By Dallas Stevens
By Gen Cohen
Using apps for kids with Autism Spectrum Disorder (ASD) can be useful for learning and social development, according to Dena Aucoin, M.Ed., the Assistant Academic Chair in the Educational Studies program at Kaplan University.
"[They allow] for learning to take place in many environments, which helps aid in generalization of the attainment of skills," she told Parenting.com. "For example, if we are only teaching the skill of greeting others in the classroom, we may see less success when attempting to greet others at the grocery store."
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"[They] can be helpful to provide visual supports, to provide structure, a schedule, and language or pictures to facilitate communication," adds Patricia Aguayo, MD, MPH, Medical Director Autism Services, Child and Adolescent Psychiatrist at Hospital for Special Care. She explains the most important thing to consider when choosing an app is what the specific needs of the child are and what your goal is for introducing it.
Aucoin adds, "Anyone can make an app so do a little research. What company is presenting this app? Are there supportive applications that go along with it? Is it credible? These considerations can help in making choices that fit the need."
Aguayo urges parents to use an app in collaboration with the school team.
"It is important that everyone involved in the child's life is consistent and use the same app or device," she says.
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She recommends two books to help parents narrow down their app options:
- "Apps for Autism" by Lois Jean Bradley, MA, CCC-SLP
- "Top 60 Recommended Apps for Autism" by Linda Hodgdon
But here are 11 autism apps for kids that our experts recommend trying:
This app provides visual schedules to help with transitions and decrease anxiety. "First-then support can offer children of most intellectual and language abilities to understand what is expected of them, and what will come next, or what the reward will be," explains Aguayo.
Cost: $9.99, available for iPhone, iPad, iPod Touch and Android.
"iPrompts is a highly recommended app for supporting organizational skills, setting expectations for performance, and setting up subtle supports and reminders," says Aguayo. Users can create and modify visual schedules, as well as use a countdown timer with picture supports to indicate how much longer a task or activity will last.
Cost: $49.99, available for iPhone and iPad.
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3. Autism Track
This app is brought to you by the creators of iPrompts and is designed for parents of children with ASD to help them track data. "This customizable data tracking tool allows parents to easily track behaviors, interventions and symptoms in one place," says Aguayo. "Behaviors and symptoms can be rated, as well as particular medications and their doses, diet changes and therapies. Parents can also review trends in their child's data and share these data with school and medical providers to inform treatment planning. This app is especially helpful for children with challenging behaviors, psychiatric conditions or both."
Cost: Free to $9.99, depending on the version, available for iPhone and iPad.
"This app uses a child-friendly character to teach emotion words, facial expressions associated with emotions, and to identify emotions in others," Aguayo says, and it may also help with the development of language, communication, and social skills.
Cost: $4.99, available for iPhone, iPad and Android.
This customizable, bilingual app is designed for augmentative communication using a family's own pictures. Aguayo says it's free, but time-consuming to set up and customize.
Cost: Free, available for Android.
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"S2L offers parents and educators the ability to create personalized stories using photos, text, and audio messages," explains Aucoin. "These stories can be used to promote an individual's literacy, leisure, as well as social skills." The app supports reciprocal play, non-verbal communication, playground and school rules, turn taking, and more.
Cost: $13.99, available for iPhone and iPad.
"[This] is a great visual teaching tool for helping your child learn to navigate challenging locations in the community. Each location contains a photo slideshow of children modeling appropriate behavior," says Aucoin. Locations include the hairdresser, mall, doctor's office, grocery store, restaurant and playground.
Cost: Free, available for iPhone and iPad.
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This online interactive program addresses core deficit areas standing in the way of school, social, and life success for kids with social learning challenges. It uses "highly interactive and visual presentation" and animations to encourage children to practice social skills in an interactive way. According to Aucoin, this app "employs rich graphics and audio and offers a high degree of quality in every aspect of the app."
Cost: Free for version II, monthly and annual rates available for iPad.
Dr. Clara Lajonchere, former VP of clinical programs at Autism Speaks, helped to develop the Cognoa evaluation tool, which not only identifies autism in kids, but also tracks a child's behavior and milestones for doctors and teachers. "Features include expert-recommended activities, which can help autistic children who have issues with fine motor and sensory, socialization, tantrums and more," she says.
Cost: Free, available for Android and Apple products and online.
