.” Alex

in the classroom, and she did not

behavior issues around the vacuum.

was terrified of the vacuum cleaner

run the vacuum so long as this

According to Alex’s teacher, this

being used. This may have been

symbol was attached. Alex learned

symbol could be used anywhere else

because the loud noise bothered

the pattern: the vacuum with the

with the same beneficial result.

him or for some other reason,

symbol on it was not going to be

we cannot know for sure. In any

turned on. He quit having outbursts

event, if he was in a room with a

in response to the vacuum cleaner.

vacuum in it, he was completely

The image had to remain consistent for it Alex to remember it and for it to be effective across different platforms. In this way, it is impor-

distracted by its presence even if it

tant that a symbol for the same idea

sat unplugged and unused, the mere

remain the same, whether it is used

presence of the vacuum was enough

at school, at home, at grandma’s

to drive him into a tantrum.

house, or anywhere else.

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5

Materials must be tough. A common complaint I heard

Some teachers used lamination

Cardboard would be a superior

when speaking to teachers about

machines to laminate their

substrate to either paper or

their visual supports was that

supports, making them tougher.

printed paper. Image Engine will

they were to flimsy. Teachers

However this had its own

establish relationships with

generally print visual supports

problems. Many schools do not

printing vendors who can produce

on their home or school printers,

have a reliable lamination

supports on more durable

using regular paper and cutting

machine, or cannot afford to use

substrates such as cardboard.

them out with scissors. Students

one frequently. Also, the tactile

Community members will be able

would often crumple up these

quality and sharp edges of the

to build a shopping cart of images

supports, and general ware and

laminated paper creates a

suitable for a particular child, and

tear would break them down

distraction for may children with

with a few clicks with their mouse

quickly so that they often needed

autism, who are often sensitive to

have a vendor produce and send

replacement.

tactile stimulation.

them the desired visual supports.

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6

The iPad is a game changer. Within the autism support

Because it is such a visual and

With the right organization,

community there is a great deal

intuitive device, and because it is

users can pull up any image they

of excitement about the iPad

so easy to transport, many people

can think of, without searching

and what can be done with it in

believe that it will make visual

through many pages. The iPad

support of children with autism.

communication that much easier

makes this a very exciting time to

with children with autism. It will

be working with visual supports.

allow people to carry potentially thousands of symbols without having to carry a heavy binder.

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Engaged adults must work together. In talking to teachers and autism

page.� Teachers greatly appreciate

The structure of Image Engine

specialists, it was clear that a

having open communication

will allow parents, teachers,

child’s best shot at improving

channels to parents and parents

therapists, aides, and other

communication was when all

do as well.

adults who work with the child

the adults in his life worked

to communicate over the site.

together. Children benefitted

The site will provide a forum for

when everyone was “on the same

them to discuss and improve their support of the child.

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Part three

The response

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Image Engine will improve the way visual supports are used. They will become more consistent across all places in a child’s life because all of the people who know him or her best will have a place to work together to determine the best supports for the particular child.

A visual support is a tool that is used to communicate an idea or concept to a child with autism. Because children with autism tend to be strong visual learners, this can be a very effective way of creating predictability and stability in a child’s life, and can even be the building blocks of speech for children who are non-verbal.

Autism is lifelong impairment in the way a person processes information. Children with autism generally need additional help in understanding the world around them.

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Image Engine is an online platform to share and improve visual supports for children with autism.

Users can share visual support images with each other by uploading and downloading them from an open source library. The images in this library will be tagged for easy categorization and searching.

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Research Conclusions

Every child is different.

Just the necessities.

Supports are fully customizable using an entire library of images, based on their child’s needs.

Users will be instructed to upload images with minimal excess information, favoring line drawings over photography.

Must be easy to use.

Image Engine

Website will be organized as a web app, making a direct route through the most commonly used functions of the site.

J o r d a n C l a r e - R oth e


Consistency, consistency, consistency

Materials must be tough.

“Support circles” will enable users to share visual supports so that the same ones are used at school, at home, and at grandma’s house.

A partnership will be established with a third party vendor who will take orders for visual supports, print them on hard cardboard, and ship them to the user.

The iPad is a game changer.

The Image Engine mobile application will have all site functions, allow users to carry their image Libraries with them, and pull supports up on the go.

Engaged adults must work together.

T h e R e sp o n s e

Children’s pages will serve as a forum exchange ideas and keep track of what approaches are working for each specific child.

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Mobile application A key touch point of Image Engine is the mobile application. Using an iPad or other tablet computer, the user is able to access the Image Engine image library and build supports, customized for an individual child. The application has three major entry points; my images, my supports, and my children. This allows the user to access their saved supports quickly and easily. From the tablet, the user can show a visual support to a child on the screen. Alternatively, for a more permanent support, the user can print from their own printer or for larger, more complex supports, elect to have the them printed remotely and shipped.

