COMPUTER-BASED INTERVENTION: “BALDI” THE 3D ANIMATED TUTOR This treatment option utilises a computer program that consists of Baldi a 3-D animated tutor. It is designed on the premise that children with autism use multiple sources of information to identify and interpret language input (Massaro, 1998; Paul, 2001). These include the speaker's face (including articulators) and accompanying gestures, as well as the actual sound of the speech (Massaro, 1998). AUTISM AND BALDI (COMPUTER-BASED INTERVENTION) Baldi is a 3-D animated talking head that provides realistic visible speech which is almost as accurate as a natural speaker (Massaro, 1998). Baldi has teeth, palate and tongue which move to mimic natural oral movements (Massaro, 1998). The orientation of Baldi’s face can be changed to display different viewpoints while speaking, such as a side view, or a view from the back of the head. Also, the skin on the face can be made transparent to reveal the internal articulators and their movements during speech (Massaro, Cohen & Beskow 1999). IMPLEMENTATION OF BALDI (COMPUTER-BASED INTERVENTION) Language training programs can be easily created that utilise Baldi as the conversational agent who guides children through a variety of exercises designed to teach vocabulary, grammar, to improve speech articulation, and to develop linguistic and phonological awareness (the targets depend on the needs of the child) (Bosseler & Massaro 2003). Refer to the following website for an online demonstration of a Baldi lesson and information on how to create personalised lessons for your client with autism http://speech.bme.ogi.edu/toolkit/register. The child interacts with the program by selecting the appropriate answers by clicking on them with their mouse. Reinforcement is provided by the computer program. Baldi’s face changes from happy to sad depending on the result and spoken reinforcement is also provided from Baldi. Additional reinforcement may be provided by the Speech Pathologist or parent or caregiver. (Bosseler & Massaro, 2003). SPEECH AND BALDI (COMPUTER-BASED INTERVENTION) Baldi is a life-like character whose articulators move in alignment with natural speech. It can be programmed to make the face transparent to show the articulators which can provide a useful cue for children with autism who are learning articulation. Baldi can be programmed to work on the specific articulatory needs of the child (Bosseler & Massaro, 2003). EXPRESSIVE LANGUAGE AND BALDI (COMPUTER-BASED INTERVENTION) Baldi can be programmed according to the needs and level of skill of the child. It targets expressive language through teaching vocabulary and grammar. This is achieved by utilising a combination of the following modalities: auditory presentation of the stimulus (e.g., the word/sentence being spoken by Baldi) and visual images of the stimulus (e.g., the written word/sentence and the visual presentation of Baldi producing the target). The child is provided with immediate reinforcement from the program (Bosseler & Massaro, 2003). Immediate reinforcement has been found to benefit a child who is learning language (Paul, 2001). PRAGMATICS AND BALDI (COMPUTER-BASED INTERVENTION) Turn-taking and joint attention are often difficult for children with autism (Paul, 2001). These are targeted implicitly by the program as the child has to attend to the Baldi character and wait until it is their turn to respond (Bosseler & Massaro, 2003). PROFESSIONAL TRAINING A Speech Pathologist would best be able to select targets within the program. The program only requires basic computer skills for use and can be downloaded for free from: http://speech.bme.ogi.edu/toolkit/register. ADVANTAGES OF BALDI (COMPUTER-BASED INTERVENTION) There are many proposed advantages to this program that have been supported by level IV research (descriptive research) (Refer to Evidence Table) which include (Bosseler & Massaro, 2003): Popularity of computers for children with autism. Presenting intervention via computers may reduce the social difficulties some children with autism experience when interacting with a teacher, carer or clinician. Availability of the program-once programmed, it is available for lessons 24 hours a day which is convenient for the child and carer. The child can use Baldi independently or with the aid of their carer depending on their skills. Individualised instruction: the Speech Pathologist can set up a language program for the particular child which provides automated practice, feedback and learning of skills. The program provides teaching via two modalities: spoken language and visual feedback from the face which better guides language learning than either modality alone. Can provide visual representation of articulators during speech by making the face transparent which is a useful cue for some children with autism. Children enjoy working with Baldi as he offers extreme patience and does not become tired or bored. DISADVANTAGES OF BALDI (COMPUTER-BASED INTERVENTION) The disadvantages of Baldi include: The Speech Pathologist is required to have some knowledge of how to use a computer in order to create the specialised lessons; however this requires only basic computer knowledge. The child with autism needs to attend to the computer which may be difficult for a highly distractible child. Some children may have difficulty interpreting facial expression and animation that Baldi shows. EFFICACY OF BALDI (COMPUTER-BASED INTERVENTION) Research was conducted to determine the level of effectiveness of using Baldi as an intervention for children with autism. This research was a level IV descriptive study. Caution should be applied when implementing this program as this research was not of a high evidence level and therefore the conclusion that Baldi is effective cannot be drawn. When determining whether this intervention is appropriate it would be useful to ascertain if the child enjoys using computers, is able to manipulate a computer (with limited help) and importantly whether the child is able to attend to faces and interpret facial expression as this is the basis of the intervention.