Pictello is a simple way to create visual stories and talking books, explains Aucoin. "Each page in a Pictello Story can contain a picture, a short video, up to 10 lines of text, and a recorded sound or text-to-speech using natural sounding voices." The app can be used to teach social skills or to help kids remember events, and supports non-verbal children in communication with others. Better yet, stories can be shared with other Pictello users and even non-users.
Cost: $18.99, available for iPhone, iPad and iPod Touch.
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This unique app uses a pillow with embedded transducers that play relaxing music through vibration to induce relaxation and sleep. A study on kids with autism conducted by Dr. Sarah Schoen of the SPD Foundation concluded all 15 participants showed improvements in sleep initiation, duration of sleep, reduction in night waking, and improved daytime behavior.
Cost: the pillow is $169, and the accompanying app is free; available for Android and Apple devices.
Check out Assistive Ware and I Get It apps for more apps that support autistic children. Parents should also note that while not specifically created for kids with ASD, developers, such as Toca Boca, Oceanhouse Media, Duck Duck Moose and Spinlight Studios are consistently developing apps being used in treatment settings.
But Aguayo wants to caution parents: "It is also important to keep in mind that, just as with typically developing children, electronics can become an obsession, and their use for breaks, reinforcers, and during free time should be monitored and limited. Apps, even those that can help children with ASD, should never replace real-world interactions and interventions that help to develop social and communication skills in natural settings."
By Gen Cohen
Make your daunting childcare search more manageable by asking these questions
Childcare: For some parents, just hearing that word can bring on a panic attack. Whether it's the thought of leaving Baby with someone new when maternity leave ends or simply adding up the often-astronomical cost of care, finding the right childcare provider can be extremely daunting. Though the biggest factors when making a decision are usually price, availability, and location, it's also important to know providers' standards, qualifications, and procedures, whether you're looking for everyday, all-day care or just a twice-a-week, Parents' Day Out program. To make the search more manageable and informative, here are 10 important questions you should ask your child care provider:
1. What licensing or accreditation do you have?
No license means the center doesn't undergo state-mandated inspections. With Parents' Day Out programs, it's a different story. Your child is there less than 10 hours a week, so it's up to you to do the inspecting.
2. What is the teacher turnover rate?
A high turnover rate is a serious red flag. Teacher happiness is very important. Not only does it indicate that the center is a great place to work, it also suggests the teachers are providing great care. Long-term service means a great working environment with high-quality caregivers.
3. How extensive are teacher background checks?
You don't want to leave your child with just anybody. Keep in mind, parents' day out programs are typically not required to do background checks unless they are licensed, so it's important to ask.
4. What is the teacher-to-child ratio?
Again, if the location isn't licensed, it doesn't have to follow state requirements on teacher-to-child ratios. But a ratio that's better than the requirement — meaning fewer children per teacher — is a good thing. It means the teachers aren't overworked, the rooms aren't overrun, and the facility isn't just trying to keep the rooms maxed out to capacity.
5. How much information about a child do you need? How is it filed?
Children are increasingly becoming the targets of identity theft, so be cautious. Your child's exact birth date, middle name and social security number should not be needed. It's important that your child's private information is accessible only to the director.
6. What are the cleaning and sanitizing practices? How often are carpets and toys cleaned?
Stomach viruses can live in carpets for up to 14 days. Make sure the facility places a high priority on cleanliness.
7. Are teachers CPR/first-aid certified?
This is a must if the place is licensed, but you should verify to be safe.
8. What are the safety practices or security measures?
You'll want to know whether the doors are locked, what measures are taken when children go outside for play time, and what identification is required when your child is picked up by someone other than you. Also check that the facility is well ventilated and has a defined and posted emergency procedure for fires, tornadoes, earthquakes, or other emergencies that may occur in your area.
9. How much emphasis is placed on education vs. unstructured play time?
Will your child spend the entire day in the corner playing with toys, or will he be engaged with learning activities and story times? Learning activities should be offered before preschool.
10. What is the disciplinary policy, and at what age does discipline start?
"Time-out" is what you should expect to hear, and it should start no earlier than 2 years old. The number of minutes in time-out should equal the child's age.
Even if you are certain of which childcare provider you want to use, a good rule of thumb is to check out at least three places before you select one. Bottom line: Your child will most likely spend three or more years at the facility, so do the research now to avoid surprises and the need to switch to a new provider later.