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fa Q

E x pa n d c at e g o r y

View image

New c at e g o r y

new image

S e a r ch

Add

s e a r ch l ib r a r y

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Image Engine mobile application wire frame

Ab o ut

R e g ist e r / lo g i n

Images

supp o r ts

Kids

Kids images

Kids supp o r ts

A d d ki d

E n t e r typ e

new image

I n d ivi d u a l supp o r t

Enter Name

sta r t e r

S e a r ch

New

View

Replace image

s e l e ct avata r

Add

From my images

S av e S upp o r t

Fa c e b o o k

Tweet

Print

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Vendor

Email

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The mobile app has three navigational starting points; my visual supports, my images, and my kids.

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Mobile devices are not only used to build visual supports, but also to show them on the go.

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Website

Another touch point of Image Engine is the website. The web will allow users all the functions of the mobile application with some additionally features. Users will be able to build supports from the Image Engine image library. They will also be able to connect with their community by creating “support circles� of people who know the same children with autism, so that they can collaborate on support for a child even if they are not in the same place. Significantly, they will be able to upload their own images from their computer or from elsewhere on the web into the image library, so that the people who use Image Engine will also keep it populated with a robust set of images.

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The Image Engine website allows users to connect with each other and share supports and images.

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If the proper image is not available to a user, she can upload it from her computer or elsewhere on the web.

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Physical forms

A third touchpoint of Image Engine is the physical manifestations of the supports. The website and mobile application will allow users to create hard copies of supports to use in their homes and classrooms. They can do this either by printing supports on a home or workplace printer, or by using an Image Engine print service. Printing from home is free of charge and immediate, while printing through the service has other its own advantages. Users will be able to create supports in large sizes, and image cards on tough board that can stand up to the wear and tear of repeated use by several young children. For a reasonable fee, the Image Engine printing service will mail these to the user in a couple of days. Whether printing at home or through our service, teachers and parents can have physical editions of their visual supports.

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Brushing my teeth

1

Put toothpaste on the brush

2

3

brush teeth for 90 seconds

rinse the brush

F o l d H e r e I F lo g o I S d I S T r a C T I n g To C H I l d

www.image-engine.org

Jackson’s day bus

circle time

playground

snack time

www.image-engine.org

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reading time


Top Image Engine users can build customized supports and print them at their home or workplace. Bottom Other visual supports can be ordered directly from Image Engine and shipped within a few days.

playground

snack time

circle time

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bus

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Image Engine users can have their image cards printed remotely and shipped to them. Image cards are mounted on thick board and are sturdy enough to endure daily use by several children.

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Image Engine features an open source library of images. Users of the service upload their best images from their own computer or from elsewhere on the web.

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Features & functionality The touch points of Image Engine, including a website, mobile application, and physical materials are designed with the user in mind, to address the needs of people who work and spend time with children with autism. It is designed to create a collaborative community that continually builds and improves a library of images to be used in visual supports, as well as a system to build images into visual supports across a range of media. Open Source Library Image Engine provides an open source library to its users. An open source library is a body of work that has many contributors and is freely distributed. Both the workload and the rewards are shared by a community. A well known example of an open-source project is Wikipedia. At Image Engine, any single user can upload an image to be used in a visual support — either artwork from her own computer, or, with proper attribution, images from anywhere across the web. The system trusts the user to know what sort of images will be effective with her children. Once an image is in the library it can be used by any other user for his children’s visual supports.

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Image diversit y In all areas of life, there is great variation in kids with autism, and picture recognition is no exception. Some children understand the specificity of photography better, other need the simplicity of line drawings. Some children enjoy color while others are over-stimulated by any color at all. The same image will not work for all children, and so the image selection must be made by those who know the child best.

Different children respond to different kinds of pictures so Image Engine includes several kinds of images.

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Image boards store the images that work well for a particular child.

Images Images are the basic elements of visual supports for children with autism. Illustrations which symbolize a specific meaning, in a way that is recognizable to the child. Images are the basic unit that makes up the modular visual supports. To use an analogy, if visual supports are the meal, then images are the ingredients. Visual Supports The core function of Image Engine is to create visual supports. Visual supports are specific structured combinations of images used to communicate ideas, commands, phrases, schedules, and actions to a person with autism. Visual supports can take several forms, and this site will focus on daily schedules, image exchanges, calendars, checklists, first/ then charts, and task steps. Because children with autism generally struggle with auditory input, and are good at receiving visual input, visual supports can be greatly beneficial in the classroom and at home to provide structure and communicate to children with autism. Image Boards An image board is the web space where all of a child’s images are stored. All members of his support circle can post images to the image board. These images then become the ingredients for a child’s visual supports. Images from the image board can be dragged and dropped into place onto a visual support (such as a task list). Because every child is different and responds well to different styles of images, this allows the people who know the child best to select the images that will work for him.

