Occupational Therapy & Clicker 4

Reviewers: Marina Herold & Betsy Coville - Occupational Therapists, plus Celeste Mukheibir - Director Inclusive Computer Solutions, Forest Town School, Johannesburg, South Africa
Email: garym@ibi.co.za

Software: Clicker 4 from Crick Software
Single User: $199, 5 User Lab Pack $399, 30 User Site License $899
Toll-free: 1 866 33 CRICK
http://www.cricksoft.com/
Available on CD for Mac or PC
Rating: A+

The primary goal of Occupational Therapy is to help people function as effectively as possible in their environments. In pursuit of this goal, OTs are turning increasingly to the advances in technology to meet the needs of their clients. Because of the computer’s extensive power, universality and infiltration into almost all areas of life, computer access has become an important role for Occupational Therapists. Their training in the use of adaptive devices and task analysis enables them to identify the specific needs of a potential computer user and customise appropriate solutions for the most effective method of computer access.

The Clicker 4 software program has provided Occupational Therapists with a very powerful and versatile therapeutic medium for attaining computer access. It is limited only by the imagination and I have not found anything that Clicker can not do.

Features of Clicker 4

Clicker 4 has an option at installation time for US or British vocabulary.
Clicker 4 has two sections Clicker Writer (word processor) and Clicker grids .

Clicker 4 as a word processor.

• It has its own default application, Clicker Writer, which is a talking and picture word processor for juniors .
• Clicker can operate in conjunction with other applications, such as Microsoft Word.
• Text can also be spoken in the voice of your choice. Clicker enables students to write with whole word, phrases and pictures.
• Clicker grids give students instant access to words, pictures and sounds. Just click on a word or picture in the grid to send it into Clicker Writer.
• Clickers’ unique talking spell checker can be set up to check only the words you wish to focus on, thus encouraging success rather than highlighting failure. The spell checker can use pictures and sound for added support

Clicker grids

• Clicker 4 grids consist of any number of cells that can be programmed in a variety of ways. The cells can be programmed for the way in which they are displayed and for what must be sent to the application when they are activated.
• The contents of the cells may be PCS symbols, words, phrases, graphics, scanned in pictures or photographs, video clips or combinations of these. The cells can also carry sound — built-in software speech (in various voices), recorded sounds and even music.
• Cells can emulate keyboard functions and the keyboard can be designed to meet individual requirements.
• Cells in a grid can be programmed to open up into other grids, linking grids together.

Operating Clicker

• Clicker 4 can be operated with a mouse, a keyboard, rollerball or even switches.
• Through the grids, Clicker 4 embraces many of the hardware access needs that Assistive Technology users require.
• Adapted peripherals such as alternative keyboards can be substituted for within the software program, making it a fully inclusive tool.
• Clicker 4 has switch access for users unable to manipulate a mouse. Any single, repeatable movement (even an eye blink or eye gaze) can activate a switch and control almost all the functions of the computer.
• Setting variations of the Switch Access features are comprehensive. Cells can be scanned, individually, in rows, in columns or in user-specified groups. Scan timings and acceptance delays can be set. Even files and folders can be scanned and navigated through.
• Tools such as Return, Delete, Print and Save, Tab, Up and Down arrows can be incorporated into the scanned grids. The mouse can also be controlled through grids and switches.
• Cells can even be selected without a click using a Mouse Dwell property.
• Clicker together with a laptop can be used as a communication tool. Linking grids using PCS symbols, words, pictures and phrases makes Clicker a versatile tool.
• A library of graphics is supplied with Clicker 4 and others can be added. Clicker 4 is Internet-Friendly and has e-mail facilities.
• Grids can be made to fill the whole screen - this is useful in Talking Books.
• A collection of free, ready-made grids are available on the Internet, and a number are supplied with the program, but the beauty of Clicker 4 lies in the ease with which new grids can be made and customised to individual needs.

Some examples of how Clicker grids can be used in therapy in a school for children with disabilities

Clicker grids have provided a major breakthrough for users with communication impairments, as they can be given access to an output medium, both in speech and written work. Careful programming can provide a non-verbal child with a series of linked grids that can give the child access to a large store of words and phrases whereby he can express himself.

Children unable to write can produce written work in the class by doing their work on a computer using Clicker grids.

Cognitively impaired children can have the written word supplemented with pictures, or have words in the cells instead of letters, etc, thereby simplifying the task. Visually impaired children can have the items of their ‘keyboard’ as large as necessary, and sound clues can help them navigate their way through the grids.

The youngest children are trained in computer usage through graded techniques from switches through to mouse access. At the earliest stages, Talking Books can have their pages turned by single cell activation, and mouse control and co-ordination can be taught, grading from large cells to small.

Perceptual activities and basic concepts such as colour, number, sequencing and memory can readily be incorporated into the Clicker grid system.

All phonic skills training can very easily be translated into Clicker grids, as can the acquisition of reading. Single cell grids lend themselves well to flash cards.

Working through fun Clicker grids or Talking Books while doing exercises for improving hand function can be a motivating way of handling the exercises! A particular strength of Clicker is its switch access and switches can be set up to elicit almost any specific movement.

Although time consuming (and more the teacher’s domain), almost all curriculum material, from the earliest grades to the highest grades, can be presented in Clicker grid form. Occupational Therapy consultation with the teacher is needed in the case of children being trained in computer access and usage through Clicker. The child must receive support in using the device in the functional setting where its use is most natural and important.

In Conclusion

The Occupational Therapist’s particular expertise in adapting equipment and designing individualised solutions to specific problems is especially helpful in providing users with computer access. Clicker 4 is a very useful tool to achieve that access. The long-term goal is to maximise the user’s function and independence in society. Through efficient computer control he may possibly find employment, communicate socially, control his environment and discover the pleasure of participation and productivity in an ever-widening world of opportunities and experience.

Many thanks to the Occupational Therapy Department at Forest Town School for their input into this bulletin and case studies presented at this course.