By Gen Cohen
They're doing and thinking a lot more than we used to believe
The first time I played my acoustic guitar for my son, Michael, he was just a few months old. But even though the only other occasions he could have heard me play was when I was pregnant with him, he turned around and gave me a smile that seemed to say, "I recognize that sound!"Was it possible that he was remembering what he had heard in the womb?
For years, doctors assumed that babies were born without any knowledge about the outside world. But recent research is questioning this assumption, offering clues to what babies comprehend in utero, what they remember after they're born, and how that information prepares them for the world outside the womb. Today, doctors realize that babies begin to engage many of their senses and to learn about the world around them during the last trimester of pregnancy—and maybe even before.
What's That Noise?
The uterus isn't exactly the quietest place to hang out. Not only can a baby hear the sounds of his mom's body—her stomach growling, her heart beating, the occasional hiccup or burp—but he can also hear noises from beyond. If mom sits in a movie theater with state-of-the-art sound or walks by a noisy construction site, odds are the fetus will react to all the ruckus by kicking or shifting around.
Of course, not all sounds are the same. Perhaps the most significant one a baby hears in utero is his mother's voice. Around the seventh and eighth month, a fetus's heart rate slows down slightly whenever his mother is speaking, indicating that mom's voice has a calming effect.
By the time they're born, babies can actually recognize their mother's voice. In one study, doctors gave day-old infants pacifiers that were connected to tape recorders. Depending on the babies' sucking patterns, the pacifiers either turned on a tape of their mother's voice or that of an unfamiliar woman's voice. The amazing result: "Within 10 to 20 minutes, the babies learned to adjust their sucking rate on the pacifier to turn on their own mother's voice," says the study's coauthor William Fifer, Ph.D., an associate professor of psychiatry and pediatrics at Columbia University's College of Physicians and Surgeons. "This not only points out a newborn's innate love for his mother's voice but also a baby's unique ability to learn quickly."
Interestingly, there is no evidence that newborns show a similar preference for their father's or siblings' voices, or for any other voices they may have heard frequently while in the uterus. "The difference could be that the maternal voice is communicated to the fetus in two ways: as ambient sound through the abdomen and internally through the vibration of vocal chords," says Janet DiPietro, Ph.D., a developmental psychologist at Johns Hopkins University. "In contrast, external voices and other noises are only heard as ambient sounds."
In fact, research has shown that if newborns are given a choice, they prefer the version of mom's voice that sounds closest to what they heard in the womb. "In studies where we gave day-old babies a choice of hearing their mother's voice filtered to sound as it did in utero—muffled and low—or as it does outside of the womb, they showed a distinct preference for the filtered voice," says Fifer.
An Ear for Language
Muffled or not, unborn babies seem to develop a fine ear for certain sounds. Research reveals that babies had their first lessons in their native language while still in utero. They'll suck more vigorously to turn on tape recordings of people speaking in the language of their mothers, rather than in a foreign tongue. Of course, it's likely the babies are picking up on the rhythm and melody of the speech, rather than individual words.
This doesn't mean that moms need to converse directly to their swelling belly to give their child a head start on language, however. A developing fetus gets all the information he needs just by listening in on his mother's conversations with others. He also may be picking up something from any books she reads aloud. Besides being able to tell the difference between English and French, a study shows that babies in the womb may be able to recognize the specific rhythms and patterns of the stories they hear. Pregnant women read out loud one of two stories—The Cat in the Hat or The King, the Mice, and the Cheese—twice a day for six weeks before they delivered their babies. After birth, when the infants were three days old, they were played tape recordings of unfamiliar voices reading those stories: They consistently changed their sucking patterns on the pacifiers to hear the story they'd heard in utero.
Seeing the Light
Since there's no such thing as a womb with a view, it's no great loss that a baby's eyes, which form in the first trimester, are sealed shut until about the seventh month. After they open, the fetus is able to see, but there's little or no light to see anything by. Some doctors have reported, however, that if you shine a very bright light up inside the uterus, the fetus will turn away from it. Similarly, doctors suspect that the fetus may be able to detect a faint glow if a strong light is pointed right at mom's belly. Ultrasound has also revealed that fetuses gradually open and close their eyes more and more as they near delivery, as if practicing for blinking and seeing in the outside world.
