Category Archives: RPM

Learning to Communicate Changes Lives

Here is proof that learning to communicate changes lives. I get thrilled every time I hear how my book has helped others move to communication. Life misunderstood, isolated and silent is not an adequate result for  years of therapy and a parade of specialists who marched through this family’s house.

There are stubborn people who have to listen to us, but they won’t, I’m afraid. But there are open people who have listened.

Things are improving, little by little. Here is one family’s story.

Harder than It Looks: Learning to Type on a Letterboard and Keyboard is a Process

Guest Post

by Susan Finnes, with Christopher Finnes

My son Christopher is now 17. He is non-verbal and outwardly behaves in a way which would lead people to believe he lacked intelligence/understanding. The Rapid Prompting Method (RPM) has enabled Chris to show us, through pointing on a letterboard, that he is a creative and intelligent young man.

Ido has been an inspiration to us – his book particularly helped me to understand and to discuss with my son the issues he faces with his motor control/purposeful movement. When people see students like Ido using his iPad independently it is only natural that they aspire to getting their own children to this stage as quickly as possible. There is often a lack of appreciation of the amount of work that may need to be done before getting to that stage.

People say to me, “Why don’t you just get Chris to type straight onto a laptop?”- if only it was that simple! It is important to understand that the amount of time it will take to develop the pointing/typing skills will vary greatly between students and, as Ido has already explained in his book, the belief of the people who surround the student will also have a huge impact on progress.

I am sharing parts of our journey here primarily to help give some more perspective on this skill building process as, for us, it has taken a long time and is still a work-in- progress: — We first saw Soma in 2011 for six RPM sessions (and have seen her each year since then). Chris started pointing on the 3 large stencils and each day we saw how Soma built his skills through verbal and air prompts until he was able to point on the single A-Z stencil. We were also able to observe other students who were at different stages of RPM – some who had more motor challenges than Chris – some were already using iPads. It was clear that everyone had their own rate of progressing.

These first sessions were all a bit of a whirl wind. At the time it was difficult to fully appreciate exactly what Soma was doing and why – as a parent you find your emotions run high and it is hard to detach yourself and analyze what is happening.

It was hard to replicate Soma’s success at home. Chris was ‘all over the place’ – how had he been able to have a conversation with Soma? I had a small team of people working with Chris and we realized that we needed to first build our own skill levels before we could help him to move forward. How did we do this? – by analyzing and studying the videos of the sessions : how did Soma pass the pencil? What angle was she holding the board at? etc, We transcribed word-by- word Soma’s sessions –looking at how she phrased her questions and how she gave verbal prompts. Then we practised, filming ourselves, writing up our sessions in detail and giving each other feedback – continually setting improvement goals for ourselves.

Our learning never stops – constant analysis needs to happen even now as issues are always coming up e.g. Chris may spend time with his hand wandering around the board before getting to the letter he wants. When this happens we need to work out how to help him with the skill of getting straight to the letter.

One aspect of RPM which I feel is particularly important to appreciate is that it works using academics. Learning the skill of accurate pointing on a letterboard would be exhausting and tedious without a context. The teach/ask part of RPM lessons not only provides intellectual stimulation by giving Chris interesting information but also, when he is giving us ‘known’ responses, we can identify his motor challenges and the issues/skills we need to work on. We present a wide variety of age-appropriate topics – history, biology, physics, poetry, current affairs, art.

We also work on the skill of open communication – beginning with single words and gradually increasing to longer outputs. This is another important point – all of Christopher’s most creative and expressive work has been as a result of an academic lesson. There is a skill to this – we don’t just say, “now how do you feel about that?” We instead explore something related to the lesson and maybe discuss it in the third person eg. ‘if you were living in that era and writing a diary entry what would it say?”

– Once we had built up our skill levels on the stencil it was time to push Chris forward onto the laminated letterboard. This was after six months of practise on the stencils – (three sessions a day) and it was gradual transition – sometimes just a few letters on the laminate. At first we held this vertically and gradually began to tilt it. This process will vary greatly with different students -some need lots of ‘mirroring’ from one board to another, others can transition in a few sessions without a lot of help.

