The choice of activities and exercises, adapted to the level of
acquisition and emerging abilities, will depend on the assessment.
It is these exercises which will have to be integrated into a computer
programme. A great many exercises, which are well adapted to the
specificities of the autist's learning difficulties, already exist.
Computerization of some of these exercises could be quite easily
undertaken. One could also look at existing educational computer
programmes for exercises, which although not specifically developed for
autistic people, could very well be of an appropriate level and which do
not, above all, present any disconcerting characteristics for autistic
people. It is, moreover, in this category that the highest number of
computer experiments may be found. Finally, teachers could also invent
new exercises which make specific use of the progressive animation and
integration capacities of several of the new tool's sensorial modes.
To this end, writing aids for educational programmes have been developed
which may either assist in the creation of new programmes or in enhanced
personalization of educational
programmes. Consideration and examination
of the progress made in understanding autism will be extremely important,
ensuring that educational programmes are fully adapted to the
specificities of this syndrome.
In a more targeted approach to the possibilities provided in the field
of educational programmes, one may, in relation with the WHO's
classification of handicaps: Deficiency, Disability and Handicap,
submitted by Wood in 1980 distinguish three levels of intervention:
- interventions which aim to reduce the "deficiency", that is to
say which involve cerebral plasticity;
- interventions which aim to compensate the "disability" by offering
standard learning exercises which have been adapted to the
specificities of autism;
and finally,
- interventions involving the handicap itself, that is to say which aim
at developing social skills, thereby enabling better social integration.
It is evident that regarding the current status of the research into
the causes of autism, the first type of educational programme, which
aims at acting on one or several specific deficiencies encountering
in autism, is only in its infancy.
In contrast to this, however, several experiments involving computer
aided teaching in the second area would appear to show encouraging
results. It is very important to remember the autistic person's
difficulties with memorization, sensorial integration, attention
span and generalization which have been highlighted by recent research
into this disorder.
As far as exercises which promote socialization are concerned, fairly
good educational programmes are now available. Here again, the
"Multimedia" technology ought to enable exercises to be offered which
more closely match real (social) situations.
Up to now, computer technology has above all been used as a
communications aid in cases of cerebral motory disabilities.
Depending on the brain damaged person's motory and intellectual
abilities, various communications systems based on a pointing method
using pictures, symbols or even words displayed on a screen, enable a
level of communication which considerably increases the person's
autonomy.
This type of use with non verbal autistic people or those experiencing
difficulties in expressing themselves verbally has been experimented with
by various specialists. This may involve pointing systems using drawings
or symbols, similar to the communication cards already used by a number
of autistic people to communicate with their entourage. By combining
the principle of card communication with the possibilities provided by
computers, new fields of application will be developed. For instance,
voice synthesis which enables easier communication with an interlocutor
or the system of unfolding pictures.
For some autistic people, who do manage to learn to read and write,
communication using a computer keyboard or reception using a visual
document, either displayed on a computer screen or printed up, could
be easier than verbal communication or reception, especially due to the
marked preference shown by a high number of autistic people for visual
stimuli but also because of the permanence of visual stimuli compared
with the transitory nature of auditory stimuli. However, great care is
called for in this area in view of certain overly optimistic views
linked to the use of a technique known as "Facilitated Communication".
Information technologies can indeed facilitate communication in a more
general manner, in particularly via computer networks.
This kind of infrastructure could indeed constitute a potentially very
powerful and rapid source of information exchanges, for instance
the "INTERNET" network."INTERNET" links up several computer networks
worldwide, with these being mainly used by universities.
An Electronic Mailing List particularly devoted to autism has already
been set up, in which professionals, parents of autistic people and
autistic people capable of using a computer keyboard can take part.
Other discussions devoted to autism have emerged in discussion
groups of a more general nature, called NEWSGROUPS, which operate
within the USENET network.
A great number of other subjects concerning psychiatry are dealt with by
these networks. Some discussions are open to a wide public: professionals
and non professionals alike rub shoulders, which can occasionally be
irritating for some but is often a very interesting experience. Other
discussions are only open to specialists, with access being controlled
by the specialists themselves.
I do not wish to consider the use of computers and computer technology
to be found in most medical research laboratories: this is a tool for
statistical analysis, graphical representation, signal processing, etc...
I am thinking more of computer technology which, by modifying one or
several parameters, is able to describe and analyse certain brain
activity. In some cases, the computer model can even simulate this
activity, thereby providing scientists with an experimental field
previously not available to them for obvious ethical reasons.
Recent developments in symbolic Artificial Intelligence and the
exploration work carried out in the field of so called "neuronal"
computers, sometimes also known as connectionist systems, have provided
neuro psychologists and neuro-biologists with exploration models,
enabling them to test their hypotheses. Indeed, I am of the opinion
that this could be an area of profitable cooperation between scientists
working in the field of autism and those doing research on Artificial
Intelligence.
The latter find themselves confronted by the "pathologies" of their
artificial systems: learning difficulties, rigid behaviour patterns,
the near impossibility of making generalizations based on previous
experience and above all the difficulty of integrating several outside
stimulus at the same time. There is no doubt that, as already mentioned
earlier, this will involve working in an area in which some will be
able to rediscover with pleasure their fascination for the world
of
computer technology.
