Assistive technology (AT) includes a huge range of tools that can be helpful or even life-changing for people with autism. Defined under the Technology-Related Assistance for Individuals with Disabilities Act of 1988 (Public Law 100-407), AT can be any item that “is used to increase, maintain, or improve functional capabilities of individuals with disabilities.”
TYPES OF ASSISTIVE TECHNOLOGY FOR AUTISM
Assistive technology is usually divided into groups—low-tech, mid-tech, and high-tech. In general:
• Low-tech AT includes anything that needs no electricity; think weighted vests, sensory balls, or picture boards.
• Mid-tech AT is simple enough to be relatively inexpensive and easy to operate. Examples include battery-operated sensory toys, visual timers, and social skills videos.
• High-tech AT is digital technology and can include anything from augmentative communication technology for non-verbal people to robots built to increase social skills in children on the spectrum.
Because people with autism don’t have obvious physical disabilities, and many people on the spectrum are verbal, it’s easy to forget how helpful assistive technology can be. For people on the autism spectrum, assistive technology can help in many different areas of life including:
• Basic communication
• Reading, writing, and math
• Telling time and managing schedules
• Learning and using social skills
• Managing sensory challenges
• Staying safe
• Activities of daily living (managing household chores and self-care)
AT FOR COMMUNICATION
One of the most important uses of AT is in providing the means for people on the spectrum to communicate their thoughts and needs.
According to some estimates, as many as 40% of people with autism are non-verbal. While this number may be an exaggeration, a very large percentage of people on the spectrum have difficulty with verbal communication and virtually all people with autism have at least some difficulty with social communication.
At the low-tech end, there are low-cost, easy-to-use tools such as picture boards and picture cards, including those created by PECS—a highly-regarded organization whose products have been used in schools and by therapists for many years.
At the mid-range, there are apps for both augmentative communication and speech therapy. None of these apps were created specifically for people with autism—after all, there are many reasons why a child or adult might not be able to speak—but they are extremely useful and cost-efficient for someone who is unable to use expressive speech effectively.
Two examples of speech-generating apps include:
• Proloquo2Go by Assistiveware, which features over 10,000 words, is easy to customize for physical or cognitive needs and can be used in many different languages. Compatible with iOS; costs about $250.
• TouchChat HD by Prentke Romich Company, which provides English and Spanish options and allows the user to choose a voice that fits their personality. Compatible with iOS; costs about $150.
Apps for speech therapy are intended not only to substitute for the human voice but are also to help build speech and language skills. Two highly regarded options include Articulation Station and LAMP Words for Life.
AT FOR LEARNING AND EXECUTIVE FUNCTIONING
According to Autism Speaks, “31% of children with ASD have an intellectual disability (intelligence quotient [IQ] <70) with significant challenges in daily function, 25% are in the borderline range (IQ 71–85)." More than 30% are diagnosed with attention deficit hyperactivity disorder (ADHD) and up to 40% experience some level of anxiety. These issues, added to the core symptoms of autism (which include speech, social, and sensory challenges) create some significant issues in school and in the workplace. Most significant are: • Difficulties with processing spoken and written language (including challenges with some types of math such as word problems) • Sensory challenges that can make fluorescent lights, buzzers, and other ordinary noises painful and sitting still particularly difficult • Executive functioning difficulties making it hard to manage schedules, stay on task, and plan projects • Assistive technology can help with all of these issues, whether at school, at home, or in the workplace. Low-Tech
Low-tech options for handling sensory issues include simple tools for reducing anxiety and increasing focus, such as stress balls, worry beads, weighted vests, and standing desks.
For executive functioning, ordinary written planners, color-coded schedules, and visual reminders can all make a positive difference. Most children with autism do best with hands-on and visual learning, so manipulatives like Cuisenaire rods (which are also available in virtual form) and alphabet blocks are good choices for teaching academic skills.
Mid-range options are easily available and relatively low-cost. Some examples include watches with alarms, visual timers, sound-blocking headphones, and calculators.
For many people with autism, audiobooks and recordings can be a great way to replay lectures or instructions. Because many people with autism are very visual learners, videos can be a good alternative to written books or spoken lectures.
At the high end, there are many types of software and apps that are intended to help visual learners think, write, and communicate.
Some are intended for the general market; these include mind mapping software like Lucidchart which are used to make connections among apparently disparate ideas and turn those connections into usable outlines and other products.