When you find a way to hold the board that works for your child at an angle that suits their ability to point accurately and have open communication it would be easy to stop and think you have achieved your goal. However this will always leave the child reliant on a skilled facilitator – I am always looking to move Chris on to the next skill to enable him to eventually become fully independent.

– So five years into our RPM journey Chris is currently pointing quite confidently on the laminated letterboard when it is held nearly horizontally. He can also point on a QWERTY keyboard which is held at a slight angle. He still needs verbal prompting to ‘keep going’ and his tolerance can vary greatly from day to day (he is also affected by some ongoing health issues).

We are working on his independence by mirroring words to either the laminate or keyboard flat on the table or held by him. I have learnt that it is not a great idea to compare Chris’s progress to others – e.g. some students can easily move from one board to another, some have the ability to ‘match’ so can easily touch a letter on the laminate and then on a keyboard. Chris, on the other hand, has to learn this all through muscle memory so requires continual practice and repetition – and lots of verbal/air prompting. I have helped other students to get started with RPM and learnt that every student is different and will progress at their own rate – so there is no rush.

Over the years we have done lots of skill work outside of the RPM academic sessions. I believe that all of these things also contribute to his improving letterboard skills. Skills have included physical exercises (including participation in Special Olympics events), horse riding, playing games, learning to draw, helping around the house.

Everything we teach is focused on helping Chris to move his body purposefully and independently. Each action has to be broken down into small component parts, explained and motor-modeled so his muscles can learn how the movement ‘feels’. Just to explain further , Chris cannot just imitate an action -I have to physically lift his leg, touch his thigh muscles telling him to engage them to show
him how to step over a hurdle. Then we have to practise, practise, practise and practice until he has the muscle memory to enable him to move onto the next skill – running over the hurdles (he can do this now!). I believe it is possible to teach him anything – but it will take longer than for other people.

In a recent discussion with Chris he wrote, “MANY PEOPLE
DO NOT REALISE THE IMPORTANCE OF BUILDING SKILLS. I DIDN’T REALISE THE IMPORTANCE MYSELF UNTIL I BEGAN TO WORK ON THEM. BUILDING SKILLS IN A VARIETY OF WAYS – RUNNING, SPORTS, CRAFTS AND GAMES – IS HELPING ME TO CONTROL MY BODY, LEARN NEW THINGS WHICH BRINGS ME ENJOYMENT AND HELPS ME TO BE ABLE TO BE PART OF THE COMMUNITY.”

Here is a short clip of us discussing skill building in relation to his pointing

IT HAS NOT BEEN EASY. EVERY DAY I HAVE TO PRACTISE.

How do you feel about using the keyboard/ipad?

IT IS HARD TO LEARN NEW SKILLS. I AM SLOWLY IMPROVING BUT IT TAKES A LONG TIME.

What Chris said above I can equally apply to myself. I am constantly learning with him, developing my own skills and know that I still have so much to learn. Some days it seems that the journey is insurmountable – but breaking it into small achievable goals makes it more manageable – one day and one step at a time!

No, I’m Not a Horse: A Refutation of the Clever Hans Comparison to Autistic Typers

This is a horse.

This is a human.

This is Clever Hans. He was a horse in the early 1900s who looked like he was doing simple math equations by stomping his foot. Turns out he was just picking up cues from his handler.

Horses have no innate propensity to develop language, understand complex language or communicate in language. I love horses, but they are horses, not humans. Humans have an innate propensity to develop language, understand complex language and communicate in language; therefore even humans who lack typical access to verbal communication because of a disability still have the capacity to grasp language (except in extreme circumstances).

Humans who are deaf develop sign language.

Humans who can’t speak verbally type or use augmentative communication.

Humans with Down Syndrome understand and speak utilizing the complex patterns of language.

So, why is it so hard for some professionals to believe that humans with autism have innate language capacity?

