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Read Any Good Books Lately?

Compiled by Ann Rash, Teacher Trainer, TSBVI, VI Outreach

A vision loss impacts all areas of development. As vision teachers, we do not always have the expertise we need in motor and language development. We usually work closely with the speech therapists and occupational therapists but they do not always have the needed expertise on the impact of the vision loss. A possible solution would be to read and share these two new booklets from the TSBVI curriculum department, written by an OT for OTs and a speech therapist for speech therapists.

For OTs and PTs

Excerpted from Impact of Vision Loss on Motor Development: Information for Occupational and Physical Therapists Working with Students with Visual Impairments by Chris Strickling, OTR (Pages 13-14).

Mouthing Persists

Mouthing gives information about temperature, composition, texture, shape, and weight. This information is sometimes unavailable through other means for the child with low vision or blindness, so mouthing will sometimes persist up to age 4 or 5 or beyond. Children with low vision also use their chins and mouths as stabilizers. They are reluctant to put the objects down because putting an object down often means losing it. Mouthing usually diminishes as pincer grasp is developed, which can be quite late for these children.

Possible Interventions:

Ask yourself these questions when considering whether or not to intervene in mouthing behaviors:

Is there functional use of objects, or just mouthing?

If the student already has some functional manipulation schemes with objects, redirect the mouthing behavior to more appropriate manipulation. If not, try to engage the child in a meaningful action on the object as a replacement. Teaching more meaningful interactions with objects will often result in a decrease in mouthing.

Is this the child's only way to explore the object?

If the child is not yet ready for manipulation schemes, then helping the child explore the object will expand the child's exploration. Using the object in a game, adding pressure to the object and contacting the body with it; and adding texture, vibration, or sound to the action of the object are all ways of increasing exploration. In some cases offering more and different objects to explore orally before attempting to move the child from mouthing to a more mature exploration may be helpful. Alternatives for appropriate oral stimulation should be considered if mouthing is being used to increase sensory awareness.

Is the mouthing for exploration or just a way to retain the object?

Teach the child how to keep an object within grasp by providing a container, placing it in a pocket, or establishing some other place for it. Mouthing is sometimes just a way to keep objects close at hand.

For Speech-Language Pathologists

Excerpted from Language Assessment and Intervention with Children Who Have Visual Impairments: A Guide for Speech-Language Pathologists by Maria L. Munoz, M.A., CCC-SLP (Page 22).

Effective Intervention Strategies

Visually impaired children who also have language impairments may have difficulty relating the language they hear to their sensory experiences, so these connections must be taught explicitly. Children need to relate sensory events to the language of an event. Developing these relationships helps children learn to organize and interpret information. One effective strategy is to modify what the child is already doing to make it more functional. Children who are echolalic or who use only question forms are trying to fulfill particular communicative functions, such as commenting, requesting, or maintaining an interaction. An SLP can model more appropriate language for the child to meet these functions.

When working with children with visual impairments, these additional guidelines will enhance the effectiveness of intervention strategies. Such strategies should:

(Both of these booklets are available from Texas School for the Blind and Visually Impaired for $5 each.)

For VI Teachers Serving Children with Visual and Multiple Impairments

Vision teachers are often asked to assist or adapt classrooms for students with visual and multiple impairments. Many VI teachers are comfortable adapting the classroom but become frustrated when asked to design the schedule and all of the activities for the student with the visual impairment. Teaching Students with Visual and Multiple Impairments: A Resource Guide by Millie Smith and Nancy Levack is a resource for classroom teachers and vision teachers. An excerpt (Pages 152-153) follows:

Establishing a Schedule of Meaningful Activities

Activities can be meaningful to students for a variety of reasons. They may value the activity because family, peers, and teachers value it. They may enjoy it because it relates to personal likes and interests. Or it may be significant only because it provides an opportunity to interact with people whose company they enjoy. Activities are usually more meaningful when they are a regular part of students' lives and when students understand the outcome of participating in an activity and value that outcome.

In the past, many self-contained special education classrooms were designed with a combined medical and developmental model. A student's schedule consisted of various therapies, positionings, diaper changes, medications, and meals. Toys, stacking rings, puzzles, and stuffed animals were provided regardless of age.

Today, we know that a better approach is to establish a daily schedule for a student which integrates special services into meaningful activities. However, special services can't be integrated until activities are established. Teams switching from a medical/developmental model can use inventories to generate ideas for activities. In inventories, typical environments are listed for a given student. These might include cafeteria, classroom, gym, bathroom, music room, and playground. Next, at least one meaningful activity for each environment is identified.

A sample inventory of environments and activities for a 10-year-old nonambulatory, nonspeaking student with low vision might look like this:

Sample Environment/Activity Inventory
Environment Activity
cafeteria Eat breakfast and lunch.
classroom Clean chalkboard using a sponge mop.
Play bingo with classmates.
Play cassette tapes.
Make snack.
gym Race in wheelchair relays.
Throw basketballs in a basket.
bathroom Wash hands.
Toilet.
music room (with regular ed class) Play rhythm instrument while peers sing.
Record and play back songs.
playground Turn the rope for jump rope.
Hit T-ball with bat and run bases with peer assistance.

The chalkboard-cleaning activity was chosen for this student because she likes water and enjoys squeezing the sponge mop out in a pan of water. Typical peers also have chores. Playing cassette tapes was chosen as a recreation/leisure activity in order to give her a chance to learn to play her favorite music independently using adaptive equipment. The direct implementors of instruction are the classroom teacher and the paraprofessional. The VI teacher assists by planning modifications and adaptations and by role releasing procedures for teaching specific sensory skills.

(This book is available from the Texas School for the Blind and Visually Impaired for $40.)

If you are interested in other books and materials available through TSBVI, please contact our Curriculum Office by mail at 1100 West 45th St., Austin, TX 78756, phone (512) 206-9183, or visit the TSBVI website at <www.tsbvi.edu>.

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