Dr. Raymond Heipp

Recently, I had the opportunity to lead a PD session for one of our larger US districts with a focus on working with our neuro-diverse students and how to best support them. We know from our experience that by building a foundation through executive functioning, we can give our students the best opportunity to succeed in life while living as independently as possible. Like other areas, we simply cannot apply a specific recipe for dealing with executive functioning as the issues our individuals are facing vary. There are some techniques that we can look at which cover a more generalized approach to executive functioning that we can incorporate into everything we do daily.

When we define executive functioning, I like to refer to my colleagues over at the Cleveland Clinic who describe it in this way:

“Executive functioning refers to the skills that you use to manage everyday tasks like making plans, solving problems, and adapting to new situations. The three main skills are working memory, cognitive flexibility, and inhibition control.” (CCF, 2024  Executive Function: What It Is, How To Improve & Types) 

By using this as a starting point, we can begin to look at how to structure our classrooms and other environments in ways which can support all our students, especially those with some executive functioning issues.

Within our classrooms, we often see issues around the following areas:

1.       Weak Time Management
2.       Forgetfulness
3.       Issues with starting and/or finishing tasks
4.       Issues with making sudden changes due to external factors
5.       Weak self-regulation skills

These are the areas where making some adjustments within our classrooms and other environments can make the most impact for everyone. When we read the research on issues within executive functioning, we realize that this is not simply an issue with conditions like ADHD or autism spectrum disorder. The research points to the fact that even in neurotypical adults, skills in executive functioning can begin to decline as they age. Hence, by introducing some of these techniques in your classroom, you can build a foundation which remains for the entire life of a person.

Time Management

Let’s start with Time Management as that area has many schools of thought in best practices. The most important thing to remember is that if you can introduce even a few of these techniques, you are going to be helping. The reason for the various schools of thought depends upon the interpretation of what actions help and which ones seem to enable. The first thing I want to suggest is that you have three forms of available information designed to help students with what is happening. The first is to have some form of a calendar on the wall which promotes the important and major events which are happening. The second form is to have an area on your dry-erase board that lists how the day will flow, so basically an agenda for the day. The third form is another area on the dry-erase board which lists any assignments that will be homework is you are giving homework.

I suggest taking those second two forms one step further and incorporating color coding into each based upon the subject areas. So, for example, on the daily agenda, math might be written in blue, reading in green, and literacy in orange. Then, use the same colors for the assignment area as well; math homework in blue, reading in green, etc. The color coding allows for another layer of processing and categorizing the information.  This color coding takes the information to another layer when the individual is taking it into their minds. I am a big proponent of color coding as I use this in all my planning as well.

For those who speak to enabling the individuals by having things listed out, the reality is that if the individuals do enter the workplace or use calendar features on their phone, these actions provide modeling for how to properly use those types of calendars and keep daily activities organized. I am also a fan of redundancy to reinforce awareness of daily activities. For example, I have a full year calendar on my office wall which I update regularly using color-coded items for quick visual access. I also have a physical planner for times when I simply want to open the planner and see either a daily or monthly review of activities with consistent color coding. I also use my computer calendar and can access it online as well as through my phone. Yes, items on there also have color coding.

Forgetfulness

When we look at the idea of forgetfulness, we can see that having something for the students to take home may help, like a planner or a notebook. However, there is more to it than simply expecting them to write things down. Have a set time where you guide them with assignments that are due. Create a system where the parents or guardians understand that they need to check the planners, work with the student, and put them back in the backpack. I saw an interesting one where the student had a notebook which was attached to a string and connected to their backpack. Thus, the notebook, even when taken out of the backpack, was still connected and would not be forgotten. Creating a system like this is not enabling, it is modeling how things need to be remembered. Having set times both at home and at school helps to establish a routine that can become habit when completed enough times.

Issues with starting and/or finishing tasks

For issues with starting and/or finishing tasks, create superstructures along with visual timers to make sure things get started and done. There are several reasons why procrastination occurs. We cannot address all the core reasons, but we can address how to set the structures in the classroom and provide the timing support. Please use Time Timers for ALL activities! Seeing the passage of time decreases anxiety levels and helps to keep focus on the task at hand. Have those tasks on the daily agenda and keep them consistent. You can create a routine which helps the student to expect certain things at certain times. As they progress through school, the activities might change. You just want the process to remain consistent, which will allow it to translate into later life.

Issues with making sudden changes due to external factors

 What happens when something like a fire drill or a severe weather drill interrupts the day? Many of us have been in situations where this causes escalations and more issues than the drill taking place. Start early in the year and practice some of these drills on your own when the students are still getting used to a new routine. Do not be afraid about doing them without the rest of the school. Let the students know this is something that will help them and that later, they will be practicing this with other students as well. Do it on a Tuesday one week and a Thursday the next. Again, the idea is to make it something that interrupts the daily routine but is not seen as overwhelming. In speaking with a group of nurses at the National Association of School Nurses Conference in July, I explained that practice sessions like this assist not only in the drills and any potential school evacuations, but also with the idea that change can happen any day and that is okay. Once our students are beyond our walls, they will encounter change on a regular basis. Having them become acclimated to schedule changes can only help them later in life.

Weak self-regulation skills

Finally, when working with weak self-regulation skills, teaching concepts like breathing can help. Work on breathing techniques when the students are calm. That way, they can begin to use the technique with it moving into some muscle memory. Simply telling a student to breathe when they are escalating is not going to do anything outside of increasing the escalation. You can also have some classroom appropriate fidgets which are only available when a student has calmed themselves through breathing. By introducing the use of these fidgets after practicing breathing, you begin to associate the fidget with a level of calm. That way, if a student does escalate and breathing is not immediately working, you can also share that fidget to assist in the deescalation process.

The main thing to always remember is that there is no one-size-fits-all approach to assist with executive functioning. By setting up your classroom and routines, you can support your students this year as well as in their life beyond school because of the skills and modeling that you have provided.

Over the last few blog posts, we have looked at Reader Pens and standard forms of switches. I want to make sure that I also address some of the more specialized switches that work along with AAC and other devices improving the lives of individuals and moving them toward greater independence.