For example, here is a course in the Applied Behavioral Analysis department at a university (instructor’s name removed), which is described this way:

Ever since Facilitated Communication (FC) crashed onto the shores of the U.S. in the early 1990s, remarkable claims of sophisticated communicative abilities in otherwise nonverbal people with autism have proliferated. FC itself has morphed into other forms, including the so-called Rapid Prompting method. However, regardless of the name, all of these techniques have one thing in common: They claim to show that previously nonverbal people with autism are in fact highly verbal and expressive so much so that the diagnosis of autism is sometimes questioned. This is not the first time in history in which remarkable claims of communication have been made about nonverbal individuals. Perhaps the most famous case was that of a horse in Germany around the turn of the 20th century, named Clever Hans. In this talk, Dr. X describes the story of Clever Hans, including the experiments carried out by the German psychologist, Oskar Pfungst, which revealed the nature of Hans’ cleverness, and its lessons for recent claims of remarkable communicativeness in people with autism. Dr. X urges the same level of scientific scrutiny regarding these claims as with Clever Hans, and suggest (sic) that all stakeholders in autism should approach remarkable claims skeptically and scientifically.

I will analyze this paragraph sentence by sentence.

Ever since Facilitated Communication (FC) crashed onto the shores of the U.S. in the early 1990s, remarkable claims of sophisticated communicative abilities in otherwise nonverbal people with autism have proliferated.

When I was in high school I learned in my English class about loaded language intended to bias the reader. FC “crashed on the shores.” Its claims of success are “remarkable,” because the typed communication of nonverbal people is “sophisticated.” Ha ha. You see, autistic people thinking and typing is a joke already.

FC itself has morphed into other forms, including the so-called Rapid Prompting method.

Here RPM is lumped with FC , the method that “crashed” on our shores, in an apparent attempt to discredit it. RPM is actually a different teaching method than FC, and though it is referred to as “the so-called Rapid Prompting Method,” that is the actual, copyrighted name of the method.

However, regardless of the name, all of these techniques have one thing in common: They claim to show that previously nonverbal people with autism are in fact highly verbal and expressive so much so that the diagnosis of autism is sometimes questioned.

This sentence is packed with disinformation. Nobody questions the autism of people who type except for those who don’t believe that severely autistic people understand language. By their logic, if an autistic person types he can’t be autistic. This is circular logic.

My old ABA supervisor said exactly this about Tito Mukhopadyhay because he communicates by typing independently. He stims. He has every autistic symptom in the books but since he is obviously communicating sophisticated thoughts he can’t be autistic. Ha ha. What would his correct diagnosis be then, and why was he diagnosed with autism as a young child before he typed? It is intriguing that these particular professionals don’t question whether their understanding of autism is correct when someone with autism comes along who challenges their theory. Rather, they claim that it’s the person who is incorrect. My book actually explains pretty thoroughly what it is like having autism.

This is not the first time in history in which remarkable claims of communication have been made about nonverbal individuals.

No, it is not. How can we present autistic communicators as a joke?

Perhaps the most famous case was that of a horse in Germany around the turn of the 20th century, named Clever Hans.

By comparing autistic people to animals. How witty.

In this talk, Dr. X describes the story of Clever Hans, including the experiments carried out by the German psychologist, Oskar Pfungst, which revealed the nature of Hans’ cleverness, and its lessons for recent claims of remarkable communicativeness in people with autism.

As I mentioned, I think a horse is an animal with no innate capacity for language and a person with autism is a human with innate capacity for language despite being severely hampered by bad theories, bad instruction and a severe mind/motor disconnect. (For more information on the mind/motor problem, please see my essay Motor Difficulties in Severe Autism.

Dr. X urges the same level of scientific scrutiny regarding these claims as with Clever Hans, and suggest (sic) that all stakeholders in autism should approach remarkable claims skeptically and scientifically.

By all means, skepticism is good. I have dealt with and convinced skeptics for many years. Biased, hostile people are not skeptics, nor scientists.  (See Scientific Un-Query and More on Scientific Un-Query). By the way, people who have autism are stakeholders too, as are their parents.

Science is filled with stories of people who introduced new theories only to be treated with scorn by professionals who toed the line of the day, but the theories were ultimately  proven to be correct. Now we laugh at the obtuseness of the critics in these cases, but they actually ruined lives and reputations.

I’m an autism expert. I didn’t study it in class. I didn’t teach ABA to kids. I did however live and breathe it. I learned that experts and professionals can be well meaning but wrong. I learned that I, and others who type, have much to teach about the truth of the disability. My expertise is solely based on empirical evidence and anecdote. I never ran tests on myself. Nevertheless, I know my nonverbal autism inside and out. My autism is a mind/motor disconnect. It isn’t a language processing issue. It isn’t cognitive delay. It is a real disability, hard to live with, and mostly it is painful to be unable to speak, but not speaking is not the same as not thinking.

