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By Stacy Shafer, Early Childhood Specialist, and Ann Adkins, Education Specialist- TSBVI Outreach Programs

Abstract: This article describes some of the techniques of Dr. Lilli Nielsen's Active Learning Theory.

Key Words: blind, deafblind, Active Learning, Lilli Nielsen, real objects, Little Room, resonance board, position board, play

Editors Note: In a previous edition of See/Hear, we printed "An Introduction to Dr. Lilli Nielsen's Active Learning" and promised to provide additional information on active learning in each issue this year. In this issue, we'd like to examine some of Dr. Nielsen's learning strategies and the importance of using real objects. We would also like to hear from others who have used active learning, and encourage you to contact Ann Adkins at , Sara Kitchen at , Scott Baltisberger at , or Chris Montgomery at to share your experiences.

 


 

Visually impaired children learn by exploring and manipulating the objects in their environment and by comparing new objects to familiar ones. They need as many experiences as possible with real objects and textures. Hands-on experiences with a variety of objects, made out of as many different materials as possible, allow students to work on a variety of skills and learn about their environment. Concrete experiences with real objects also facilitate concept development. It is important to give students ways to actively impact their environment and teach them to be active participants in their world instead of passive recipients of stimulation from adults. The active learning techniques developed by Dr. Lilli Nielsen provide excellent opportunities for visually impaired students to gather information through the exploration and manipulation of real objects. Dr. Nielsen's approach encourages children to be active learners, and helps them discover that they can control events in their lives.

Equipment

Some of the active learning equipment and materials that we have observed include:

The Little Room

The Little Room is described in detail in Dr. Nielsen's book, Space and Self, and in the article in the last edition of See/Hear. It is a piece of equipment that provides students with a safe environment for independent play and exploration. Many children are more willing to tactually explore objects when they are in control of an activity and can anticipate what might happen. The objects in the Little Room are attached with elastic and go back to their original positions when the child lets go of them, enabling him to find them again and repeat an action as quickly and as often as he wants. It gives students the opportunity to work on object exploration and manipulation, object comparison, object permanence, cause and effect, spatial concept development, problem solving, independent play, recognition, anticipation, sensory integration, and spatial memory. The Little Room also provides the opportunity to learn about the different materials from which objects are made (paper, leather, wood, metal, etc.) and the different attributes of objects (size, weight, temperature, etc.). As students experience these different objects and learn about their specific characteristics, they will discover that some objects are better for some activities than others. They will learn that some objects make better sounds when batted at than others, some are better for mouthing, some are more interesting to touch, etc. Although the Little Room is an independent activity, it MUST be supervised at all times.

The Position Board

This is a piece of pegboard to which objects are attached with pieces of elastic and is also described in Space and Self. It may be used as an independent activity if the position board is placed so it will remain stationary, or it may be used with an adult. It can be attached to a student's wheelchair tray, attached to a wall, or placed on the floor or table. Like the Little Room, objects should remain in the same position to encourage the development of object permanence, and the elastic attached to the objects needs to be long enough for students to be able to bring the objects to their mouths. Be sure to include objects with different weights and textures.

The Scratching Board

This is a piece of wood with different textures attached to it. These textured squares are approximately 3" X 3". Examples of textures to include are: leather, carpet, cork, shiny wrapping paper, packing "bubble" sheets (if there is not a danger of the student tearing off a piece and getting it in his mouth), corrugated paper from a box of chocolate candy, shiny ribbon, suede, etc. Fine screening, like tea strainers or cooking strainers, can also be used if the edges are covered to prevent injury. The scratching board can be attached to a student's tray or positioned so that it can be used while the student is lying on the floor, with either his hands or feet. The Scratching Board can be stabilized so it is an independent activity.

The Tipping Board

This is a board that is fixed in an upright position. Hang objects from the top of the board so that students can receive sensory feedback by batting at them. Again, it can be positioned so that a student can use both his hands and feet. Some objects to consider using include: shiny bead necklaces, strings of interestingly shaped beads, chains (such as those used in the 70's as belts and necklaces), bells, a plastic or metal slinky, wooden spools strung on cord, etc. Inexpensive necklaces can be restrung with nylon fishing cord or dental floss to prevent breakage. The Tipping Board is an activity that students can do independently, with supervision, if the board is stabilized.

Vest with Objects

The Vest is like a cummerbund with Velcro. Objects and interesting textures are attached to it for students to explore independently. Headliner fabric may be used instead of Velcro to reduce the possibility of abrasions.

The Resonance Board

Playing on a resonance board can be a very rewarding activity for students, providing them with sensory input from the vibrations created by their play. Position the student on the resonance board with several interesting objects around him to encourage him to explore his immediate environment. Playing on the resonance board can be an independent activity, or it is an activity that could be shared with an adult or another student. The child should be on the Resonance Board when using a Little Room.

All of the activities described above encourage students to use their hands to explore their environments. Visually impaired students need repeated opportunities to tactually explore and examine real objects every day. They need a variety of experiences that require active responses. Additional information on active learning can be found in Dr. Nielsen's books, Space and Self and Are You Blind? These books also include information on suggested objects to use with the activities. The student's educational team should work together to choose appropriate objects. Objects should be pleasurable, graspable, and have tactile, auditory, and visual qualities. Real objects from everyday experiences and daily activities are recommended because they can provide more meaningful and rewarding experiences than toys. Toys and commercially available objects are often made of plastic, and plastic provides little information that is tactually meaningful for visually impaired students. Objects should also be presented in such quantities that the child will have the opportunity to choose, compare, and play counting and sequencing games. They should also vary in weight and texture. Caution is advised because some objects are not appropriate for use with all students. Teams should ensure that all materials and boards used in active learning activities are splinter free, that rough edges are covered with heavy layers of masking or packing tape (especially pegboard), and that any paint, acrylic, or finishing agents used are nontoxic. Even though these are independent activities, they MUST be supervised at ALL times.

References

  • Nielsen, Lilli. Space and Self, SIKON, 1992.
  • Nielsen, Lilli. Are You Blind?, SIKON, 1990.
  • SEE/HEAR Winter 2004

Last Update: 4/12/2017 AKL

Video of student in the HOPSA dress

When a student is visually impaired or deafblind with significant cognitive and physical disabilities (especially if the condition is congenital) unique instructional strategies must be used to systematically teach what other children learn incidentally. One of these strategies is known as Active Learning, an approach developed by Dr. Lilli Nielsen. This approach uses specific equipment and techniques to help students from birth thru high school age functioning developmentally at ages younger than 4 years or 48 months. This approach focuses on creating environments for the learner to develop foundational concepts and skills in all areas. It can be used to provide instruction at an appropriate learning level in both the standard curriculum and the expanded core curriculum for these students with the most profound disabilities.

Some teachers and administrators have questioned the use of Active Learning because it looks very different from typical instructional approaches used in most educational settings. It looks like “play” to many people. However, very specific learning goals and prerequisite skills are the focus of a true Active Learning approach.

In a guidance letter from Office of Special Education and Rehabilitation Services, Department of Education (November, 2015) the appropriateness of a focus on prerequisite skills aligned to the standard (or general) curriculum was discussed. Below are pertinent excerpts from this document related to these students:

Based on the interpretation of “general education curriculum” set forth in this letter, we expect annual IEP goals to be aligned with State academic content standards for the grade in which a child is enrolled. This alignment, however, must guide but not replace the individualized decision-making required in the IEP process.5 In fact, the IDEA’s focus on the individual needs of each child with a disability is an essential consideration when IEP Teams are writing annual goals that are aligned with State academic content standards for the grade in which a child is enrolled so that the child can advance appropriately toward attaining those goals during the annual period covered by the IEP.

The Department recognizes that there is a very small number of children with the most significant cognitive disabilities whose performance must be measured against alternate academic achievement standards, as permitted in 34 CFR §200.1(d) and §300.160(c). ….The standards must be clearly related to grade-level content, although they may be restricted in scope or complexity or take the form of introductory or pre-requisite skills.


Excerpt from Pages 4-5 of a guidance document from OSERS on alignment to the standard curriculum, November 2015

Texas School for the Blind & Visually Impaired Outreach Programs has developed a process for aligning instruction for these special learners that utilizes Texas Early Learning Pathways, Pre-K Guidelines, Essence Statements, and Texas Essential Knowledge and Skills. This is done by utilizing the Functional Scheme assessment and other assessment tools to determine the learner’s current developmental levels prior to developing the PLAAFP and setting priority areas goals and objectives. For learners at this level, many if not all of these goals are focused on pre-requisite skills.

We invite you to learn more about Active Learning and utilizing this approach at Active Learning Space (http://www.activelearningspace.org/active-learning-and-general-education), a special website developed by Penrickton Center for Blind Children, Perkins School for the Blind and Texas School for the Blind and Visually Impaired. You may also want to view a webinar about Active Learning, alignment and instruction which can be found at http://library.tsbvi.edu/Player/12992.

Active Learning Space

Please go to Active Learning Space at www.activelearningspace.org for more detailed information about Active Learning. This is a new website collaboratively developed and managed by Penrickton Center for Blind Children, Perkins School for the Blind, and Texas School for the Blind and Visually Impaired.

About Active Learning

"For the things we have to learn before we can do them, we learn by doing them." -Aristotle

"We are not teaching skills; we are activating neurology." - Daniel Kish

Active Learning is an approach developed by Dame Lilli Nielsen to aid visually impaired and deafblind individuals develop tactile skills and build foundational skills in other critical cognitive, physical and emotional development. Based on typical child development, this approach targets individuals of all ages who function under a developmental age of 3 when real learning only takes place by "doing". To learn more about this approach, explore the resources listed on this page.

Dame Lilli NielsenDame Lilli Nielsen (1926-2013)

Dame Lilli Nielsen passed away in June of 2013 only days after the Active Learning Conference in Houston.& We honor her life and work and mourn her passing.

Active Learning Theory was developed by Dame Lilli Nielsen, sibling of and teacher to individuals with visual impairments and deafblindness in Denmark. Her approach has been widely used throughout Texas, the nation and the world to address learning for these children.

In an effort to promote the use of Active Learning theory with students who are visually impaired, visually and multiply impaired or deafblind, Outreach Programs has collected relevant articles and information to share with professionals and family members. What follows is a listing of training events, articles, books, videos, websites, and other materials on this approach.

On this webpage:

Articles and Fact Sheets

Books

Forms

Handouts

Videos & Webinars

Websites

Other Materials


Articles and Fact Sheets

An Introduction to Dr. Lilli Nielsen's Active Learning- This article discusses some of the basic strategies of Dr. Lilli Nielsen's Active Learning Theory.

Active Learning and the Exploration of Real Objects- This article describes some of the techniques of Dr. Lilli Nielsen's Active Learning Theory.

Incorporating Active Learning Theory into Activity Routines- This article focuses on Phase IV and V of Lilli Nielsen's five educational phases of educational treatment outlined in her book, Are You Blind?, and how the Active Learning principles can be incorporated into activity routines.

Five Phases of Educational Treatment Used in Active Learning- This article focuses on five phases of educational approaches that teachers are to use in working with children if they are using an Active Learning theory approach. It summarizes the information first published as part of Dr. Nielsen's book, Are You Blind?

How to Make a Texture Board to Scratch, Grab, Hold & Release (downloadable doc)

Job One for Educators: Becoming a Good Playmate- If children learn through play, then we must become better playmates in order to facilitate better learning for the child.

Resonance Board and Little Room Design Information

Tactual Skills for Students with Visual Impairments (downloadable doc)

Taking a Look at the FIELA Curriculum: 730 Learning Environments by Dr. Lilli Nielsen- This article is based on a book by Dr. Lilli Nielsen titled The FIELA Curriculum: 730 Learning Environments and lists the developmental behaviors in three-month increments as described in this book.

Touch: A Critical Sense for Individuals with Visual Impairments (downloadable doc)

What My Daughter Taught Me About Active Learning or Whose Goal Is It?- A parent shares her journey in encouraging her daughter's learning through play—on her own terms at home and at school.


Books

Dr. Neilsen's books are published in the United States and sold through LilliWorks. These books include:

  • The FIELA Curriculum: 730 activities
  • Functional Scheme:Functional Skills Assessment
  • Early Learning Step by Step
  • Spatial Relations In Congenitally Blind Infants
  • Educational Approaches
  • Are You Blind?
  • Space and Self
  • The Comprehending Hand

One of her colleagues, Dr. van der Poel, has published a book of interest to those seeking information on Active Learning.

  • Visual Impairment - Understanding the Needs of Young Children

Forms

Active Learning Forms used by staff at TSBVI Outreach Programs

Active Learning Planning Sheet is a form created to capture information about the child's preferences and responses for use in planning Active Learning instructional activities.

Attractive Objects includes a list of objects that might be used in Active Learning activities and environments suggested in Lilli's book Space and Self.


Handouts

Handouts and Notes

Handout for Active Learning for Students with Visual and Multiple Impairments Conference in 2013

Active Learning Study Group Webinars 2013-14

September 2013 - Handout

October 2013 - Handout

November 2013 - Handout

January 2014 - Handout

Feb 2014 - Handout

April 2014 - Handout

Active Learning Study Group 2014-15

September 2014 - Handout

October 2014 - Handout

November 2014 - Handout

December 2014 - Handout

January 2015 - Handout

March 2015 - Handout

April 2015 - Handout

Websites

LilliWorks

Narbethong State Special School

Penrickton Center for Blind Children

The ABCs of Child Development: Developmental Milestones for Your Child's First Five Years

Site of Senses Project

Check out this blog from a parent using Active Learning!- Thanks for sharing this, Cindy Peters!


Videos & Webinars

Webinars and TETN Broadcasts on TSBVI's On the Go Learning

Videos & Webinars

Perceptualizing Aids: How, Why and When

Instructional Strategies for VI Students Under the Developmental Age of 3 - TETN 20440- Archived broadcast from 2013 on the TSBVI Distance Learning site.

Sophie's Resonance Board- YouTube video of a toddler in an Active Learning environment

Washington State Services for Children with Deaf-Blindness videos on Active Learning and Hand Under Hand

http://www.wsdsonline.org/hand-under-hand/

Zoe in the Little Room on YouTube

http://www.youtube.com/watch?v=X7_S4dfN_-U

http://www.youtube.com/watch?feature=endscreen&v=BOn6E8C0kb0&NR=1

Other Materials

Active Learning Equipment

Braille Literacy: Back to the Basics- An article on teaching tactile skills from Paths to Literacy website.

