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https://www.theottoolbox.com/sensory-play/

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https://www.pathstoliteracy.org/experience-books-tool-conversation/?fbclid=IwAR11VZYze6_UzVVwohC_717Dq97KPev_hZj_o98Lf_hhVpomygDNOEIO4U0

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Smelling Sensory Bottles Free Printable Labels

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Share & Remember | Celebrating Child & Home

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For our "My Amazing Body" theme, I made some Smelling Sensory Bottles. Although my version doesn't really follow the traditional Montessori method because I labeled the jars and it's not really a matching activity, the kids have really enjoyed them.

It all kind of started with this pickle relish container I put out for the kids to use in the kitchen area. The kids like the flip top cap - which is now missing. I observed them opening the lid, squeezing the bottle near someone's nose and saying "Smell the fresh air." So funny! It did not smell like fresh air! Pickle relish! A couple of the parents didn't think it was pleasant either!

I used spice containers found at our grocery store by the bulk spices. $1.59 each. There's one cotton ball in each container with an essential oil or extract on it. Essential oils are preferred but I used what I had available. Our scents include:

Stormy got in on the action too and got to smell them all. He didn't really appreciate it but it was super cute to watch!

Smelling Bottle Scents

Vanilla: this one is an oil used for scenting soaps from Hobby Lobby
Cherry: cherry extract. It smells very much like cherry cough syrup! This one is a give away because it's red.
Almond: Almond extract or almond oil
Cucumber: Cucumber Melon fragrance oil
Grapefruit: essential oil
Peppermint: essential oil
Lavender: essential oil

My one little girl, amongst all the boys, declared one of the scents " ucky " and tried to throw it away! It's fun to observe and see what their responses to the scents

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Smelling Sensory Bottles Free Printable Labels

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For our "My Amazing Body" theme, I made some Smelling Sensory Bottles. Although my version doesn't really follow the traditional Montessori method because I labeled the jars and it's not really a matching activity, the kids have really enjoyed them.

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Build a sensory space

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AIRCB order form for APH Products

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All items can be ordered for students at no charge but must be returned https://www.aph.org/aph-catalogs/

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CVI Apps - A List of Apple or Android Apps - Seeing Sadie & CVI

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Picture of Doodle Buddy with Math

Featured App:
Doodle Buddy

One of Lisha and Sadie's most used apps! You can highlight features on a picture, use the black background with high contrast for math, spelling, writing.

And we also go to this Website to help learn typing which will be extremely important for Sadie since handwriting is an issue for her. Click on the link below to check it out.

Suggested Applications for Children with CVI

The information below has been gathered by Lisha Yochimowitz, M.Ed. through other teachers, parents, professionals, along with trial and error for children with CVI interested in Apps.

Sadie's keyboard for typing app

Check out our Video Snippets for Sadie Jo doing typing club for learning to type on her keyboard! Sadie Typing -Link

CVI Friendly iPad Applications

Fluidity

Tap-n-See Zoo

Little Bear Sees

Baby Rattle Toy

Peekaboo

iLoveFireworks Lite

Sparkabilities

Bubbles

Bubbles Logic HD

Baby Piano

iBabySee

First Words for Baby

Touch, Look, Listen

My PlayHome - Fun play time app

Drawing Pad

Doodle Buddy use the black background feature

Learn to Count by Prime Run- Use the crows game, really helped with +/-

Magnitic ABC - Use the black background

Starfall ABC

Starfall Numbers

Writing Wizards

Glow Draw link

Epic: on-line books that can highlight and read, your school may already have a subscription for you child to use but there is also a one month free trial.

Bits Board - We use this to create our own learning slides, lessons, activities, go to settings to make it high contrast and larger

Go Noodle

Joy Doodle

Check out these other CVI Advocate websites for additional apps:

Check Out Additional CVI Resources

error: Our content is protected.

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CVI Apps - A List of Apple or Android Apps - Seeing Sadie & CVI

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Featured App: Doodle Buddy One of Lisha and Sadie's most used apps! You can highlight features on a picture, use the black background with high contrast for math, spelling, writing. And we also go to this Website to help learn typing which will be extremely important for Sadie since handwriting is an issue for her.

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https://instagram.com/primaryplayground?igshid=YmMyMTA2M2Y=

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CVI Teacher on Instagram

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View this post on Instagram

A post shared by Melissa | Special Ed | CVI (@specialachievers)

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Instagram sensory input

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Wait Time
Timehttps://www.smore.com/hj9qe-sensorimotor-spotlight?fbclid=IwAR3qXPO_BDbGsg5sh4mOHvi9M6oJgZgjNPxhG2At1CETz2BASN70qnEVaZc

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What does "Literacy" mean for children with multiple disabilities?

All children, regardless of whether or not they have a vision loss or additional challenges, learn through repeated and frequent exposure to meaningful hands-on experiences in order to develop basic concepts that are the foundation of literacy. In this sense, literacy is much more than learning to read, whether it be in braille or print, as it begins with an understanding of one's environment, including people, activities, and routines. Learning to communicate about these experiences may be through speech, sign language, objects, or some combination of these. Literacy is a broad topic that encompasses many different forms, including print, braille, objects, speech, sign language, and other symbol systems.

With this broader focus on language (including sign language), literacy includes recognizing objects, pictures, or other symbols, and using them to communicate. Making choices, anticipating events, following simple recipes, creating or "reading" lists, and other forms of self-expression are all part of functional literacy.

What do we mean by "multiple disabilities"?

Children with multiple disabilities are not a homogenous group. This term encompasses a wide range of functioning levels, depending on the severity and specifics of each type of disability. A student who is totally blind and profoundly deaf will have different educational needs from a child who has low vision and mild cerebral palsy. Some students may be academically close to grade level, and in need of emotional support, or have physical challenges that make it difficult for them to hold materials or write with a braillewriter or pencil. Students with significant intellectual impairments may need to have extensive modifications to the curriculum, educational materials, and instructional techniques. It is up to each educational team to assess the student and determine his or her individual needs. We offer ideas and suggestions from the field in the assumption that teachers, families, and others working with a child will evaluate comprehensively and make individual determinations of what is appropriate.

Please see the section on Struggling Readers for information about students with visual impairments and specific learning disabilities.

Do students who are deafblind have the same needs as other children who have multiple disabilities?

As above, children who are deafblind are a diverse group, depending on the amount of vision and hearing they have, at what age they lost their vision and hearing, the etiology of their sensory impairment and whether they have other disabilities. There is a specific section devoted to strategies that are unique to students with both visual and auditory loss. Many of the practices focusing on communication, routines, and concept development are similar to those used for children with multiple disabilities. Children who are deafblind who are at the same academic grade level as their peers are sometimes called "proficient communicators". Please see also the Texas Deafblind Project website for more information about this group.

How can we engage children in developing foundational concepts?

Because children with multiple disabilities often have limited experiences and access to the world, they may not fully understand everything that is happening around them. Basing lessons on meaningful and interesting experiences can help motivate students to actively participate in literacy activities. Experiences from the child's own life that are familiar and concrete are often a good place to start. For example, daily routines such as bathing and dressing, helping to prepare meals, going to a restaurant, or visiting friends and relatives are common experiences that most of us have. Talking about these events before they happen and developing a process for referring back to them afterwards is an important foundation for reading stories about other life experiences.

