Visual aids for a vocal beginning

Until a few years ago, Vinaychand Ravi would communicate using pictures and one or two words. But over the past three years, thanks to an iPad app, this 10-year-old autistic boy has started communicating in sentences.

“Some kind of ability was ignited after he was introduced to the app,” says his father Amarchand Ravi, a Bangalore-based software consultant. “He was unable to speak clearly, so he started off by typing relevant words on the iPad. Recently, he started typing full sentences and we realized that he is aware that the elections are on and who the important candidates are. Earlier we had no idea what he was thinking of or what he knew.”

The life-changer for Vinaychand was Bol, an app he was introduced to at Project Prayas, a computer centre for individuals with autism spectrum disorders (ASD), started by the Autism Society of India in Bangalore. Since early 2011, Prayas has been collaborating with German software company SAP Labs, a global provider of business solutions, to develop customized apps for children with ASD in India.

“iPad interventions seem to be more effective compared to other teaching methods, because of graphics and touch screen,” says Kavita Sharma, founder, Prayas, and a member of the executive council of the Autism Society of India. “Over 60% of individuals with autism have difficulties in communication as well as cognitive functioning,” she says.

“Our early efforts were to establish the use of iPads, or any touch-screen devices, as effective reinforcement technology for communication and learning,” says Sridhar Sundaram of SAP Labs in Bangalore, who volunteers with Prayas.

“We initially conducted a series of workshops with parents, teachers and children to gather inputs. After three months, we realized that iPads can be effectively used to teach children with autism, but there weren’t any apps that catered to specific needs with respect to Indian languages and content.”

Bol’s primary aim is to teach and aid communication in children with speech difficulties. The app is available on iOS, and the Android version will be out in June. Bol combines three elements—auditory, visual and instant feedback.

It allows teachers and parents to build customized audiovisual content in the native language. Prayas and SAP have also collaborated in developing iKatha, an app that uses storytelling as a medium of learning, as well as an open sources content platform, www.learn4autism.com, that provides structured lessons across subjects and skills. All these are available for free.

Just how much of an enabler technology can be for children with ASD becomes evident with Akila Vaidyanathan recounting her experiences of raising her son. Nishant, 18, is autistic, non-verbal and has features of attention deficit hyperactivity disorder (ADHD). Vaidyanathan is the founder-director of the Coimbatore-based Amaze Charitable Trust, which works for autism awareness and advocacy, and also runs a technology-based intervention program called Daksh.

“Nishant’s early education was done the old way, through pictures. I would download or draw pictures to teach him,” she says. “Since I had a technology background, I tried to include the PC in his life as much as I could, because I could see that it made things much easier for him.”

For Nishant, help came in the form of Avaz, a speech therapy app developed by the Chennai-based Invention Labs, developed for children who are non-verbal or have difficulty speaking.

Launched in 2009, Avaz’s AAC (Alternative and Augmentative Communication) is a picture-based tool. It helps children with ASD use their picture-identification skills to create visual messages, which are then spoken out by a speech engine. It won the President’s National Award for the Empowerment of Persons with Disabilities in 2010. The software is available for ₹ 6,000 and runs across the iOS and Android mobile platforms.

“Avaz has become Nishant’s aawaz (voice) since he started using it four years ago,” says Vaidyanathan. “It has given him a whole range of easy-to-use communication symbols.”

The recently launched Autista, which focuses on improving motor and speaking skills, goes a step further. The app has puzzles, voice exercises and spelling games, and can be customized depending on the child’s needs.

Autista has been developed by MadRat Games, in collaboration with the US’ Cornell University and Bangalore-based Communication DEALL (Developmental Eclectic Approach to Language Learning) Trust, an early intervention programme for children with developmental language disorders. The app received special mention at the 2013 Nasscom Game Developers Conference in the “Game of the Year” category.

“Many of these kids cannot verbalize, so it was important to get them to practise what is difficult,” says Rajat Dhariwal, who founded MadRat Games along with wife Madhumita Halder and brother Manuj Dhariwal. Manuj recently left them to start his own venture.

“Since they were comfortable interacting with an iPad, we wanted to use that to build their verbal skills. So we have levels in a make-or-break picture puzzle. There are different scenarios like kitchen and playground, and pieces of the puzzle are scattered around. You have to say the object’s/creature’s name and put the puzzle together,” adds Rajat.

Many believe that such early interventions through technology can be life-savers for children with ASD. “We keep hearing how, in some cases, children have started to learn independently,” says Sundaram. “Compare this with when parents, especially mothers, always had to be present with the child. Technology makes learning interactive, progressive and standardized.”

“The reason it is called a ‘spectrum’ ailment is because abilities vary even within children of the same age,” says Archana Nayar, director of the Autism Centre for Excellence in New Delhi which focuses on creating long-term intervention strategies. “Devices like touch tablets serve as the voices and thoughts for many with limited or no verbal abilities commonly seen in autism.”

However, access to these devices is a major stumbling block. “Even a basic iPad is upwards of ₹ 20,000, and that is unaffordable for many families,” says Vaidyanathan. “There are not many apps available on Android. I rely on laminated flashcards at my centre, which is very limiting”.

An estimated 10 million children in India have ASD, according to Rajat. It’s a daunting number, and special educators say that without government support, ensuring widespread access to technology will be hard.

It has taken years of struggle by advocacy groups for ASD to be considered a disability. Perhaps the bigger challenge is changing attitudes towards ASD. “Many parents don’t want to acknowledge that their children have ASD,” says Rajat, who taught at the Rishi Valley School in Andhra Pradesh for a few years before launching his company. “Massive effort is required. We need to encourage people to come forward if their kids have autism.”

It will be a while before we are able to treat autism as a minor headache. But early steps in digitally enhancing real lives is likely to make that dawn break sooner rather than later.

Shai Venkatraman is a journalist, teacher and blogger.