When we look at specialized switches, there are several that I have worked with which come to mind. There are several from Enabling Devices which stand out. First, the Finger Switch offers a great way to harness the ability of an individual who might have enough movement in a finger to activate this switch. I like its design and how it can be adapted to various individuals. The Velcro harness allows it to be attached to a hand without need for other means of connecting. Next, the Bright Red Switch offers a larger activation area which also lights up and vibrates. Many of you have seen me with this at conferences and presentations. The characteristics of this permit it to be used by a range of individuals including those with visual impairments. Next, the Grip and Puff switch is a switch which addresses the needs of individuals who may only be able to access devices using a puff technique or may need something placed in their hand which can react to a squeeze. The fact that this switch can do either allows us to accommodate multiple individuals with a single device. Finally, the Sound Activated Switch offers access to those individuals who may need to rely on making sounds in order activate a switch. The sensitivity of the microphone can be adapted to best meet the needs of the individual without having indirect triggering by individuals around them.

Pretorian Technologies also offers some excellent switch solutions for individuals. Some of their devices were highlighted in previous blog posts. I want to focus on the following devices from them for the sake of this post. First, one of my go-to switch interfaces comes from them. You may have heard me speak of the APPlicator over the years. They continue to develop this product so that you can get high levels of access for individuals. They also have the APPlicator Max to make more complex activities accessible. They have done a lot of work in making workplace activities and gaming more accessible. In order to support both of those areas, they also have the Ultimate Switchbox which can connect up to 6 devices to a computer for a range of keystrokes. This means that many more individuals can engage in the activities that demonstrate the depth of their knowledge and skills.

Adaptivation is the group which brought forth the Honeybee which I discussed as part of the proximity switch discussion. The other amazing switch series they have is the Pal Pad series. The Pal Pads come in different sizes and lay flat on a desk, table, or even on a mount. The touch needed for activation is somewhat light. I like the idea of using these switches to also train the behavior of a swipe. There may be some of our individuals who with the right guidance and support would be able to use iPads and Tablets in the future. However, based on their initial state of understanding and fine motor abilities, swiping may not be something that they can easily do. The Pal Pad offers that way of creating a swiping behavior while still activating devices or interacting with a computer. They also have the Tapio which is a great interface for switches with iOS systems.

As we move into AAC, I want to make sure everyone is aware of the Logan ProxTalker and ProxPad from Logan Tech. These devices have been around for over 15 years and continue to allow individuals to communicate at higher levels while creating easy access to changing phrases for teachers, therapists, or other caregivers. The brilliance of these devices lie in the RFID tags and how they can easily be recorded for immediate use.

Shifting over to mid-tech devices, AbleNet has a range of products that can provide so many different approaches to communication within classrooms and all other areas. When we speak about single message communicators, both the BIG Mack and the Talking Brix2 stand out for me. Many of you have experienced how I have supported districts into bringing BIG Mack devices into areas like the Nurse’s office and Principal’s office. This device, aside from its larger activation area, offers a lot of flexibility in how it can be used in any environment. The Talking Brix2 highlight the idea of being able to use single message communicators for a variety of purposes. They are great to have out for choice selection. They can also be used for putting together words in the creation of basic sentences. What some people do not realize is that they can be used throughout a classroom as basic instruction communicators allowing the teacher to be in four places at one time; one physical and the other three through their voices placed appropriately through the Talking Brix2 devices. I have also been working with groups who are now using them to begin an introduction to following sequential directions.

When it comes to mid-tech multi-message communication, I recommend QuickTalkers for a number of purposes. First, they can act as a standard communication device. How many areas for activation will be determined by the cognitive abilities of the individual. Beyond that, these devices can be used for factual review; like showing a word or picture and then having the correct auditory response associated with it. Facts can also be incorporated into these devices. I have seen them being used to identify elements in the Periodic Table or dates with historical significance. Finally, they can also be used with books to create read-alongs for emergent readers or those who enjoy stories and want them read out loud. The iTalk series by AbleNet also gives switch activated ways of choice selection or communication of set ideas. Using an iTalk 2 as a yes/no or true/false selector or an iTalk 4 as a way to address multiple choice selections can also be utilized for those non-verbal individuals who have the cognitive ability to answer these types of questions, but not the physical abilities to write them out or interact directly on a computer.

One final device I want to bring to your attention is the CMPSR Digital Music Instrument. This device has begun assisting individuals with fine motor issues play a variety of musical instruments that actually sound like the real instruments themselves. The interface looks like a joystick for a power wheelchair. However, the strength of it lies in how it creates the music through an iPad or MIDI unit. Students have been able to join in their school orchestras or bands with sophisticated sounds that go beyond a drum beat or tapping of a cymbal. They are now playing instruments and feeling empowered through sharing their joy and musical abilities.

I know we have reviewed a lot over these last three blog posts. Please feel free to reach out to me with any questions at rheipp@schoolhealth.com.  There is not any “one-size-fits-all” to switch selection, AAC usage, or even specialized devices. We should always base our recommendations on the SETT framework and seek to enhance the lives of our individuals.

The question is often asked of myself or our fantastic AT Specialists, “What is the best kind of switch?” The answer will always be the same – “The one that works for that individual!” As we assess the types of switches out there, we need to recognize that all switches are not alike. Even within types of switches, we need to think of them like types of apples. There are different types which people prefer and can be used for different things. Think of it this way, a Granny Smith apple might be good for baking a pie or those of us who like a tart apple. A Red Delicious is sweeter and makes for a great snack. They are both apples, just liked by different people and able to be used in different ways.

In this blog, we are going to focus on the following types of switches: standard, proximity, and wireless. We are going to focus our next blog on specialized switches. Within the category of specialized, we will look at a number of different switches which can be used for specific situations. Any of the switches I am discussing here or next month, I have used and received feedback on from our colleagues in the field. I am going to stay away from discussing homemade switches as the stories around them are dependent upon so many variables. There are also inconsistencies within how they are manufactured that does not always allow for generalizations. Don’t get me wrong, some of them are well designed and work well. However, there is not a solid track record due to not having a set way of manufacturing.

