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School Based Therapy Training Module

Theoretical Bases


The goal of this curriculum is to help you think through issues you face when dealing with Deafblind (DB) students, not to tell you, specifically, what to do. To that end, this section introduces three bodies of theory from within DB education,

as a way of familiarizing you with ideas that are widely implemented by various members of the DB team.

Once you know the theoretical bases of much of the work done by educators with DB students, the hope is that you can apply these ideas in your work as a therapist, and in doing so, move the whole team into a more fully developed awareness of the whole child.

There are two primary contributions that school-based therapists can make for DB students and their educational teams:

  1. Use your awareness of the developmental progression of motor development, and your ability to evaluate quality of movement, to help members of the team know what movements need to be encouraged through activities (and, of course, help set up those activities for everyone to use with the student)
  2. Infuse the physical and occupational therapy strategies into the daily curriculum for the student. Research and experience shows us that integrating facilitated, structured movement into the daily experience of DB learners helps with concept development, communication, security and attachment to others, and development of functional skills.

Jan van Dijk

An Educational Approach that Appreciates Movement as an Essential Basis of Learning

Living Along With a Child   

  • Focus on dialogue between teacher and student 
  • Experiencing with a child versus teaching 
  •  The educational program IS a motor program

Four Essential Strategies for Learning, developed by Jan van Dijk

Lillie Nielsen's Theory of ACTIVE LEARNING

Active Learning

Created for children whose developmental age is three-and-a-half years or younger, the Active Learning approach enables the child with multiple disabilities to learn in the same way that very young children without disabilities learn-by doing, rather than being trained or taught. In this approach the child is provided with opportunities to learn through active exploration and examination of the environment. Teachers (and parents) set up developmentally appropriate environments that encourage the child to touch, move, and explore. They then respond to the childs actions and sounds and interact with the child at his/her level of interest and development&.Active Learning works with even the most significantly delayed and disabled children, enabling them to learn that they can act upon the world and initiate interaction with others.

Active Learning Equipment and Materials:

Little Room

The Little Room:

The Little Room consists of a metal frame supporting three side panels with various textures, a Plexiglas ceiling, and two play bars from which a variety of objects (everyday objects or toys) are suspended. This gives the child the opportunity to experience the properties of objects, to compare different objects, and try out different things to do with the object on his own without adults interpreting that experience for him. Since the objects are stable, it allows the child to repeat his actions with an object as many times as he needs to, at one to two-second intervals, without dropping and losing it. The immediate repetition enables the child to store the information gained from the experiences in his memory.

Resonance Board:

The resonance board is a thin plywood panel carefully designed to vibrate to every movement a child makes while lying on it. It enhances the effectiveness of the Little Room, but can also be used alone to encourage play and movement.

Use the Resonance board for:

  • helping a child get feedback for even insignificant movements
  • intensifying the auditory properties of objects
  • defining a safe area for play and exploration
  • establishing or extending sitting tolerance
  • focusing staff and student attention on meaningful movement

For information about ordering equipment designed by Lillie Nielsen, contact:
LilliWorks Foundation links to another website
1815 Encinal Avenue
Alameda, California 94501
(510) 814-9111; fax: (510) 814-3941.

Books and Curriculum: The full line of Dr. Nielsens books is available from:
Vision Associates links to another website
2109 US Hwy 90 West Ste. 170 #312
Lake City, Florida 32055
Phone: (407) 352-1200; Fax: (386) 752-7839

Barbara Miles

Talking the Language of the Hands to the Hands links to another website

Revised October 2003

  • Hands as useful and intelligent sense organs
  • Developing Tactile intelligence
  • Hands as essential to the sense of self
  • Reading and speaking the hand
  • Bonding, object permanence, mobility, all hand functions for the DB child

Twelve Suggestions for working with a child to develop hands that speak and also do all those other less dramatic, daily functions, too:

  1. Watch and/or touch the childs or adults hands and learn to read them
  2. Think of hands as initiators of topics in conversational interactions, particularly with young children who do not yet use  words.
  3. Use hand-under-hand touch to respond to exploration, initiation of topics and expressions of feeling. This hand-under-hand touch (or finger-alongside-finger touch)
    • is non-controlling.
    • allows the child to know that you share the experience of touching the same object or of making the same kind of movements.
    • does not obstruct the most important parts of the childs own experience of any object she may be touching.
  4. Make your hands available for the child to use as he or she wishes.
    • Imitate the childs own hand actions, your hands under thechilds.
  5. Play interactive hand games frequently.
  6. Make environmental provisions to encourage hand activity, appropriate to the developmental level of the child.
  7. Encourage energetic throwing in appropriate settings and at appropriate developmental times.
  8. Invite access to your own hands while they are engaged in a wide variety of activities.
  9. Invite the person who is deafblind to have frequent tactual access to the environment.
  10. Model whatever hand skills you wish the child or adult to acquire and allow her tactual access to that modeling.
  11. Make language accessible to the hands of the person who is deafblind.
  12. Become aware of your own hands as carriers of feelings and pragmatic functions.

More References

Adamson, Bakeman, & Smith, (1994) Gestures, words, and early object sharing. V. Volterra, and C.J. Erting, (Eds.), From gesture to language in hearing and deaf children. Washington, DC: Gallaudet University Press.

Fraiberg, S. (1977). Insights from the blind; comparative studies of blind and sighted infants. New York: Basic Books.

Miles, B., Riggio, M. (Eds.) (1999). Remarkable conversations: A guide to developing meaningful communication with children and young adults who are deafblind. Watertown, MA: Perkins School for the Blind.

Lane, H. (1997, June). Modality-appropriate stimulation and deaf-blind children and adults. Address to the Hilton-Perkins Conference on Deafblindness, Washington, DC.

Quigley, S.P., & Paul, P.V.(1984). Language and deafness. San Diego, CA: College-Hill Press.

Smith, T. (1994) Guidelines: Practical tips for working and socializing with deaf-blind people. Burtonsville, MD: Sign Media, Inc.

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