Including the child in hands-on activities using real objects can help to develop an understanding of what objects are used for, as well as basic concepts about the world, such as cause and effect and object permanence. Daily activities can also give children experience with attributes, such as big/little, wet/dry, heavy/light, and other concepts that are essential to the understanding of same/different and comparative thought.

How can we make literacy experiences meaningful to children with multiple disabilities?

It may be daunting at first to imagine how to include children with significant multiple disabilities in early literacy experiences. If they cannot see the book, and if additional challenges make it difficult for them to hear, to understand, or to help to turn the pages, parents and teachers may be at a loss on how to make this experience meaningful.

Meaningful hands-on experiences benefit all children when they provide an opportunity for active engagement, language enrichment, and concept development. Every time children get to DO something fun, they are building potential stories. These experiences can be the foundation of literacy through the creation of memory boxes, retelling the sequence of events that happened, and writing experience stories.

For example, if a child loves to make and eat popcorn, this activity can be made into a literacy activity by collecting parts of the activity (e.g. unpopped kernels of popcorn, pieces of popped popcorn) and writing a few sentences about the activity with the child.

By placing the materials in a small plastic bag and attaching the bag with Velcro to the page, the child can begin to make the association between the actual activity and the retelling or anticipation of it.

Sequence from Real Objects to Tactile Symbols

When presenting materials to students with visual impairment and multiple disabilities, begin with real objects that are familiar to the child. These can be arranged on a sequence board or boxes to relay information about an experience. This is the equivalent to pictures that are used for sighted children beginning literacy. For example, begin with a spoon, bowl, and packet of pudding and talk to the child about the experience of eating the pudding. "Do you remember when we had pudding at snack time today? First we got the spoon from the drawer, then we got the bowl out of the cupboard, and then we got the pudding out of the refrigerator. It was chocolate. Yum! I love chocolate!"

After a student recognizes these objects and demonstrates understanding of the function of the spoon, bowl, and pudding packet, these objects can be paired with tactilely significant portions (e.g., the handle of the spoon that she will grasp, a ring like that hanging on the metal bowl, an empty packet) and these two can be compared and used together in the sequencing. Eventually, when the student is able to transfer their understanding to this partial object, it can be paired with a less concrete representation - a tactile symbol. The journey from reliance upon the real objects to meaningfully using an abstract tactile symbol can take time, and consistent modeling. Some students may progress to braille, while others will find tactile symbols the most meaningful systems to support communication and build reading and writing skills.

We encourage you to explore related sections, including:

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Overview of Multiple Disabilities - Paths to Literacy

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All children, regardless of whether or not they have a vision loss or additional challenges, learn through repeated and frequent exposure to meaningful hands-on experiences in order to develop basic concepts that are the foundation of literacy.

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Tics vs Stimming vs Compulsions: What's the Difference? | WonderBaby.org

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WonderBaby.org - Helping Your Baby Reach Greater Wonders

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Tics, stimming, and compulsions are repetitive behaviors related to anxiety.

Tics and compulsions present as an overwhelming need to be released.

Much of the time, stimming can be controlled and is used as a means to self-soothe.

Mental health professionals can teach parents techniques to manage these behaviors.

Doctors may prescribe medication at times to control some unwanted repetitive mannerisms.

As a school nurse in an elementary school, I frequently had contact with kids who would stim to self-soothe or were dealing with various forms of tic disorders and compulsive behavior.

I recall one child who could not walk forward into the lunchroom as the floor tile was different than that in the hallway. This change in flooring represented a line that he could not cross if he were striding in a head-on direction.

Instead, this young man needed to repeatedly walk backward into the cafeteria on his way to his lunch table. He could not help his behavior, and by repeating this ritual, he was able to satisfy a driving need inside himself to accomplish his goal.

This boy suffered from obsessive compulsive disorder (OCD), and once his parents had him seek treatment, many of his symptoms diminished.

Compulsive behavior such as the one in this illustration is a mental disorder that is unintentional and completely uncontrollable. This article will help you figure out involuntary behaviors such as tics vs stimming as well as compulsions in children.

After breaking down some basic educational information about these complex disorders, we provide tips on how to manage tics, stimming, and compulsions in children to better help you deal with what can be a perplexing and frustrating issue as a parent.

Identifying Tics

Have you ever known a child or adult who seemed to clear their throat over and over for months on end although they do not appear ill? Just when you think you can not stand the maddening throat clearing any longer, it stops, only to be replaced by constant finger snapping and tapping.

Although this person may just have an annoying habit, there is a good possibility their disturbing habit can't be controlled. They may be experiencing tics, which are completely involuntary, repetitive behavior that may involve vocal sounds or movement.

Tic disorder may be found in those with tourette syndrome, obsessive compulsive, and autism spectrum disorder. However, there are cases where these repetitive movements and behaviors are not associated with any other conditions.

What Causes Tics?

The cause of tics is very complex and mostly unknown.
Studies show that the "majority of children with tics demonstrated significant emotional sensitivity (70%) and tendency to repress fear and anger (60%)".
Additional factors that may contribute to tic disorders are due to the following:

Mild brain changes (shown on MRI)

Genetic factors

Stress

Gestational risk factors

Learning disabilities

Underlying epileptic spikes

Those with tourette syndrome and other tic disorders have what is described as a premonitory urge to move or vocalize in a certain way. This feeling to act on this impulse will not go away until the repetitive movement or speech has been released.

Types of Tics

Tics can take on different forms and may change at any time. In fact, a tic disorder is noted for the transient changing of the tic behavior.

Tics are categorized into vocal (phonic) tics and motor (physical) tics. Tic disorders are further differentiated by the complexity of the tic, meaning that the behavior or movement involves more than one muscle group or meaningful sounds (like words or phrases).
Simple vocal tics are identified as a single sound repeated frequently.
Vocal Tics

Examples of simple verbal tics are:

A complex vocal tic incorporates actual words or phrases and can be mistaken for purposeful speech, such as:

Swearing

Insults

Repeating what others say

Calling out inappropriately

Motor Tics

Motor tics are frequent repetitive movements that involve muscle. Once again, these are involuntary movements that may come and go over time.

Physical tics can also be broken down into complex and simple tics.

Simple motor tics may present as:

Shoulder shrugging

Facial grimacing

Head banging

Neck stretching

Nose wrinkling

Lip biting and licking

Eye blinking

A repetitive movement that involves more than one muscle group is identified as a complex motor tic. Many times this type of repetitive behavior is mistaken for purposeful negative actions.

Complex motor tics may look like:

Kicking

Mimicking other's movements

Twisting of their body

Several motor tics happening at once

Slapping and touching others (or their property)

What Age Do Children Start to Exhibit Tics?

M. Cristina Victorio, MD at Akron Children's Hospital, indicates that tic disorders "occur in about 20% of children, many of whom are not evaluated or diagnosed. Tourette syndrome, the most severe type, occurs in 3 to 8/1000 children. Male to female ratio is 3:1".

Children can exhibit different types of tics at once, and repetitive mannerisms can change forms at any time. They typically develop between the ages of 4 and 6 and peak during puberty, only to lessen in the teen years.

Identifying Stimming

The term stimming is commonly associated with autism spectrum disorder. However, most people stim in some fashion. In fact, we may call these behaviors a "habit" (albeit usually considered a bad one).