Let’s start with standard switches. When I say standard switches, I am referring to a simple press down switch like an AbleNet Jelly Bean. These are switches that can be used for a number of purposes but do require the user to have enough fine motor skills to press down on them. Since I began with an AbleNet switch, let’s stay with them as a manufacturer. AbleNet has the Jelly Bean, the Buddy Button, the Big Buddy Button, the Big Red, and the Specs IC that operate in the same way. There are differences within each that lend themselves to certain situations. For example, the Jelly Bean can be mounted and is a strong go-to when it comes to a switch that can be used for a number of activities. It’s 2.5-inch surface allows the user to have a nice-sized area with which to connect. If the individual needs a larger area for connection, the Big Red provides a 5-inch surface to assist those individuals who need the larger area. The Buddy Button helps those individuals who need to be able to activate a switch with a lighter touch. For those with moderate to severe upper extremity and motor issues, moving to the Big Buddy Button offers higher levels of access and potential success in activation. The Specs IC, with its 1 and 3/8-inch surface offers a smaller footprint for individuals who need to use a switch and have strong fine motor control.

Pretorian has the Smoothie Switch which is great for those individuals who may only have the ability to touch along a side of the switch for activation. They use the same style for their Simply Works switches as well. If you have an individual who is rough on switches or may have some drooling issues, then the Piko Button would be a likely choice. The water-resistant switch allows that individual to continue to use a switch even if they are getting it wet. Enabling Devices has the Gumball Switch which is good standard type of switch with its 2 ½-inch surface. For those who need something a little smaller, their 11/4-inch compact switch works well and they even include Velcro to use as a mount. For those who need something a little larger, their Jumbo switch fits the bill giving a larger area for contact.

When we look at proximity switches, we want to recognize what they do and how they can be best utilized. The AbleNet Candy Corn is the best known of the proximity switches. It does come in only the big size now. It also has the ability to have both sound and lights on or off to acknowledge activation. I still recommend this switch as a head or cheek switch alternative.  Adaptivation has created the Honey Bee Switch which combines both proximity and touch into a single switch. This is great for OTs who are working on fine motor skills and touch abilities. Another one of my favorites is the Movement Sensor Switch from Enabling Devices. This switch can be adjusted to pick up even the slightest fluctuation of a digit to activate the switch. We wrap up the proximity switch section with one from Pretorian which also is a Bluetooth wireless switch and that is the ToFFEE BT. This switch gives the flexibility of having both proximity features along with being wireless.

When we look at wireless switches, we need to know what we are connecting to as well. For example, when connecting to an iPad, the AbleNet Blue2 stands out as it was the first switch to connect to this device. The current version also has light touch and lights up to show activation. AbleNet also has the Jelly Beamer and the Big Beamer for those situations where you want to move an individual from a Jelly Bean or Big Red which are connected via a wire to a wireless option. The switches look similar, have the same surface area, and allow the user to feel comfortable with the change.

There are other specialized switches which fit into these categories as well. I am going to keep those for next month though as there is a lot to discuss around them as sometimes we need to make sure it is something that can accommodate the needs and strengths of our individuals. There may be some switches which I have not mentioned here as well. That is due to either no experiences with them or less than satisfactory experiences. The switches that are a part of this blog have strong track records and have helped many individuals. As always, if you have any questions, feel free to reach out to me at rheipp@schoolhealth.com.

Assistive Technology madness can mean many things. It can be a reference to the March Madness tournament that we see in college basketball or the madness that comes along with knowing what the best device for our individuals may be. Either way, there will be devices that work well and those that cannot rise to the occasion. Knowing about every device is not possible. Also, trying to fit the needs of the individual into devices is the opposite of what might be most effective in supporting them. We need to fit devices into the needs of the individual. That is why you might have heard me say before that the best device is the one that works for that individual.

For the sake of keeping this a blog and not a novel rivaling War and Peace in length, I am going to structure this blog into three general categories, switches/access, AAC, and Reader Pens over the next three writings. I realize that we will be leaving out those devices which assist in daily life activities as well as those which may have more specific purposes. However, I want to address the questions which I am most often asked by our schools and therapists. I am going to begin with Reader Pens in this blog as we strive to improve our literacy skills here in the US.

Reader Pens

You have heard me speak about this before. There are only three manufacturers with whom I am comfortable recommending to anyone for reader pens. Those three manufacturers are C-Pen, Scanmarker, and OrCam. I have not had enough information shared with me or the ability to test things out from other manufacturers to have the same comfort level. Each of these manufacturers has both the research and the field successes to be something that would be worth investing in for your individuals.

When we are looking at the OrCam Read, no matter what version, this is something that can work for those with visual impairments as well as reading issues. The point-and-click ability allows individuals simplicity in use. When we look at the OrCam Read 5, the addition of AI really allows that device to support individuals when they encounter reading and researching, as well as being able to use it for other daily purposes. The only concern I have is the cost. This is a device that offers a lot, but you want to make sure your return on investment supports your purpose.

C-Pen is the next manufacturer we will review. The research and case studies around their devices is solid. All their devices have demonstrated the ability to support those with reading difficulties as well as other health issues when it comes to processing text. We have seen this manufacturer be accepted by groups throughout the globe, including multiple groups which focus on dyslexia. I am a big fan of both the Reader 2 and Reader 3 devices as they are flexible in how and where they can be used. The Reader 2, because it is not connected to the internet, offers security from issues that may exist outside of the building. Its smaller size also works well for smaller hands when one is grasping it to be used. I tend to recommend this device for any environment where one does not want a connection via the internet as well as for students at the elementary or middle school levels.  The Reader 3 adds the depth of being able to connect to the internet so that it can include multiple dictionaries (quite helpful at the secondary and post-secondary levels), simple translation tools in five languages when not connected to the internet and forty+ additional languages when connected, a voice recorder, and the ability to have both scanned text and voice notes saved for easy review. It is a little bigger in size than the Reader 2, but it offers so much more for students as they progress through their lives and into the workplace. It becomes a great tool for reading, studying, and even reviewing things like manuals or directions which rely on written text. The design of the Reader 3 incorporates the menu button of the Reader 2 along with touchscreen capabilities so that a continuation of the physical and intellectual behaviors can be maintained when moving between devices.

