Istimulation: Apple iPad use with Children who are Visually Impaired, Including those with Multiple Disabilities

Abstract

Since its creation in the early 1980s, Light Box, a product developed by the American Printing House for the Blind (APH) that is designed for working on functional vision tasks with children who have visual impairments or multiple disabilities, has been an effective tool to help teach children with visual impairments to locate and track items visually (Wright, 2012). The Apple iPad, first available in April 2010, represented a new technological option for such teaching that was significantly more visually appealing and motivating to stimulate visual engagement. This Practice Report describes a pilot study initiated by the Infant & Early Childhood Program of the Junior Blind of America, which found that the iPad increased progress on developmental goals for children with low vision when compared to the APH Light Box. The multistep study conducted by the Junior Blind was designed to investigate the use of the iPad with children with visual impairments or multiple disabilities as a means of strengthening or initiating visual engagement, parental interaction, communication, visual attentiveness, reaching, and activating (making contact with the screen to initiate a desired response; for instance, turning a page or moving an item to or removing an item from the screen). The study gathered data from a sample of 60 children ranging from birth to three over a period of six months, and identified the iPad as an appropriate educational tool to increase a child's development in multiple areas. The developmental goals established were based specifically on the child's current cognitive age and developmental and physical abilities. METHODS Using methods similar to those initiated by Smith and Cote (Smith & Cote, 1982), Junior Blind's study observed the use of the iPad in comparison to the Light Box. Employing six-item pretest and posttest sessions, data was analyzed that focused on the children's performance in executing tasks with the iPad for three months following a three-month period of Light Box use. The study was structured so that the developmental domains covered the areas of visual engagement, parental interaction, communication, visual attentiveness, reaching, and activating. The domains were monitored with a developmental tool that was created to track the goals reached by each participant in a concrete and objective fashion. Each of the developmental domains covered was divided into subcategories from simple to complex skills. The tool was created by a process of researching developmental guidelines, ages, and stages, and by examining the different milestones a child needs to accomplish in order to demonstrate growth in each of the areas while allowing for the differences in a child with multiple disabilities. Using multiple iPad applications, measured and divided by difficulty and genre, the iPad was introduced to the participants as a tool similar to the Light Box. Following a similar study conducted at Auburn University, directed by Margaret Flores (Auburn researchers using Apple iPads to help children with autism spectrum disorder, 2010), optimum applications were used that elicited activation and interaction. Prospective participants were identified before information regarding the study was shared. A parent or guardian of each child participant signed an informed consent form allowing data to be collected regarding the child and giving full permission to use the child's name, information, pictures, data, and video recordings that were gathered as part of the collection process. This research model followed the World Medical Association's Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed and approved by the Junior Blind Human Subject Research Committee on Junior Blind's Los Angeles campus. The participating children were divided into two groups. An attempt was made to balance the groups to ensure that equal sets of children with varying disabilities were represented in each group. …