56 Tactile Math Ideas: Ideas and Suggestions for Development of Early Maths Skills - Math activities that include an Active Learning Approach on the Paths to Literacy website.

Pre-Braille - From Paths to Literacy information about important concepts, motor skills, auditory skills and tactile skills needed for developing literacy skills in children with visual impairments. All of these skills can be worked on through Active Learning approaches.

Downloadable catalog from LilliWorks with information on purchasing all of the Active Learning equipment.

Lily Voekel Foundation makes Resonance Boards for families who need one in their home and are unable to get it through typical channels. Learn more about this resource.

This website features information about Dr. Lilli Nielsen's techniques that emphasize simple ways to change the environment so that a child becomes an "active learner". Active Learning Space is developed collaboratively by Penrickton Center for Blind Children, Perkins School for the Blind and Texas School for the Blind & Visually Impaired.

Click here for redirect to Active Learning Space.

by Millie Smith

Many VI teachers are familiar with the object calendars that are part of the communication methodology developed by Dr. Jan van Dijk for students with deafblindness. The calendar boxes represent time, usually one school day. The objects in the boxes represent the major activities that will take place during the day. Here is an example of a typical daily calendar.

   Image of daily calendar with a sequence of object symbols

Some students have trouble learning that objects represent activities in this time frame. Sometimes the communicative function of a series of objects can be learned more efficiently when the time frame is shortened to one specific activity. In an activity calendar, the boxes represent the sequenced steps of the activity and the objects represent the event in that step. Here is an example.

Activity: Making Chocolate Milk
Steps:Symbol:
1. Pour milk in blender. Milk carton.
2. Pour chocolate syrup in blender. Syrup can.
3. Put lid on blender. Lid.
4. Blend for ten seconds. Switch.
5. Pour milk in glass. Glass.

 

 To begin, the student might take the milk carton out of the first box and pour it directly into the blender. Later, or at first for a higher functioning student, an empty milk carton might be in the first box. In this case, the empty carton would be a symbol for the step of going to get the real milk to pour into the blender. Adapt to ensure success. Do things like putting only the desired amount of milk in the carton so the student doesn't have to worry about over filling the blender.

Here are some of the communicative things that can happen in this routine.

  • The student can ask for help by directing your hand to an object.
  • The student can tell you what needs to happen next by getting the appropriate object.
  • The student can request chocolate milk by getting one of the objects used in the activity and showing it to you.
  • The student can eventually choose between chocolate or some other flavor by putting the desired container in the appropriate box.
  • The student can tell you how to make chocolate milk by putting the objects in the boxes in the correct order.

Just as with daily calendars, the object symbols can be made gradually more and more abstract. Instead of the whole milk carton, you might use a piece of the milk carton. Eventually the piece might be mounted on a card with a braille label written on the card. The student should be doing several of the above communicative functions with the actual object used in the activity before you increase the level of abstractness.

Also as with daily calendars, the time or sequence display can be changed. Boxes can be replaced by a carpet strip with yarn dividers. A book format might be used. Carefully control changes. You might not want to change symbol levels and format levels at the same time.

Activity calendars and daily calendars can be used by the same student simultaneously. If a student has a daily calendar and an activity calendar, it might be helpful to have boxes made out of different materials for each type calendar to help make a clear distinction between the functions of each.

TROUBLED BY TINA'S  TANTRUMS?
SICK OF SAMMY'S SCRATCHING?
Who Do Challenging Behaviors Challenge?

Presented by: Marilyn H. Gense, Willamette ESD and D. Jay Gense, Oregon Department of Education

Things to consider...

  • The behavior
  • The age of the student
  • How long its take to teach new skills
  • Interest and motivations
  • Communication skills and systems

Things to Remember.... Behavior is Communication!!!!

Things to Determine... Function of the Behavior

Functions of behavior include:

  1. Get
    • Social Reinforcement
    • Tangible Reinforcement
  2. Escape or Avoid
    • Task
    • Situation
  3. Both (1 & 2)
  4. Communication
    • Choice
    • Understanding

Checklist For Developing Behavior Intervention Plans

  1. Identify the behavior to change
  2. Define the behavior clearly
  3. Complete a functional analysis of the behavior including frequency, intensity and/or duration
  4. Complete a reinforcer assessment
  5. Develop hypothesis
  6. Develop strategies for teaching new behaviors
  7. Develop strategies for reinforcing desired behaviors
  8. Develop data collection system
  9. Develop appropriate communication strategies
  10. Develop a crisis plan, if needed
  11. Develop process for sharing and reviewing with the team
  12. Develop procedures for generalizing skills to a variety of settings
  13. Implement, review and modify plan as needed
Functional Analysis: Targeting Behavior for Change
Target BehaviorWhere did it occur?When did it occur?With whom did it occur?How long did it last?What happened after it occurred?
           
           
           
           
Comments:          
Sample - Functional Analysis: Targeting Behavior for Change
Target BehaviorWhere did it occur?When did it occur?With whom did it occur?How long did it last?What happened after it occurred?
Biting Others (opening mouth, moving head toward person or making physical contact with mouth on another person) On the way to the music room 11:00 (after swimming was cancelled) IA (Sue) He made three attempts bite in one minute He sat in a chair outside of music class but did not participate.  Went to lunch as soon as music was over.
Slapping Others (reaching out arm, moving arm quickly toward another, slapping another with hand) When asked to complete a work activity at the table as teacher  was physically prompting 2:00 Teacher (Jean) 8 attempts and one connection in 5 minutes. Teacher would stop and wait for student to calm down. After completion, moved to leisure activity.
Comments:  He is quick to grab, even if you are not right next to him          
Sample: Crisis Intervention Plan
Escalation StageCrisis StageCalming Stage
  • Behavior Signals:
    • High pitched vocalizations
    • Repeated requests for food (Want treat, want treat, want treat)
    • Puffing and blowing through mouth
    • Dropping cane
    • Slapping self on chest
  • Strategies:
    • Use calm voice
    • Reduce demand
    • Complete activity if appropriate and move to a preferred activity
  • Avoid:
    • Physical contact
    • Disliked activities
    • Teacher sounding stressed and raising voice
    • Using the word no
  • Behavior Signals:
    • Biting
    • Crying and screaming
    • Throwing shoes
    • Tipping furniture over
  • Strategies:
    • In a calm yet stern voice tell T. to sit down
    • Move children
    • Move any nearby equipment and furniture out of the way
    • Reduce noise level in setting
  • Avoid:
    • Trying to talk to Student
    • Any attempt at an Activity
    • Sounding upset
    • Physical proximity
  • Behavior Signals:
    • Soft crying
    • T. vocalizing are you calm
    • Sitting on floor quietly
  • Strategies:
    • Reinforce effort to calm self
    • Assist T. to put on shoes
    • Move to chair or calm area
    • Show schedule
  • Avoid
    • Physical contact
    • Excess talking

Additional Planning:  Review data collected on crisis behavior. Review skills being taught to assure T. is being taught to communicate when he needs a break.  Review schedule to assure a good mix of preferred and non-preferred activities.   Review opportunities for choice throughout day.

Contact:

Marilyn Gense
Willamette ESD
Salem, OR

Addressing Challenging Behaviors of Children Who Are Vision Impaired and Have Autism Spectrum Disorders (ASD) (125k)

English Version

Por María L. Muñoz, M.A., CCC-SLP

Adquisición de la lengua primaria

Los bebés nacen con la capacidad para distinguir el habla de los otros sonidos que escuchan, aún cuando no entienden el significado. Cuando llegan a la edad de ir a la escuela, ya hablan con oraciones complejas, mantienen conversaciones y entienden la mayoría de lo que escuchan. ¿Cómo sucede el desarrollo del lenguaje?

El cerebro de los niños está diseñado para que puedan aprender un lenguaje. Desde que nacen sus cerebros registran y procesan los sonidos que escuchan. A medida que se desarrollan su sistema motor, su cerebro y su capacidad de pensar, también crece su entendimiento y uso del lenguaje para comunicarse. Subyacente al desarrollo del lenguaje se encuentra la capacidad para reflexionar sobre el mundo y explorarlo con la vista, el oído, el olfato, el tacto, etc. Cuando el niño comienza a darle sentido al mundo a través de sus exploraciones, el lenguaje se une a esas experiencias. Progresivamente, el lenguaje se va desarrollando desde las palabras sueltas de los 12 meses hasta las oraciones complejas de los 5 años y de los conceptos simples (jugo, zapatos) a los más abstractos (frustración, suma). Los niños en edad escolar continúan aprendiendo y usan un lenguaje cada vez más abstracto y complejo.

Como el lenguaje primario se elabora a través de la exploración sensorial y la comprensión del mundo, el desarrollo del lenguaje para un niño sordociego o con discapacidad visual será afectado por la naturaleza y la gravedad de su deficiencia sensorial y por otros factores tales como sus capacidades cognitivas y motoras. A algunos niños con pérdidas leves o moderadas de la visión o de la audición, se les puede enseñar a compensar la falta limitada de información visual o auditiva. Llegan a esto usando sus otros sentidos, sus capacidades de reflexión y su experiencia práctica en aprender los significados asociados a palabras y oraciones.

Adquisición de una segunda lengua

El desarrollo de una segunda lengua puede ocurrir de maneras diferentes. Por ejemplo, un niño puede ser expuesto desde su nacimiento a dos lenguas al mismo tiempo o un alumno de escuela secundaria puede tomar un curso de idioma extranjero como elección. Deseo tratar aquí el caso específico de niños que aprenden in idioma diferente del inglés en casa y comienzan a aprender inglés cuando entran en la escuela. Dependiendo de la preferencia de los padres y de los servicios disponibles en el distrito local, estos niños pueden ser colocados en una clase de idioma inglés, una clase de enseñanza de inglés como segunda lengua (ESL) o en clase de educación bilingüe. Hay que remarcar que la colocación del niño en una clase o en otra, influenciará el desarrollo tanto de la primera como de la segunda lengua. La educación bilingüe estimula el desarrollo de técnicas lingüísticas, tanto en inglés como en la lengua madre del niño. Las clases de ESL estimulan el desarrollo de esas técnicas solamente en inglés, una estrategia que puede ser asociada con una adquisición más lenta del idioma abstracto.

En general, estos niños entran a la escuela con buen conocimiento de su idioma nativo, que luego utilizan como base natural para aprender inglés. El proceso para adquirir el inglés es gradual y sigue un modelo de desarrollo parecido al de adquisición de la primera lengua. Por ejemplo, producen las oraciones simples antes que las más complejas. Los errores que cometen en inglés reflejan las reglas lingüísticas de su lengua madre; por ejemplo, un niño de habla hispánica puede decir en inglés "I want the ball green", porque en español los adjetivos se colocan después de los sustantivos. Las técnicas de conversación se adquieren en aproximadamente 2 años, mientras que el desarrollo completo del lenguaje abstracto necesario en una clase requiere entre 5 y 7 años. Estos niños también aprenden mejor el idioma por medio de la práctica y la experiencia.

La adquisición de una segunda lengua, sin embargo, sucede a menudo durante las actividades de clase dónde se enseñan técnicas específicas centradas en el inglés, en vez de a través de la experiencia práctica típica de la adquisición de una lengua primaria. Se desafía a los niños a aprender inglés rápido, mientras tratan de no atrasarse con el aprendizaje de los nuevos conceptos presentados en clase todos los días. Tienen muy poco tiempo para aprender el inglés básico antes de entenderlo y usarlo en actividades académicas altamente abstractas y sin contexto.

Las discapacidades visuales y auditivas en la adquisición de una segunda lengua

Se ha dado por sentado, en general, que si la lengua primaria del niño se desarrolla normalmente, lo mismo sucederá con la segunda lengua. ¿Por qué esta premisa puede NO ser cierta en el caso de niños sordociegos o con discapacidades visuales?

Muchos profesionales, incluyéndome a mí, han observado que los niños con discapacidades visuales o sordoceguera, que pueden hablar, tienen a veces gran dificultad en aprender un segundo idioma. Pueden también tener dificultades en pasar de una educación bilingüe a una instrucción puramente en inglés. Creo que las diferencias entre aprender una primera y una segunda lengua yacen en la forma en que esos idiomas son adquiridos. Como todos los niños, aquéllos con discapacidades visuales o sordoceguera también aprenden su primera lengua gradualmente, durante varios años. Si bien la información que obtienen del medio ambiente es reducida, dentro del contexto de las experiencias multisensoriales altamente significativas, se usan otros sentidos para dar apoyo y compensar la limitada información visual y auditiva. Se construye una base de lenguaje relativamente normal sobre la cual se agrega el lenguaje complejo exigido en la escuela.

La enseñanza de un segundo idioma en clase es por naturaleza primeramente visual y auditivo. Así, un lenguaje es usado para enseñar otro lenguaje, ya sea a través del uso de un primer idioma o de explicaciones de conceptos simplificadas, en el segundo idioma. A menudo los niños no tienen tiempo para elaborar gradualmente un lenguaje complejo porque se espera que usen y entiendan conceptos académicos abstractos en inglés casi inmediatamente. Los niños sordociegos o con discapacidades visuales tienen dificultades para compensar la información limitada o distorsionada que reciben por medio de sus sistemas visuales y auditivos. Frecuentemente, no pueden servirse del tacto, el olfato, el gusto o el movimiento para aprender conceptos abstractos que son enseñados en forma visual y auditiva. Por lo tanto, deben confiar en sus conocimientos previos para entender lo que están escuchando y viendo. En forma rápida y fácil pierden o malinterpretan los conceptos que se les enseñan.

A continuación, un ejemplo de cómo un estudiante sordociego puede tener dificultades en aprender una segunda lengua. Juan, estudiante de habla española con discapacidades visuales y auditivas, está en una clase que comienza el estudio de los océanos. El maestro muestra la foto de una playa, (Juan ve un bulto claro y oscuro, pero no reconoce lo que hay en la foto). El maestro dice, "We are going to study oceans." (Juan oye "oin" ya que su discapacidad auditiva no le permite oír los sonidos /s/ o /sh/. No está seguro de lo que es un "oin" y no puede ver la foto lo suficientemente bien como para deducirlo). Luego, el maestro muestra una foto de un pez y dice, "We are going to study saltwater fish", pero Juan no sabe qué es un "altwatei" y nuevamente no puede ver la foto. Con su conocimiento limitado del inglés y su discapacidad auditiva, no se da cuenta de que son dos palabras. Entonces, cuando el maestro pide a la clase que escriba un pequeño párrafo sobre los océanos, Juan mira a su alrededor y ve a los otros niños escribiendo, pero él está confundido y no entiende el tema.