Over the last few years, Scanmarker has established themselves as another important manufacturer when it comes to reader pens. The Scanmarker Reader is a good pen when one understands that it works through an app and does a good job when it comes to taking notes, translating into many languages, and adjusting font on the computer to create even more ease in reading, processing ideas, and having a place where textual information can be stored and used for other work. The two devices that I tend to see most these days are the Scanmarker Pro and the Scanmarker Max. The Pro is a great device for reading, translating, and carrying on conversations in multiple languages. It can be connected to the internet for additional capabilities. The Max takes the features of the Pro to the next level. It is a device which allows the teacher or administrator to lock out any function on the pen. So, if you did not want students to log onto the internet, use a dictionary, or have access to the recording feature, those could be locked. The Max also has a static IP address for those who have strict requirements with their IT. One of the features that the Max has that is now being used is the Phonics feature where a list of common words can be scanned and then broken down into their phonemes. This allows the device to be utilized in early reading classes which are using the Science of Reading as a foundation.

There are a couple of other pens that I am currently reviewing. They all have similar features. However, until I see them in action and hear from teachers and therapists using them in the field, I cannot, in good conscience, blindly recommend them. The major caveat I have for you is to beware the many “less expensive, but just as good” knockoffs that you might find on places like an Amazon. Many of these knockoffs do not have the depth of features, the computing capacity, or the strength of the camera which allows for consistency which benefits the user. That is why I would always recommend one of the three manufacturers when you are considering buying these devices.

So, Which One is the Best? 

The one that works for your individuals. I have worked with districts that choose one and use them across the board. I have also worked with districts which choose to have class packs of each and do some trialing with the individuals to gauge which device best meets their needs. In my mind, all three are number one seeds. As you go through your decision-making process, feel free to send any questions you might have to me at rheipp@schoolhealth.com. We can set some time to review your questions and see what might be best for you.

Our next blog will focus on switches, so stay tuned for that one!

As we move through the month of February, the outside world thinks of bouquets and chocolates. In the world of Assistive Technology, we begin thinking about assistive technology and the bouquets of spring and new opportunities to access the world around us. ATIA is a great reminder of the assistive technology which can make a difference in the lives of the individuals with whom we work and this year, that reminder rang out like the songs of the birds of spring.

Many of the discussions in which I was engaged at ATIA focused on two topics; what the funding might look like, and what assistive technology was making the most impact on students today. The discussions on funding elicited emotions ranging from cautious optimism to absolute frustration. Since those discussions were happening before the funding from the government was formally approved and signed into action, the anxiety associated with funding was quite high. That is not to say that everything has worked out perfectly for funding. However, with the recognition that we will, at least, have funding equivalent to FY25 for FY26, that anxiety can be lessened to a degree.

We will not see the idea of block grants being passed down into the states. That is important as we were uncertain of what that would actually entail when trying to access those funds. Hence, the current formula will be similar to what we have had to this point. There will be some pressure on us though as the future continues to be clouded due to the ever-changing shape of the Department of Education and where exactly that our Special Education department will be housed.

Knowing that we will have funding available to us, it is important that we use those funds for next year and with an eye toward the future. That leads us to the crossroads of the two topics which came up at ATIA. The folks who engaged in discussions around the technology which was making the most impact looked at the areas of literacy and access that could be used throughout one’s life. I do want to take some time to address those two areas and some of the products I encountered which fit into those areas.

 When starting with the idea of literacy, one must begin with Reading Pens. I will begin with my usual caveat which is to beware of inexpensive pens on Amazon as you get what you pay for. Even though some of the pens look like the name brand ones, that does not mean that they are of the same quality. There is no such thing as a “generic” version of a reader pen. There are different styles and versions from the major manufacturers which we will discuss here. However, the costs for producing these pens stem from the quality of the camera and the internal computing capabilities.

Our colleagues from Scanning Pens were at ATIA and had great information to share. They are the ones who have the C-Pen line and have maintained high levels of research into their products. Currently, their offerings include the Reader 2, the Exam Reader 2, and the Reader 3. I like the Reader 2 for a couple of reasons. First, its slim style fits into many different sizes of hands, including smaller ones. Next, it does its work of reading, having a dictionary, being able to scan, and saving documents without being connected to the internet. It’s ability to have each of those areas locked so that they cannot be easily accessed, especially during a test, is very helpful. The Exam Reader 2 does much of the same, but comes in a different color so that it is identifiable to proctors and teachers. The Reader 3, which has been out for about a year now, adds the dimension of being able to be connected to the internet as well as offering some translation capabilities. Its user-friendly touch screen allows differentiated access. These three reader pens have set the bar for consistency, usability, and evidence-based success. I always recommend them based on the needs of the individuals.

Scanmarker’s own Ioana Lazar spent time in our booth as they were promoting their latest release, the Scanmarker Max. The Max takes all of the features of the Scanmarker Pro and adds in some great new features as well. The new features include “Photoscan” which allows the pen to operate like an OCR device by capturing a picture of words and speaking them out. They also include “Transcription” which allows for the spoken word to be converted into editable text. Finally, for those of us who work with the Science of Reading, the “Phonics Support” button allows some scanned words to be broken down into phonemes with those phonemes being sounded out. As a Reading Diagnostician, I am quite impressed with the work they have done to create this feature. They are also engaged in educational studies right now to review the effectiveness of this feature for all students.

There were some other reader pens at ATIA. However, as I shared with those who attended my session, I have not been able to personally review them and do the research I do before making any recommendations. Some could work, but I am not comfortable recommending them for specific instances at this point.