 

 

 

 

More from The Spectrum of Opportunity Conference, Parent Panel

Here is another great speech from the great Spectrum of Opportunity conference. Hopefully you can get encouraged by Duval Capozzi’s speech. I recently posted his son, Samuel’s speech, and here Sam’s father tells the story of from a father’s point of view. Importantly, he seems to have no interest in regret or in feeling down about the time his son didn’t communicate. Rather, he rejoices in the miracle of his son going from silent and unable to communicate and believing his son had no ability to understand basic concepts, to a son who types his thoughts and is now a freshman with a 4.0 GPA in a university. I hope that many parents take his message to heart and rethink autism.

Good afternoon! My name is Duval Capozzi, I’m Samuel’s dad, and I am in the honored role of being a Dad’s voice! As involved as I have been, I must say—most of these moms, my wife included are “Navy Seal Moms!!”

Samuel’s name means, “asked of God’, and boy, did God answer! He’s been our biggest blessing, and his life has enriched ours in incredible ways. We have delighted in him all the days of his life!

Samuel started to communicate using the letter-board and iPad at the age of 16 ½ in May of 2012. To some that would be late in the game while for others maybe not. Either way, it was perfect timing for us—perfect timing for him. He was so ready; he took off like a rocket! As far as I understand, his response to learning and implementing the method was quicker than most. I’m not sure why, but it was.

A year before that, my wife Kathy started to research and pursue RPM (Rapid Prompting Method) and suggested that we visit Austin, Texas and visit Soma.Now, at first I was very cautious and not as excited as her (tried many things and have spent lots of money on things that gave little results).

So we saved up, got on the list and made the trip in May 2012. Initially, we were hoping to get some novel phrases from Samuel—something that truly came from him, not something memorized. Boy, did we get the shock of our life!

While we were there, Samuel was able to share several personal feelings that we never heard or knew about him, and his communication started taking on a whole new meaning during that week. We were shocked. We are his biggest fans and advocates, yet even we had no real idea of what was going on in our boy’s mind. We knew he was capable of so much more than he was able to articulate or demonstrate, but we had no idea!

We came home and within two weeks, Samuel was spelling out simple conversations, explaining what his faith in God meant to him and that he wanted to get baptized. First things first!

He began asking questions about marriage/girlfriends. Could he learn how to drive? And he wanted a cell phone and Facebook account. We laugh because he was after all a teenager, but this is stuff we had no idea he either understood or cared about. We were continually surprised at what had been hidden inside of him. We sometimes still are. These are things we were resolved to not know…to never hear this side of heaven. Can you imagine our shock? Our joy? Our relief? We could ask him if he was in pain. We could ask him how he felt. We could ask him what he wanted to do, eat etc.!

Our understanding of him, of autism, and how to support meaningful communication with him was so misguided, was so wrong. As you can imagine, our hearts and minds were elated! Our life as we then knew it what was forever changed!

We have homeschooled Samuel since 2nd grade for a number of reasons. As he described, he went from VERY remedial math to pre- algebra from May to August of the same year. My wife sat with him all summer remediating and discovering any gaps that he may have had. In high school he took 3 years of Latin (Why) He said, “Because I want to be a lawyer!” Talk about a shock!

To give you an idea of where we were at this time, we had no idea that he even knew what a lawyer was. I think this is key—key because no matter which direction you go as a parent, educator, therapist or otherwise—just because someone is non-speaking doesn’t mean they are non-thinking. My son taught me that—in a new way—in a life changing way. He told us over and over that, “I was ALWAYS LISTENING.”

He was learning, as he describes as ‘incidentally’ all the time. How we think. How we act. What we expect from our kids and loved ones MATTERS. We won’t speak to our loved ones as if they understand if we don’t believe that they DO understand. We won’t invest in someone if we think they’re not understanding-they are. I hope this is a Take-Away for someone today.

Again, Samuel graduated high school last June and is nearly finished with his first year of college at CSU Channel Islands as a Political Science major. Samuel believes he has a calling in his life to be an advocate for those who have special needs, for those he believes are marginalized and misunderstood. He says “I want to be a voice for the voiceless” —I know what that’s like.