AT FOR SOCIAL SKILLS AND COMMUNICATION
People with autism are very different from one another, but all share difficulties with social skills and social communication. For some, the challenges are relatively subtle; for others, even basic human interaction can be a struggle. Fortunately, there is a vast range of assistive technologies to help with these issues—some of which are very high tech.
At the basic, low-tech level, an industry has arisen around teaching children with autism (and adults with more severe challenges) to prepare for and manage new or complex social situations. Among the most popular are:
• Social stories: These short, simple, visual stories were first developed by Carol Gray and are used to prepare people with autism to think and behave appropriately in any situation. There are pre-existing social stories for common situations such as getting a hair cut or going to the dentist; therapists and parents can also write and illustrate customized social stories for unique situations such as starting a new school.
• Social skills cards and games: Many specialized companies have created cards and games to help build social skills. There are social skills games similar to Chutes and Ladders created to reinforce empathy; Uno cards focused on feelings; and dice games that are intended to reinforce social communication skills.
Mid-level technology for social skills focuses largely on video modeling and apps (though many video games intended for preschoolers focus on social-emotional concepts).
Video modeling is a tried and true technique for teaching social skills, and companies like Model Me Kids are dedicated to creating videos to teach everything from polite greetings to joining a conversation to asking someone out on a date.
Apps are more interactive and can allow learners to select areas of interest and actually practice their skills and receive feedback. The Social Express is a social skills tool for middle school learners with autism and related disorders.
Social skills teaching at the high end is truly techie—and can be extremely expensive. That’s because the goal is to create interactive artificial intelligence and robots that can literally take the place of human beings.
These tools are being used to help both children and adults build social skills in a risk-free, highly-interactive, and very intriguing way—and preliminary research is encouraging.4 A few of the more advanced projects along these lines include:
• Kiwi, a “socially assistive robot” created by a team of researchers from the University of Southern California that teaches autistic children both how to do math and socialize.
• QTrobot, created by a company at the University of Luxembourg, which is intended to “increase children’s willingness to interact with human therapists, and decrease discomfort during therapy sessions.”
• Human-shaped robots created at MIT to help develop social skills and empathy in children with autism.
AT FOR SENSORY CHALLENGES
Sensory challenges in people with autism can result in over- or under-responsiveness to sensory input. In other words, people with autism may under-react to physical injury but find school buzzers to be painful.
Sensory therapists seek to “regulate” the sensory systems using assistive technology while teachers, parents, and adults with autism tend to look for tools to deaden sound and calm the nervous system.
Most adaptive technology for sensory challenges is low or medium-tech. Therapists may use trampolines, swings, brushes, balls, and similar tools to help over-responsive sensory systems become less sensitive.
Classroom teachers and paraprofessionals often use noise-canceling headphones, weighted vests, and tinted glasses to help students avoid excessive sound and light. To calm the nervous system, teachers and parents may use ball pits, weighted blankets and vests, or “squeeze machines” to provide tactile input.
Apps are commonly used for sensory “breaks.” These tend to be simple tools that allow you to do things like pop bubbles, meditate, follow images with your eyes, or play repetitive music. While not necessarily created for people on the spectrum, such apps can be very helpful. A few such apps include:
• Miracle Modus
AT FOR SAFETY
Many children with autism, and some adults with more severe autism, are at risk for eloping (running away). Children with autism can be very good at manipulating locks, and even “babyproofing” may not be enough to keep them indoors.
Thus, in addition to ordinary door chains, baby gates, and latches, many families (and some group homes and schools) use ID bracelets and tracking devices to maintain safety.
There are a number of companies that produce ID bracelets, tags, cards, and trackers. They provide name, address, and contact info and, in some cases, automatically connect with first responders. All are quite similar, however, and the choice depends on your level of need and your budget
A few companies that make such products include:
• Alert Me Bands
• AWAARE: Autism Wandering Awareness Alerts Response and Education Collaboration
• Project Lifesaver International
A Word from Verywell
While it’s easy to spend a great deal of money on AT for children and adults with autism, it is rarely necessary. Most items required for schoolchildren can be requested through and paid for by either the school district or health insurance.
Even the most expensive apps cost only a few hundred dollars. And AT that is used for ordinary activities of daily life—paying bills, making grocery lists, keeping track of time, communicating with others—can often be bought at the stationery store (or the app store) for just a few dollars.