En este ejemplo, Juan no aprende el vocabulario en inglés porque no lo escucha claramente. No puede llenar los vacíos auditivos con las figuras porque no puede verlas. La recepción visual y auditiva limitada no le permite reconocer el tema y no se da cuenta de que la clase está hablando de cosas que él conoce como el mar y los peces. El lenguaje aprendido en este contexto de clase es muy diferente que aprender sobre los océanos yendo a la playa a jugar en la arena y con las olas, oler el aire salado y sentir el roce de un pez en la pierna. La capacidad de aprender inglés de Juan está limitada por las demandas altamente visuales y auditivas que se enfatizan en su clase.

Algunas sugerencias para estimular el aprendizaje de una segunda lengua

Siempre implementar modificaciones y dispositivos para mejorar la visión y la audición, tales como audífonos y anteojos.Siempre que sea posible, enseñar a los niños a través de actividades prácticas multisensoriales, que les ayuden a aprender tanto en forma experimental como lingüística.Utilizar la lengua madre de un niño para reforzar el entendimiento de la segunda lengua.Ayudar a los niños a entender las relaciones entre los conceptos nuevos que se enseñanza y sus experiencias propias.Tal vez los niños precisen entrenamiento específico en la segunda lengua, para discriminar entre cada sonido del habla e identificar los límites de las palabras. Estas técnicas son críticas para el desarrollo de la lectura y la escritura.Controlar los apuntes del niño periódicamente y hacer preguntas para verificar la comprensión de conceptos y la interpretación correcta de la información visual y auditiva.

BIBLIOGRAFIA

Guinan, H. (1997). ESL for students with visual impairments. Journal of Visual Impairment and Blindness, 91(6), 555-563.

Munoz, M. L. (1998). Language Assessment and Intervention with Children who have Visual Impairments: A guide for speech-language pathologists. Austin, TX: Texas School for the Blind and Visually Impaired.

Snyder, T. (1972). Teaching English as a second language to blind people. New Outlook for the Blind, 66(6), 161-166.

Williams, C. B. (1991). Teaching Hispanic deaf students: Lessons from Luis. Perspectives in Education and Deafness, 10(2), 2-5.

(Originally published in Spring 2004 SEE/HEAR Newsletter)

By Ann Adkins, Education Specialist, TSBVI Visually Impaired Outreach

Abstract: This article describes the advantages of teaching and using uncontracted Braille to meet the literacy needs of visually impaired students.

Key Words: programming, literacy, reading, Braille, uncontracted Braille, contracted Braille, Grade One Braille, Grade Two Braille, alphabetic Braille


In an effort to meet the needs of all visually impaired students, teachers of students with visual impairments (TVIs) must explore all forms of literacy and be able to teach them to their students. In the "News and Views" section of this edition of SEE/HEAR, Phil Hatlen encourages us to expand our definitions of literacy to include a variety of types of literacy, including print literacy, Braille literacy, tactile literacy, auditory literacy, and media literacy. In our ongoing look at literacy, we encourage teachers, students, and parents to consider all options, including a combination of approaches to literacy. In this article, we would like to examine the use of uncontracted Braille (also called Grade One Braille or alphabetic Braille).

For tactual learners, literacy should not be limited to the use of contracted (or Grade Two) Braille. In the past, many TVIs in Texas have emphasized the use of contracted Braille and, for some, Braille literacy has even been defined as the ability to read and write in Grade Two Braille. This may have been because most instructional materials used contracted Braille (such as the Patterns program from the American Printing House for the Blind) and because most Braille books were printed in contracted form. Other reasons for emphasizing the use of contracted Braille were discussed in a previous SEE/HEAR article, “Reading for Everyone: Expanding Literacy Options” by Cyral Miller and Ann Rash (Summer 2001), which described the results of a survey of VI professionals. The primary use of uncontracted Braille seems to have been with students who had learning problems or additional disabilities, and the results of the survey showed that uncontracted Braille can “increase literacy options for visually impaired students with multiple disabilities.” (Miller and Rash, 2001). One common belief seemed to be that uncontracted Braille was a good method only for students who were not able to master the contractions of Grade Two Braille. In the list below, we encourage you to consider why other students might benefit from uncontracted Braille as well.

  1. Uncontracted Braille can provide increased opportunities for literacy. Miller and Rash (2001) describe its use by a variety of VI professionals to expand literacy options for all tactual learners.
  2. Uncontracted Braille works well with phonics-based reading programs, which are found in many elementary classrooms. Uncontracted Braille provides 1-to-1 correspondence and promotes letter/sound associations, important components of literacy instruction. The use of contractions does not reinforce basic phonics skills.
  3. When students use uncontracted Braille, they can participate in reading lessons with their sighted classmates. They can use the same reading materials as their peers, only in a Braille format.
  4. Teaching materials are now available to teach uncontracted Braille, such as Un’s the One: Uncontracted Braille FUNdamentals, from TSBVI, and One is Fun PDF document  links to another website, by Marjorie Troughton. A greater variety of books are now available in uncontracted form (see www.braillebookshare.com), and the Texas Education Agency (TEA) is currently working to provide textbooks and assessments in uncontracted Braille. These changes help alleviate the concerns of many TVIs about having adequate materials and curricula to support instruction in uncontracted Braille.
  5. Because there is a letter-to-letter correspondence between uncontracted Braille and print, it is easier for sighted peers, parents, siblings, and teachers to learn to read uncontracted letters. Everyone in a Braille reader’s life can be a participant in his literacy.
  6. Uncontracted Braille allows for immediate feedback from a classroom teacher. She doesn’t have to wait for the VI teacher to transcribe Braille once she learns the basic letters or consults a cheat sheet.
  7. Because the rules of spelling are the same in uncontracted Braille and print, students can sound out and spell words at the same time and in the same way as their classmates.
  8. 39 of the 50 most common words in English have contractions when written in Grade Two Braille. Many also include lower cell signs. According to The Reading Teacher’s Book of Lists (Prentice Hall, Fourth Edition, 2000), these words make up about one third of all printed material and are the words elementary teachers emphasize to their students as “instant words.” Examples include many common words such as the, and, of, from, for, and it and lower cell words such as be, to, in, was, were, and his. Common suffixes also appear in early reading and involve the use of Braille contractions, such as –ing, -ed, -er, -est. The use of contractions in these early words makes reading more difficult for beginning Braille readers.
  9. There are 180 rules to learn in uncontracted Braille compared to 450 rules for contracted Braille.
  10. Uncontracted Braille can promote greater speed and fluency in reading (Troughton ,1992. Miller and Rash, 2001).
  11. Uncontracted Braille can promote more interaction with peers. Sally Mangold reported in the Braille Monitor (October 2000) that Minnesota students showed greater interaction and participation with sighted students, both academically and socially. Marjorie Troughton’s research also showed greater peer interaction when students used uncontracted Braille.
  12. The Minnesota teachers (Mangold, 2000) and the teachers involved in Troughton’s study also reported higher academic achievement scores, in both reading rate and accuracy, with uncontracted Braille than with contracted Braille.
  13. In One is Fun, Troughton described how motivation and interest in reading improves with the use of uncontracted Braille. Although difficult to measure, teachers in her study noted that it encouraged thinking rather than memorization, allowed their students to help their sighted classmates, and was “great fun.” Miller and Rash also cite Instructional Strategies for Braille Literacy (AFB, Wormsley and D’Andrea, 1997), which showed that uncontracted Braille can promote self-esteem.
  14. Uncontracted Braille facilitates a quick transition from print to Braille for adults and adventitiously blind students (Mangold, 2000). Uncontracted Braille offers early successes with the mechanical challenges of Braille reading (Miller and Rash, 2001), and these successes can be easily recognized and supported.
  15. Uncontracted Braille can be a successful approach to reading for students who later transition to the use of contracted Braille (Miller and Rash, 2001).
  16. Fewer reversal errors have been reported when using uncontracted Braille, especially for those students who use uncontracted Braille for a longer period of time before they transition to contracted Braille (Troughton, 1992).
  17. Uncontracted Braille works well with a linguistic approach to reading.
  18. Uncontracted Braille works well with ESL students and foreign languages.
  19. Uncontracted Braille works well for students using dual media for literacy, such as those students who use print but need Braille as well.
  20. Uncontracted Braille can work well with students with deafblindness because finger-spelling does not correlate with Braille contractions.
  21. Because it matches print letter for letter, students can use uncontracted Braille in a variety of board games (Monopoly, Scrabble), card games (Uno), and leisure activities with sighted friends and family members.
  22. Troughton found that because it is easier to write in uncontracted Braille, children can write their own compositions sooner and can write more independently.
  23. Marjorie Troughton found that books written in contracted Braille do NOT take up significantly less space than the same books written in uncontracted Braille. Research presented at the CEC National Convention in 1999 showed that contracted Braille only saved 20% (Ross, Scheira, & Urick).
  24. Uncontracted Braille can make production of Braille materials easier and helps with computer-assisted Braille (Troughton).

Many of the ideas in this article were generated as part of a Braille Study Group to improve the Braille and literacy skills of visually impaired students in Texas. We hope that you will discover other advantages as you explore the uses of uncontracted Braille, and we encourage VI teachers, students, and parents to examine all literacy options. We also encourage you to contact the VI Outreach team with information about your experiences with uncontracted Braille (Ann Adkins at 512-206-9301 or ). Ann Rash, Education Specialist with TSBVI Visually Impaired Outreach, is currently collecting data on the use of uncontracted Braille in Texas and invites those who are interested in trying uncontracted Braille to contact her (at 512-206-9269 or ) to participate in the collection of this data.

References

Mangold, S. "Trends in the Use of Braille Contractions in the United States:  Implications for UBC Decisions." Braille Monitor. October 2000. The National Federation of the Blind.

Miller, C. & Rash, A. "Reading for Everyone: Expanding Literacy Options." See/Hear. Summer 2001. Texas School for the Blind and Visually Impaired, Austin, Texas.

The Reading Teacher's Book of Lists. (2000). 4th Edition. The Learning Network, Prentice Hall, p. 47.

Ross, D., Scheira, J. & Urick, M.J. "Print Materials in Grade 1 and Grade 2: Physical Comparison for Space Usage." CEC National Convention, Charlotte, NC, April 16, 1999.

Troughton, M. (1992). One is Fun: Guidelines for Better Braille Literacy. Brantford, Ontario. http://faculty.sfasu.edu/cadyd/indexpagextra/BRAILLE/Case%20for%20Grade%201%20Braille.pdf

Wormsley, D.P. & D'Andrea, F.M., eds. (1997). Instructional Strategies for Braille Literacy. American Foundation for the Blind, New York.

 

 AI Teacher

 VI Teacher

SPED Teacher

 Teacher of DB

Informal assessment and/or formal evaluation

 Contribute to assessment of communication skills and determination of primary mode of communication. Contribute to physical portion (otological and audiological information,) social/emotional, cognition, and achievement as it relates to AI

 Functional Vision Evaluation Learning Media Assessment Eye report VI Registration Consent form DB Census Consent form

 

 Functional Communication assessment (communication Matrix, ADAMLS, JvD’s Child guided Assess, ISA, SLK)

Contribution at ARD Meetings

 Contribute to AI Supplement (in ARD document), interpretation of otological and audiological reports; PLAAFP of communication skills

 VI Supplement (interpretation  of parts A&B, as they pertain to FVE/LMA); Contribute to PLAAFP on  use of vision; interpretation of eye report, recommendations from FVE/LMA

PLAAPF

 DB Supplement (interpretation of AI/VI supplement as it pertains to DB implications)

Ongoing Data Collection

 Participate in ongoing data collection  and progress monitoring

 Participate in ongoing data collection  and progress monitoring

Data collection and progress monitoring

 Data collection and progress monitoring

Contribution at ARD Meetings Annual Goals and Objectives

Update Annual Goals and Obj’s  as they relate to AI (this may include communication, academics, and/or social emotional/behavior)

Annual Goals and Obj’s as they relate to VI

Annual Goals and Obj’s

Annual Goals and Obj’s – As they relate to DB

Contribution at ARD Meetings

Contribute to accommodation page as related to AI

Contribute to accommodation page as related to VI

Contribute to accommodation page

Contribute to accommodation page

Contribution at ARD Meetings

Provide parent information packet annually for A.I. (should include TSD and any other resources)

Parent information packet for VI (Annual ARD) Must include information on TSBVI; include Benefits of Braille if student is functionally blind; Benefits of O&M and any other resources and supportive agencies

 

Parent information packet for DB (Annual ARD)

Versión Español de este artículo (Spanish Version)

By Olga Uriegas, VI and O&M Specialist, Region 11 Education Service Center

(Originally published in Fall 1996 SEE/HEAR Newsletter)

Editor's note: Olga's ideas are pretty easy to implement. However, you may want to consult with your child's Orientation & Mobility Specialist about where to begin, given your child's current skills. She/He may also be able to demonstrate the best ways to support the baby's body as you help him/her with specific movements.


Initial orientation and mobility lessons should be with and for the parents of children with visual impairments. Here are some things you can do, Mom and Dad, with your infant or toddler.