Examples of stimming can be as commonplace as:

Hair twirling

Nail biting

Neck cracking

Cracking of knuckles

Foot jiggling

Drumming your fingers

Most of us can cease our self-soothing ritual when it is pointed out to us that it is annoying.

However, those in the autistic community employ self-stimulatory behavior that sometimes appears more atypical and, to a certain extent, self-destructive. In this case, these mannerisms are hard to control, and children can not easily stop stimming on command.

Stimming appears in these instances like:

Hand flapping

Head banging

Biting/sucking/rubbing body parts

Rocking

Pulling hair

Hitting own face

Repeating words or phrases

Walking around on toes

Visual stimming such as staring at one object for long periods of time

What Causes Stimming?

The word stimming is based on self-stimulating behavior. Although it is often associated with autism, there are other conditions such as ADHD and some developmental disabilities where stimming is prevalent.

Children stim as a coping mechanism when they experience anxiety or sensory overload. Family members report flapping hands and rocking back and forth repeatedly as the most common self-soothing behavior for their children with autism.

Identifying Compulsions

A compulsion is a strong and unrelenting drive to perform purposeful specific verbal or physical movements. Only after this powerful urge is satisfied through a particular ritual can they carry on with their daily activity.

Many of us have compulsions that are not typically concerning to ourselves and others.

Commonplace compulsions can be as straightforward as:

Frequently checking our cell phones

Waking up every hour to check our clock when we have an early wake-up scheduled

Keeping our house spotless

Repetitive "Hail Marys" when feeling anxious

Compulsions only become a problem when it interferes with your life and many times are not in your best interest.

A person experiencing a more serious compulsion can not stop themselves from this behavior and feel that they "have" to do the same things over and over to get through the day.

Examples of compulsions that may be regarded as significant are repetitive acts such as:

Handwashing

Avoiding cracks in sidewalk

Counting objects

Checking and double checking

Repeating certain words and phrases

Any of these examples can be quite harmless, but when repeated over and over throughout the day causing a child to miss out on school, play, and meals, it is a serious concern.

Obsessive compulsive disorder (OCD) is the primary condition associated with compulsions. However, many other conditions manifest in compulsions that can be equally troublesome, such as:

Eating Disorders

Mental compulsions (ex. to harm self or others)

Hoarding

Compulsions may occur when a person is trying to adapt to a stressful or out-of-control situation. Their adaptation response somehow goes awry, and they learn to deal with their uncomfortable feelings in an unconventional manner - which is their compulsive ritual.

Differences Between Tics, Stimming, and Compulsions

Tics, stimming, and compulsive behaviors may appear to overlap and have many similarities. Although all stem from anxiety, the difference is the why children perform these repetitive behaviors.

The table below helps to simplify these disorders.

Difference Between Stimming, Tics, and Compulsions

Behavior Purpose/Outcome

Stimming
Self-regulatory behavior to de-stress

Helps to calm

Feels good

Mainly involuntary but at times can be controlled

Tics
Intense feeling that builds until tic is released

Ticcing is the only way to get rid of intense "pre-tic" feeling

Does not help to calm anxiety

Never voluntary

Can suppress for short periods but needs to come out at some point

Compulsions
Brings a sense of relief

Overwhelming urge to perform before can move on to other activities/thoughts

Can put off but may not be able to proceed to another activity

How to Deal With Tics, Stimming and Compulsions in Children

Having a child who displays confusing and repetitive behaviors such as those diagnosed with autism spectrum disorder, OCD, and tourette syndrome can be quite concerning for parents.

If you have a child who may be dealing with compulsions, tics, or displays stimming behavior, it is best to talk to experts familiar with these issues. Being misinformed on how to manage these habits and mannerisms may only serve to reinforce concerning behaviors.

Once you and your provider and psychologist have developed an action plan, share the findings with those who deal with your child regularly to ensure consistency in response. Include your child's school, daycare provider, siblings, and other close relatives and friends.

Other tips to help with repetitive behaviors include:

Provide a calm environment such as a sensory garden.

Stick to a routine as much as possible.

Learn effective ways to discipline a child with concerning repetitive habits. Avoid punishing the behavior.

Stay calm.

Do not focus on unwanted behavior. Instead, support emotional well-being.

In addition to behavior modification, your provider may prescribe medication to help ease tics and compulsions, such as those found in children with tourette syndrome and OCD.

One Last Word of Advice for Parents

Dealing with a child who displays compulsions, tics, or stimming behavior can be trying and exhausting for parents. Extra energy and patience are needed to tend to a child who needs special attention.

Remember that you need to take care of yourself before you can adequately tend to your daily responsibilities.

Find support through your provider, counselor, Facebook parent groups, and family. Take the initiative to give yourself a break and elicit help when needed (and before you burn out).

Parents of children with special needs are exceptional people. Give yourself credit for all that you have accomplished for your child to this point.
The information WonderBaby provides is not intended to be, and does not constitute, medical or other health advice or diagnosis and should not be used as such. Always consult with a qualified medical professional about your specific circumstances.

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Tics vs Stimming vs Compulsions: What's the Difference? | WonderBaby.org

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Tics, stimming, and compulsions are repetitive behaviors related to anxiety. Tics and compulsions present as an overwhelming need to be released. Much of the time, stimming can be controlled and is used as a means to self-soothe. Mental health professionals can teach parents techniques to manage these behaviors.

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In this webcast, Elizabeth Torrey talks about the use of "tangible symbols," a term originally coined by Charity Rowland, Ph.D. and Philip D. Schweigert, M.Ed, to support the development of communication in children who experience a variety of severe communication disorders and who are unable to use abstract symbols. The webcast draws from the work of J. Van Dijk as well as the work of Rowland and Schweigert.

Elizabeth Torrey is a Speech and Language Pathologist in the Early Learning Center at Perkins School for the Blind. She has extensive experience working with children with visual impairments who are at the early stages of language development.
Read full transcript "
Download: Tangible Symbols handout "
Chapters:

1. The Use of Tangible Symbols to Support the Development of Communication

2. What Are Tangible Symbols?

3. How Tangible Symbols Should Be Presented

4. The Benefits of Using Tangible Symbols

5. Considerations When Developing Tangible Symbols

6. For more information, visit Behavioral Benefits. Perkins Scout.

CHAPTER 1: The Use of Tangible Symbols to Support the Development of Communication
TORREY: Children who have multiple disabilities including blindness and deaf/blindness have special challenges in developing communication skills. And to support that, we need to find other ways, multisensory ways, to help them achieve those goals of relating to their peers, establishing communication with families, expressing their needs, being able to say, "Hey, I'm thirsty, I need a drink."

How about, "I need to use the bathroom," or to make a choice about what games and things that they want to play with? What's their favorite activity? And the way that we'll get to know that is by offering these children choices. Let's make another choice, Jen.

NARRATOR: In a video clip, a teacher presents a young girl who is blind two tangible symbol cards.

TORREY: Robby the rabbit, or we do the hokey pokey?

NARRATOR: One has a small stuffed rabbit attached, the other, a wooden block with a hole in the middle. The girl chooses the rabbit, and is shown playing with the large rabbit toy.

TORREY: The difficulty arises when so many of the students that we're working with here can't just say what they want. They don't have verbal language. So in order to give them a way... a means to express themself, we have to find other routes, and something that we found really, really works is using tangible symbols with these students.

