A computer voice utters a simple statement. Sometimes, it’s “My name is Elijah.” Other times, “My parents are Brian and Leah,” or “I feel happy.”
For the first time in his life, Elijah can tell his mother, ‘Yes, I want a hug.’
Another phrase — “I love the Patriots” — is often repeated.
And a brown-eyed, curly-haired kindergartener’s eyes light up. He smiles and laughs out loud.
It’s a whole new world for 5-year-old Elijah Gauthier, says his mom, Leah.
Alycia Berg, Elijah’s speech language pathologist, introduced a variety of augmentative communication options, starting with laminated index cards with pictures and sign language during infancy and toddlerhood.
Berg and her colleagues often begin working with children early in infancy, collaborating with doctors in neonatology, neurology and complex care who refer patients at-risk for communication challenges because of their medical diagnosis and history.
When he was 2, Elijah graduated to an iPad with the same picture symbols as the index cards. The idea was for him to point at a picture or symbol, and the software would speak each word out loud, says Berg.
Pointing at a specific picture, however, is a challenge for Elijah because his fine-motor skills are limited, making it difficult for him to reach and use a touch-screen device. “It was so frustrating for him,” says Leah.
In March, Berg introduced Elijah to a new technology that uses eye tracking rather than requiring Elijah to use his arms.
The computer is loaded with pictures — photos of Elijah’s family, books, football and much more. After being asked a question, Elijah focuses his gaze on the picture that matches the response he wants to give.
“He understands he is operating the device with his eyes. Sometimes, I’ll prompt him with a list of activities, and he’ll choose, ‘I want to read,’” says Leah.
Other times, Leah and her family ask Elijah simple yes-or-no questions.
Leah’s favorite question is, “Do you want a hug.” For the first time in his life, Elijah can tell his mother, “Yes, I want a hug.”
Elijah and his younger sister Cozette have found new ways to play together now that he has found his voice. He tells Cozette, “Please come here.” She’ll run to him and then run away, giggling.
“It’s the first time they’ve been able to make up a game together,” says Leah.
The device also has given Elijah a sense of control over his environment.
One day in September, shortly after starting kindergarten and getting the device, Elijah surprised Leah and Brian, telling them, “I feel tired. I want to go to bed.” It was 7 p.m., an hour earlier than his bedtime.
“His daily report from school had noted he seemed tired, but we would have stuck to our regular routine,” says Leah.
After Elijah communicated how he felt, Brian and Leah gave him a quick snack, read him a story and tucked him in. He was out like a light in minutes.
Elijah is finding other ways to surprise his parents, too. He used to sign, “I love you,” to Leah every night as she put him to bed. Now, he grins and teases her by pointing to a photo of a beloved hero — Tom Brady.
Learn more about the Boston Children’s Augmentative Communication Program.