  1. Mom and Dad hold baby close to your body, let him/her hear your heart beat, smell your scent, bond with you, etc.
  2. Say the baby's name as you touch him/her.
  3. Mom and Dad, talk to your baby while you actively move the baby's body.
  4. Mom call baby's name while Dad assists baby to turn from back to side.
  5. Rattle toy and assist baby to turn from back to side to touch the noisy toy.
  6. Dad or Mom assist baby to turn from back to left side and back to right side while in the crib, on the bed, or on the floor.
  7. Mom or Dad assist baby to turn from stomach to right side or stomach to left side while in the crib, on the bed, or on the floor.
  8. Mom or Dad assist baby to turn from stomach to back, from back to stomach.
  9. Mom or Dad assist baby to turn from back to front using a blanket.
  10. Say the baby's name as you touch him/her, talk to the baby, tell him/her what you are doing.
  11. Lie the baby on his/her back and gently massage baby lotion on the baby's arms. (Talk to baby and tell him or her "This is your arm.")
  12. Gently bring the baby's hands together and massage baby lotion on those little hands.
  13. Lie baby on his/her back and gently massage baby lotion on his /her legs. (Talk to the baby and say, "This is your right leg.")
  14. Lie baby on his/her back and gently massage baby lotion on the baby's tummy. (Talk to baby and tell him/her "This is your tummy.")
  15. Perform body massage while offering consistent body part labeling, rhythm (sing!) and language.
  16. Lie baby on his/her stomach on top of Dad's stomach, baby should be facing Dad's chest/neck area (Dad, talk to the baby).
  17. Lie the baby on his/her stomach on your knees and rock calmly and slowly while talking or singing a lullaby.
  18. Lie baby on his stomach, in your lap and gently rock him/her while singing, stop rocking when you pause in your singing.
  19. Enjoy your baby!
  20. Carry baby in front baby pack, let body awareness and bonding take place.
  21. Lie baby on his/her stomach on favorite blanket and give the baby a ride across the bed.
  22. Lie baby on his/her stomach on a favorite blanket and give the baby a ride across the carpet or the wooden floor or the grassy backyard.
  23. Mom or Dad help baby to turn in the crib or the bed from stomach to back.
  24. Dad and Mom assist the baby to turn to noisemaking toy that you are holding. Gently guide baby's hand toward the sound of the toy. Assist the baby with grasping a toy. Allow him/her plenty of time to explore the toy. Vary toys, but at first explore one or two toys which the baby prefers.
  25. Gently guide baby's hand toward the crib slats. Then guide the hand to grasp and shake (attach noise makers to the top of the slats).
  26. Assist baby to reach for a noisy mobile suspended from the crib.
  27. Combat crawl (with stomach contact) in the crib, on the carpet, on the linoleum floor. Combat crawl in cross pattern (with stomach contact) on the wooden floor.
  28. Straddle baby and assist him/her to creep across the surface moving arms, then moving arms and legs.
  29. Straddle baby to assist him/her to creep across surface at least 5 feet in a cross pattern.
  30. Assist baby to maintain sitting position for at least one minute.
  31. Have the baby sit with the sofa as a support. Place a small beach ball (with rice inside) in your baby's lap.
  32. Sit baby in the infant seat and explore a favorite toy.
  33. Sit baby in the infant seat placed on the grocery cart, while Mom brings items to touch, smell, and feel before she places them in the cart.
  34. Sit in a warm sandbox with pillow as support.
  35. Sit in warm sudsy water in the bathtub with Mom as support.
  36. Sit the baby in his/her high chair and explore a favorite toy.
  37. Mom or Dad sit behind baby and with your hands move baby's hands to play patty cake.
  38. Place baby on his/her tummy, assist baby to push up on hands.
  39. Roll a beach ball from Mom to baby, from Dad to baby, etc.
  40. Guide baby by the forearm (rather than a hand) to reach noisy toy.
  41. Assist baby to pull self to standing positions using support.
  42. Assist baby to stand and maintain his/her position with support.
  43. Dad, stand baby on your lap, support baby at trunk and waist.
  44. Allow baby to assume standing position without support.
  45. Assist baby in grasping a toy by lightly guiding the arm from the shoulders.
  46. Mom and Dad support baby to make walking movements.
  47. Let the baby walk with the support of the sofa, table or bed.
  48. Walk the baby without support from objects.
  49. Walk without support of objects with his/her arms outstretched with a wide base at the feet.
  50. Walk with weight evenly distributed, toes pointed in the direction he/she is headed.
  51. Walk from Mom to Dad with arms swinging at his/her side.
  52. Mom and Dad give baby the opportunity to walk on even and uneven surfaces . . . sloping hills, driveways, etc.
  53. Ascend steps on all fours by creeping or scooting.
  54. Make stair ascending movements with support from Mom or Dad.
  55. Ascend steps alternating forward foot (one foot per step).
  56. Descend back door steps on buttocks by scooting.
  57. Make stair descending movements with support.
  58. Descend front door steps one at a time ( both feet on each step) then progress to using alternating forward foot (one foot per step).
  59. Locate the top step.
  60. Descend 5 step stairs.
  61. Stop at the front/back door stair landing.
  62. Make running movements, while holding his/her hand.
  63. Run together, hand-in-hand.

By Terri Bohling, TVI

Originally published in the TX SenseAbilities in 2009.

Each week he would cut out his real object and paste it onto a piece of braille paper. At the end of the year, I put the pages in a large-ring binder. It was a wonderful book for him.

As an outgrowth of that list, I expanded to a listing of real objects that would fit in a manipulative tub. From there, I added body parts, actions, animals, concepts of position, foods and things (too big for a book or tub). Terri Bohling - 

Download Alphabet chart in RTF (465k)

Alphabet Book Objects, Manipulatives and Other Things
LetterObject BookManipulative TubDemonstrate
        Body PartActionAnimalPositionConceptFoodThing
A Aluminum Abacus Apricot Arm   Ant     Apricot Ashes Airplane
Arrow Acorn Apple Ankle         Asparagus Ax April
  Airplane Asparagus           Apple August  
  Ax                  
B Bean Book Bowl   Bow (motion) Bird       Boat Bread
Bag Ball Box     Butterfly       Beard Brick
Bandaid Banana Bow (tie)     Bat       Bike Brush
Barrette Basket Bone     Bear          
Book Bell Block     Bugs          
Button Berry Beanbag                
  Bag                  
C Comb Candle Can   Crawl Cricket   Corner Cake Clock  
Cotton ball Cassette Candy   Cry Cat       Computer  
Candle (b-day) Camera Cap   Cut Cow       Compact disc  
Cardboard Clay Car   Clap         Cover  
Crayon Cookie Corn   Cough         Claw  
  Crown Cup             Calendar  
D Dot Dice Dinosaur   Draw Deer       Door Drag
Diamond (shape) Dog collar Dollar   Drink Dog       Day Drawer
  Dress Daisy   Drop Dolphin       Desk Drip
  Doll     Dig Donkey       Dirt Drill
          Duck       Drum December
                  Dust  
                  Doctor  
E Envelope Egg   Ear Exercise Eagle   Edge Egg    
Eggshells     Elbow Echo  Eat Elephant          
8     Eye Empty            
F Feather Film Flag Face Fall Fish Front Flat Flour Family February
Fork Flashlight Flower Foot Fast Fly   Full Food Fat Friday
4 Football Frame Finger Find Frog       Farm  
5 Fur   Fist Fill Fox       Field  
      Fingernail Fold         Fire  
        Fly         Floor  
        Float         Fence  
        Follow         Fence  
        Freeze         Freeze  
        Frown            
G Gum Gift Glue   Gallop Goose       Game Ground
Glasses Glove Grape   Giggle Goat       Garage Guitar
Glove Grapefruit     Give         Gate Grass
                  Girl Garden
                  Glad  
H Hair Hammer Hat Hand Hang Hen High Half Hamburger Hall Hole
Heart Helicopter Helmet Head Hear Hippo   Hard Honey Handle Hill
Hanger Horn   Heel Hide Horse   Heavy   Happy Helicopter
      Hip Hurry         Heat  
I In Ivy Iris Iris Imitate Iguana Inside Inch Ice Cream Ink Incline
Ivy       Imagine Insect   Inside   Iron Ivory
Inch       Inhale         Infant  
        Itch         Indian  
J Jellybean Jar Jacket Jaw Jog       Jam Jeans  
        Jump       Jelly January  
        Jerk       Jellybean June  
        Join         July  
K Key Kernel     Kick Kangaroo     Ketchup Kite  
        Kiss Kitten     Kiwi Kindergarten  
          Koala       Kitchen  
L Lace Lock Lime Leg Laugh Lamb Layer Large Licorice Love Lump
Leather Leash Lollipop Lip Lay Ladybug Left Loud Lemon Ladder Lullaby
Lavender Licorice Lily Lap Lead Leopard Line Light Lettuce Lake Lens
Leaf Lemon Lilac   Listen Lion Last Little Lime Lamp Ledge
  Lettuce     Lean Lizard   Long Lollipop Lid Lunch
        Leave Llama   Loose Lunch Lawn Library
        Lick     Less   Leaf Letter
        Lie     Little   Loaf  
M Macaroni Magnet Mouth Muscle Measure Monkey Middle Many Milk Melt  
Match Marble Mask   Mix Mouse   Most Marmalade Metal  
Marshmallow Magazine Mail   Move Moose   Much Melon Model Mustache
Mitten Marigold Moccasin   March Mosquito     Mint Month Map
  Mint Mug   Mash Mule     Muffin Mud Monday
    Mustard     Mole     Mustard Music Mat
                  March May
N Nail Newspaper Nut Neck Nod Nest Next Narrow Nut Name New
Needle Net Nylons Nose Noisy   Near None Nutmeg Night No
Name Badge 9   Navel Nap         November  
Noodle     Nostril Nibble            
Napkin                    
O Oval Overalls       Octopus Over Open Omelet Oil October
Oatmeal Oak leave       Ostrich Out Other Onion Office Old
          Otter   Off Orange Opera Outdoors
          Owl   On Oatmeal Organ Outline
          Orangutan   Old   Oak tree Oven
          Opossum   One   Orchid  
          Ox   Only      
          Oyster          
P Pebble Paper Plate Palm Pass Panda   Pair Peach Page Pants
Pen Pocket Puppet   Pat Parrot   Pile Pancake Paint Pajamas
Pin Purse Puzzle   Peel Peacock     Pea Pan Petal
Paper Powder Pipe   Pet Penguin     Peanut Picture Plant
Paintbrush Plug     Pick Pig     Pepper Poem Pot
Paperclip       Play Polar Bear     Pie Parachute Pattern
Patch       Please Pony     Pizza Pedal Piano
Peg       Point Puppy     Popcorn Pillow Playground
Pencil       Pull Parakeet     Potato Pole Powder
Penny       Press Paw     Pudding Pansy Petal
Postcard       Push       Pumpkin Pipe Police
Putty       Pour       Pickle Pulse  
        Pump       Prune    
Q Quarter Quilt     Quiet Quail       Quack  
        Quick         Question  
R Rectangle Radio     Race Rabbit Right Rough Radish Refrigerator Rain
Ribbon Ring     Raise Rat   Round Raisin Rake Road
Rice Rope     Run Reindeer   Row Raspberry Robot Rhyme
Rock Ruler     Reach Reptile     Rhubarb Room Rose
Ruler Rattle     Read Rhino       Rubber Rug
Ring Racket     Rest Robin       Ramp Razor
Rubber Band Rose     Ride Rooster       Recess Recipe
        Roar Raccoon          
        Roll Ram          
        Run            
        Rub            
        Rip            
S Seed Saucer     Swallow Seal Second Sharp Salad    
Shell Scarf   Shoulder Sit   Say Shark Side Short Salt Sail School
Soap Scissors   Skin Skip  Sew Sheep   Shut Sandwich Shelf Sand
Spoon Shoe   Skull Scratch Snail   Slow Soup Screen Shirt
Star Sock     Scream Snake   Small Spaghetti Scale Season
Square       Search Spider   Smooth Snickerdoodles Sign Seat
Stick       Shake Sweep Squirrel   Soft Squash Seesaw Sink
Straw       Share  Sort Swan   Square Sour Shade Sheet
String       Shout  Sing     Straight   Skirt Shower
6       Sleep  Spill         Slice Song
7       Slide  Smell         Sour Stairs
        Smash         Step Statue
        Smile  Spin         Stem Store
        Sneeze         Story Stove
        Splash         Street Student
        Squash         Summer Sum
        Squeeze         Sunshine Sweater
        Stand         Sweat Saturday
        Statue-game         September Sunday
        Stay  Swing            
        Stop  Stretch            
T Triangle Tongs Train Teeth Talk  Tap Tail Third Tall Tomato Table Teacher
Tissue Tweezers Timer Tears Tear  Tie Tiger Through Thin Tangerine Television Temperature
Terri Telephone Thread Thumb Tired Toad Toward Tiny   Thirsty Time
2 Towel Toy Toe Trip  Taste Turtle   Top   Tent Tire
10 Tub Tube Tongue Tiptoe     Thick   Tree Trumpet
Tape T-shirt Tennis ball   Turn  Twist     Tight   Trunk Teepee
Twig Tape recorder Tie   Taste     Together   Tower Tuesday
  Tissue     Throw         Thursday  
U Umbrella Umbrella Undress     Unicorn Under     Unhappy Uncomfortable
Under   Undo       Up     Underground United States
    Unfold       Upside down        
    Unload                
    Untie                
V Valentine Vase Video                
Velvet Vine Visor           Vanilla Volume (sound) Vending Machine
Velcro Veil Vest           Vegetable VCR     Van Violin
                Vinegar Violet Vacation
                  Vitamin Vacuum cleaner
W Wax Wool Web Waist Wait  Wrap Whale   Wet Waffle Wagon Warm
Wire Wallet Whistle   Wake Wolf   Wide Walnut Wall Water
Watch Walnut     Whisper Worm   Whole Watermelon Weather Week
        Wave  Wind Weasel     Wheat Wheel Wheelbarrow
        Wash  Walk Whisker       Win Wind
        Weigh Wing       Wish Window
        Whistle Woodpecker       Wing Wood
        Write         Winter Wednesday
        Weave            
        Wind            
X   Xylophone               Xerox X-ray
Y Yarn Yardstick Yo-yo   Yawn Yak   Yesterday Yolk Yellow Yes
        Yell     Yard Yeast You Year
        Yodel       Yogurt    
Z Zipper       Zip Zebra   Zero Zucchini Zinnia  
Zigzag       Zoom            

 

This year I had a blind student in kindergarten. One of the table jobs the class did each week was cut out pictures of objects beginning with the letter of the week and paste it on a page for an alphabet book. I developed a list of real objects, small and flat enough to be pasted in a book, for my student to use.

Each week he would cut out his real object and paste it onto a piece of braille paper. At the end of the year, I put the pages in a large-ring binder. It was a wonderful book for him.