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User pings remind the community to participate

User Pings In order to encourage users to return to Image Engine and use the site, the site will occasionally “ping� them with e-mail messages. When a member of their support circle has uploaded a new image or created a new visual support, for example, the user will receive an e-mail. This will help remind users about the site and will keep them coming back. Karma Karma is a way of tracking how active users are on Image Engine, and to encourage users to contribute to Image Engine. Users are granted Karma points for making positive contributions to the site, such as uploading images, providing feedback on images, and tagging images. Each of these actions benefits the overall use of Image Engine, and Karma is a way to let users know their actions are appreciated. A color coded system of hearts will make easy reference to how many karma points a user has built up. Image Ranking Once a user has used an image in a visual support with his child, he will be encouraged to rank the effectiveness of that image, that is, how well the child was able to understand its meaning. Through an easy system of ranking, Image Engine will keep track of which images are more and less effective, and be able to encourage users to use images that have received high marks in their visual supports. More highly reviewed images will show up higher in a search query.

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use Images

with kids upload Images

Give feedback

Mechanisms within Image Engine create a virtuous cycle in which the community uses images with their children, provides feedback on their effectiveness, and return to improve upon the images.

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Support Circles Image Engine organizes its users into support circles with an individual child at the center. A support circle is a small social network of two to eight people, and it allows a group of people who all work with or are related to a single child to contribute to that child’s image board, using an agreed upon and consistent set of images to create that child’s visual supports — as well as send messages related to the care of the child to the whole support circle or to an individual member. Messages arrive in user’s e-mail accounts. Imagine Jackson, a bright six-year-old child on the autism spectrum. Jackson has several adults concerned with his education and ability to communicate: two parents, a classroom teacher, a classroom aide, and his speech language pathologist. Jackson receives the best support when all of these adults are supporting him together, when they are using the same visual language. Nothing is more important to visual language than consistency. Jackson has a problem with wandering away when he should not be. However, his speech language pathologist discovered that when there is a symbol on the door of a stop sign (downloaded from the Image Engine library), it helps Jackson remember that he is not supposed to leave. His speech pathologist shared this image with Jackson’s support circle, and so his dad put it on the door of their house, and his teacher put it on the door of the classroom. The consistency of this image being used in several different locations reinforces its meaning and helps Jackson remember to stay inside.

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User Scenarios

Julia

Julia is a pre-school special education teacher. She lives with a cat and a dog. She uses the internet most days, and most commonly does searches on Google and checks in on her friends on Facebook. Julia has been using Image Engine for three weeks. Today, she is visiting Image Engine to make a visual schedule called a first/ then chart for a five year old student in her class named Jackson, for whom she has already created an account.

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1

2

3

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1

Julia navigates to image-engine.org.

2

Julia logs in to her Image Engine account

3

Julia selects Jackson’s image board.

4

Julia clicks the plus to add a new visual support. 5

She selects to build a first/ then visual support. 6

Julia drags images from Jackson’s image board and drops them into the first/ then visual support. 7

Julia prints the first/ then visual support on her home printer and then tapes it to Jackson’s desk.

8

Julia has the option to share with other people. She can connect to them through Facebook, Google+, or email. Julia would like to share this schedule with Jackson’s parents. She has the email address for Jackson’s dad and she enters it here, which sends him an invitation to Image Engine and to be included in Jackson’s “support circle.”

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Raul

Raul is an engineer. He is Jackson’s father and has one older daughter. He is comfortable with the internet, but he uses it mainly at work. Raúl has never used Image Engine before, but he received an email from Jackson’s teacher asking to connect with her to be in Jackson’s support circle on Image Engine. He has tried using images around the house that a speech language pathologist recommended, but he has not updated them in a while for lack of time.

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1

Raúl clicks a link in his email that brings him to Image-Engine.org

2

Raúl signs up for an account by quickly entering a password and user name He sees that he has been invited into Jackson’s support circle by Jackson’s teacher, and he accepts. Raúl reads brief descriptions about challenge areas. He reads that outbursts — a behavior that Jackson has been having — is most often caused by a child not being able to predict what is happening is the world around him.

1

3

Raúl selects First/ then supports.

4

Raúl selects from the Image Engine library an image of a child waiting and an image of a bus to fill in this support.

2

5

He saves it to his visual support board.

3

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4

5

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6

6

A week later RaĂşl and Jackson are waiting for the bus together. The sign says that the bus is running late again.

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7

RaĂşl takes out his iPad and shows Jackson the support. Jackson understands that it means that they need to wait for the bus to arrive. Jackson does not have an outburst.

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Thank you

Special thanks to Edward Boatman, Beth Cain Curtin, Sarah Curtin, Caitlin Daly, Carolina de Bartolo, Phil Hamlett, Michael Kilgore, Pamela Wolfberg, Scott Rich, Rachel Selman, Kathy Small, Nathan Waterhouse, & Niko Villars. Without your help this project would not have been possible. Many thanks!

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bus

therapist

Visual support images are designed to convey meaning to children with autism

Brushing my teeth

1

Put toothpaste on the brush

2

Brush teeth for 90 seconds

3

Rinse the brush

Visual supports use images to provide children with autism control and predictability

What is Image Engine? Children with autism can greatly benefit from the use of visual learning supports. Image Engine is a platform for teachers and parents to share visual support images and build visual supports to the meet the individual needs of their autistic children.


Image Engine: Visual Supports for Children with Autism