CHAPTER 2: What Are Tangible Symbols?

TORREY: Tangible symbols grew out of the work by Dr. Van Dijk back in the 1960s, and he did a lot of work with students who were deaf and blind, and he found that several things really can help these children achieve communication and establish links with others, and that's, you know, using movement and using objects, real objects, and then some tangible symbols. And from this, people started working with students using, specifically, objects and tangible symbol systems.

NARRATOR: In a video clip, we see two tangible symbol cards. One is labeled "health services" and has part of a stethoscope and tubing attached. The other, with a small stuffed bear, is labeled "social play."

TORREY: They're basically manipulable- that means you can hold them, you can actually grasp them in your hands. They're static in that way that they can... that they're permanent; that they can... you can affix them to something, but that they... the child can hold them for a long time until that understanding comes through.

NARRATOR: A small plastic dosing cup has been attached to a large white card labeled "meds." Glued to a different card labeled "tooth brushing," we see a small tube of toothpaste.

TORREY: You can discriminate what's on them through your tactile sense. So they might have different textures on them, some... they can be made with different objects attached to them. And another important aspect about tangible symbols is that they can be... that they represent something else, so that they're symbolic, and yet they... they don't put a lot of demands on a child's memory.

So their recall memory, which can be very difficult to access, doesn't have to go into overdrive. They put very little demands on a child's visual system, so a child with low vision might want to use the symbols too, but they're using their hands to explore them. For example, a piece of a slinky toy might be embedded into a card, and that would represent the slinky. So it's actually taking a piece of the slinky and using it to represent the slinky.

NARRATOR: A large white tangible symbol card with a few coils of a plastic slinky toy attached is displayed on a blue felt slant board. A full size slinky is draped over the board.

TORREY: One of the symbols that I use a lot with the students, a lot of the kids, they love to get in those big therapy balls, and they're that funny feeling rubbery stuff with the ridges in them, so I had one that had popped, so I cut a piece of it. So the ball that I have on my card is not a ball, per se, but it's a piece of that same material that's embedded on the card, so when the child touches that, it'll feel the same.

NARRATOR: In a video clip, we see a tangible symbol card with a small piece of a therapy ball attached. As the shot widens out, we can see a large orange therapy ball just to the right of the card.

TORREY: And then it ranges from something that's so iconic to something that's quite abstract, because we can't cut a piece of the day to become a "days of the week" symbol, and yet, we've developed "days of the week" symbols for the children to learn about as they're singing the song, their hands are moving left to right as if they're reading those as the day... Sunday, Monday, all the way through the days of the week.

NARRATOR: In a video clip, a young girl who is blind and her teacher sit at a small table and examine a tangible symbol calendar while singing a song about the days of the week.

TORREY: ( singing ) Tuesday, Wednesday, Thursday...

NARRATOR: Distinct shapes or textures differentiate the days.

TORREY: I think one of the other benefits for a child using symbol systems that we've found in our work with young preschoolers is really getting those hands ready to learn and take in more sophisticated information in the world of Braille. So we're getting those kids that... developing that understanding and how to "read" with their hands, so that all of that pre-Braille literacy work begins very early and a lot of it begins with the symbols.

Ideally, a symbol would have part of the object attached to it along with a Braille label and then a print label so that somebody who's a print reader would be able to understand what this... what this symbol is representing, but then the Braille label too, so that the child who's initially just touching it is going to have that experience of, oh, finding the Braille. "What's this at the bottom?"

NARRATOR: A spoon with a yellow plastic handle is glued to a tangible symbol card labeled "snack/lunch." Below the spoon, a Braille label is clearly visible.

TORREY: Each time the child is touching that same symbol, they're getting all of that information through their hands, so that... that's all supporting the literacy that will hopefully come for the children.

CHAPTER 3: How Tangible Symbols Should Be Presented

TORREY: When I start teaching a student how to use tangible symbols for communication purposes, I like to begin, actually, with real objects. And I develop a song or game routine, something the child's really going to like, and we find that they often like to play with something like a slinky. And I'll offer that child a choice.

"Would you want to play with the slinky, or do you want a different toy?"

And if the child keeps choosing the slinky, I know that that's something the child will really like and will want to play with a lot. What I'll then do is I start pairing a symbol with the slinky, and I start with a piece of the slinky embedded in a card that I then present at the same time. So I offer the object- "Do you want to play with the slinky?" And then I'll guide the child's hand over to tap the symbol. "Oh, that's right. You want to play with the slinky."

I'll do that a few times, and then maybe the next time, I'll come out and I'll offer just the slinky symbol. And as soon as the child touches that symbol, I have the slinky right there. It's important to be able to really pair those two things together for that child to develop the meaning and the understanding.

NARRATOR: In a video clip, a young girl who is blind and her teacher are assembling the girl's daily calendar using tangible symbol cards.

TEACHER: And then you have a meeting.

NARRATOR: The teacher uses speech and tactile signing to prompt the girl to find the appropriate card.

TORREY: When we're using tangible symbols as a teaching tool, there are some really important things to keep in mind. One is consistency of use. That's really critical.

A child who comes in contact with a symbol a lot will learn it more often. It's important for us to use the same language so that we, you know, we don't have one teacher saying, "Well, it's time for story time," and another saying, "It's time for book group learning time," when they're using the same symbol for both and using different labels. So it's important to keep the labels consistent, and that's why I think it's important to have a print label on there as well, so different teachers will know what that symbol is representing.

NARRATOR: Outside a classroom doorway, we see a large sign reading, "Story and Game Room." The tangible symbol card for "Story and Game Room" is just to the right. It has a small book attached and is identified with text and Braille.

TORREY: In my case, when I have a child come into my space, it's called "Story and Games Time," so they touch the "Story and Games" symbol on their schedule box in the hallway. There's the identical symbol on my doorway, so it's a landmark also. So when they come into my room, they know that's the Story and Games room. Yeah, Story and Games.

NARRATOR: In a video clip, a boy who is blind and his teacher touch a "Story and Games" symbol card that is displayed on his calendar box. We then see them proceed into the Story and Game Room, stopping to touch the identical symbol card displayed outside the doorway.

TORREY: I'm using the consistent language, and that child has that opportunity then to feel the symbol multiple times coming in, and then on the way out, we take the symbol and we're putting it in the "Finish" box so that child knows that that class is done.

CHAPTER 4: The Benefits of Using Tangible Symbols

TORREY: There are many, many benefits to using tangible symbols with students and young children. Children who have blindness and other disabilities really have to have their world brought in close. When children are developing and have vision and they're very young, what they do is they point to things that they want.

They see things out in their world and they point to them, and when they do that, their parent will say, "Oh, yeah, that's a truck, that's a dog, that's a ball; you want the ball," and will bring it over. One of the most important things to understand is that the child has a choice.

Do you want... ( singing ) I'm bringing home a baby bumble bee, or... ( singing ) the wheels on the bus go 'round and 'round?

CHILD: ( humming )

NARRATOR: In a video clip, a young girl who is blind vocalizes after choosing between two symbol cards representing songs she would like the teacher to sing. She chooses "Wheels on the Bus," and the teacher presents a large plastic bus which they play with while they sing.