As an outgrowth of that list, I expanded to a listing of real objects that would fit in a manipulative tub. From there, I added body parts, actions, animals, concepts of position, foods and things (too big for a book or tub). Terri Bohling - 

Download Alphabet chart in RTF (465k)

Alphabet Book Objects, Manipulatives and Other Things
LetterObject BookManipulative TubDemonstrate
        Body PartActionAnimalPositionConceptFoodThing
A Aluminum Abacus Apricot Arm   Ant     Apricot Ashes Airplane
Arrow Acorn Apple Ankle         Asparagus Ax April
  Airplane Asparagus           Apple August  
  Ax                  
B Bean Book Bowl   Bow (motion) Bird       Boat Bread
Bag Ball Box     Butterfly       Beard Brick
Bandaid Banana Bow (tie)     Bat       Bike Brush
Barrette Basket Bone     Bear          
Book Bell Block     Bugs          
Button Berry Beanbag                
  Bag                  
C Comb Candle Can   Crawl Cricket   Corner Cake Clock  
Cotton ball Cassette Candy   Cry Cat       Computer  
Candle (b-day) Camera Cap   Cut Cow       Compact disc  
Cardboard Clay Car   Clap         Cover  
Crayon Cookie Corn   Cough         Claw  
  Crown Cup             Calendar  
D Dot Dice Dinosaur   Draw Deer       Door Drag
Diamond (shape) Dog collar Dollar   Drink Dog       Day Drawer
  Dress Daisy   Drop Dolphin       Desk Drip
  Doll     Dig Donkey       Dirt Drill
          Duck       Drum December
                  Dust  
                  Doctor  
E Envelope Egg   Ear Exercise Eagle   Edge Egg    
Eggshells     Elbow Echo  Eat Elephant          
8     Eye Empty            
F Feather Film Flag Face Fall Fish Front Flat Flour Family February
Fork Flashlight Flower Foot Fast Fly   Full Food Fat Friday
4 Football Frame Finger Find Frog       Farm  
5 Fur   Fist Fill Fox       Field  
      Fingernail Fold         Fire  
        Fly         Floor  
        Float         Fence  
        Follow         Fence  
        Freeze         Freeze  
        Frown            
G Gum Gift Glue   Gallop Goose       Game Ground
Glasses Glove Grape   Giggle Goat       Garage Guitar
Glove Grapefruit     Give         Gate Grass
                  Girl Garden
                  Glad  
H Hair Hammer Hat Hand Hang Hen High Half Hamburger Hall Hole
Heart Helicopter Helmet Head Hear Hippo   Hard Honey Handle Hill
Hanger Horn   Heel Hide Horse   Heavy   Happy Helicopter
      Hip Hurry         Heat  
I In Ivy Iris Iris Imitate Iguana Inside Inch Ice Cream Ink Incline
Ivy       Imagine Insect   Inside   Iron Ivory
Inch       Inhale         Infant  
        Itch         Indian  
J Jellybean Jar Jacket Jaw Jog       Jam Jeans  
        Jump       Jelly January  
        Jerk       Jellybean June  
        Join         July  
K Key Kernel     Kick Kangaroo     Ketchup Kite  
        Kiss Kitten     Kiwi Kindergarten  
          Koala       Kitchen  
L Lace Lock Lime Leg Laugh Lamb Layer Large Licorice Love Lump
Leather Leash Lollipop Lip Lay Ladybug Left Loud Lemon Ladder Lullaby
Lavender Licorice Lily Lap Lead Leopard Line Light Lettuce Lake Lens
Leaf Lemon Lilac   Listen Lion Last Little Lime Lamp Ledge
  Lettuce     Lean Lizard   Long Lollipop Lid Lunch
        Leave Llama   Loose Lunch Lawn Library
        Lick     Less   Leaf Letter
        Lie     Little   Loaf  
M Macaroni Magnet Mouth Muscle Measure Monkey Middle Many Milk Melt  
Match Marble Mask   Mix Mouse   Most Marmalade Metal  
Marshmallow Magazine Mail   Move Moose   Much Melon Model Mustache
Mitten Marigold Moccasin   March Mosquito     Mint Month Map
  Mint Mug   Mash Mule     Muffin Mud Monday
    Mustard     Mole     Mustard Music Mat
                  March May
N Nail Newspaper Nut Neck Nod Nest Next Narrow Nut Name New
Needle Net Nylons Nose Noisy   Near None Nutmeg Night No
Name Badge 9   Navel Nap         November  
Noodle     Nostril Nibble            
Napkin                    
O Oval Overalls       Octopus Over Open Omelet Oil October
Oatmeal Oak leave       Ostrich Out Other Onion Office Old
          Otter   Off Orange Opera Outdoors
          Owl   On Oatmeal Organ Outline
          Orangutan   Old   Oak tree Oven
          Opossum   One   Orchid  
          Ox   Only      
          Oyster          
P Pebble Paper Plate Palm Pass Panda   Pair Peach Page Pants
Pen Pocket Puppet   Pat Parrot   Pile Pancake Paint Pajamas
Pin Purse Puzzle   Peel Peacock     Pea Pan Petal
Paper Powder Pipe   Pet Penguin     Peanut Picture Plant
Paintbrush Plug     Pick Pig     Pepper Poem Pot
Paperclip       Play Polar Bear     Pie Parachute Pattern
Patch       Please Pony     Pizza Pedal Piano
Peg       Point Puppy     Popcorn Pillow Playground
Pencil       Pull Parakeet     Potato Pole Powder
Penny       Press Paw     Pudding Pansy Petal
Postcard       Push       Pumpkin Pipe Police
Putty       Pour       Pickle Pulse  
        Pump       Prune    
Q Quarter Quilt     Quiet Quail       Quack  
        Quick         Question  
R Rectangle Radio     Race Rabbit Right Rough Radish Refrigerator Rain
Ribbon Ring     Raise Rat   Round Raisin Rake Road
Rice Rope     Run Reindeer   Row Raspberry Robot Rhyme
Rock Ruler     Reach Reptile     Rhubarb Room Rose
Ruler Rattle     Read Rhino       Rubber Rug
Ring Racket     Rest Robin       Ramp Razor
Rubber Band Rose     Ride Rooster       Recess Recipe
        Roar Raccoon          
        Roll Ram          
        Run            
        Rub            
        Rip            
S Seed Saucer     Swallow Seal Second Sharp Salad    
Shell Scarf   Shoulder Sit   Say Shark Side Short Salt Sail School
Soap Scissors   Skin Skip  Sew Sheep   Shut Sandwich Shelf Sand
Spoon Shoe   Skull Scratch Snail   Slow Soup Screen Shirt
Star Sock     Scream Snake   Small Spaghetti Scale Season
Square       Search Spider   Smooth Snickerdoodles Sign Seat
Stick       Shake Sweep Squirrel   Soft Squash Seesaw Sink
Straw       Share  Sort Swan   Square Sour Shade Sheet
String       Shout  Sing     Straight   Skirt Shower
6       Sleep  Spill         Slice Song
7       Slide  Smell         Sour Stairs
        Smash         Step Statue
        Smile  Spin         Stem Store
        Sneeze         Story Stove
        Splash         Street Student
        Squash         Summer Sum
        Squeeze         Sunshine Sweater
        Stand         Sweat Saturday
        Statue-game         September Sunday
        Stay  Swing            
        Stop  Stretch            
T Triangle Tongs Train Teeth Talk  Tap Tail Third Tall Tomato Table Teacher
Tissue Tweezers Timer Tears Tear  Tie Tiger Through Thin Tangerine Television Temperature
Terri Telephone Thread Thumb Tired Toad Toward Tiny   Thirsty Time
2 Towel Toy Toe Trip  Taste Turtle   Top   Tent Tire
10 Tub Tube Tongue Tiptoe     Thick   Tree Trumpet
Tape T-shirt Tennis ball   Turn  Twist     Tight   Trunk Teepee
Twig Tape recorder Tie   Taste     Together   Tower Tuesday
  Tissue     Throw         Thursday  
U Umbrella Umbrella Undress     Unicorn Under     Unhappy Uncomfortable
Under   Undo       Up     Underground United States
    Unfold       Upside down        
    Unload                
    Untie                
V Valentine Vase Video                
Velvet Vine Visor           Vanilla Volume (sound) Vending Machine
Velcro Veil Vest           Vegetable VCR     Van Violin
                Vinegar Violet Vacation
                  Vitamin Vacuum cleaner
W Wax Wool Web Waist Wait  Wrap Whale   Wet Waffle Wagon Warm
Wire Wallet Whistle   Wake Wolf   Wide Walnut Wall Water
Watch Walnut     Whisper Worm   Whole Watermelon Weather Week
        Wave  Wind Weasel     Wheat Wheel Wheelbarrow
        Wash  Walk Whisker       Win Wind
        Weigh Wing       Wish Window
        Whistle Woodpecker       Wing Wood
        Write         Winter Wednesday
        Weave            
        Wind            
X   Xylophone               Xerox X-ray
Y Yarn Yardstick Yo-yo   Yawn Yak   Yesterday Yolk Yellow Yes
        Yell     Yard Yeast You Year
        Yodel       Yogurt    
Z Zipper       Zip Zebra   Zero Zucchini Zinnia  
Zigzag       Zoom            

By Joan Guthrie Medlen, R.D., L.D.

Program Director and Editor

Reprinted with permission from Disability Solutions,a publication for families and others interested in Down Syndrome and developmental disabilities. To learn more, please go to their website at http://www.disabilitysolutions.org/

Abstract: One parent shares her perspective on maintaining a healthy balance between being an effective advocate for your child with disabilities and practicing the fine art of forgiveness. The author provides a wonderful guide for parents to use in making forgiveness part of their advocacy tool kit.Key Words: family, parent perspective, parent advocacy strategies

Author's Note: This October 12, 2005 blog is admittedly written from the slant of the parent. However, all the concepts are true from the perspective of a teacher or support person.

Joan Guthrie Medlen is the mother of a son with Down syndrome and is a long-time advocate in the Down syndrome community. She can be reached at her Website, <www.downsyndromenutrition.com>.  Although this article is not specifically pertinent to advocacy for blind children, it addresses issues that can have a profound effect on any parent who fights for a child's rights in the special education system.


Living the life of a disability advocate can make the world seem like a very adversarial place. Of course, a lot of it depends on your experience. Most of the time, parents of children in early intervention services feel nurtured by their early childhood specialists. Everyone is concerned about the development and health of your baby and looks for the typical milestones along with you. Parents feel supported as specialists suggest strategies to keep the baby from sliding out of the high chair, to finally get up on all fours to crawl, or to sign their first word, "more," which everyone regrets later. I hear many parents describe Early Intervention services as a type of cocoon, protecting them from what lies just around the corner: school-aged services.

Over the years, I've had to advocate staunchly for my son. I remember walking into a "brainstorming meeting" to find it was a full-blown IEP review with no notice. Seventeen (17) people sat around a table smiling pleasantly at me, reassuring me there was nothing to worry about. He was only five at the time. In those early years I was devastated after every meeting. I felt exhausted—like one of the "Dementors" from Harry Potter had sucked all but a last breath from me. In just a short time, "advocacy" became synonymous with anger and frustration.

Since then, I've learned that being an effective advocate for my son, who has significant disabilities, means having impenetrable skin. It also means not thinking of him as my son, or me as his mother, during the meetings or at school. Rather, it becomes a business deal from my perspective. I force myself to sit back and watch the interaction of the team, listen to their comments, and then ask for the time I need to process the information. All must be done with as little emotion as possible. Sometimes I am more successful than others.

There are times when my feelings get the best of me and I am overwrought with anger, hurt, resentment --- every negative feeling we have words to describe and some we do not. It is easy, perhaps too easy, for parents to fall into a constant pattern of righteous indignation. One of the best things about the years Andy was included in elementary school was being able to spend time with other parents who were constructively involved with the school community rather than being surrounded by anger and frustration all the time. This is because the school did not have a "special education room." When he moved on to middle school, I cried when I met some parents in his homeroom, a visually-based classroom. The first meeting I attended was filled with anger, bitterness, and blame. I felt like I was being poisoned.

How did this happen? I agree that more often than not parents have a lot to be frustrated and angry about. Constantly maneuvering to find someone who sees your child as a great kid (rather than being told all the things he can't do) is not easy. Living under the microscope of special education without feeling judged at some point is impossible. The "evaluation" is not limited to academics, school situations, or your child's strengths. Folks tend to want to know just what it is we're doing at home to teach our children.

I've been doing some reading on forgiveness over the past year. I am increasingly convinced it is the missing link in advocacy efforts. Not being able to forgive eats away at us and breeds bitterness. The injustice takes on a life of its own; it is all consuming. It becomes a part of daily life. That means your adversary wins.

My first introduction to this concept came from the book, How Good Do We Have to Be? By Harold Kushner. He tells the story of asking a woman whose husband had an affair, left her, and fell chronically behind in child support payments to forgive her husband. When asked how he could suggest such a thing, he replied, "'I'm not asking you to forgive him because what he did wasn't so terrible; it was terrible. I'm suggesting that you forgive him because he doesn't deserve to have this power to turn you into a bitter, resentful woman.'" For me, that was a new spin on forgiving someone.

The last thing my children need is a bitter, resentful, angry mother, nor do I want to be that person. I enjoy life and like to revel in the good things, large and small. I love watching my children learn and grow, each at their own pace. I enjoy being helpful and looking for constructive solutions or steps to overwhelming situations. I like to laugh. I want to be a nice, warmhearted person, not a sour, negative, cross one. I want to be able to walk into my son's school community and be the person I was before special education entered my life.

Like many people, I wondered if I forgive people who have hurt me—whether it was intentional or not—I also agree that nothing wrong happened. What I have learned is I do not. I had to learn what forgiveness is, and what it is not. Here is some of what I have learned.

Forgiveness is:

  • Letting go of the anger and resentment you feel.
  • Looking for the good in a situation.
  • Restraint from seeking revenge and harboring resentment.
  • A freely chosen gift.
  • A personal decision. It only takes one person to forgive.
  • A way of healing your wounds from the injustices and hurts you have incurred.
  • Healthy. Research suggests forgiving those who offend you may ease depression, high blood pressure, backaches, muscle tension, and even heart disease.
  • Brave. It takes a brave person to forgive someone who has hurt them without asking for anything in return.

Forgiveness is not:

  • Forgetting what happened. In fact, it is better to forgive without forgetting. "You can forgive the bully and still watch your back." (Bob Enright, International Forgiveness Institute) We can learn from every experience and make corrections. This strategy seems the best for advocacy work. Learning (and remembering who you can trust) without hanging on to the bitterness.
  • Letting the other person or people off the hook. You can forgive someone and still hold them accountable for their actions. This is especially true in legal situations, including IEP meetings. Rules are rules.
  • A guarantee there will be reconciliation. Forgiveness is a gift we choose to offer to another person. They may not reciprocate. It takes two people to reconcile.
  • Overlooking what happened. In fact, in order to forgive, a person must truly understand the offending event.
  • Condemning someone. Backhanded forgiveness doesn't do anyone any good. In other words, offering forgiveness to show how hurt you are defeats the purpose.
  • A means to justice. Forgiveness does not demand compensation first. You choose to give it or not, no strings attached.

I believe forgiveness strengthens my ability to advocate effectively. By letting go of resentment and anger, people are more willing to talk and problem-solve. They are less likely to worry that the discussion will become a battle with an angry parent. Remember, forgiving someone does not mean they are not accountable for their actions. No one loses their rights by forgiving an injustice.