When we look at access, we want to target the manufacturers who are tried and true in our environment. The big news was the launching of the new Cosmo Learning System. It was wonderful to have our colleagues from Filisia there showing what the Learning System is able to do. It was also great to catch up with the folks in whom I believe and recommend on a regular basis. Those groups include Time Timer, LoganTech, Adaptivation, OrCam, Pretorian, and Widgit. Of course, School Health represented AbleNet there as well. All of those groups spoke about their commitment to maintaining high levels of quality within their products and doing what they could to offer products at reasonable prices. The concern from all of these groups is what will happen with the upcoming potential for increased tariffs. Hence, the need to make wise purchased now when the funding is available to us.

I had many folks ask about virtual presentations as well as calls about students. Please feel free to reach out to me at rheipp@schoolhealth.com so that I can support you in making the best decisions for your students. Remember, there is no “one-size-fits-all” when it comes to assistive technology, so you want to be sure that your funding is being used in ways that allow for access and engagement for the most individuals. In the next few months, I will be focusing my blogs on other aspects of the best assistive technology along with best practices around those devices. I look forward to working with you in your creation of accessible and inclusive environments!

We tend to begin New Years with so much hope for the better in the upcoming months. As we transitioned into 2026, that hope is still there. However, unlike other years, there is still a cloud of uncertainty floating around hindering long term planning. With that in mind, we need to refocus our thoughts, look toward what is new, and design what we can with the tools we know will still be here.

We began this academic year with a focus on literacy and we are seeing that continue. The movement back to basics within literacy has shifted how we approach all students, let alone those who may struggle due to conditions beyond their control. What are those tools we can continue to count on and how do we make sure that they are being implemented properly? As we get ready for ATIA let me share my favorite tools going into the conference and any insights on updates that may be announced there.

Reader Pens have become an essential part of supporting our individuals who struggle with reading due to processing issues or other conditions like dyslexia. It seems that each year, a new pen appears at ATIA that seems to address the cost factor while doing everything we need. Unfortunately, those companies tend to be short-lived as their products, which seem to be too good to be true, in essence, are not what they are cracked up to be. Whether is be the installed hardware or the design and material of the pen, those pens do not work well, break down easily, and end up costing more in the long run. Those pens also give a bad name to reader pens in general and have IT Directors saying that a student simply needs and iPad/Tablet and text-to-speech software. 

As you know, there are two manufacturers that I firmly believe in and recommend. They are C-Pen and Scanmarker. The research that has gone into the design and implementation of these pens is solid. Students have found consistent success with these pens. Both companies make adjustments necessary to enhance the capabilities of the pens in order to continue to address the evolving needs of students. For those who argue with the reasoning of using an iPad/Tablet to capture a picture and then use text-to-speech software miss the fact that some of our individuals would find that approach confusing, cumbersome, and, sometimes, impossible. Reader pens, when used properly, allow for independent reading and a feeling of competence.

C-Pen introduced us to the Reader 3 pen last year. This touchscreen pen offers a great upgrade from the Reader 2 pen. For those who began by using a Reader 2, the transition was easy to the Reader 3. The fact that it offered touchscreen access to its controls promoted more confidence in the users. I still recommend the Reader 2 as well due to its design and the fact that it does not connect to the internet, adding a layer of security for students and districts alike. I like the features of both which support students in accessing physical text in so many different ways.

Scanmarker is introducing a new version of its pen this year with the Scanmarker Max. I have had the opportunity to try this pen and like that it has all of the features of the Scanmarker Pro, along with some new features, including a Phonics area which breaks words down into their phonemic sounds. This feature aligns itself with the Science of Reading, permitting students with dyslexia or other reading conditions to understand words from a phonics base.

I am also excited to see the developments within Cosmo by Filisia. This group is releasing their new Cosmo Learning System which takes the place of the older Explore and Excel versions. The new version comes with 8 Cosmo Dots allowing many more uses, including being able to play a full octave of notes. They also have their app suites which now include some STEM activities.  When purchasing the Cosmo Learning System, users will have full and lifetime access to all of their apps.

I will share other ideas that I learn from ATIA in our next blog. I always prefer to see and interact with any new devices or software, come to an understanding of the research that has been done in the field, and hear of potential applications before I begin recommending it to others. I also enjoy meeting with so many of the presenters at ATIA to hear their stories as well as see the positive effects that they are having with their students and individuals with whom they work.

Attending conferences like ATIA and interacting with presenters throughout the year is what gives me the continued hope that there will continue to be successful approaches to making learning and life more accessible and inclusive. I understand the uncertainty that is out there. However, by working together, we can create a better world for our students and ourselves.

When we think of the holiday season, we often look at the ideas of happiness and cheer. While these can be themes for many out there, there are some individuals who are not looking forward to the holidays for a few reasons. Some of those reasons are within our control and can help guide us to creating a sense of safety for those who are dreading this time.

One of the reasons that some individuals do not like this time of the year is due to the sights and sounds around them. It almost sounds counter-intuitive as the sights and sounds are exactly what creates feelings of happiness and joy in many. However, for those with sensory processing issues, all those sights, sounds, and even scents can create anxiety and lead to sudden escalations. We don’t want those individuals to become the one who “ruined the holidays” due to an escalation in front of others. So how can we help?

First, as we decorate our classrooms and buildings, let’s keep the lighting tasteful and fitting of the area. We are not looking to land airplanes in our hallways or trying to out do Clark Griswald in decorating with lights. Keep it simple with the lights. I have had people ask if there is a specific type of lighting that is best and the answer is no. We recognize that the issue is often too much lighting making it too bright and overwhelming. Think of the lighting on trees, walls, or even ceilings as an alternative to the fiber optic lighting we see in sensory rooms. Different colors and styles are fine, just don’t attempt to have your classroom seen from space!

The second item to consider is music and sounds. There are so many wonderful songs associated with the holidays, and they are nice to have in the background. It is the volume that can cause anxiety with some of our individuals. Aside from the music, loud excited groups of students and faculty can also add to the din potentially causing an escalation. For the students who are affected by loud noises, consider having a set of noise reducing headphones available. By reducing that sound, anxiety levels can be better controlled. Consider if this student uses noise reduction in other daily activities. If that is something which is part of their daily routine, be sure to include any activities where the sounds of songs and excitement need to be lowered.