TORREY: I can use my hands to reach out into the world and people will understand me, when I'm touching this symbol, that that's what I'm getting. So it's really important that we're using the symbols in a way that's very meaningful for the child so that child knows, "As soon as I touch that, I can receive that." And we've often found, and there's research to show, that children with multiple disabilities often aren't offered choices at the same rate as children who don't have disabilities.

NARRATOR: In a video clip, a young girl who is blind is offered a choice of songs represented by two symbol cards. One has a small fuzzy bumble bee attached, the other, a plastic spider.

TORREY: We find that, for many children, it's their bridge to actual verbal language. I've had students that come in that weren't talking at age three, four, and five, but slowly started using... making choices and using, you know, a "yes/no" symbol and "more" and "finished" symbols, and they developed the understanding then, they've heard this spoken to them, they start using those actual words, and that's very exciting.

So we're always pairing the symbols with... with the words. We're often pairing them with signs, as well, with manual signs, so that we're giving a child a multimodal, a multisensory approach to language learning that we find really effective. Tangible symbols can be used to help a child access the curriculum, again, thinking of the multisensory piece that it helps provide. But what we'll do is we're working on a theme of gardening, say, and we want to help the child understand that we're going to be going out in the garden and planting seeds and here's some of the tools that we use.

NARRATOR: In a video clip, we see displayed several items, including a tangible symbol card with half of a small plastic plant pot attached and labeled "greenhouse" in both text and Braille.

We see a Zip-Loc bag full of potting soil and a small trowel. There is also a card with a small plastic shovel attached. This card is labeled "Garden Story" in text and Braille. A book titled "The Surprise Garden" is displayed nearby.

TORREY: So we'll develop symbols then to use with the gardening unit to help that child, again, understand what's going to happen next in the day, what the expectations are, and then how we actually use these tools. So the child will then handle the symbol and then maybe the little rake and the hoe and then actually go out and do a gardening activity with those things, come back in, read a story box, read a book that might have some of the actual objects in it, and again, then have access to that symbol. So it's linking the real activity with the literature activity with the whole theme that the whole school, the whole class, is doing together.
CHAPTER 5: Considerations When Developing Tangible Symbols
TORREY: In developing tangible symbols, some... the learner needs to be taken into consideration, and that would mean what... what... how is that... what is that child's experience in using his hands? Are there textures that that child loves and are there textures that that child pulls away from? How much is a child using his hands?

NARRATOR: In a video clip, a black felt board hangs on a wall with more than a dozen tangible symbol cards attached. The cards represent a variety of objects depicted with different shapes and textures, such as a plastic egg, a rubber figurine, and a leather baby shoe.

TORREY: If a child is only wanting to touch things with the palm of the hands versus the fingertips, how will that affect the symbol that we make? What... how will that child then be able to take in that information? Then the... then this... the texture that's used might have to be quite different than something that needs more fine discrimination. So it's all those kinds of things. Does a child have low vision? In that case, maybe you want to be thinking about putting dark outlines on the backs of symbols so that... to really make the symbol pop out for that child.

NARRATOR: A cassette has been colored with a black permanent marker and glued to a white symbol card labeled "music tape." The contrast provides a visual clue to those students with low vision.

TORREY: Or you might want to use the brighter colors and maybe the red or the yellow for a child with cortical visual impairment. So those are things that really need to be thought about in developing symbols too.
CHAPTER 6: Behavioral Benefits
TORREY: We find that children with challenging behaviors, we see a decrease in those behaviors as they start to gain some understanding of their day and understanding of how to use these symbols to tell us what their needs are, and then they also know like, when I'm... when they're touching their symbol, "Someone's listening to me," and that's a big piece of this too.

We're not just giving the child information, we're also expecting the child to give us some information back again, and that's where that exchange comes from that's so important for building language.

NARRATOR: In a video clip, a teacher and a girl who is blind sing songs together.

TORREY: ( singing ) Here a tweet, there a... tweet. Everywhere...

GIRL: Tweet, tweet.

TORREY: ( singing ) Old McDonald had a farm...

GIRL: ( singing ) Ee-i-ee-i-o.

NARRATOR: Part of their interaction involves a song about putting a hat on and taking it off. We see the girl taking a straw hat off her head and placing it on the table.

TORREY: We find that the benefits are that the children start... well, I call it "happy up." I have kids who come in and they're... they're upset and angry, they don't understand what's happening in their day, they often are... because they don't have a way to express themselves verbally or in more symbolic ways, they express themselves through hurting themselves or hurting others.

Once a child starts to learn that he has control over what he wants and how he can express it, we find that those children then develop a sense of autonomy and they become much more a part of the group; that they're much more willing to engage with different communication partners. They feel like they have something to say and that there's somebody willing to listen to them.

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Tangible Symbols - Perkins School for the Blind

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In this webcast, Elizabeth Torrey talks about the use of "tangible symbols," a term originally coined by Charity Rowland, Ph.D. and Philip D. Schweigert, M.Ed, to support the development of communication in children who experience a variety of severe communication disorders and who are unable to use abstract symbols.

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Sensory learning

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I had a dilemma over the past year in working with my students who have Visual & Multiple Disabilities (V&MD). One student in particular challenged my teaching methods. My dilemma was:

Sensory activities are important

Communication & Literacy are important

Working on them all separately resulted in limited growth

How could I combine things to make learning more effective?

The answer I came up with is that PAIRING sensory activities along with working on Communication and Literacy skills is more effective. In addition, I realized that Communication and Literacy is really the SAME thing with students who have V&MD's. Communication & Literacy will look very similar because most students who have V&MD cannot physically write, type, or spell to make words. Rather, using their communication system/symbols (whatever they may be) in a variety of ways IS Literacy for these students.

reading a symbol from their own system receptively

using their symbols to make (i.e. write) lists and phrases

using their symbols to tell someone what to write for them

I created a series of Sensory Boxes that have all the materials needed to easily and effectively have others (i.e. classroom aides) implement these activities on a regular basis. Each box is theme based and contains:

All sensory items needed

Books about the activity

All communication tools needed

All writing tools needed

I developed my own series of sensory activities that can be used with each sensory box. Using the same materials over and over for a while in a way that fosters exploration supports the most communication and literacy growth.

1. Initial Experiences - sensory focused

Exploring the materials, target asking questions - what do they do

Explore descriptive properties, modeling & teach associated language

2. Early Activities - focus on communication

Using the materials for a purpose - model & assist using the nouns, verbs & adj/adv

Target using words they know: people, feelings, quick words

Talk and/or write about the experiences - how they felt about it, who did it, what they did, etc.

3. Extending Literacy - reading and writing

Reading books about the activity & using items as props - especially teacher made books using pics from early activities - this lets you tailor the language to match your students

Other writing - journals, letters, lists (ex - Things we Like/Don't Like, Who Liked It, who was silly, etc. - I LOVE lists!)

4. Extending Learning - exploring & comparing

Using the items in a new way (Ex - what will happen if we drop the instruments on the floor?)

Compare & contrast the experiences, list what was funny, awful

Do extension crafts & other related activities

5. Publishing - creating something to share with others

Writing your own book - use pictures taken during the activities

Talk about the pictures & have students write their own words

Have students read their own book or use the props while you read, send copies home

Adopting this sensory approach has made a huge difference for all of my students. For my students who use symbol systems (low or high tech), my realization that communication and literacy are actually the same thing has allowed my students to make huge gains in their ability to use their symbol systems.

