Amelie began using Speak for Yourself (SfY) independently as long as a single button was open on the screen. She was using it consistently for about two weeks in the therapy room, at home and at school. Despite the enormous success, we knew it was too early to pat ourselves on the back. Having just one button open on the screen while she uses it to make requests wasn’t functional. It was critical that we started opening up the buttons that were familiar so she could discriminate and choose the one she wanted. So during one of her sessions, I tried opening up two buttons (banana and peach). She was familiar with both words. However, the only snack we had was a banana. We didn’t have a peach. We started the session by displaying her snack (banana), and then placing her iPad (now referred to as her “talker”) in front of her. By now, she knew the drill. Like a pro, she hit “eat” which lead her to the secondary page. Now, instead of just one option, there were two. The couple of times she hit “banana” there were no problems. But, when she hit “peach” and I said “Oh, sorry, we don’t have peach today,” there was a meltdown. If she could talk, I know she would be saying, “But I hit the button! What more do you want?!!” After a few episodes, I found myself thinking, “Gosh I wish there was an easier way to do this.” It made me think of an old PECS® training I had attended many years ago. They work on discrimination by pairing a highly desired object with something the child did not care about.

So for the next session, I asked mom to send a food item that Amelie doesn’t like (pickles) along with her favorite snack. So this session I displayed the two snacks and placed her talker in front of her. Once again, hitting “eat” was easy. Again, two options were open on the secondary page: a desired item (banana) and a non-preferred item (pickles). This time, when Amelie hit “pickles” and was presented with pickles, we didn’t have a meltdown. She looked confused. She even tried putting it in her mouth. She spat it out after a few seconds and instead of crying, she reached for her talker again. While this may not seem like a huge deal, to her nanny and I who waited for her outburst with our breaths held, it was an enormous achievement. For the next few trials, every time she hit “pickles,” she shook her head as if to say “no, no, that’s not it,” and then went ahead and hit “banana” instead. Suddenly it seemed that she realized that different buttons meant different words. She understood that because I gave her the pickle when she asked for it. Having her press a button and then say “Oh, I don’t have that,” was too much to process through her frustration. Now that she understands the concept of different buttons for different words, we are seeing a dramatic decrease in tantrums and meltdowns. I can now say, “I’m sorry, there’s no more banana. Would you like grapes instead?” There are no more tantrums. She reaches for her talker and tries again.

Hindsight is always 20/20. I think I should have worked on discrimination earlier than I did. I don’t think Amelie needed the two weeks I gave her to familiarize herself to her talker. Instead of closing all the buttons except the one she was requesting may not have been necessary. In the long run, I don’t think that two weeks is a lot of time lost, but I know that in the future I will push a little harder and move a little faster. While there is the occasional drama when she hits the wrong button sometimes (truthfully, it wouldn’t be Amelie without the drama), the big picture is that she has almost a dozen words on her talker that she can use to make a choice.