Learning about forgiveness has given me a lot to think about. Have I truly forgiven every situation I am resentful over? No. But I am working on it. I am learning that it is harder to forgive those things that I have held onto for a long time—such as the IEP I mentioned earlier—than events that are recent. Perhaps our response to situations becomes so ingrained that changing how we feel about it takes time and work. After all, forgiveness is not meant to be easy, if done correctly.

These days I am not as easily upset in meetings about my son, though I have my moments. I am working on remembering to truly examine the situation, tease out the lessons, and then work on forgiveness. It feels much healthier. And I am much happier for the work.

Take care of each other.

Originally re-printed in See/Hear Winter 2006.

by Stacy Shafer, Reprinted from VISIONS newsletter, Volume 3, No. 2, June 1995

Dr. Lilli Nielsen has worked as special education adviser at Refsnaesskolen, National Institute to Blind and Partially Sighted Children and Youth in Denmark since 1967. She was trained as a preschool teacher and psychologist. She has performed research in the area of spatial relations with infants who are congenitally blind and has written several books and articles about educating children with visual impairments and multiple disabilities. Dr. Nielsen's approach is called Active Learning. She has presented week-long training sessions on developing the full potential of young children with visual impairments and multiple disabilities in countries around the world. We were very fortunate that she presented in Dallas, Texas, May 1994. 1 was asked to write about some of, the information she has shared with us.

All young children learn through play. They need to be encouraged to explore their environment and objects in their environment. Dr. Nielsen believes that all very young children learn by being active, rather than passive recipients of stimulation. We need to observe typical children to see how they learn to move their own bodies (raising their heads, reaching for objects, sitting up, etc.); use their bodies to explore their surroundings (including any and all objects within their surroundings); and actively participate in interactions with other people. A visual impairment prohibits a child from having enough opportunities to develop these abilities and have these experiences without intervention. She encourages the adults to set up the child's environment so that he can do this.

Here are a few of Dr. Nielsen's recommendations when developing the child's environment:

  • Observe the child. It is imperative that we know what the child can do, what activities s/he enjoys, what type of objects does s/he like, etc. Assessing the child's existing skills and preferences is the first step in programming. Observation will help you note the current developmental skills the child has. A child's preferences are indicators of the underlying strengths of his system. These preferences can guide you in the selection of objects and activities. You need to know a child's repertoire so you can notice change and improvement.

  • Provide the child with more activities and objects that are similar to those he enjoys. This will encourage the child to explore and experience new things and broaden his knowledge base. Young children with visual impairments need to be encouraged to explore not only toys from the toy store, but also every day objects around the house.

  • Give the child opportunities to practice and/or to compare. As adults, we are often tempted to remove materials as soon as the child shows that s/he can use them. We all relate new information to things we already know. For example: The first time you successfully drove a car around the block, you still needed lots more experiences driving in different environments, on different types of roads and highways, different vehicles, different times of the day and night, in different types of traffic, with the radio on and off, with friends in the car, etc. before you really mastered all the skills and concepts about driving. When a child begins to bang one object on another one, he needs to be given the opportunity to bang lots of different objects on lots of different surfaces. (The sound produced when banging a metal spoon on the couch is much different than banging it on the coffee table or a metal mixing bowl.) Children need to be able to repeat an action many, many times; in order to learn.

  • Provide a few materials and activities that are at a slightly higher developmental level to provide a challenge for the child, so he doesnt become bored. You only model these activities for the child. You do not expect him to imitate.

  • Do not interrupt a child by talking when s/he is actively engaged in play. Most of us have had the experience of talking to an infant who is busily kicking her legs and having the child stop kicking to listen to our voice. When a child is exploring or playing with an object or practicing a new movement, we need to wait to talk with the child about what he was doing until he turns to us to share his experience, or at least until he takes a little break in the activity. This does not mean that we need to stop talking to our young children with visual impairments, just that we need to pick our moments.

  • Slow down, when interacting with a child. We must be willing to wait and give the child time to take a turn in the interaction. When playing with a child, Dr. Nielsen tells us to give the child time to explore an object alone, rather than jumping in and showing her/him how to use it. At a conference during a child demonstration, Dr. Nielsen offered a battery operated facial brush to a child. She let him explore the brush in his own way. He held the brush against various body parts, moved it from hand to hand, turned it over, put it on a tray, moved it against other objects on the tray, picked it back up, put it to his lips, and did many other things with it. Then he turned to Dr. Nielsen to share the experience. That was the moment she talked with him about the facial brush and the things he had done while playing with it.

  • Let the child have control of her/his own hands. Dr. Nielsen feels it is important when we are interacting with a child who has a visual impairment, that we not take her/his hand and bring it to the materials. Instead, we need to develop alternate strategies for presenting objects to the child (e.g., gently touching the toy to the child's arm or leg to alert her/him of the object's presence, making noise with the object to arouse her/his curiosity to encourage her/him to reach out, placing several objects that are touching the child's body or very close to it so any movements s/he might make will bring her/his body in contact with an object, etc.)

  • Dr. Nielsen has developed several pieces of equipment to provide children with visual impairments the opportunities to actively participate with their environment. One of these "special environments" is the "Little Room". The "Little Room" consists of a metal frame supporting three side panels and a Plexiglas ceiling from which a variety of objects are suspended which the child finds interesting and enjoyable. 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.

Dr. Nielsen has given us lots of information about ways to encourage a child with a visual impairment to learn and develop. She will be conducting a week long training in Novi, Michigan June 19-23, 1995. For more information about Dr. Nielsens Active Learning, contact the Consultant for the Visually Impaired at your Education Service Center or call Outreach Services at Texas School for the Blind and Visually Impaired.

References:

Nielsen, Lilli. Environmental intervention for visually impaired preschool children with additional disabilities, VIP Newsletter, Vol. 8, No. 3.
Nielsen, Lilli. The blind childs ability to listen, VIP Newsletter, Vol. 10, No. 3.
Nielsen, Lilli. Active learning, VIP Newsletter, Vol. 10, No. 1.
Nielsen, Lilli. Space and Self, SIKON, 1992.
Nielsen, Lilli. Early Learning Step by Step, SIKON, 1993.
Nielsen, Lilli. Are You Blind?, SIKON, 1990.
Notes taken from lectures given by Dr. Lilli Nielsen at conferences in Albuquerque, New Mexico, September of 1992, in Milwaukee, Wisconsin in October 1993, and Dallas, Texas, in May 1994.

(Originally published in in the June 1995 edition of VISIONS)

Summer 99 Table of Contents
Versión Español de este artículo (Spanish Version)

By Stacy Shafer, Early Childhood Specialist, TSBVI, VI Outreach


Dr. Lilli Nielsen has worked as special education adviser at Refsnaesskolen, National Institute to Blind and Partially Sighted Children and Youth in Denmark since 1967. She was trained as a preschool teacher and psychologist. She has performed research in the area of spatial relations with infants who are congenitally blind and has written several books and articles about educating children with visual impairments and multiple disabilities. Dr. Nielsen's approach is called Active Learning. She has presented week-long training sessions on developing the full potential of young children with visual impairments and multiple disabilities in countries around the world. We were very fortunate that she presented in Dallas, Texas, May 1994. I was asked to write about some of the information she has shared with us.

All young children learn through play. They need to be encouraged to explore their environment and objects in their environment. Dr. Nielsen believes that all very young children learn by being active, rather than passive recipients of stimulation. We need to observe typical children to see how they learn to move their own bodies (raising their heads, reaching for objects, sitting up, etc.); use their bodies to explore their surroundings (including any and all objects within their surroundings); and actively participate in interactions with other people. A visual impairment prohibits a child from having enough opportunities to develop these abilities and have these experiences without intervention. She encourages adults to set up the child's environment so that s/he can do this.

Here are a few of Dr. Nielsen's recommendations when developing the child's environment:

  • Observe the child. It is imperative that we know what the child can do, what activities s/he enjoys, what type of objects s/he likes, etc. Assessing the child's existing skills and preferences is the first step in programming. Observation will help you note the child's current developmental skills. A child's preferences are indicators of the underlying strengths of his system. These preferences can guide you in the selection of objects and activities. You need to know a child's repertoíre so you can notice change and improvement.
  • Provide the child with more activities and objects that are similar to those he enjoys. This will encourage the child to explore and experience new things and broaden his knowledge base. Young children with visual impairments need to be encouraged to explore, not only toys from the toy store, but also everyday objects around the house.
  • Give the child opportunities to practice and/or to compare. As adults, we are often tempted to remove materials as soon as the child shows that s/he can use them. We all relate new information to things we already know. For example: The first time you successfully drove a car around the block, you still needed lots more experiences driving in different environments. For example, you needed to drive on different types of roads and highways, different vehicles, different times of the day and night, in different types of traffic, with the radio on and off, with friends in the car, and so forth, before you really mastered all the skills and concepts about driving. When a child begins to bang one object on another one, he needs to be given the opportunity to bang lots of different objects on lots of different surfaces. (The sound produced when banging a metal spoon on the couch is much different than banging it on the coffee table or a metal mixing bowl.) Children need to be able to repeat an action many, many times in order to learn.
  • Provide a few materials and activities that are at a slightly higher developmental level. This will provide a challenge for the child, so he doesn't become bored. You only model these activities for the child. You do not expect him to imitate.
  • Do not interrupt a child by talking when s/he is actively engaged in play. Most of us have had the experience of talking to an infant who is busily kicking her legs and having the child stop kicking to listen to our voice. We need to refrain from talking to a child who is exploring or playing with an object or practicing a new movement. We should wait until the child turns to us to share her/his experience or at least until s/he takes a little break in the activity before commenting. This does not mean that we need to stop talking to our young children with visual impairments, just that we need to pick our moments.
  • Slow down when interacting with a child. We must be willing to wait and give the child time to take a turn in the interaction. When playing with a child, Dr. Nielsen tells us to give the child time to explore an object alone, rather than jumping in and showing her/him how to use it. At a conference during a child demonstration, Dr. Nielsen offered a battery operated facial brush to a child. She let him explore the brush in his own way. He held the brush against various body parts, moved it from hand to hand, turned it over, put it on a tray, moved it against other objects on the tray, picked it back up, put it to his lips, and did many other things with it. Then he turned to Dr. Nielsen to share the experience. That was the moment she talked with him about the facial brush and the things he had done while playing with it.
  • Let the child have control of her/his own hands. Dr. Nielsen feels that when we are interacting with a child who has a visual impairment, it is important not to take her/his hand and bring it to the materials. Instead, we need to develop alternate strategies for presenting objects to the child (e.g. gently touching the toy to the child's arm or leg to alert her/him of the object's presence, making noise with the object to arouse her/his curiosity and encourage her/him to reach out, placing several objects near or touching the child's body, so any movements s/he might make will bring her/his body in contact with an object, etc.).
  • Provide opportunities for the children to actively participate with their environment. One of these "special environments" is the "Little Room". The "Little Room" consists of a metal frame supporting three side panels and a Plexiglas ceiling from which a variety of objects are suspended. These objects should be ones that the child finds interesting and enjoyable. This gives the child the opportunity to experience the properties of objects, to compare different objects, and to try out different things with the objects on her/his own without adults interpreting that experience for her/him. Since the objects are stable (secured to ceiling and walls), the child is able to repeat her/his actions with an object as many times as s/he needs to, at one to two second intervals, without dropping and losing them. The immediate repetition enables the child to store the information gained from the experiences in her/his memory.

Dr. Nielsen has given us lots of information about ways to encourage a child with a visual impairment to learn and develop. For more information about Dr. Nielsen's Active Learning, contact the Consultant for the Visually Impaired at your Education Service Center (You can find a map of Texas Education Service Centers at http://tea.texas.gov/index2.aspx?id=2147503292) or call Outreach Services at Texas School for the Blind and Visually Impaired at 512.206.9268).

References:

Here are some of the books and articles written by Lilli Nielsen.

  • Environmental intervention for visually impaired preschool children with additional disabilities, VIP Newsletter, Vol. 8, No. 3.
  • The blind child's ability to listen, VIP Newsletter, Vol. 10, No. 3.
  • Active learning, VIP Newsletter, Vol. 10, No. 1.
  • Space and Self, SIKON, 1992.
  • Early Learning Step by Step, SIKON, 1993.
  • Are You Blind?, SIKON, 1990.
  • Notes taken from lectures given by Dr. Lilli Nielsen at conferences in Albuquerque, New Mexico, in September 1992, in Milwaukee, Wisconsin in October 1993, and Dallas, Texas, in May 1994.

by Kate Moss, Family Training Specialist

Based on material presented by Jim Durkel, Audiologist and Education Specialist for Texas Deafblind Outreach

Originally published in See/Hear Newsletter prior to 2008

HOW DO WE HEAR?

In a normal ear, sound waves are collected by the outer ear which is made up of the pinna and ear canal. The sound wave is resonated and focused as it travels down the ear canal to the tympanic membrane (ear drum). When it strikes the ear drum the vibration produced causes the tiny bone chain in the middle ear (ossicles) to move in a pumping or rocking motion. The ossicles are attached to the window of the inner ear. The hearing mechanism of the inner ear is made up of the cochlea (sensory) and the VIIIth cranial nerve (neural). The inner ear also houses the vestibular mechanism responsible for maintaining balance.

The movement of the ossicles sets off motion in the fluid that fills the cochlea. Within the cochlea exists the organ of Corti which is lined with approximately 15,000 hair cells. These hair cells resonate at certain frequencies and convert the sound wave motion into electrical impulses.

These impulses trigger nerve impulses in the auditory nerve which in turn sends impulses to the auditory centers of the brainstem and brain. There the auditory information is processed by the brain so that we understand and respond to the sound source. (Flexer, 1994)

CAUSES OF HEARING LOSS

Damage may occur at any point along the hearing mechanism and result in hearing loss. In humans there are two systems that work together to allow us to receive and process auditory signals. The outer ear, the middle ear and the inner ear make up the peripheral auditory system while the brainstem and the cerebral cortex make up the central auditory system. If there is a problem in the area of the outer ear or the middle ear it is called a conductive hearing loss. We all have experienced this type of loss when we have a bad headcold or water in our ears. If there is a problem in the inner ear, it is called a sensorineural hearing loss. This is the type of loss most typically thought of as deafness. When there is a problem which occurs at the brainstem or the cerebral cortex we consider these as auditory processing problems.

Conductive losses occur when:

  • impaired movement of the bones of the middle ear (ossicles) because the bones are damaged or missing or can not move efficiently due to fluid or infection,
  • the absence of the outer ear,
  • unusually small ear canal,
  • obstructions in the ear canal such as wax build-up or small objects (beans, rocks, etc.),
  • and damage to the tympanic membrane.

