Written Output and the Least Restrictive Intervention

Hey Tek-Ninjas! Lately I've been fielding a lot of questions about voice dictation for young children (first through third grade).

Here are my thoughts on the subject...

• In Occupational Therapy grad school, professors told us that the best opportunity to impact handwriting is up until the end of third grade. With this in mind, I never want to jettison handwriting instruction/therapy too soon. 
• In special education we discuss the importance of placing children in the "least restrictive environment" to help them be successful. Meaning: too much support is just as bad as not enough support. I feel the same way about technology...if a student can learn to use standard available word processors, that is ideal.  Our hope is that a student could enter any library and access any computer for word processing. If they need special software or hardware, that becomes less likely. 
• Voice dictation requires a relatively clear voice (though this is getting better all the time) It also requires fairly succinct sentences, or you get a lot of "uhms", "errs", and other filler phrases. Along with these necessities, one needs a fairly thick skin, aka a strong frustration tolerance. Apple's Siri is remarkable, and I've spent no time with the Android version, but hear it too is good. 

All that considered, sometimes a student's handwriting is just simply not functional. So, while their peers have already learned the task of writing, and are now learning with their writing, some students are still learning to write, and missing the next level content. 

In such a situation, if feasible, I like to introduce word prediction, and have the student engage in keyboarding instruction daily (10-15 minutes tops). The only way to become proficient keyboarding is to practice, and use it regularly.  For longer assignments we might ask the educational team to provide a scribe, thus allowing the student to focus on his/her content and not the arduous task of writing.

If the team envisions the child being able to learn and utilize keyboarding, that is my first choice. If not, then we consider voice dictation, knowing that we will ultimately be binding that child's productivity to a specific piece of equipment and software. 

I'd be curious to hear how other's navigate such questions. Thanks, and happy therapy!

Talking BIG Math

Hey Tek-Ninjas! Recently I have been working with a unique situation.

I have a student whom I will call Mike. Mike is very bright. Exceedingly bright. Top of the curve bright. However, he has some significant motor impairments, which leave him unable to write with a pen/pencil, and unable to type functionally.

I have worked with Mike for many years. We've tried voice dictation on and off, but his voice quality was never quite good enough. I always thought, eventually his voice would mature, he might get better breath control, and the voice dictation software would continue to become better.  All of which has come true.

Mike is taking Calculus. He has been dictating formulas to a scribe/TA. It is challenging to find

people who can dictate such formulas easily that are also willing to work for a TA salary. Let me be clear, I don't mean to denigrate, the fact is, I would be hard pressed to scribe for him. Math has never been a strong point for me.

Recently Mike asked to give voice dictation a try again. We set him up with a Windows 7 computer and Dragon 12. Mike was able to successfully complete the Scott Adams training module, which is the hardest of the training modules. I choose the harder one, because in order for Mike to be able to use this tool functionally, he needs to be able to dictate with the sophisticated vocabulary he utilizes.  Anything else, would essentially be pointless. He struggled with just a few words, but overall it was a great success.

Along with Dragon Naturally Speaking, we are using Scientific Notebook and Math Talk.  Scientific Notebook is essentially a word processor designed to create documents that contain text, mathematics, and graphics. Scientific Notebook can be downloaded for a free 30 day trial to get a sense of what the software can do.  A student license is $79.

The third component, Math Talk is a unique and phenomenal piece of software that integrates with Dragon Naturally Speaking to allow the user to voice any math phrases, including pre-algebra, algebra, trig, calculus, statistics, and graphing. An individual student version retails for $275.

Now, these are all pretty robust pieces of software. Layering of technology can often lead to problems. But, when loaded correctly, following the directions from the folks at Math Talk, and the training is completed, it is very impressive what a user can accomplish.

This is not a particularly inexpensive intervention when you tally a laptop, Dragon Naturally Speaking  Scientific Notebook, and Math Talk. But, in the long haul, it is significantly less expensive than hiring a scribe.  Also, I have yet to find anything that will work in this type of situation. My expectation is that the intervention will open up a significant level of independence for Mike.

One more note to make. The dove-tailing of 3 pieces of software can at first seem daunting. It did to me, and I tend to be fluent in this sort of venture.  If you follow the written directions from the Math Talk, it will work.  Or, if you call Math Talk for help, you will get NanciLu on the phone. She is the creator and owner of the company. She will make you laugh, and help you experience success with dictating complex math to a computer.  That is a win!

For the right student, this intervention is phenomenal, and I encourage you to take a look at a video or two if you think you have that student.

Happy therapy!

Just Let Them Dictate...

Recently I was in conversation with a fellow OT and colleague (Molly) whom I've worked with since I came to this district. She is a veteran therapist, a wealth of knowledge, willing to share, and inquisitive ( I work with some really terrific people).

We were discussing the amazing progress in voice dictation software. We also discussed some of the inherent challenges of voice dictation, which users often don't recognize. Switching from brain-->pen/paper to brain-->voice output is not as simple as it might seem.

She made some really interesting observations, and so, seeing a gold mine to tap, I asked her to guest blog.

Below you will find Molly's thoughts on helping to train/teach students how to use voice dictation successfully.

The “go to” solution for children with handwriting problems used to be “just let them keyboard.” This solution was rarely a quick fix – 

keyboarding is a skill that needs to be learned and if a child has fine motor problems to begin with, keyboarding is also going to present challenges.  

Now, a frequent “go to” solution is using a speech to text program.  Thankfully, these programs have improved immensely in recent years and can be effective in helping a reluctant writer get words onto paper.  

However, what are the necessary component skills to make a child a competent dictator of text?  How can a therapist or teacher help a student use this software successfully?  

I am on the beginning of this learning curve, but have learned a few things that might be helpful for others.  

1.     Reading pre-written sentences is a good way to start using speech to text.  It gets the child used to the “mechanics” of the program (like turning the microphone on/off), and gives them a degree of instant success.
2.      The child will need to learn to say punctuation.  Reading from a written copy with big red periods/question marks helps teach this skill.
3.     As with writing, using some type of graphic organizer is crucial to organize and sequence information before dictating.  Using a traditional graphic organizer with key words does not work well.  The child sees the key word(s) and says that without thinking about putting it into a sentence.  What works better is “sentence starters” combined with the key word(s) so the child knows where to begin.
4.     Rehearsing with the graphic organizer can help achieve increased success.  It might also lead you to add additional words or cues to the graphic organizer if you see “stumbling” points.
5.     Proof-reading is vital.  Dictation software is not perfect and the child must learn to read their dictated text carefully to catch mistakes.  (You might even use a text to speech program to read it back to them.)
  

Dictation software has come a long way from the days when you would end up swearing at the computer because it was mangling your words.  It can now be an invaluable tool for children who are resistant to writing for any number of reasons.  You might even find yourself beginning to use it.

I hope this provides you with some useful tools in working with your students. Thanks for the guest blog Molly!

Happy Therapy!

Voice Dictation on your Mac

Hey Tek-Ninjas! If you have a Mac, and it has Lion or a newer operating system, you have the option to run a pretty powerful voice dictation. I've posted a video here, on how to turn the feature on. Pay particular attention to using the Enhanced Dictation. This feature creates a more robust dictation when off line.  I have been very impressed with Apple's voice dictation, especially considering that users don't need a special microphone.

Happy therapy!