CUSTOMIZE YOUR SWITCH There are many ways to customize a switch. In addition to trialing various switch placements, considering the angle and location of the switch when using direct access with a hand can also support successful switch activation. Positioning the touch switch at a 45-degree angle can facilitate activation by eliminating the need to press directly on a flat surface. Instead, the individual can activate the switch by moving their hand to- ward it or by performing a side-swipe motion from left to right. This can be done by using a mount or by cutting a pool noodle or a piece of foam. There are low tech mounts and surfaces for purchase such as the Maxess Switch Mounts to vary positions at a 45-degree angle (See image 10). Also, touch switches can be positioned by placing them within a piece of foam so that the surface is nearly flat. The individual then can then rest their arms or hands on the foam and move to the recessed area to activate the switch. There is a photo example of a child using recessed switches on Ablenet’s Switch Access Beyond Cause and Effect: Stepping Stones for Effective Learning – Part 1 by Linda Burkhart and Fio Quinn (2020). Switches can also be positioned at various angles through the use of rigid switch arm mounts or through flexible switch arm mounts like those described in the Closing the Gap front page report, Flexible Mounts Created by Modu- lar Hose for Assistive Technology. This low-cost option allows teams to easily adjust the mount location on the fly. Often some will continue to pursue a ‘perfect’ switch site be- fore beginning to engage in switch related activities. Waiting until then could result in significant delays or it potentially not happening at all, as there is always room for improvement. The goal should be to find some good possible switch placements and then provide opportunities for the individual to learn how to use them. As the individual engages with the switch and a functional purposeful activity, that will then inform and refine the identification of switch sites. Positioning, motor tone, fa-
tigue, and the activity all influence the potential success of switch sites. The best thing to do is jump in, try it, use it and con- tinue to refine while the individual is engaged in switch activi- ties. It is best to ensure that the cognitive load is reduced while they are learning, such as engaging with switch games and not pairing the new motor pattern required for switch use with com- plex communication and language tasks. Parallel Interventions should take place concurrently that in- clude both building switch skills through play and games as well as utilizing low tech and/or mid tech tools for supporting com- munication needs. Examples of building switch skills through play and games include cause and effect online activities through a computer or iPad and switch adapted toys. Examples of supporting communication through low tech and mid tech tools include the use of providing aided language stimulation, partner assisted scanning for low tech communication books or PODD books, use of eye gaze frame and low-tech picture sym- bols and simple voice output communication aids (VOCAs). STARTING WITH PLAY AND GAMES There are many reasons why individuals who need alternative access should start with building switch skills on the computer. The computer (or iPad) will always provide feedback when a in- dividual activates a switch, and that feedback will be consistent. When engaging in switch activities that are reliant upon adults or peers, the feedback can vary and be inconsistent. One adult may provide a more enthusiastic response than another, pro- vide varying amounts of verbal responses or even at times be unable to respond due to contextual factors. Computer-based games and activities also can provide high contrast and visual interest. When an individual is positioned properly in front of the computer, the screen is directly taking up their visual field, and therefore providing high visual interest feedback. It also supports individuals with visual impairments including cortical visual impairment (CVI) as many of the switch-adapted games and activities include accessibility features that support high contrast. In addition to the visual feedback, computer-based games and activities can also provide intense auditory feedback. This can be done through the built-in speakers of the computer, Chromebook, or iPad or headphones can be used to reduce ex- ternal noise and increase auditory support. Starting with prac- ticing switch skills using computer-based play and games are reducing the cognitive load for the individual in order build the foundation for accessing higher level academics and communi- cation. The goal should be to try to move from one switch to two switch scanning when working beyond the level of cause and effect. While a secondary switch site may not be possible for all, those supporting the individual should exhaust all avenues to identify a secondary switch site and determine that is not possi- ble as a team. Two switch step scanning allows more control and active participation for the individual by being able to control
Image 10: Flat switches can be angled by cutting a pool noodle to create a 45-degree angle.
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