A pregnant woman really is eating for two, and the quality of what she eats matters as much as the quantity. Taste buds develop in a fetus around the seventh or eighth week and, by week 14, there is some evidence to suggest he can taste bitter, sweet, or sour flavors in the amniotic fluid. As with his other senses, he uses taste to explore the womb around him. Ultrasounds have even shown that fetuses lick the placenta and uterine wall.
Studies indicate that the flavors and aromas of the foods mom eats during pregnancy, which pass through to her amniotic fluid, may affect her baby's taste preferences long after birth. "The more varied a mother's diet during pregnancy and breastfeeding, the more likely that the infant will accept a new food," says Julie Mennella, Ph.D., biopsychologist at the Monell Chemical Senses Center, in Philadelphia. Studies have also found that breastfed babies are more willing than those who were formula-fed to consume a new food when they get older. "This could be because they've learned to accept the many different flavors that have passed through the mother's digestive system to her breast milk," says Mennella.
A Nose for Mom
An unborn baby not only tastes foods, but can smell them as well. Doctors have noted that, at birth, amniotic fluid sometimes carries the scent of cumin, garlic, fennel, and other spices a mother has eaten while pregnant. Amniotic fluid, which babies swallow and breathe in during their time in utero, not only has the smells of the foods mom eats, but of mom herself.
That, in fact, may be how newborns recognize their mothers. "It's possible that in the first few hours after birth, a baby's sense of smell may be more important in helping him identify his mother than his vision is," says Mennella. In fact, studies have shown that if a mother washes just one breast right after birth, the baby will prefer to nurse at the other, unwashed breast. (This is why some doctors advise new mothers not to shower until at least after the first feeding—to allow their natural aroma to help establish breastfeeding.)
Perchance, to Dream?
Through ultrasound tests, researchers have seen evidence that babies in utero experience rapid eye movement (REM) sleep, which is associated with dreaming, at around 32 to 36 weeks. No one knows whether they're actually dreaming, since their brain waves can't yet be monitored, but doctors believe that it's certainly possible.
In fact, the sleep patterns of fetuses in this stage of development closely resemble those of newborns: They spend a lot of their time in REM sleep, but also in a quiet, deep sleep where there is no eye movement. Researchers have also observed babies in utero in a state of quiet alertness, which suggests they may be concentrating on something—listening to mom talking, perhaps.
Ready for the Big World
Babies eagerly investigate whatever they can get their hands on—and the fun starts before birth. As early as 20 weeks, fetuses react to what's around them. (Ultrasounds have shown that some try to grasp the amniocentesis needle when it's inserted into the uterus.) But it isn't until the third trimester that they really begin to grow curious about their intrauterine world. Though there isn't a whole lot in there to play with, fetuses entertain themselves by sucking on their hands and fingers (especially their thumb, which they discover at about 18 weeks). They also 'walk' around by pushing on the uterine walls with their feet, and yank, pull, and swing their umbilical cord—they even practice breathing.
All this playing around helps them develop important reflexes they'll need once they're born. Sucking will not only be crucial to taking in food but will also be a source of comfort. And feeling things with their mouth is an important way for babies to explore things. Filling their lungs and moving the diaphragm up and down—albeit with fluid instead of oxygen—is also good practice; by the time the baby makes his entrance into the world, he will have learned to breathe on his own.
Doctors believe that pushing off the uterine wall probably helps the fetus develop the ability to reach his mother's breast soon after birth. When a newborn baby is placed on his mother's bare abdomen, his primal instinct starts to kick in: Within the first hour of life, he'll push his way up toward his mother's breast, guided mostly by scent, according to research by Marshall Klaus, M.D., author of Your Amazing Newborn.
So compelling is the research on this early dance between mother and baby that Dr. Klaus and other neonatal researchers are now urging hospitals to change their procedure for handling newborns: Instead of weighing and bathing the infant right after delivery, they suggest placing him between the mother's breasts immediately after an initial examination and waiting at least an hour after birth to perform any necessary procedures.
All this goes to show that a baby isn't just passively waiting to be born while in the womb. He's already building important skills and developing a strong bond with one of the most important people in his life—his mother.
Laura Flynn McCarthy is a New Hampshire-based freelance writer who specializes in health and parenting issues. She is also the mother of two boys.