One of the items some of you have heard me address before is that of scent. Please be careful before adding any artificial scents to the area, like pine or peppermint. While scents, especially ones like peppermint and citrus, may enhance aspects of the focus and attention of some students, they can also be a trigger toward escalation for others. Throughout the year, if you have introduced scents to all the students without issue, then feel free to continue those scents in moderation. However, new scents may bring about disruptions if you are not careful. We must remember that the olfactory is the strongest of the senses for some. We know that Olfactory Dysfunction is made up of several different types. Outside of those types, scents can be directly associated with traumatic experiences as well. We just want to be careful when introducing any new scents and not operate to excess with others.

The next item to be aware of is food allergies. We have so many students with food allergies these days that we need to be cautious of any treats brought into the building or classroom. Share with those offering to bring in treats some of the products to avoid, especially products made in locations where nuts may be present. Many more people are accepting of these types of allergies today as almost everyone knows someone with them. Be sure to have products like Neffy® available too just in case one of the individuals finds themselves going into anaphylactic shock. I like using Neffy® as an alternative to epi pens as it works and does not look as frightening as giving someone a shot.

As we look at those ways of support, we see that they are focused on physical inputs. We cannot forget the mental/psychological inputs that also occur at this time of year. Some individuals have lost people close to them during this time in other years. Losing a family member or even a dear pet can adversely affect how one views the holidays when that grief is not fully processed. Another issue which arises stems from how some of our individuals may be spending their holidays. We forget that for some of our students and even peers, the school environment is safe and protective. When they are home, that safety may not always be there. Even if the home environment is safe from physical or mental duress, it may be a time of loneliness. So, if some of our students shy away from the celebrations, talk to them first.

How do we support these students? First, find a time and space to talk to them about it. If they can communicate their concerns to you, honor those concerns. Look at some of the resources which Anne Kubitsky has put together for trauma-based instruction and support. She has done a wonderful job of creating products which can help without having to go to professional support. If things do seem serious for that individual, be sure to bring in counselors who can assist that individual in processing their own feelings and coming to a better understanding of the support systems in place for them.

As you prepare for guests at your house or being the guest in others’ homes, take some of these ideas with you. Make your environment festive and supportive. Understand how some in your family might be affected in your own home and seek to address it before it happens. When you travel, bring along items that can help you or yours deal with the sights, sounds, and scents in other places as well. Having plans to “escape” for breaks as well as signals when things get overwhelming can assist in maintaining calm, even when the environment is not.

Finally, take time for yourself this holiday season! Find a few minutes each day just to be you. Relax with a good book, some nice tea – my favorite at the holidays - hot chocolate! By starting with yourself, you are best able to be aware of the needs of others and be prepared for potential escalations along the way.

May you and yours have a wonderful holiday season and may 2026 be your best year ever!

As we approach Thanksgiving, we are often reminded about being grateful for many of the things in our lives. Yet, much like other ideas, we should not limit gratitude to a set time frame like some Hallmark card. Rather, we need to recognize the science behind gratitude and how it can help us deal with our daily lives, especially in the unique times in which we live.

I refer to the science behind gratitude much like I have referred to the science behind hope. In the fantastic work done by Kathryn Goetzke, we have learned that hope is indeed a science and by practicing activities around it, we can change both our physical and mental well-being. In her book, The Biggest Little Book About Hope, Goetzke spends time identifying gratitude as one of her “Hopeful State Practices.” She speaks to the fact that adopting gratitude can lead to healthier relationships and positive internal feelings. Her discussion of gratitude as a part of the science of hope is important for us to understand as gratitude begins to change the body and mind in many ways.

We have heard about or even read books from various authors who focus on gratitude as a seminal piece of setting a healthy approach to life. One of my favorite modern authors/ coaches is Christy Whitman who addresses the need for gratitude in all of her books including her recent one, The Flow Factor. Whitman lists gratitude as one of the components we feel when we are in the “Flow State.” In her work, she emphasizes that gratitude creates a resonance within us that draws more attention to those positive things which occur as well as giving a better perspective on those negative things which occur.

Brene Brown, noted researcher, author, and organizational guru, lists gratitude as an important piece in how we approach the world. For those of you who follow her (and I recommend you do), she consistently speaks to the research she and others have conducted which demonstrate that vulnerability is such an important factor in those leaders who are considered great. Ironically, her stance on gratitude differs from my title of this piece as she sees gratitude as an important practice and not just an attitude. I defer to her on that point as she is spot on. She also points out that this practice of gratitude is what can cultivate joy within us. If you haven’t read or heard her, you definitely want to! Her latest book, Strong Ground, is fantastic and her discussion on paradox will have you thinking multiple ways at one time!

There is a lot of research on gratitude. If you take some time and visit the site positivepsychology.com, you will find a recent (September) article from Melissa Madeson, PhD entitled “The Neuroscience of Gratitude and Its Effects on the Brain.” She demonstrates that gratitude activates parts of the brain that deal with emotional wellbeing, reward, and contentment. Regular practice with gratitude can create changes within the brain which support positive mental health as well as resilience to many external pressures. Madeson, as well as many other researchers including those listed above, suggest that one of the simplest ways to maintain this practice of gratitude is to write things down in a journal which can be referred to on a regular basis.

So what does this mean for us within our schools or workplaces? First, gratitude can create a state of mind for us where we become proactive and not always reactive. There are times in many of our lives when we react to some stimulus which has happened to us and come to regret it later. That immediate reaction may also lead to moving ourselves into a negative place which can have its own less than desirable outcomes as well. This does not mean that we let things simply slide. It means that we look at things differently. An example which many of us can identify with would be when someone cuts us off on a road or highway. A reactive response is to share some non-verbal language (as well as a few things said inside your own vehicle) and anger. That anger can diminish how well we react to other issues further along on the road and even affect how we interact with others as soon as we complete our journey. A proactive response would be to consider how grateful we are that there wasn’t an accident and that we are safe.

Take that idea into your dealings with individuals then. You can be more present, especially to the needs of some of our individuals, teachers/therapists having a bad day, and respond in a manner that helps them. The times we currently live in focus too much on issues that are presented as “black or white.” Through the practice of gratitude, we can become better listeners and understand all of the shades of gray in between. That can help us be the guide those individual need at that moment.

