Boston Public Schools
Teenagers and young adults
Individual
AAC + Cause-effect & navigation activities
Specialist classroom
Complex communication needs; physical access needs; significant medical needs (multiple examples across students)
Organisation’s bio: Boston Public Schools is a public school district in Massachusetts providing inclusive and specialist education for students with a wide range of learning, communication, and physical access needs.
What was the aim of the conducted activity?
The team aimed to support students in moving from errorless cause-and-effect access toward intentional communication, navigation, and choice making.
Cosmo was used alongside AAC systems to support:
- Cause and effect learning
- Navigation through communication pages
- Opinion sharing
- Initiating communication
Activities used included Fishtank, Storytelling, Video Storytelling, My Voice, and Toggle.
How was Cosmo used?
Cosmo was mounted and positioned individually based on each student’s physical access needs, including head switches and mounted hose systems.
Students used Cosmo to:
- Restart scanning during communication
- Make selections within communication categories
- Initiate interactions socially
- Navigate between communication topics
Staff noted that many students are highly social and enjoy scanning and sharing information. When scanning pauses, students often quickly activate their switch to continue communicating.
Cosmo was used alongside:
- Low-tech PODD
- TD Snap communication systems
Bilingual communication work (including Spanish PODD development)
What worked best?
- Switch Location + Visual Feedback
- Students appeared to locate switches more easily due to the light feedback.
- Social Communication Motivation
- Students showed strong motivation to restart scanning to continue sharing information socially.
- Multi-System Communication Support
- Cosmo worked effectively alongside PODD and TD Snap rather than replacing existing communication systems.
What was challenging?
Sustaining attention during communication tasks – Cosmo’s lights and interactive feedback helped students stay engaged for longer.
Restarting scanning during AAC activities – Students quickly learned to activate the switch to continue communication when scanning paused.
Locating switches with limited motor control – The light feedback helped students identify and activate the correct switch.
How did learners respond?
Overall Findings
Staff observed an increase in students initiating communication across sessions.
Student Impact Examples
Student M.P.
14 years old, primary language Portuguese.
Medical: seizure disorder, developmental delay, bilateral hip dislocation, spastic quadriplegia cerebral palsy, and microcephaly.
Uses head switch with Cosmo mounted on right side.
Observed communication examples:
- Requesting repositioning (“Something’s wrong → I need a position change”)
- Navigating to colour categories
- Expressing opinions
- Participating in yes/no questioning routines
Staff noted he appeared able to locate the switch using the light feedback.
Student A.R.
16 years old, primary language Spanish.
Medical: Spastic quadriplegic cerebral palsy with hydrocephalus (VP shunt), intellectual disability, epilepsy, significant visual impairment (including cortical visual impairment and legal blindness), scoliosis, and mixed receptive-expressive language disorder.
Uses head switch with Cosmo mounted on left side.
Observed communication examples:
- Requesting objects (“Play with something → Spikey ball”)
- Referencing past experiences (holiday gift discussion)
- Reporting discomfort (“Something’s wrong → Body parts → Stomach”)
Team is developing Spanish PODD access alongside Cosmo use.
Student T.S.
15 years old, primary language Portuguese.
Medical: Profound developmental delay, seizure disorder, microcephaly, cortical visual impairment, and non-ambulatory status with complex medical needs (including G-tube feeding).
Uses outward push motion with the left arm for access.
Observed communication examples:
- Reporting pain location accurately
- Asking question-based communication (Who / What)
- Referencing shared classroom experiences (e.g. Polar Express activity)
Student A.M.
20 years old, primary language Spanish.
Medical: Complex medical profile including chromosomal deletion, significant neurological impairment, cortical visual impairment, chronic respiratory needs (oxygen-dependent), G-tube feeding, and multi-system health involvement.
Uses Cosmo mounted on a tray.
Observed communication example:
- Leisure choice selection (“Listen to music → Selena Gomez”)
Continues to require navigation support for communication sequences.
Measurable Impact
- Increased communication initiation across students
- Increased participation in scanning-based communication
- Improved engagement during communication routines
- Increased social communication attempts during sessions
In One Sentence: What Has Cosmo Supported?
Cosmo supported students in moving from simple cause-and-effect interaction toward more intentional communication, navigation, and social sharing.