Although some years ago one of the main obstacles to the
implementation of computer aided educational programmes was the
price of the equipment, this aspect has now become a secondary
consideration. Indeed, first rate computer hardware/software can
be bought at very reasonable prices. The difficulties encountered
are of two kinds:
- human difficulties,
- technical difficulties.
But new wine must be put into new bottles. It is, indeed, much easier
to quote this saying from the Bible than to put it into actual practice.
The use of computer technology may require changes in the care, whether
therapeutic or educational, afforded autistic people. Such changes
must be prepared. The resistance which this technology may give rise
to will have to be considered: "It doesn't work, it's useless. We are
going to make our children in robots, they will become prisoners of
mechanical behaviour, etc..."
In the first part of my paper, I dealt with the importance of only
considering the computer as a useful aid in caring for autistic people
and not as a finality in itself. This at least partly answers some of
the fears expressed. As far as the computer aided programmes lack
of efficiency is concerned, it is difficult to be convincing by opposing
theoretical arguments. It is far better to promote exchanges with
teams who have already gained experience in this field.
This leads me to talk about another prerequisite for implementation
of computer technology and above all the necessary adjustments to
be made during use. It is important that the various teams, who have
decided to adopt computer technology, are given the opportunity of
frequent and practical communication between themselves. This will then
lead up to the second area of difficulties, those which concern the
technical aspect. To promote such exchanges, communication tools,
like those already mentioned in the first section, will have to be
set up. Although communication networks, such as INTERNET, exist
more or less worldwide and the equipment required for writing and
reading messages has become considerably cheaper, there are not
very many access points, at least not outside the USA.
As an illustration, there are more than ten million people linked to
INTERNET in the USA and less than 500,000 for all of Europe. Since it
is above all universities and scientists who use these networks,
the USA's lead over the rest of the field can be appreciated.
To return to the more immediate implementation of computer aided
solutions, especially within the field of computer aided teaching, one
will have to look and see which existing programmes are most suited
to the person's learning abilities. This is not a particularly easy
task. There is no general list classifying education or recreational
computer programmes on the basis of their cognitive level.
One must not forget to examine non specialized programmes,
whether this concerns educational programmes or games. The informed
professional may very well find unexpected resources, which will no
doubt require some adaptation and/or departure from the programme's
original intention. Some games, for instance, can provide an opportunity
for learning social skills: learning to play in turns for example.
Computer simulation in a known environment can help the person to
learn basic rules, frequently impossible in a real situation,...
Programmes known as utilities, such as word processing programmes or
computer aided programmes for artistic creation are another source of
assistance for the mentally handicapped and autistic people. The mentally
handicapped people frequently have difficulty in executing a task such as
writing or drawing. This does not involve a lack of artistic ability
but rather difficulties linked to disorders accompanying their handicap,
motory problems, precise coordination, slowness, etc.
An interesting aspect of computer technology is that it accepts
a certain degree of error. Word processing programmes enable typing
errors to be corrected, some even correct spelling mistakes. Computer
aided graphics programmes allow the "painter" to go back over the
drawing if it is not quite right. In both cases, one does not have
to start again from scratch. This type of programme can be used to
help a person tell a story, either with the use of the text or with
the help of drawings or even both at once. This can be done
individually or collectively. One may also envisage the same
type of possibility with certain programmes specifically designed
for musical creation.
Another difficulty resides in the lack of standardization of educational
material and programmes. Once the first step involving the choice of
programme suited to the needs of a particular person has been reached
and even taken, the programme will then have to have been rewritten
for the educational team's specific type of equipment. Nonetheless,
there are some excellent suppliers of educational programmes which
operate with several types of computers. These are unfortunately too
few and far between.
A number of programmes are poorly suited to the specific needs of people
with learning difficulties, especially autistic people. Some are written
by experts in specialized teaching and are thus very good from the
didactic point of view but their technical qualities are often not
up to scratch: insufficiently reliable, insufficiently flexible,
laborious implementation, etc. Other programmes have been written
by computer scientists which, despite evident good will and obvious
computer skills, have only been able to create programmes with
generally fairly limited teaching qualities. There is a crying need
for coordination between the two groups. Beyond these
two specialties and in light of the complexity of the group of people
for whom these programmes are developed, it would be good if multi
disciplinary teams, including teachers, psychologists, neurologists,
psychiatrists, as well as cognitive specialists and occupational
therapists took part in the development of educational programmes.
As a step in this direction, the following associations: Autisme France,
Autisme Europe, the ARAPI and the UNAPEI have organized, in
conjunction with IBM France's computer centre and services to
the handicapped, France Telcom, an international conference on the
subject of Autism and Computer Technology, which brought together
specialists from various fields.
This conference was held in Nice (France) at the ACROPOLIS in
January 1995.
The five themes, mentioned earlier, have been presented:
- DIAGNOSIS
- ASSESSMENT
- TEACHING
- COMMUNICATION
- RESEARCH MODELS
We hope that this conference has provided the opportunity of establishing
links between the various teams interested in the application
of computer technology in the field of autism. I, for my part, am
convinced that by considering the specific needs of autistic people and
by using the appropriate computer techniques to meet these needs, we
shall provide important assistance to the cognitive and social
development of autistic people.