Sensorinueral losses occur when:

  • there is damage to the cochlea due to noise exposure, disease, or trauma, or hereditary condition;
  • there is damage to the auditory nerve, because of trauma, disease, or hereditary condition.

In auditory processing disorders, even though information seems to be reaching the brain, the individual is unable to process that information correctly. Often individuals with this type of disorder have language problems and may function as if they have some type of hearing loss.

Auditory processing disorders occur when:

  • there is damage to the brainstem or cerebral cortex due to trauma or disease;
  • there is underdevelopment of neural pathways.

Additionally individuals may have combination losses which include a conductive component, a sensorineural component, and/or auditory processing component. When any part of the auditory system fails to function properly the auditory signal (words, environmental sounds, etc.) is not processed correctly and the person experiences hearing loss.

CHARACTERISTICS OF SOUND

What do we need to know about sound to help us understand how our hearing mechanism processes it? First of all the signal or sound has physical characteristics which can be measured: intensity (loudness) measured in decibels (dB) and frequency (pitch) measured in hertz (Hz). This holds true for any sound whether it is a sound produced by the human voice or environmental sounds.

The second thing we need to know is that these physical characteristics combine in spoken language to create what is known as segmentals (letter sounds like k, t, æ, ƒ, th, etc. ) and suprasegmentals (loudness, pitch, rhythm).

COMPONENTS OF UNDERSTANDING THE SPOKEN WORD

Segmental And Suprasegmental Elements

All of this linguistic (language) information is important in helping us to understand speech. We must be able to distinguish specific vowel and consonant sounds. It is important to understand the segmental aspects of speech so that we can distinguish "cat" and "bat" or "cat" and "calf" or "want" and "wanted".

We rely on information provided by the segmental elements, but we also respond to the suprasegmental elements (pitch, loudness, and rhythm) to make sense of what is said. The rise and fall of the human voice carries meaning for us. For example, "you ate this" changes from a statement to a question if the pitch of the "this" rises. ("You ate this." "You ate this?") Pitch typically helps us tell the gender and general age of a person simply by hearing their voice. Sometimes we can also get an idea about their emotional state or physical health because of the pitch, loudness, or rhythm of the voice.

This information guides us in understanding what has been said in order to respond correctly. For example, a strange, male voice shouting, "What do you want?" would get a completely different response from your mother’s voice quietly asking the same question. We have to interpret more than just the words to determine what our response should be.

Language Scheme

We also rely on our understanding of certain situations to help us in processing the information carried by the auditory signal. Take the example of the loud male voice speaking the words "what do you want." If you are in a football stadium and you see the popcorn vendor coming toward you, and your friend asked this question, you would probably respond with, "A large popcorn." If you are walking down a dark street and hear the same thing, you will probably turn and run. Our knowledge of situations play a part in how we interpret what we hear.

This is also true of environmental sounds. If I hear a car alarm outside my bedroom it generally means that the neighbors accidentally set it off. When I hear the same sound outside my motel room in a strange town, I immediately race to the window to see if someone is stealing my rental car. I have learned how to respond to that sound based on where I am when the sound occurs. In other words, I have developed a scheme about the meaning of a car alarm at my home and one about a car alarm at a motel.

Developing scheme is also important in helping me to sort through the auditory signal coming at me to find out what is important for me to pay attention to auditorily. For example, I may not be aware of all of the sounds around me in an airport when I am waiting for a flight, but if my flight is announced, I tune into that information. Why? Because I have a scheme filed under "airports and returning home" in my experience that helps me know when to pay attention to the voice on the speaker overhead.

These scheme are very important to us in using our auditory skills. Think of all the situations we have filed away in our memory that have red flags for listening: a fire drill at school, driving around town, parties, taking a test, eating out at a restaurant. Because we know what to expect as possibilities or probabilities in those situations, we don’t have to put so much of our energies into sorting out what is important to pay attention to and what can be ignored.

OTHER FACTORS INFLUENCING AUDITORY SKILLS

Acoustics

Sometimes our ability to pick up on key auditory information can be affected by environmental factors. For example, the amount of noise around us can drown out (mask) the sounds that are important. Reverberation (echo) can also make listening difficult.

Competition From Other Senses

If there is too much competition from our other senses, listening can become more difficult. Think about trying to listen to what someone is saying to you on the phone while watching your child run out into the street after a ball. You are so engrossed in what you are seeing that you probably don’t hear what the person says.

Motivation

Motivation can impede or improve our ability to hear certain things in certain situations. We are all aware of the phenomenon of "selective hearing." If you are at a party and many people are talking, you may be unaware of what is being said or aware of only a general buzz of voices. However, if someone says your name, you most likely will pick up on their conversation and be able to hear it.

Emotional State And Demand On Memory

Likewise, emotional state can be a factor. "She was so upset I don’t think she heard a word I said." Additionally the demands on our memory can have impact as well. Since I am not fluent in Spanish I have to work hard to pick out the words I might know in Spanish when someone is talking to me. Listening to an English speaker I do not have to listen as carefully to follow the conversation.

Redundancy Of Language

There is also a lot of redundancy in spoken language. For example, if I hear a sentence beginning with a "wh" word and ending with a rising pitch, I know that you are asking me a question. Even if I do not specifically hear the first word, I can make assumptions based on other features of what is said.

In order to understand spoken language or even to understand the significance of environmental sounds, we must have highly developed skills. Some of these skills are related to detecting and interpreting sound on an auditory level and some of these skills relate to more general understanding of the world around us. Even children with mild or moderate hearing loss may need specific instruction and adaptations to access this information and make meaning of it.

THE ROLE OF VISION AND HEARING IN EARLY LEARNING

We know how important the first five years of life are in creating a basis for all learning that will take place throughout the life of an individual. Looking at a child without disabilities we can see how dramatic the development and learning process is during this time period. The foundation for all learning is laid during these critical years as the infant’s body works to complete the development that began in utero. While it is easy to understand the impact of severe and profound sensory loss (vision and hearing) to a young child’s development, it is often easy to overlook the impact of mild and moderate sensory loss during this same critical period of development. In thinking about a child who may also have some type of visual impairment the impact of this type of loss becomes even more dramatic.

When we are born, our hearing skills, much like our vision and our motor skills, are not fully developed. Our brains literally develop the neural pathways that will allow us to use the information coming in through our senses to comprehend ourselves and the world around us.

A hungry baby cries and mom pads across the room and talks to the baby as she picks it up to be fed. Over time the baby comes to expect this response and associates these sounds with getting fed. As most parents will tell you, after a while the baby will cry for assistance and calm the minute he hears the parent’s voice or footsteps. That baby has already developed skills that allow him to:

  • detect the sound of her voice or steps ;
  • recognize it is mom’s voice and not the vacuum cleaner;
  • know that mom’s voice is responding to him;
  • know that mom is at the door of his room;
  • comprehend she said "want bottle";
  • and understand all of this together means that dinner is on the way.

Beginning at birth, vision and hearing play a critical role in the overall development of a child and his ability to learn.

"Piaget describes the first two years of life as the sensorimotor stage during which time the infant progresses from reflex activity to more systematic and organized behavior. He learns that he has control over the object world and will visually search for a toy he has lost. He will reach for and grasp his toys. He learns that objects are independent of himself. He learns to imitate and to respond to people through imitative behavior. Finally, he takes the first steps toward establishing verbal communication. The acquisition of speech begins with the cooing of the infant at about 16 weeks; babbling at about 28 weeks; and putting sounds together at about 40 weeks. Language development proceeds in a similar sequential fashion. At 28 weeks the infant attends to voices and by 40 weeks responds to simple commands. By 15 months he says single words together to express ideas and by 2 years he puts words together to form simple sentences. (Scholl, 1986)

Vision and hearing are the senses that help him understand his separateness from the people and the world around him. They serve as the motivators in his exploration of his body and of the world. This leads to his ability to move his body, use his hands, walk around a room, and so forth. A child does much of his early learning by observing the sights and sounds of the world around him. Watch a group of three year olds at play and you will understand just how much they have learned simply by looking and listening in their environments.

"A greater quantity of information is gained in a shorter period of time through use of the visual system than through any other single sense organ." (Scholl, 1986)

"Auditory processing and listening for learning is the ultimate level of auditory progress and is a skill essential for academic progress and continued cognitive development of visually handicapped students." (Scholl, 1986)

" A child with a minimal, borderline, or slight hearing impairment may experience problems in the following areas: 1) hearing faint or distant speech (in fact, at least 10% of classroom instruction may be missed); 2) detecting subtle conversational cues which could cause the child to respond inappropriately; 3) keeping up with fast-paced communicative interactions; and 4) hearing the word-sound distinctions that comprise morphological markers for tense, plurality, possessives, and so on. In addition, the child may appear immature and be more fatigued than peers due to the increased level-of-effort needed to hear." (Flexer, 1994)

When you consider the importance of vision and hearing to the overall development it becomes apparent that even a mild or moderate sensory loss at this critical phase can have dramatic consequences. Even though these children are receiving a great deal of visual or auditory information, this information is distorted. They may also miss visual or auditory information that occurs at a distance from them.

ADDRESSING THE EFFECTS OF HEARING LOSS

Regular Periodic Hearing Screening

All children, especially children with visual impairments, should be screened for hearing impairment regularly. Many schools provide hearing screenings from time to time, but parents shouldn’t rely on these screenings alone. Make hearing screenings a regular part of the yearly check-up routine.

Medical Treatment When Appropriate

Because many mild or moderate hearing losses can be corrected or treated, good medical management is a must. Ear infections usually require medication, and if they are chronic, the insertion of tubes in the eardrum to keep fluid from impeding the movement of the middle ear bones.

Obstructions in the ear canal are also not uncommon. Young children do indeed "put beans in their ears" and some children may produce an excessive amount of earwax which builds up and creates a blockage. These types of problems can usually be corrected without extreme measures.

Modern surgical procedures have made it possible to correct problems with the ossicles in the middle ear. The chain of bones may even be replaced by prosthetics.

Amplification

Many children with mild or moderate hearing loss can benefit greatly from the use of hearing aids and auditory trainers. It is important that these devices are monitored daily to assure that they are working properly. It is also important that the child wear the device as much of the day as possible. Specific training to help the child build tolerance for the device and to learn to use the improved signal provided by the device is critical.

Improving The Listening Environment

Reducing noise goes hand-in-hand with improving the signal quality. The difference between the loudness of the sound and the loudness of the other noises in a listening situation is called the signal-to-noise ratio. The signal-to-noise ratio in most schools and homes is poor. Carpeting rooms, adding acoustical ceilings, closing doors to noisy hallways, and using study carols are a few of the things that can improve the signal to noise ratio. Many homes and some classrooms may constantly have a radio, record player or television playing. Simply turning off these noise makers can greatly improve a child’s ability to function auditorily.

Another problem causing auditory clutter is constant chatter. We may think that constantly talking about everything that is happening is beneficial to the child with hearing loss and especially vision loss. Rather than a constant chatter, clear and simple statements about what has or is about to happen may be more helpful to the child. This is especially true if the child has multiple disabilities or seems to have trouble processing auditory information. Too much information makes it even more difficult to sort out what needs to be attended to auditorily.

Making the listening environment pleasant and varied is important. Total quiet is not the goal; managing noise and auditory information is.

Ongoing Training To Develop Better Auditory Skills

Remember, in order for auditory information to be useful to us, we not only need to be aware of the sound but need to be able to attach meaning to that sound. When a child is visually impaired the need to attach meaning to the sound becomes more important. Auditory training for children with identified hearing impairment should be included as a part of each child’s educational goals in school. However, parents can also be a major force in the development of these skills through the everyday activities at home.

STRATEGIES FOR DEVELOPING LISTENING SKILLS

Determine Current Skills

First of all, it is important to establish what the child responds to auditorily. In addition to appropriate audiological testing, parents should observe what types of sound the child responds to and how he responds. Does he respond to male or female voices better? Does he seem to search for the source of certain sounds or become animated or fussy if the sound occurs? Is there a different type of response to environmental sounds and human voice? Does the child show an awareness when the sound starts or stops? Providing a rich auditory environment and carefully observing the child’s responses to that environment are key.

Draw Attention To Sound In A Non-Pressuring Way

Consistently drawing the child’s attention to the sounds in the environment in a non-pressuring way and helping him to build scheme around the sound are critical. Make listening a rewarding and pleasant experience. For example, help him find the dog when it is barking. Discuss why the dog might be barking. Let him pet the dog or give it a treat to quiet it. Imitate the dog barking and try to get the child to imitate the sound, too.

Model A Variety Of Reactions To Sounds

Model a variety of reactions to different sounds especially tuning in to the suprasegmental features of pitch, rhythm, intensity, and duration. For example, move or dance to music that alternately is fast or slow. Respond to loud and soft sounds by covering and uncovering your ears. Relax to soft, slow music and exercise or dance to faster tunes.

Present Sound In A Variety Of Contexts

Present the same sounds in a variety of contexts. For example, the keys at home, the keys at the grocery store, and the keys at grandma’s house are used to cue the child that "we are about to go somewhere in the car." Your goal is for the child to react consistently and differentially to different sound classes. For example, no matter who is clapping or how the claps sound, the child knows this means "someone is about to play a game with me" and indicates he is anticipating what will come next. The sound of running water causes the child to anticipate washing his hands or bathing wherever he is when he hears the sound. He anticipates this activity because he has heard that sound many times and developed associations related to that sound.

Make Sound A Part Of Routines

Using sound within routines to establish and reinforce the meaningfulness of sound is very important. For example, call the child’s attention to the sound that the pans make when you get them from the cupboard or put them away. Have him listen for the sound of the can opener as you open up the food container. Listen to the sound of the spoon against a pan as he stirs, etc.

Pair Visual And Tactile Cues To Sound

Pairing visual, tactile, and auditory cues within these routines is also helpful. For example, cue the child to reach for the microwave by touching his hand or get him to watch for the flashing light on the timer to get him to open the microwave as it beeps. Later on you can fade the touch and/or visual prompt, letting the auditory prompt of the beep alert him to opening the microwave door. 

Engage In Turn-Taking

Response to the human voice is a very important concern for social and communication purposes. Engaging in turn-taking routines which involve vocal play can be helpful. Having the child listen and respond vocally with the "pop" sound or its approximation in when dad sings "Pop Goes the Weasel" is an example of this type of turn-taking. Imitate the child’s vocalizations whatever they are and try to get a turn-taking interaction going.