When we adopt the practice of gratitude and, as the research demonstrates, our brains begin to adapt, we also model how to handle situations differently. It is through that modeling that we can begin to influence others as to how to handle situations differently. Gratitude at that point becomes so much more than simply saying “I am grateful for you.” It becomes a feeling which manifests itself far beyond words. One can still say “I am grateful for you,” but the words gain a palpable depth.

I am grateful for all of those who dare to research ideas like gratitude and hope. I am grateful for all of those individuals (students, colleagues, friends, acquaintances, and family) who have influenced my career and my life. I am especially grateful for all of you who tirelessly work towards helping others towards living their best lives. May the gratitude of this season spread well beyond the holidays and surround you in all that you do!

Augmentative Alternative Communication is much more than just a device which can share words or phrases with others. It really is any tool or approach that an individual can use to make sure they are able to communicate thoughts and ideas. When we think about how we approach communication, we realize that it can take many shapes. Verbal communication is only one of the ways we can send a message to others.

In neurotypical individuals, non-verbal communication is used daily to get points across. Think about how a look or how someone chooses to dress can send a message. How many times has a parent or partner given “the look” which is immediately understood by the person being addressed. In the business world, we may see individuals using certain colors or styles of clothing to attempt to gain some advantage over others.

We have also seen the development of communication via the printed word over time. Growing up in the 60s, sending letters was a way of communicating with those who did not live nearby as means of communication when the phone was not available. There was an art to writing a letter as it attempted to communicate feelings as well as thoughts. In today’s society, we have email, texting, and instant messaging which allows real-time communication between individuals without any words being spoken. Although the art of putting feelings into writing has shifted, using emoticons and other abbreviated phrases shares the feelings we may have. Think about when someone posts a sad message on a social media platform and we respond with a crying face, a hug, or a heart.

With all of these possibilities, we find that spoken communication is still the most preferred manner of sharing messages. For some of our individuals though, speaking as a form of communication is not easy or even possible. That is where the advent of devices to communicate messages has made a significant difference. For some of our individuals who have conditions like CP or ALS, using a high-tech device which may utilize eye-gaze technology is the best choice for allowing verbal communication to occur. These devices are provided through insurance and are specially aligned to make that communication as easy as possible for the individual. We have seen in the news and on TV individuals like Stephen Hawking using such devices.

However, not everyone needs devices such as these. When thinking about AAC devices, we need to start with how the device is going to best support the individual and how we can personalize it to their needs. What are those phrases that will be most important for them? How can we make sure that what is being said can communicate those ideas as best possible in the shortest amount of time, requiring the least effort by the individual as well? The goal of any AAC device should be the inclusion of that individual into the daily discussions in which they may partake with their peers, family, or colleagues.

One of the methods for this inclusion focuses on how these devices are perceived within the community. The idea of single message communicators is something that offers a quick way of sharing a single thought. These are seen in public through the idea of an “easy button” which speaks. You may have heard me discussing the use of a Big Mack device to have a “You are Awesome” button in nurse’s offices or administrative locations. Having something in more public areas that gives some thought that people want to hear helps to desensitize others to the use of such devices. That can be carried on to the use of Talking Brix throughout a classroom or area where each device shares some directions for that station or location.

In the idea of literacy development, we can also bring in AAC devices to enhance the learning of the students by adding tactile and auditory feedback of the work they are doing. Using multi-message communicators can help with that idea through having sounds, words, or phrases being able to be put together for word development. I am a big fan of using a ProxPad with tactile cards for the pairing of words to objects. These cards can be used to identify the object when questions are asked and can be an inclusive approach to the classroom. With devices like a 7 Level Communicator, literacy development can become a structured approach which builds upon earlier lessons utilizing the technology.

When we take this learning in literacy to the next level, we can then see how we can create “Read Along” books by having pictures from a page placed into the grids of a QuickTalker, allowing students to have the books read “out loud” as they follow along with the words. We can also use a device like the ProxTalker in identifying how to put words together to make phrases which communicate answers to the questions being asked or ideas that the individual wishes to share.

Many of you know that I do not like AAC or any assistive technology device sitting up on a shelf in a cabinet. Get these devices out and make them a part of how we teach literacy. This approach begins to define communication as an inclusive activity, even when some cannot physically speak. Using alternative forms of communication in literacy development also assists all students in preparation for their futures as well. In the past, we simply used paper and pencil in learning how to build words and phrases. That worked for a world that relied on those approaches in all aspects of life beyond school. However, we live in a world with technology as a central piece of how work and life get done. By bringing in AAC to literacy development, we are incorporating technology in the essence of literacy development properly. We want our students to learn how to communicate properly no matter what medium they may be using in the future.

So what innovations are out there now? We are seeing more good apps which can be downloaded to a phone. We must remember though that access will be critical for our individuals no matter how they are communicating. Please don’t simply place an app on a phone or a tablet without the proper physical training for access. Don’t solely rely on accessibility features from device platforms either without testing them out and making sure that individuals can access them if they cannot be formally set as automatically opening.

When we look at our cell phones of today, we need to understand that we are holding devices that are more powerful than some of the early computers that we built and took up full labs space-wise. When they are tailored to the needs of the individual, they can be very powerful tools. Training and modeling of how to properly use them are key to making sure that our individuals can interact with others in ways that encourage acceptance and understanding.

AI also provides another way of having communication designed for the needs of the individual. Training and proper adaptation will also be critical here. As AI applications increase, we should not fear the way that they can help some of our individuals interact within the world. We do need to monitor and select the right approaches though. Otherwise, it can become a fancy “gimmick” that does not promote inclusivity of the individual and their ideas.

AAC devices are powerful tools in helping to develop and maintain communication between people. Thinking through how to use these tools creates strategies that promote inclusion as well as effective communication. We must look at the inclusion of devices the same way we look at non-verbal forms of communication. They are alternatives to get messages across without having to rely on the physically spoken word.

