iHelp for Autism

For autistic children, the new iPad is an effective, portable device for teaching communication and social skills. It’s also way cool.

Clearly excited to be home, Leo books it to his backyard play area, where there is a pool, a trampoline, a rocking horse, a large swing, and toys galore. "This whole house is set up for Leo," she says.

The Rosas used to live in a smaller home across town, but when things with Leo began to deteriorate, they knew they needed a different setup. "We got this house so that I could see him from anywhere," Rosa says.

Although the house is tidy and welcoming, a close look reveals abundant evidence of Leo's destructiveness. Along the banister that runs up the stairs, several pegs have been displaced; he kicked them out. Cabinet doors have been dislodged, walls have been scraped, and the living room couch springs have ruptured. His mother doesn't really even notice the damage, she says, other than when guests are here.

Leo has plenty of toys, including this circular balance beam, but nothing tops the iPad.
Kelly Nicolaisen
Leo has plenty of toys, including this circular balance beam, but nothing tops the iPad.
Leo’s therapist, Victor Cabrera, comes over four times a week for respite hours.
Kelly Nicolaisen
Leo’s therapist, Victor Cabrera, comes over four times a week for respite hours.

"Want a sandwiss," Leo says. His mother asks what kind, already knowing the answer: peanut butter. She asks anyway, because when Leo wants food, there is an opportunity to get him to speak. He seems to realize that the fastest way to get the food is to answer questions as best he can.

When she places the food in front of Leo, he goes to town on it.

"Small bites, please," she says. He ignores her. "Leo, small bite."

After eating, Leo runs to his room and reemerges naked, carrying his swim outfit of trunks and a long-sleeved white shirt. His mother helps him dress, then secures goggles over his eyes. He backs into the pool and immediately begins splashing wildly, then swimming adroitly in patterns. "He's like a little naiad," Rosa says.

Leo used to drink the pool water and then have "accidents," she remembers, but he mysteriously stopped. That's common. Leo will be intensely interested in something, and suddenly he just won't be. "Last year he was all going for dive toys," she says. "This year he [couldn't] care less."

The Rosas fear this could someday happen with the iPad. But for now, Leo is absorbed in it.

Quietly perched on the couch after his swim, Leo practices animals' words, which have recently become his favorite. "S! W! A! N! Swan!" the device announces as he lines up the letters, then it quacks. As Leo keeps himself occupied, Cabrera talks with a reporter about the boy's progress.

In the year and a half since Cabrera has been visiting, he has noticed advances in Leo's independence. Leo can now make a sandwich, brush his teeth, tolerate visitors, and use the bathroom on his own. Before getting the iPad, he wasn't very good at using his fingers, Cabrera says, "but look at him now."

Leo flies through apps and settles on one that helps him learn to count. "You can put anything he likes on there," Cabrera says. "Music, movies, educational apps. He can be on it."

Cabrera is an instructional aide for a class of autistic children at the Morgan Autism Center, a nonpublic school in San Jose. There is already one iPad in his classroom, and in the fall, the center will bring in several more. "We are seeing the same results we have seen with Leo," he says. "The kids are actually enjoying educational tasks."

Because children with autism often become agitated when they feel out of control, or when they don't know what will come next, they require visual schedules, or pictorial representations of the events in their day.

Prior to the iPad, those schedules were created manually. For teachers, that meant cutting and laminating pictures, then gluing them to Velcro strips. For students, it meant using the same images each day.

On the iPad, visual schedules — including interactive dragging, animation, and cool sounds — can be quickly put together using the First-Then app.

Rosa has been using this app to show her son when to expect mealtimes. In addition, she's using Stories2Learn to demonstrate how she would like Leo to behave at the dinner table. She has created a "social story," pairing photos of food with audio explanations and text. Leo has to touch the screen to move through his story; with any luck, this multimedia learning approach will make an impression.

Apple has remained characteristically silent with the news media on the "quiet revolution" its products have started in the autism community. Although a woman with an Apple e-mail address who claimed to be a representative for the iPad responded to an inquiry from SF Weekly, she refused to speak on the record.

But the company has been receiving plenty of feedback — alongside requests for discounts and donations — from parents with special-needs children. Meanwhile, health insurance companies have been hesitant to cover Apple's technology, which they consider primarily recreational, partly due to a fear that those without true medical need might try to game the system.

That isn't to say that the iPad is perfect for children with autism. For one thing, the built-in battery doesn't last forever. There are sometimes inexplicable software glitches that can crash the system. Most problematic might be its durability: One bad tantrum, and there goes the screen. Some on the autism spectrum lack manual dexterity, or are simply not capable of learning how to use a computer.

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