Frankly, for 16 ½ years Samuel was unable to tell us what he really wanted, what he thought, or how he REALLY felt. He didn’t have a voice. He was trapped. Now we can, and do, have deep conversations about life and his future. It’s priceless.

As you can imagine, it has been such a healing time for him and for us. This has made an amazing impact on our son’s quality of life and on our family’s life, and I am so glad I listened to my wife and went to Texas back in 2012.

He still deals with the various trials of having autism, living with a diagnosis of autism is very difficult for most people. But now he can learn and communicate like others even if in a slightly different way.

I truly hope this has helped some of you to understand our son’s journey to meaningful communication. What a joy to be sharing our Samuel and his breakthrough with you today!

*Afterthought- not every person’s response will be exactly as my son’s was. Nonetheless, searching for a reliable means of communication for your loved one is important.

 

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Challenging and Changing Perspectives

By Edlyn Pena, guest blogger
As a researcher who studies ways to support the access and success of students with autism in higher education and a mom to a handsome six-year old son who uses an iPad to communicate, I aim to help Ido advance his message to educators, professionals, and caregivers. My objective here is to provide context and encourage you to learn more about approaches that enable nonverbal individuals to spell and type to communicate. I’ve received criticism for endorsing approaches like Rapid Prompting Method (RPM) because they are not evidence-based. There is still much speculation in the autism community about the legitimacy of RPM and other approaches that teach pointing to letters and typing. Research on these methods are lacking. I understand that professionals will continue to question these methods until they are rigorously studied and published in peer reviewed journals. I am the first to believe in well-designed research studies. As an academic, I also believe in being open to new possibilities, ideas, and presuming competence in individuals on the spectrum. Without this openness, I would have never exposed my own son, Diego, to RPM. He would not be where he is today with regard to sharing how autism affects him daily (e.g. “Paying attention is tiring”) and to articulating unusual ideas (e.g. “Eight elephants play in a new kind of ecosystem”). I would not know the level of depth of thought and curiosity hidden in his mind. Diego’s voice is now being heard.

Ido is a pioneer in advancing our knowledge about autism and people with complex communication challenges. Ido’s book, Ido in Autismland, is by far the most powerful book I have read about autism. Other authors write compelling books about autism, prompting us to think about those on the autism spectrum. But Ido is different. He is extraordinary because he changes the way we think about autism. He disrupts our misguided notions that lack of speech equates to lack of intelligence; that students with autism are impoverished of expressing or recognizing emotions; and that all students who are non-verbal belong in special day classes without the opportunity for inclusion. Contrary to many of the messages the world receives on a daily basis about people with autism, Ido’s book tells us that the minds of people with autism are as complex, creative, and intelligent as yours and mine.

On a personal level, reading Ido’s book was transformative and allowed my relationship with my son to turn a corner. I now talk to Diego like I would any other smart and capable 6-year-old. I make efforts to talk to Diego, not about him, when he’s in the room. Ido, Diego, and children like them are nonverbal, affected by autism, and brilliant. By typing to communicate, they blow us away with their complex insights, imaginative ideas, and witty humor.

If you are a professional in the autism field, I invite you to think outside of the box about what “conventional wisdom” on autism tells us. Without doubt, this takes courage. It means acknowledging that we do not know everything about autism. You might learn, as I did, that our perceptions about the capabilities of non-verbal individuals are wrong. Rather than dismiss RPM or other approaches to support typing, I encourage you to educate yourself about the approaches. Interact with individuals who have learned to type. Read Ido’s book or watch videos of children and teenagers who point to letter boards or type independently. For example,

https://www.youtube.com/watch?v=Wvn7kYJyOFM

And, of course, Ido has posted great video clips of him typing on this website. For example,

https://www.youtube.com/watch?v=ZLtQWXdDCFo

From one professional to another and from one parent to another, I urge you to take a chance to learn more before dismissing approaches to support our children who otherwise have limited means to communicate. We have the power to make real change by enabling the individuals we care for and serve to communicate in rich and meaningful ways.

-Edlyn Vallejo Peña, Ph.D.

www.EdlynPena.com
Assistant Professor
Graduate School of Education California Lutheran University