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To iPad, or Not to iPad….That is the Question – A Table Talk Wednesday Recap

Written by Julie Higginbotham, Senior Case Coordinator, Mecklenburg County CDSA

If you’re looking for a great place to have a conversation about early intervention experiences in the field, as well as an opportunity to learn from your peers, look no further!  Table Talk Wednesdays are the place to be, and this month’s event was certainly one of our most engaging as we talked about the use of technology in the home, including iPads, smartphones, and other handheld devices.  Sherry Kornfeld, Speech-Language Pathologist and Owner of Early Bird Developmental Services, helped to facilitate this group discussion with Sheena Jennings, Unit Supervisor with the CDSA.  Right off the bat, we talked about the difference between iPads in regular visits with families vs. iPads as assistive technology, which is a formal service on an IFSP.  In fact, the North Carolina Infant-Toddler Program has released some procedural guidance around iPad Use as Assistive Technology in Early Intervention.  Once we got that distinction out of the way, we started talking more about how iPads and other electronic devices do….or do not….fit into natural, routines-based supports for children and families.  Here were the highlights:

  • The American Academy of Pediatrics recommends limited or no screen time for children under the age of 2, but it’s everywhere.  Several folks mentioned their own stances against using technology instead of encouraging children to have more meaningful interactions with family members, and even themselves as early interventionists.  Some even asked why we might go in as professionals and provide support against a reputable recommendation from the AAP.  However, there’s the issue of acknowledging that kids have ready access to tablets, smartphones, and TV.  As adults, we also tend to model screen time ourselves, and children learn from what they see.  It’s easy to give our opinions on the matter, but it’s not about us, it’s about the family and where their priorities lie.  Is There an App for That? gives some more insight from a therapist’s perspective on using technology with the little ones we serve.
  • More exposure to technology seems to have an impact on a child’s skills when teams are evaluating for eligibility determination.  This one was really interesting – we had a good number of evaluators from the CDSA, and one of their roles is to complete evaluations for eligibility and child assessments to address functional skills.  Since we look at all areas of development, there can certainly be impacts on a child’s communication and social skills, but what about their fine motor skills?  A few evaluators noted observations in which a child may be able to use one finger to work a tablet very proficiently, but when it came to feeding, doing a puzzle, or holding a pencil, the child had some struggles.  Sometimes, parents see that their children are able to do so many things on an iPad, and we don’t want to take away the fact that they see many strengths in those skills.  Sometimes, they don’t realize that their children can’t recreate those activities with real materials until we have a team looking for specific skills during an evaluation.  If we find that the child has delays in fine motor skills, we need to be sensitive in the way that we share that information and find out if the family is interested in looking further into the routines impacted by those needs.
  • We need to be looking at why we’re talking about the iPad.  The group shared a variety of experiences with seeing and/or using iPads during visits.  Sometimes, it comes up on the part of the family when they use iPads or other technology routinely during their day – maybe the child is most calm when they have access to electronic devices, or perhaps a family is unsure of how to use more natural opportunities during the day to engage with their child.  It could be that the parent sees the child learning ABCs, 1-2-3s, and completing puzzles, so that must make it a great tool, right?  TTW participants discussed how they’ve tried asking reflective questions about family views regarding the child’s engagement and involvement when the iPad is available.  Some families decided to phase it out because they realized that they wanted more face-to-face time with their children, and others were actually looking for ways to provide learning opportunities that they didn’t feel they could provide on their own.  Maybe we’re the ones bringing in the technology – one person shared experiences with using technology to “break the ice” when trying to establish a rapport with the child and family, and then only using it intermittently when needed.  Another person felt that it wasn’t natural to use an iPad during visits, especially when the family doesn’t have one or doesn’t allow the child to play with theirs.    Parents could even feel like they needed to buy one to use.  We don’t want to be bringing in toy bags, so why would we want to bring in something else that isn’t in the context of the family’s daily routines?  Could we potentially create an issue where the child connects us with getting to use an iPad?
  • But some families really want to use technology to help enhance their children’s development.  This goes back to the concept of meeting the family where they are and addressing their priorities and concerns.  We can help families find ways to incorporate technology in a more functional way, and one person made the comparison to moderation.  Even though playing outside is good for a child’s overall development, would we find it excessive if 8 hours per day were spent outside playing ball?  In the same light, if a child is on an iPad for 8 hours per day because they have it during many of their daily routines, we might want to talk about how to find a balance with more direct engagement with family members.  If a smartphone helps with a difficult transition during the day, or if another family uses an iPad as a reward to support more positive behaviors during the day, how can we help fine-tune this resource and focus on other, less stressful times of day to engage more personally?  Perhaps the child has a diagnosis, like autism or apraxia, and the family is looking for the best way to meet their child’s needs.  If it’s on the table for discussion, look at how technology might fit into IFSP outcomes so the team has more information about how to incorporate it in a balanced way.
  • What does communication really mean?  The group had a really interesting conversation about the function of communication and what happens when a screen is more enticing than another person’s face.  One attendee commented that we could be taking people out of the picture as communicative partners and that kids could be missing opportunities to play with a real ball, hold a real apple, and have more real experiences that they can carry over into other familiar environments.  Of course, a child could grow up and have an amazing career in technology, but how will they do socially?  It was funny when a few attendees “aged” themselves when they talked about the concept of “kids say the darndest things” and how parents could miss out on those entertaining moments if their children are caught up in technology at a young age.  Another person even referenced The Big Bang Theory and one character’s difficulties with recognizing facial expressions in others, even just the raising of an eyebrow.  The New York Times also covered an interview about how Steve Jobs was a Low-Tech Parent.  We want kids to notice the big things going on around them, as well as the little, more subtle things that enhance their engagement with the rest of the world.

So, what does this look like when we’re out in the field with families?  Here were some nice, functional ways for us to address technology use during ongoing visits with families….

  • If the parents report that the child responds more rapidly to the TV or iPad, but not to them, look at ways the family can intervene to encourage more social interactions. 
  • Ask good, reflective coaching questions to get more information about what the family wants to do.  Check out our Master Coaching series in our blog to see how you can get to the information you need without leading the family in any particular direction. 
  • Be sure to look at the big picture – it’s not just about the iPad, it’s also about how it impacts the family’s routines.  Is the family using technology to distract their kids so they can get other things done, or is it more than that?
  • Always go back to the outcomes on the IFSP to see how technology relates to those specific priorities and concerns – because the outcomes should be written based on the families’ natural routines during the day, strategies should revolve around activities that help move the family in the right direction.

As you can see, there are lots of mixed feelings around this topic – technology can be helpful in some ways, but can it also inhibit some of the more natural learning opportunities for children during their daily routines?  Leave us a comment – we know that there is more to the story, especially when you consider specific diagnoses, family dynamics, or any other individualized circumstance that you may encounter in your work.

Be sure to join us for our next Table Talk Wednesday event where we’ll be discussing Coaching with Interpreters on October 15, 2014.  Remember, there will be sweet treats to go along with an amazing conversation!  🙂

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