Every individual has an internal voice which can bring amazing ideas to this world. We must remember that the internal voice sometimes needs alternative ways to communicate to the outside world!

As we move into the start of the 2025-26 academic year, literacy is one of the most discussed topics within our districts. Districts are taking a serious look at how to best address issues they may be having in the area of literacy while also making sure that their curricula are supported by the latest research. In this blog, I am going to look at how literacy can be supported for students using tools which have been proven through research to provide proper support. We have to be aware that just because some device might work for one of our students, it does not mean we can generally assume that it will work for all. We also have to have the common understanding that for certain conditions, the use of an assistive technology device is the best way to help students and should NEVER be considered “cheating” or “letting students slide.”

Let’s start with some facts so that we can look at the reality of what is happening with literacy in the US and why it is so important that we work on it at school level. According to the National Literacy Institute, 21% of adults in the US are illiterate as reported in 2024-2025 Literacy Statistics | National Literacy Institute. They also share that 54% of adults have their literacy below a 6^th grade level (which is the level that newspapers, back in the day, and common online news articles are written) with around 20% of adults below the 5^th grade level which, if their abilities hinder reading and other daily tasks for life and work, may fall into the category of functionally illiterate. This does not mean that those adults cannot communicate. However, literacy rates like that do create limitations on the jobs and roles those adults can actually do. This can cause much frustration for those individuals. 

Just last week (from the time I am writing this), the latest NAEP (2024) results have been published: NAEP Reading Grade 12: Reading Results. The news that people are seeing is that the 12^th grade results are 10 points lower. That is true, when compared to the 1992 results. The 2024 results are 3 points lower than the 2019 results. Some of that is being correlated with the influence of being out of the classroom due to the pandemic. The concern that I have when looking at the chart is that with the exception of students in the 90^th percentile (so our students with very good reading skills) the other percentiles have seen a statistically significant drop in scores across the board, with that significance being from 2019 as well as the other results dating back to 1992.

Why am I starting with these facts? First, I want to make sure that you have an understanding of what the numbers actually are. Second, as we continue to work on curricula that strengthen what we do in literacy, we can begin to work on future generations having much lower numbers in the functionally illiterate range. Third, we need to be more consistent in our approaches and understanding of the tools which can help as literacy levels can dictate much of what an individual is able to accomplish throughout the rest of their lives.

With that in mind, here are some manipulatives which are great to use when our students are in the early stages of literacy development. One of the important facts to remember is that using manipulatives as a tool when putting words together and learning about how to spell enhances the student’s ability to comprehend. If we stick to the idea that a student should just write the letters out or trace them with a writing instrument, then the overall concept is visual with fine motor inputs. This approach can be frustrating to those students who have not yet achieved a level of gross motor planning that can move them into the fine motor work. That frustration can then interfere with learning around the letters and creation of words. Having simple tools like Sensory Gel Letters from Playlearn or Trace Alphabet and Trace Numbers from SiliShapes can add a gross motor side that promotes a smoother transition into the fine motor through tracing. These work better than simple plastic magnetic letters as the texture adds a tactile dimension to the learning. As the students get older and the usage of the words takes on specific contexts, using tools like Alphabet Pebbles or Phonics Pebbles by Yellow Door make more sense as the depth now becomes focused on the creation of phrases and sentences.

As we move into the middle stages and later stages of literacy development, we want to take a look at those assistive technologies which can augment what the students are doing, even if they deal with conditions like dyslexia or other reading issues. I am a proponent of reader pens for those individuals who struggle with reading. The auditory support is NOT cheating or limiting the ability for an individual to read. Rather, it enhances the ability of the individual to process the words and comprehend the text. We have to be cautious about which pens we use though. Those of you who have heard me speak know that I only recommend three manufacturers when it comes to reader pens and those are C-Pens, Scanmarker, and OrCam. All three manufacturers use an evidence-based approach to the design and features of their pens with high quality cameras and processors to keep high levels of accuracy and translation. When people ask me which is the best, the simple answer is to ask about the end user and their needs. Each pen from these manufacturers has features that can help individuals based on their needs. However, the “best” pen for any individual is the one that is easiest to use with the most impact. If you do have questions about which pen makes sense for certain individuals or your institution in general, feel free to reach out to our resident expert, Jodi Szuter at jszuter@schoolhealth.com or me so we can learn more about the end users.

Outside of pens, we have found that various types of software are also helpful, especially when we are dealing with older students and adults. If we start with basic communication, Widgit is a wonderful software that can create communication pages as well as creating templates for AAC devices. One of the nice alternative uses of Widgit is to use it and its library to create mini flashcard sets which can then be saved and printed when necessary. The power of this software outside of direct communication is that it can be utilized for projects like outdoor communication signage, creation of charts for various courses, flashcards as mentioned above, and many more. You can test this out with a 30 day trial courtesy of School Health and Widgit at: https://widgitonline.com/en/offer?code=SH2024

Another piece of software that helps indirectly with literacy, more on the notetaking side, is Genio Notes, which was formerly Glean. Notes are able to be taken with focused insights while the lecture is being recorded. This allows for those who need more time to process to cue in on significant points without the concern of missing other important pieces. It also has imbued AI to allow for synthesis of the notes afterwards. One can also generate quizzes to enhance their own review for upcoming tests. Why do I include this on the literacy side? Notetaking can be quite difficult for those with a variety of conditions. That can make earnest studying difficult and create learning gaps for those students who are academically able.

On the communication side, some individuals may have the cognitive ability to communicate but have physical restrictions. Voiceitt is a software which can give those individuals the opportunity to communicate their thoughts more effectively than having to rely on a series of communication buttons in some standardized AAC types of software.

Finally, most computers today have text-to-speech options. If the student has a good computer, be sure to have those activated. Reading and communication are the foundation for living the best life possible. As we continue to develop how we are working with all of our students in literacy, be sure to include the right tools to augment the learning process, especially for those students who need additional support.

Should you have any questions about your own approaches and how some of these tools can be added to your toolkit, feel free to reach out to me directly at rheipp@schoolhealth.com. May this be a year where we all take literacy to the next level for all of our students!