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Sensory Activities: Experiences to Improve Communication and Literacy for Children with Visual and Multiple Disabilities - Paths to Literacy

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I had a dilemma over the past year in working with my students who have Visual & Multiple Disabilities (V&MD). One student in particular challenged my teaching methods. My dilemma was: Sensory activities are important Communication & Literacy are important Working on them all separately resulted in limited growth How could I combine things to make learning more effective?

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Many children with visual impairments and additional disabilities have delayed language development and experience challenges with verbal or signed expressive and receptive communication. It is important to carefully assess a child's understanding of real objects and their function before moving to a more abstract communication system. Object symbols can be used to create stories and simple books, thereby helping to build a bridge to more formal literacy.

A child must have exposure to spoken and/or signed words and real objects in the natural environment throughout the day in order to develop an understanding of objects and their functions. Knowing that a cup is used for drinking, and that a spoon is used for eating can help a child learn to anticipate these events. As the child becomes increasingly familiar with the objects, they may be able to make a request by pointing to or picking up the item associated with an activity, such as picking up a cup to indicate that they would like something to drink. In order for this to be effective, the child must know where a cup is located and have access to it. Similarly, two objects can be presented to a child to offer a choice, such as between an apple and an orange. Through the association of real objects with familiar events, a child can begin to develop a connection between objects, symbols, and experiences.

Developing a Communication System

Any programming decision should begin with a careful assessment and discussions among all members of the team, including the family. Assessment tools include:

Hierarchy of Communication Symbols for Tactile Learners

An understanding of communication symbols moves from a concrete to an abstract form. Real objects in the natural context are the most concrete symbols, such as a spoon at mealtime or a bar of soap at bathtime. They become slightly more abstract by embedding or mounting an object on a piece of cardboard. In this way the child is no longer using the actual spoon or bar of soap, but rather begins to understand that this item mounted on this piece of cardboard represents something similar. In the same way, a partial object can represent something else, such as the top of a fork with the tines can represent the whole fork used at mealtime.

Real objects

Embedded object

Partial object

Raised line drawings

Pair object with braille label

Braille

Note that students may need intermediate steps, such as pairing the partial object with a braille label.
For a visual learner, there is a similar progression from concrete to abstract. A photograph can be paired with the real object, then progress to a picture symbol, and finally to the written word in print.

In cases where the whole object is large or difficult to mount on a card, an associated object can be used, such as a straw for a juice box.

Selecting Objects and Tactile Symbols

People often wonder how to represent something that is larger or where no immediate object is available, such as going outside or riding in the car. The key to this is to think about the experience from the child's perspective. Observe the child during a given activity and notice what aspect they are paying attention to. For example, a child may have no idea that a key is used to start a car, so keys would not be a meaningful representation of going in a car. Similarly, a miniature car would have no meaning to someone who does not have an understanding of symbolic representation. Perhaps the child feels the seatbelt in the car and a seat belt buckle may then be the most meaningful way to represent going in the car.

Making Choices

As a child begins to recognize objects associated with certain activities, he can start to point to an object or a picture to indicate a choice or a desire to do something. A child may be presented with actual objects representing different activities or with tangible symbols, which are three-dimensional representations that may be glued to a card. As the child develops a deeper understanding of objects and the activities they represent, these objects or symbols can then be used in other literacy activities, such as the creation of simple books.

To learn more about Tangible Symbols, see the Perkins webcast The Use of Tangible Symbols to Support the Development of Communication and the accompanying handout by Elizabeth Torrey, Speech Language Pathologist, or Tangible Symbol Systems Primer by Charity Rowland and Philip Schweigert.

Setting up a Calendar System

Calendar systems, which are based on the work of Dr. Jan van Dijk, are a concrete way to let a child know what will happen next, so that he can anticipate events in the future, participate in events in the present, and know when an activity is finished. This can lead into storytelling, journaling, and other emerging literacy activities. Calendar systems should be tailored to an individual child's level of understanding, so that they are at an appropriate developmental level.

Determining what kind of calendar to use begins with assessment (see tools above). Many formats are possible, such as a simple two-box system, where there is one object representing what one is doing now, and one box for activities that are "finished". Some students will use simple sequence boards that show the steps in a given routine or activity. Or calendar systems can be much more complex, representing whole days, weeks, and even months and years. Involving children in setting up the calendar, when possible, increases the opportunities for rich discussions about the items in the calendar and can lead to many related literacy activities.

In developing a format, consider where the student will use the calendar. It is essential to work as a team with the family, the speech language pathologist and others to figure out what will work best across various settings. For example, some students may be very mobile and might need a portable system. Some families may not have a lot of storage space at home and may be looking for a compact system. The more agreement there is in what type of system to use, the better the chance is that it will be used consistently across multiple settings.

Learn more about calendars:

Object Symbols as Literacy Tools

Object symbols can be used when retelling events or writing stories, thereby becoming a bridge to the more formal literacy tools of print and braille. In the image below, the text tells about a birthday party and a birthday candle mounted on a card helps to tell or illustrate the experience book story.

Additional Resources

Communication for Children with Multiple Disabilities, Family Connect

Communication Overview, Texas Deafblind Project

Literacy for Students who are Deafblind, Perkins School for the Blind

Object Communication, California Deafblind Services

Teachable Moments, Perkins eLearning
Calendar Boxes and Schedule Systems as Literacy Tools

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Object Communication and Calendar Systems - Paths to Literacy

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Many children with visual impairments and additional disabilities have delayed language development and experience challenges with verbal or signed expressive and receptive communication. It is important to carefully assess a child's understanding of real objects and their function before moving to a more abstract communication system.

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The use of tactile or tangible symbols is one of the many ways that students with significant visual and multiple impairments can communicate. These students often begin using objects and then progress to tangible symbols. These symbols typically consist of pieces or textures of objects that are associated to a referent. Tactile/tangible symbols can represent people, objects, places, activities, or concepts (Rowland & Schweigert, 2000).

Tactile / Tangible Symbols with Voice Output

For this population, one of the disadvantages of using a tactile/tangible symbols system has been the lack of voice output. The advantages of using Voice Output Communication Aids (VOCAs) is well documented in the literature. They include:

The ability of the communication partner to know exactly what is expressed

With a spoken response, the child begins to establish the meaning of spoken words and may increase verbal speech

A consistent auditory output matched with a consistent motor plan allows the child to complete the motor learning process

Language foundations are enhanced

In response to the need for tactile/tangible symbols with voice output, Joni Nygard, a specialist in augmentative alternative communication (AAC), and Dr. Betsy Flener, a specialist in working with students who have visual impairments and multiple disabilities, created the TactileTalk Toolkit and Guidebook: Strategies for Functional Communication and Literacy. This creation was the result of a 2 ½ year collaboration and is the winner of the 2015 National Braille Press Louis Braille Touch of Genius Competition for Innovation.

Using the iPad as a Communication and Literacy Tool

In recent years, the iPad has become widely accepted as a tool for voice output communication. Its special features including portability, touch screen flexibility, and social acceptance make it highly motivating and accessible. Other advantages include its low cost, long battery life, accessories, and the ability to customize various applications. Hence, the TactileTalk Toolkit was developed and launched for this population of individuals who'd benefit from the voice output of the iPad for communication and literacy purposes when paired with appropriate tactile symbols.

