CEDAR FALLS - Dallas Harper looks intently at a computer screen attached to the tray of his wheelchair.

It is filled with names, and 16-year-old Harper selects five, seemingly with a slight nod of his head.

"What did you do with them?" asks River Hills School teacher Diana Scott.

In response, Harper clicks on a button taking him to another screen, chooses the word "watch," clicks onto another screen showing the alphabet, and begins spelling words - all with the movement of his head.

Within moments, the computer speaks his answer: "Watch movies Harry Potter."

Before beginning the computer session last week, a reflective dot was attached to the center of Harper's forehead. A spherical device called a "head mouse" attached to the top of the screen sends out a beam. The beam bounces off Harper's forehead dot and can be aimed at the screen icons, clicking on them as one would do with a computer mouse.

Harper, of Waterloo, is one of more than 5,000 children served by Area Education Agency 267 with speech, language or hearing needs. Many receive services in their own community or school district.

Children with more severe disabilities often attend agency schools like River Hills. Harper, who goes to River Hills during the regular school year, has been attending this month as part of an extended summer session.

The teenager suffers from a degenerative disease called mucopolysaccharidosis type 6.

"It's a degeneration of the central nervous system," said Bob Benter, one of four full-time nurses who tends Harper. "Fat cells deposit on the nervous system because they don't have anywhere else to go."

Harper's ability to walk and move has slowly degenerated. His body has not developed normally, and he has very short arms and legs.

"He started at River Hills when he was 3," said Lisa Yoder, a speech-language pathologist who works with Harper. "He was walking at the time and he was using a computer with a regular mouse."

Today, Harper uses a wheelchair equipped with oxygen tanks because he can't breathe on his own. A tube from the tanks goes into an opening in Harper's throat to deliver the oxygen to his lungs.

Because Harper does not breathe on his own, he can't speak. But he often mouths words to family members, nurses and those who work with him at school.

In the meantime, he has begun physical therapy intended "to restore his pulmonary functions so he can breathe on his own," said Benter. "But if we can gain some more movement in his upper body that would be great."

Dana Anderson, an educational assistant at River Hills, works on physical activities with Harper in gym class. One exercise is holding his arms out in front of him and pushing against Anderson's hands.

"We just work what he can work," said Anderson. He noted Harper has been able to do the pushing exercise longer since the therapy began.

Harper has been using the computer and head mouse for the past two years. It is the latest of the dynamic display communication devices that have given him a voice since age 5.

His prior communication device would use a lengthier scanning process to find a more limited number of words or phases. Dallas would choose the words using a "head switch." But the equipment was malfunctioning, so his parents and a team of educators settled on the current device.

"The head mouse has opened up his independence and made it much more efficient," said Yoder, noting he can write words as well as select commonly used words or phrases.

"His parents (Chester and Becky Harper) were really instrumental in pushing him in the direction of wanting him to write."

Harper will always need a communication device, but Yoder said he has been learning while using it. Her emphasis has been teaching him parts of speech, how vocabulary is organized on the computer and writing skills.

"His goal that I wrote for him is to write notes and to make lists."

She said Harper has been a fast and willing learner when it comes to his communication device.

"It was a whole new vocabulary system, the way it was laid out, and he learned it really quick."

Learning to speak

The reasons for Caleb Straw's speech difficulties are not as well understood. But AEA 267 speech-language pathologist Teri Suiter said, due to early intervention and an aggressive course of action, she expects the 4-year-old Independence boy's problems to disappear within the next three years.

Barb Straw, Caleb's mom, said the problem was "just in general people understanding him, trying to verbally talk back." So her niece, an Independence kindergarten teacher, evaluated Caleb and referred him to AEA 267 speech services.

"He was probably 2 at the time that we met him and he had no speech at all," said Suiter. She expects the problems to disappear around age 7 because of the work they've been doing.

"I would like to say he progressed, too, this rapidly because his family followed through with all the things we asked them to do at home," she said.

She works with children from birth through age 5 in four school districts who have syndromes, medical conditions, hearing problems or developmental delays. Referrals generally come from parents and other family members, physicians, and preschool teachers.

Suiter noted it's important to connect children early with the AEA's free services. They may work with speech, occupational and physical therapists; audiologists; school psychologists; educational consultants; and social workers.

"When you get a kid at kindergarten, you've already missed five critical years," she said.

"You know, Caleb is one of our little puzzles," she added. "There is not, to our knowledge, any sort of clear diagnoses. He does have some what I would call 'apraxic tendencies,' which means he has difficulty controlling volitional speech patterns."

Suiter noted he can do certain movements required to blow bubbles and drink through a straw. But he struggles with those same movements when trying to form words.

She said "something was breaking down" when he tried to form words. "Because, clearly, he had ideas, thoughts and opinions."

Suiter started out teaching him a number of words in sign language.

"He picked up on sign language right away," she said, which Caleb's family learned. "That's really how he started talking first."

Caleb progressed as Suiter continued working with him, and she found he had no hearing problems or mental disabilities. He attended special education preschool as a 3-year-old and continued working with Suiter the next year.

"Now he is 4 and is speaking in full sentences," she said.

"He still has some remaining articulation errors. But the difference is night and day because he's less frustrated, his parents are less frustrated. He was in regular preschool all this year."

Barb Straw is grateful for the AEA's services.

"I hope that people come to understand there are programs out there for kids their age," she said.

"I guess if any parent ever had the doubt, it's worth taking them in just to ask and see what they think. Because we sure have been happy with how they've treated us and taken care of him."

Contact Andrew Wind at (319) 291-1507 or andrew.wind@wcfcourier.com.