Simple, Repetitious Language

Using simple, repetitious language within the context of routines is also important. Sometimes it helps to actually write down a script for the language you will use during a routine. Even if you stray from the script somewhat, it helps you to evaluate how complicated the language is that you are using with the child in that routine.

Respond To The Child’s Vocalizations

Whenever the child makes any type of vocalization try to respond to it. A fussy cry might be interpreted as a "no" response to the activity that is being offered. Give the child the choice of stopping or at least taking a break from the activity. In the same way a giggle or coo, might be interpreted as a positive response. Continue that activity a bit longer. You are letting the child know in this way that his voice has power in controlling the events that are occurring.

Encourage The Child To Experiment With Sound

It is also important to provide opportunities for the child to experiment with sounds through vocal play alone or with an adult or playing with objects or toys. Singing songs together, making sounds with your voice as you swing, taking turns saying "boo" and scaring mommy, imitating the sound of a toy, or any kind of vocal play helps develop important auditory skills. Remember to allow the child the time and space to use their voice in response, especially if that child has multiple disabilities.

Playing with more environmental sounds is important as well. Let the child start and stop the blender, ring the doorbell, turn the radio up and down. This helps to build scheme around the objects and activities and also helps him to understand he can control the occurrence of the sound. 

CONCLUSION

Auditory skills are developed, we are not necessarily born with them. Children with hearing impairment, especially mild and moderate hearing impairment, may not develop these skills readily without appropriate support.

  • Make sure your child has regular and periodic hearing screening.
  • Monitor medical conditions that may lead to permanent and more severe hearing loss.
  • Be a good observer of the way your child uses their hearing and help them to build their listening skills.
  • Use hearing aids and FM systems when appropriate.
  • Provide good listening environments that are interesting, but not cluttered.
  • Give your child positive and meaningful experiences in listening through play and routines.
  • Encourage and reward the child’s experimentation with producing and listening to sound.
  • Keep your language simple and consistent in interacting with the child.

Children with visual impairment need to learn to use their hearing well. As their other distance sense it is critical for safety and is also the key to connecting with the world and the people in it.

RESOURCES

Durkel, Jim (1986). Handout from "Auditory Assessment and Auditory Training for the Mulihandicapped" session of the Statewide Deaf-Blind Multihandicapped Conference, Austin, TX.

Flexer,Carol (1994). Facilitating Hearing and Listening in Young Children. San Diego, CA: Singular Publishing Group, Inc.

Watkins, Susan, Editor (1989). The INSITE Model - A Model of Home Intervention for Infant, Toddler and Preschool Aged Mulithandicapped Sensory Impaired Children. Logan, UT: Hope, Inc.

Scholl, G. T. (1986). Foundations of Education for Blind and Visually Handicapped Children and Youth. New York, NY: American Foundation for the Blind, Inc.

by Millie Smith and Stacy Shafer

Biobehavioral states are levels of arousal ranging from asleep to agitated. Students with profound disabilities may not respond to the stimulation and interactions around them because they have difficulty establishing and maintaining alert arousal states. They, like any other student, are available for learning only when they are alert. The primary task of teachers serving this population is to become skillful at using environmental management and specific sensory input to create conditions that facilitate establishment and maintenance of alert states. Once students are alert, appropriate learning materials and social interactions must then be provided in order for learning to occur.

Many external as well as internal factors influence arousal states. All significant factors must be considered in determining the best way to facilitate alert states with any given student. For that reason, biobehavioral state assessment is crucial before interventions occur. Under no circumstances should it be assumed that a student is non-responsive under all conditions before biobehavioral assessment and subsequent intervention has been provided.

Two of the most well known biobehavioral assessments that have come from the research and literature developed during the last twenty-five years are the Carolina Record of Individual Behavior (CRIB) and the Analyzing Behavior State and Learning Environments Profile (ABLE). Each of these tools has strengths, but cost and accessibility limit the use of each for some teachers. The informal, teacher-made assessment tool offered in this article attempts to assist teachers in their efforts to identify factors influencing their students' arousal states. Teachers are encouraged to change this tool as needed to meet the unique needs of an individual student. Teachers are also encouraged to read the resource material listed and to take advantage of training opportunities as they arise.

The success of this type of assessment is highly dependent upon the sharing of information. Parents and staff members who will be recording states and other information should plan the assessment together. All assessors must agree on the characteristics of each state for the student they are assessing. Using a video tape of the student to practice recognition of states before the actual assessment takes place is very helpful.

Example Form: Assessment of Biobehavioral States and Analysis of Related Influences

Resources

Guess, D., Mulligan-Ault, M., Roberts, S., Struth, J., Siegal-Causey, E., Thompson, B., Bronicki, G.J., & Guy, G. (1988). Implications of biobehavioral states for the education and treatment of students with the most handicapping conditions. JASH, 13 (3), 163-174.

Guy,B., Ault, M., & Guess, D. (1993). Project ABLE manual: Analyzing behavior state and learning environments profile. Lawrence: University of Kansas Department of Special Education.

Rainforth, B. (1982). Biobehavioral state and orienting: Implications for education profoundly retarded students. TASH Journal, volume 6, Winter, 33-37.

Simeonsson, R.J., Huntington, G.S., Short, R.J., & Ware, W.B. (1988). The Carolina record of individual behavior (CRIB): Characteristics of handicapped infants and children. Chapel Hill: Frank Porter Graham Child Development Center, University of North Carolina at Chapel Hill.

by Millie Smith, Education Specialist and Stacy Shafer, Early Childhood Specialist, TSBVI Outreach

Biobehavioral states are levels of arousal ranging from asleep to agitated. Students with profound disabilities may not respond to the stimulation and interactions around them because they have difficulty establishing and maintaining alert arousal states. They, like any other student, are available for learning only when they are alert. The primary task of teachers serving this population is to become skillful at using environmental management to create conditions that facilitate establishment and maintenance of alert states. Once students are alert, appropriate learning materials and social interactions must then be provided in order for learning to occur.

Many external as well as internal factors influence arousal states. All significant factors must be considered in determining the best way to facilitate alert states with any given student. For that reason, biobehavioral state assessment is crucial before interventions occur. Under no circumstances should it be assumed that a student is nonresponsive under all conditions before biobehavioral assessment and subsequent intervention has been provided.

Two of the most well known biobehavioral assessments that have come from the research and literature developed during the last twenty-five years are the Carolina Record of Individual Behavior (CRIB) and the Analyzing Behavior State and Learning Environments Profile (ABLE). Each of these tools has strengths, but cost and accessibility limit their use for some teachers. The informal, teacher-made assessment tool which follows this article attempts to assist teachers in their efforts to identify factors influencing their students' arousal states. Teachers are encouraged to change this tool as needed to meet the unique needs of an individual student. Teachers are also encouraged to read the resource material listed and to take advantage of training opportunities related to these tools as they arise.

The success of this type of assessment is highly dependent upon the sharing of information. Parents and staff members who will be recording states and other information should plan the assessment together. All assessors must agree on the characteristics of each state for the student they are assessing. Using a video tape of the student to practice recognition of states before the actual assessment takes place is very helpful.

Resources

Guess, D., Mulligan-Ault, M., Roberts, S., Struth, J., Siegal-Causey, E., Thompson, B., Bronicki,
G.J., & Guy, G. (1988). Implications of biobehavioral states for the education and treatment of students with the most handicapping conditions. JASH, 13 (3), 163-174.

Guy, B., Ault, M., & Guess, D. (1993). Project ABLE manual: Analyzing behavior state and learning environments profile. Lawrence: University of Kansas Department of Special Education.

Rainforth, B. (1982). Biobehavioral state and orienting: Implications for education of profoundly retarded students. TASH Journal, Volume 6, Winter, 33-37.

Simeonsson, R.J., Huntington, G.S., Short, R. J., & Ware, W. B. (1988). The Carolina record of individual behavior (CRIB): Characteristics of handicapped infants and children. Chapel Hill: Frank Porter Graham Child Development Center, University of North Carolina at Chapel Hill.

Editors note: If you have questions regarding the forms that follow contact Millie Smith at (512) 206-9271 or write to her at TSBVI Outreach, 1100 W. 45th Street, Austin, TX 78756, Attention: Millie Smith. The actual forms may be found in Teaching Students with Visual and Multiple Impairments (1996). Austin, TX: Texas School for the Blind & Visually Impaired, Austin, TX.


Assessment of Biobehavioral States and Analysis of Related Influences

by Millie Smith and Stacy Shafer

Student's Name: Catherine              Date of Assessment: 3/5/95

Name(s) of Assessor(s): M. Smith, P. Castro (mother), N. Jones

Assessment Period

School day starts at: 8:15 a.m
School Day ends at: 3:30 p.m.

Nonschool environments:
Place: Home From: 4:00 p.m. To: 8:30 p.m.
Place:           From:                  To:

The total assessment period should be at least one school day. Assessment of the student in nonschool environments on the same day would be extremely helpful.

Recording Schedule

Indicate the length of the interval between recordings in Part II. Intervals should be no shorter than one minute and no longer than 15 minutes. The intervals should be consistent throughout the assessment period. Part II information will be recorded every 15 minutes.

Part I

Provide the information called for in the grids for the 24 hours preceding the beginning of the assessment and throughout the assessment period. Under "Comment" indicate any significant factor that comes to mind and be sure to note when the recorded information is a departure from the student's typical routine. If there are significant departures or if the student is ill on the day of assessment, postpone the assessment.

Note: This is an informal teacher-made assessment based on the Carolina Record of Individual Behavior (CRIB), by R. J. Simeonsson et al. and the Project ABLE Manual: Analyzing Behavior State and Learning Environments Profile by B. Guy et al.

Food and Liquid Information

Each time the student eats something, drinks something, or is tube fed, enter the following information on the grid:
(the grid has five columns titled Type, Start Time, Stop Time, Amount, and Comment)

TypeTime StartTime StopAmountComment
Ensure. 8:20 8:40 16 oz  
Water. 8:40 8:45 6 oz  
Ensure 12:30 1:20 16 oz.  
Water 1:10 1:15 6 oz.  
Ensure 4:30 4:50 16 oz.  
Water 4:50 5:00 6 oz.  
Ensure 8:00 8:20 16 oz.  
Water. 8:20 8:25 6 oz  

Medication Information

Each time the student takes a prescription or over the counter medication enter the following information on the grid:

TypeTimeAmountComment
Tegretol Suspension 8:20 a.m. 200 mg  
Dimetap Elixir 8:20 a.m. 10 cc for congestion
Dimetap Elixir 12:30 p.m. 10 cc  
Tegretol Suspension 4:30 p.m. 200 mg  
Dimetap Elixir 4:30 p.m. 10 cc  

Seizure Information

Each time a seizure occurs, enter the following information on the grid:

Start Time Stop TimeDescriptionComment
       
    none observed  
       
       
       

Sleep Information

Each time the student sleeps for more than five minutes, enter the following information on the grid. If the student's sleep is interrupted for longer than three minutes, enter a stop time and begin a new sleep episode on the next line:

Start TimeStop TimeLocationComments
9:00 p.m. 12:00 p.m. Bedroom Cried to request in bed change in position
12:15 p.m. 3:20 p.m. " "
3:28 p.m. 6:15 p.m.. " Playing quietly in bed when checked at 6:15

Part II - Instructions

Time: Record the clock time for every third interval recorded. This will help show the continuity of the assessment.

State: Record the state at the moment of observation, not the prevalent state for the entire interval.

Position: Indicate the position the student is in at the moment of observation (e.g., sitting, side-lying, prone, supine, standing).

Specific External Stimuli Available: Describe the specific external stimuli available to the student at the moment of observation (e.g., music, vibrator, swing, water, food, Little Room, mobile). If no material is available, enter a zero.

Ambient Conditions: Describe the characteristics of the surrounding (e.g., room temperature, noise level, conspicuous smells, lighting) for the first state recorded and whenever conditions change. When no change occurs, put ditto marks in the column.

Social Conditions: Record the name of the person interacting with the student at the moment of observation. The person must be talking to the student, touching the student, and/or co-actively manipulating an object with the student. The passive presence of another person should not be recorded. If no person is interacting with the student, enter zero.

Key to Part II Assessment

State Key: _ = Seizure; S = Sleep; D = Drowsiness; QA = Quiet Awake;
AA = Active Awake; FA = Fussy Awake; MA = Mild Agitation;
UA = Uncontrollable Agitation.

TimeActivityStatePosition Spec. Ext. Stimuli Avai.lAmbient ConditionsSocial Conditions
8:15 Arrival QA Seated 0 Outdoors cold, windy, noisy chairlift in bus Greeted by TA  Linda
8:30 Breakfast D Supine 0 Normal temperature and lighting 0
8:45 Tooth-brushing MA Seated Toothbrush, toothpaste, water, towel Noisy bathroom,very bright lighting Hand-over-hand   manipulation; L
9:00 Hair Drying QA Seated Hairdryer, mousse, brush Normal temperature and lighting Talking; Linda
9:15 Hair Brushing QA Seated Hairdryer, mousse, brush Normal temperature and lighting Talking; Linda
9:30 Drama Class AA Seated Papier mache material Dark stage area, echoes Surrounded by peers
10:00 Changing AA Supine Cold wipes, talcum  powder Normal temperature  and lighting Patting, talking; Linda
10:15 Mail Delivery AA Rolling  prone stander Variety visual & auditory stimuli avail. Many changes; different noise levels Interaction with 6 different adults
        Remainder of day not shown    

Part III - Summary

Typical duration of alert states: 15 to 20 minutes

(Note: If the student is typically alert less than one minute, a different type of biobehavioral assessment will be necessary. Consider assessing one activity at 30 second intervals. The purpose of this assessment would be to try to determine what influences cause state changes and to provide modifications associated with changes to more alert states.)

Positions during alert states: Seated, standing (in prone stander)

Specific external stimuli available during alert states: Movement; tactual materials (e.g., paper, hairbrush); auditory, especially human voice

Ambient conditions during alert states: Normal lighting, temperature, low noise level

Social conditions during alert states: Talking and touching

Less than alert states typically occurred when: There was no social interaction

Agitated states typically occurred when: There was too much noise or strong smells and just before feeding

If you have concerns about food and liquid intake or medications, talk with parents and other team members about getting more information.

Do you have concerns about food and liquid intake being adequate for maintenance of alert states:

___X__ Yes  ______ No

Do you have concerns about medication and/or medication schedules facilitating alert states at optimum programming times:

___X___Yes   _____  No