Contents of TactileTalk Toolkit

The TactileTalk Toolkit contains: GoTalk NOW app, an in-app communication book with concept and literacy components pre-programmed entitled TactileTalk, 25 pre-made tactile/tangible overlays, 5 blank customizable overlays, along with a 124-page Guidebook and a storage case for the objects. The pre-made overlays contain textures, pieces of objects, and embossed objects.

The TactileTalk communication book (in-app) works within the GoTalk NOW app. All pages are linked together, and the first six overlays comprise the primary communication pages of the book. Other pages assist in teaching and reinforcing concepts such as positions, shapes, textures, sizes. A grooming routine with tactile symbols is also included along with a narrated and adapted version of the book Charlotte's Web, to further incorporate a strong literacy component. In creating the system, Flener and Nygard carefully planned out the navigation within the system for easy access to communication expressions and concepts. Their research included work regarding the conductivity of various materials on an iPad with an eventual strategy for the student with visual impairments to touch objects on the left of a key and tap to the right of the key to activate auditory cues and messages efficiently. This toolkit has been well-received in the field and is beginning to open-doors for students with complex issues to learn concepts and communicate their basic needs and wants using a consistent approach.

References

Rowland, C. & Schweigert, P. (2000). Tangible Symbol Systems: Making the Right to Communicate a Reality for Individuals with Severe Disabilities.

For More Information

TactileTalk Toolkit and Guidebook: $499.00

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TactileTalk Toolkit and Guidebook for iPad - Paths to Literacy

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The use of tactile or tangible symbols is one of the many ways that students with significant visual and multiple impairments can communicate. These students often begin using objects and then progress to tangible symbols. These symbols typically consist of pieces or textures of objects that are associated to a referent.

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Sensory Spectre has a life of its own. Ghostly effects move around the screen, and can be changed with touch or switch input. Change the style and colors of the effects. Full switch accessible, this could be a good app for a sensory room.

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It is more and more common for students to receive an iPad as their personal Communication Device. The most common Communication apps are designed to provide a large vocabulary to non-verbal students. However, these apps are often challenging for kids who are Visually Impaired and have Multiple Disabilities (VI/MD) to access. The visual-motor integration and visual discrimination skills are often too challenging for kids who are VI/MD typically to be successful. While these communication apps are great for many and may be the right ones for some kids who have visual and multiple disabilities, be cautious. This includes apps such as Proloque2Go http://www.assistiveware.com/ and TouchChat HD http://touchchatapp.com/. There are many apps out there for the iPad that support communication needs and are more commonly applicable to students who are VI/MD - and are more affordable for a teacher to purchase.

TapSpeak Sequence

TapSpeak Sequence for iPad revolutionizes how parents, speech therapists, vision therapists, schools, and institutions create and use message sequences to help disabled children learn to communicate. Use TapSpeak Sequence instead of sequential message switches to record and customize messages without losing any previously recorded sequences.

Yes/No from I Can Do Apps

Yes/No from I Can Do Apps is an educational tool designed in collaboration with a Speech Language Pathologist that allows non-verbal individuals to communicate yes and no. This clean and simple design allows users to indicate yes/no responses with a tap of the screen and hear their responses. Yes/No from I Can Do Apps allows individuals to work on answering yes/no questions and indicate their wants and needs more clearly.

SoundingBoard

SoundingBoard transforms your iPhone, iPod touch, or iPad into the latest in communication technology. In just minutes, you can create custom boards using AbleNet symbols or your own words. Perfect for children in special education, persons on the autism spectrum, and adults with disabilities. SoundingBoard includes switch access and is compatible with the AbleNet Blue2 Switch.

Now, let's get our kids talking!
Editor's Note: The original post from 2013 was updated on 2/16/2022 with current versions of the apps.

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The iPad & Students with Visual and Multiple Disabilities: Apps for Communication - Paths to Literacy

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It is more and more common for students to receive an iPad as their personal Communication Device. The most common Communication apps are designed to provide a large vocabulary to non-verbal students. However, these apps are often challenging for kids who are Visually Impaired and have Multiple Disabilities (VI/MD) to access.

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Those of you who know me understand how passionate I am about children with Multiple AND Visual Disabilities. Here are my personal "Top 10 Tips" to guide in helping these special children grow and develop new skills for independence.

1. Believe in them!

Believe in the student's ability to learn something new- they can do it. This sounds easy, but it can be challenging when you have tried lots of things that haven't worked. Hang in there and always remember that yes they can! My biggest initial failures often end up being my greatest successes in the long run.

2. Have a 4-year plan.

Start by developing long-term goals; what would the team like the student to be able to do in 4 years? Think functional and realistic, but don't underestimate either. Use these long-term goals to guide the direction of the individual programs you develop and the annual goals. Give the student plenty of time to make progress because new skills usually are acquired slowly, it can take months to see even the smallest amount of progress. They will need all 4 years of regular work on these big skills to get where you want them to be.

3. Work together with team members.

Update other teachers, therapists and family members on progress and co-treat regularly with other members of the team. Working together regularly generates novel solutions to problems that pop up along the way. No one person has the answer alone; it is only by combining everyone's skill sets and observations about the student's progress that we have enough knowledge to create success. Finding ways to communicate with all of these people can be challenging - look for novel solutions to staying in regular contact. Use any and all means of keeping in touch with everyone else: group emails to talk about progress and ideas, phone/conference/Skype calls, home/school notebooks, home visits, plan your schedule to overlap with other therapists, be there at pick-up/drop-off times to have face time with parents, and schedule regular planning meeting that happen on a biweekly or monthly basis. I use all of these regularly to help me keep in contact with the multitude of people on my students' teams.

4. Develop group goals.

Work together with others on the same goals so that students get lots of practice on the same things. TVI's overlap particularly well with goals related to Literacy, Communication, Fine Motor Skills and Activities of Daily Living. COMS' overlaps well with Gross Motor, Adaptive PE, Fine Motor, and Activities of Daily Living. Equally as important, work with families so that there is consistency between school and home.

5. Work directly and often with the student and their paraprofessionals.

Work with the student at least 1-2 times a week, even if you aren't the teacher on a day-to-day basis. Consultation on a monthly or bi-monthly basis is almost never effective. Model how to implement your strategies and activities with any Parapro's that work with the student. Remember to check in with the Para's regularly - they have the best feedback about how things are going, and often have the best ideas for solutions to problems that come up as well.

6. Wait for the student's response.

Give plenty of wait time when looking for a student response - some students need 30+ seconds to even a full minute to assess the situation, figure out what they need to do, and then make their body do it. In addition, many students with multiple disabilities develop learned helplessness over time, knowing that if they just wait and do nothing someone else will do it for them. Don't let yourself be the Magic Fairy! It's OK to say things like "Hmm, I don't know what urgh means, you might want to use your device so I understand you" - and then wait - even if you really know they probably want a snack.

