A Touch-Screen Smarphone Application and An Online Community for the Improvement of the Communication of Children with Severe Autism and for the Support of Their Teachers and Therapists

Background: The growth rate of children diagnosed with autism is enormous. From 1992 to 2003, there was an 805% cumulative growth rate, and in 2003, 1 out of 264 children were diagnosed with autism. Approximately one-third to one-half of individuals with autism is not able to communicate their daily needs. To help children with severe autism communicate, the paper-based Picture Exchange Communication System (PECS) is commonly used. However, the intrinsic difficulties associated with the use of PECS (such as the time needed to create a new laminated picture and to build a sentence) make communication between children with autism and their caregivers hard to achieve. Moreover, teachers and therapists of children with autism do not have access to any centralized repository where they can access relevant, up-to-date information on teaching approaches, share copyright-free images, discuss their teaching styles, and find help for evaluating the progress of the children.

Objectives: The objectives of this research project were to create: 1) an open-source software application for touch-screen smartphones that help children with autism and their caregivers to browse and combine images for communication faster than using PECS; 2) a reliable method for collecting data on the images used for communicating with the goal to track a child's progress; and 3) an online community that will help caregivers and practitioners work together to share knowledge and to improve outcomes for children with autism.

Methods: Because the final users of our smartphone application are the children with severe autism, we employed a participatory design using special education teachers as proxies to our target population. We worked with special education teachers in multiple public and private schools in North America to develop the smartphone application and the user community using a modular approach. This allowed us to incorporate new user feedback without having to re-develop the application each time.

Results: Pixtalk is open-source software application for smartphones with touch-screens. It is designed to allow users with autism and their caregivers to browse and combine images for communication. It can be used in therapy similarly to PECS but with access to an online library of images with the ability to efficiently add custom images for one or more students. PixTalk also provides the capability to log the images used and the sentences constructed by the children. Pixtalk is currently used by several children and their teachers in North America. An online community is ready to be launched. It allows the community of caregivers, health professionals, educators, and researchers to work in partnership on knowledge creation, ideas, problems and solutions.

Conclusions: Pixtalk and the online community are two technological solutions that provide an opportunity to improve the effectiveness of communication for children with autism, which will increase participation in a variety of communication settings with their families, friends and communities.