Water: PODDtastic!

This week one of my students told us about his vacation. He told us about the company he had at his house, going out to eat and going to a party. This may not sound that unusual, to talk about a vacation, but it was a huge breakthrough for this student. At 15 years old this student who has cerebral palsy, cortical vision impairment and severe apraxia has been unsuccessful with many methods of communication. He has tried communication books, sign language, static display voice output communication aids and dynamic display communication aids. He does have a few spoken words and a few signs and gestures. He is sometimes successful on voice output communication aids. Yet until PODD nothing "clicked".

This student's apraxia means that the harder he tries at communication the harder it is to communicate. This is seen mostly in his spoken language, words do not "come out" unless he is so excited or upset that they "blast" from him. However this is also seen in his alternative communication. When using a communication book he tends to just flip the pages and when using voice output his hand often hovers over a button instead of pressing down. Add some mild cortical vision impairment to the mix, which presents as an inability to look and touch something at the same time and communication has been an exercise in frustration.

Enter the PODD. PODD or Pragmatic Organization Dynamic Display is a both a method of communication/method of teaching communication and a set of manual communication books. PODD was created by Gayle Porter in Australia. PODD materials are arranged especially to be used for social interactions (pragmatically). Messages in the PODD flow from one page to the next by way of page numbers that guide the user through a conversation. So a conversation can move easily through conversational turns.

I will be the first to admit that I did not "get" PODD when I first read about it. It seemed cumbersome and indirect. I disliked how the same symbols may be in different places on different pages (being the big believer in motor learning that I am). I thought some of the language was too immature for my high school students. And finally when I saw it in action it did not work. Our SLP attempted to implement it with another student in the classroom but it was not successful, mostly because we were not using it receptively with the student. The PODD book ended up sitting in the student's cubby unused until it landed in our "drawer of abandoned communication aides"

Then I went to Linda Burkhart's workshop at ATIA in January. Wow! First of all if you ever get the chance to attend a workshop Linda Burkhart presents you should go. Second of all it is seeing videos of PODD in action that really "sells" it for use with our students. The first thing I did when I came home from the conference was apologize to our SLP. The second thing was to lay out a plan to introduce PODD into my classroom. PODD really is everything that people who use it rave about, but it can be hard to tell that from reading descriptions and looking at pictures. If you really want to see what PODD is about you should start by going to YouTube or a similar video site and watch videos of PODD in action.

PODDs are intended to be as much for receptive communication as they are for expressive communication. Communication partners of individuals using a PODD also use the PODD to communicate. Modeling or Aided Language Stimulation happens constantly as both communication partners use the PODD. For the first it pretty much only adults used the book. Eventually our student started to internalize the way PODD worked and communicate with us using it.

In our situation we are using a partner assisted scanning method of access to the PODD book. The communication partner begins on the first page and names each item, one at a time. For each item my student presses a switch for yes or no. (We use a green and a red Talk Block switch for this.) If the answer is "no" the partner continues the auditory scan. If the answer is "yes" the partner restates the message that has been created so far and turns the pages of the PODD as directed by the page numbers associated with each message. Using partner assisted scanning with yes/no switches was a big part of the "ah-ha" moment for this student. When we eliminated the physical burden of trying to look and point (or press) symbols to communicate his cognitive focus could remain on his message. On top of this the is the added motivation of the intense attention from a communication partner and ability to be "bossy" that comes with using a PODD via partner assisted scanning. All of these combined and we have communication.

The only way to purchase PODD right now, in the USA, is from Mayer-Johnson as a Boardmaker Add-on. It costs $325 (in addition to the cost of Boardmaker if you don't already have it). You will have to customize, print and bind the PODD books yourself. The PODD boards that are available for purchase are designed for direct selection. It is possible to customize these yourself for visual, auditory or multi-sensory scanning or other means of access. Gayle Porter, Linda Burkhart and others are working on creating alternative access PODD materials to sell.

PODD can also be a great bridge to high tech dynamic display communication. In our school we have modified it on a Tobii C-eye for a student who communicates through eye gaze and on Proloquo2Go on an iPad for use with direct selection. (I am waiting with baited breath for Proloquo2Go to add two switch scanning so the student described above can user his iPad to talk!) Currently using PODD on a high tech device means doing all the programming yourself, but it is worth it. I have chatted with a few high tech AAC vendors about PODD being available as a vocabulary set, but currently none of the vendors has plans to do so (at least that they were willing to share with the likes of me!).

You can read more about PODD from Linda Burkhart's website and handouts. She also has a great hand out about using PODD with Partner Assisted Scanning, the hand out is meant for working with those who have Rett Syndrome, but applies to most, if not all, situations in which you would use partner assisted scanning. Novita also has a great website about PODD.