This is a summary of my experience this past semester using the iPad as an intervention with a nusing home resident whom we will call “Tom”. Tom had a stroke 6 years ago and is completely non-verbal. He currently communicates using a thumbs up for yes and thumbs down for no. I am currently reteaching him the alphabet and word formation using the Doodle app on the iPad. He has lost the fine motor ability to use a pencil but it able to write out most letters and small words using his finger. This is an exert from my case study:
The Apple iPad is new to the idea of treatment of people with disabilities. Finding research and articles on this topic were slim and some untrustworthy. My main focus of research on this topic is from FutureAge Care. FutureAge Care is a Christian-based organization that provides services to the aging community. Their focus is “lifestyle and leisure”, diversional therapy, and any additional support needed. Their services include music, sound and multisensory enrichment programs for adults and the elderly. Jennifer Freeman who has been using and conducting most of the research using the iPad with clients said “The iPad presents a variety of uses and potential benefits within recreation therapy, occupational therapy, speech pathology and wellbeing for clients.” The iPad has many different uses and is a multisensory tool that can be used for many different client goals. With the surplus amount of apps you can find on iTunes you can cater them to your clients’ interests. This makes the iPad a highly person-centered device. Some advantages of the iPad include its large touch screen, which is very useful with clients who may have limited movement. Its multisensory appeal: visual, audio, tactile. It’s portable and lightweight, can be used bedside, positioned in their lap, or on a table. Another advantage is many of the apps are free, or low cost. The iPad can also be used for documentation of observations. After finding this information I contacted Jennifer Freeman for more information, she told me about different apps she has used on clients with a history of strokes. These included Phrase Board, Pocket Pond, Gravitarium, Doodle Buddy, and Fuji Leaves.
I did not know what to expect in using the iPad with Tom. For the first session I started out by showing it to him, I pulled up some of the pictures and we looked through them together and I talked about them and asked him questions about the photos. I then pulled up the map and zoomed in on the United States and asked him where he was from. He directly pointed to San Antonio, Texas which is where he is from. I then asked him where he lives now and he pointed to North Carolina. The next time I pulled up pictures again but this time I let him use his fingers to transition through the photos. This was a good way to work on problem solving. He had a hard time in moving some of the photos across the screen, but with repeated attempts he was able to figure it out. During that session I also pulled up pictures online of San Antonio, Texas and asked him questions about them. Such as if he remembered those places and if he had been there before. He enjoyed looking at the photos of San Antonio. Some things I observed during these first two sessions were that Tom was not as “fidgety” one time I walked into the room and he was trying to get out of his bed and once I began to show him pictures on the iPad he relaxed and focused on that and not longer tried to get out of the bed. It was a good way to redirect his attention to something else. During the third session I had him draw on the Doodle App, and each time I would change the color for him he would try to only draw over areas he had already drawn on. The fourth session I used the Pocket Pond App. This app is basically a virtual pond with water and koi fish, and each time you touch the screen it makes a water splashing noise. Tom enjoyed using app, every time a fish would swim out he would touch it, then it would swim away and he would go on to the next. This is good for visual coordination and sensory. After that I pulled up the Doodle App and asked Tom to draw the letter A, he immediately did so and went through the letter H without me prompting him with what the next letter is. He drew out the entire alphabet. I then pulled up a new page and asked him to write out his name, he wrote his first and last name with only one spelling error in his last name. On the next page I asked him to write out how he felt that day, I was not able to make out the words he wrote. So I ended the session by drawing 3 faces depicting different feelings; happy, sad and indifferent. I asked him which of those he was feeling at the moment and he chose the smiling face. It took time but we found something that works for him. For the next couple weeks I am planning on working on relearning the alphabet and then putting together short words. This has been a very successful intervention with Tom. Below are three of the picture I discussed above. I took out the one with his name.
In conclusion, the iPad was useful in beginning to meet the goals I set for Tom. We began to bring in a new way of communication for him, but it still needs improvement. Our sessions in the beginning lasted 20 minutes but in our last session we met for 45 minutes, so his ability to concentrate for longer periods of time improved. If I would have had the ability to meet with him three times a week for about 30 minutes each time that his progress would have been greater and quicker. Due to time constraints that was not possible, but is something to take into consideration for future research. This is a good first step in helping Tom meet his goal of a more efficient way of communication.