7. Make decisions based on the type of communicator they are.

Work with the Speech & Language Therapist to determine what type of communicator the student is. Are they unintentional, intentional but informal, or a symbolic communicator? If the student is an unintentional communicator, focus on shaping how staff members respond to the student's unintentional communications, including how we can shape a grunt or a point into a conversation. If they are intentional but informal, develop a plan to assist the student in becoming a symbolic communicator. If they are already using a symbolic means of communication, develop a plan to move the symbolic communication they are doing to the next level. For more information on how to help these students develop conversational skills, watch the webcast by Barbara Miles titled " Conversations: Connecting and Learning with Persons Who Are DeafBlind "

8. Make decisions based on their Learning Medium.

Use the student's learning medium to drive decisions about what kind of abstract symbol system you will use with the student. The student's Learning Medium is the primary way that they gather information - are they primarily using visual information, auditory information, or tactile information for learning? How they learn drives the type of Communicative Symbol System that will be most effective for the student. The TVI and the Speech & Language Therapist need to work together closely in determining the type of symbol system to use for communication. The way the student communicates will then drive decisions about a literacy system. This is a process that takes time and may involve several trials over a longer period of time before a final selection is made. For example, if the student is primarily an auditory learner but you select a visually based symbol system (such as Boardmaker Symbols), the student is not likely to be successful in mastering the visual symbols. You will end up thinking that they can't learn to use a symbolic system when in actuality you are just using the wrong type of system. The process of selecting a symbol system can be complex, and remember that many students with CVI will be unable to use visually based 2-dimensional symbols. My greatest success recently is a student for whom we did it all wrong in multiple ways for about 2 years before we figured out how she CAN do it. For more information about this process, watch my webinar titled " Effective Access to Communication and Literacy for Students with Visual and Multiple Disabilities ".

9. Determine how the student will respond.

Work with other team members (usually SpEd Teacher, OT, and S&L) to determine how the student will indicate their response. Will they reach with their hand or another body part using a visually guided reach, search and select using tactile skills, use eye gaze, or choose an item from an auditory list by responding with a yes or no (with a sound or body movements)? This will be determined by combining their Preferred Learning Medium along with their functional vision and fine motor skills. Once the way the student responds best has been determined, make sure everyone who works with the student knows HOW they will respond. I create cards for staff to refer to that summarize this for each student and hang on their wheelchairs or have at their desks.

10. Trust your gut in regards to mastery.

Being data driven is important, but it can limit us as well. If you have mixed mastery data, go with your gut feeling about whether or not a student has mastered a skill. When you think they have mastered it, move on to teaching them the next steps. Often students with multiple disabilities aren't able to show mastery of a skill at even an 80% level because of the multiple factors impacting their accuracy. It is tough to determine why these students make mistakes - are their mistakes because they don't understand, because we haven't made the skill or activity exciting or interesting for the student, because it is so hard to get their body to move in the way they want, because they are bored of working on the same thing for so long, or because they happened to be tired or sick that day? I often use 3/5 or even 2/3 trials as a mastery level rather than a higher 3/4 or 4/5 that we might expect for a student without motor issues. If you think the student "gets it", then start teaching them the next skill on their path toward their long term goals. Students and teachers both get sick of over-working a specific skill for too long, and this really can limit progress in the long run. Conversely, when a student really doesn't show mastery after a period of time, work with the team including para's and parents to figure out WHY they haven't really mastered the new skill. Use the WHY to help modify the approach so that it is successful.

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Top 10 Tips for Working with Students Who Have Multiple Disabilities and Visual Impairments - Paths to Literacy

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Paths to Literacy Top 10 Tips for Working with Students Who Have Multiple Disabilities and Visual Impairments. For teachers, families, and others interested in literacy for children and youth with visual impairments

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Creating interactive learning among our students creates interest, exploration, and uses a variety of skills. Using sensory bins for theme based learning touches on various learning objectives.

Why Sensory Bins are Great Teaching Tools:

Using theme based sensory bins involves tactile skills practice along with other fine motor skills

They promote play and using imagination

Makes learning more meaningful than just a book or a one time activity

By allowing children to use the sensory bin over a course of time, they can reconnect with concepts taught

Sensory bins cross curriculum by integrating math, science, art, language arts, etc., depending on the theme and materials

Sensory Bin Ideas

Here are some great examples of learning bins that this mom of three, Sarah, does in her home for her young children. Sarah has a child, age nine, who has as diagnosis of CVI (cortical/cerebral visual impairment). She has bought a sensory table with two bins but you can make it with a container and items you already have in your house to make a theme your own child would enjoy.

Buried Treasure

A buried treasure sensory bin can focus on coins, small shovels, sand, a treasure container, and even some fake jewels or gold. Look for some fun books to go with it. Maps can come into play with this sensory bin.

Buried treasure sensory bin

Farm

Lots of classes use a farm as the unit of learning so a farm sensory bin is a great addition to that learning. Items to include in the farm sensory bin can be farm animals, tractors, plastic vegetables and fruits, a small toy barn, and dried beans.

Farm sensory bin

Health

A sensory bin that addresses the body is a new twist that can include a Melissa & Doug body puzzle.

Health sensory bin

Dinosaurs

If you are adventurous you can put dirt in the sensory bin to dig up plastic dinosaurs. Use little shovels and brushes to be like a real paleontologist.

Dinosaurs sensory bin

Spring

A spring sensory bin is a great fine motor activity if you use plastic eggs with "surprises" in them. Open and close the eggs and then count how many items you found in the eggs. It's fun to use paper grass and to use tongs to pick out materials like plastic flowers.

Spring sensory bin

Butterflies and Flower
This seasonal sensory bin is great to use with a science unit about the life cycle of a butterfly and/or the growth of a flower. There are so many great books to include with this theme, including a favorite to most, The Very Hungry Caterpillar, available in braille with touch and feel pictures.

Sensory Bin Variations:

Sensory bins are endless teaching tools that can include many different topics related to your theme

Try brailled objects that are "hidden" in dried rice or beans

In winter bring snow into the sensory bin

During warmer months make the sensory bin into water play activity

Practice washing dishes in the sensory bin

Place plastic letters in the sensory bin and a magnetic board next to the bin

Make a favorite book into a sensory bin like Chicka Chicka Boom Boom, available in braille. PLUS- See the lesson on this book

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Creating interactive learning among our students creates interest, exploration, and uses a variety of skills. Using sensory bins for theme based learning touches on various learning objectives.

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Professional tools for practicing the functions of the visual system at the critical age of its development.

This free web based app was designed by an OT (occupational therapist) student in Israel and has worked at Eliya Association for the Blind for the past 10 years. It is widely used there.

Helping Our Young Students Make the Most of Their Functional Vision

The first few years of life are the most important for developing visual functions. However, toddlers with
severe visual impairments may neglect their sense of sight and trust other more reliable senses instead.
Therefore, it is important that therapists will help them engage and train their visual functions at this critical
age. For example, by using high contrast lights in a dark room.

Scan, locate and pop slowly moving bubbles on the screen

A screen has a strong electronic back lighting that can engage toddlers in visual tasks. Light activity is a free non-profit software that does just that, helping visually impaired babies and toddlers practice their visual skills with a therapist in a dark room, with about 40 different activities.

Learn how prolong press to make prolonged feedback with sensitive cause and effects games

Examples include:

Cause and effects games

Understanding illustrations

Sensory games with vibrations

Relaxation activities

Timing games

Model matching

Scanning and locating static or moving objects

Hand-eye coordination games

Switches

Virtual light box

Illustration printing

Coloring page printing

Have fun catching fast frogs to add them to the swamp until its full

This software is being used by almost all therapists and organizations in Israel that work with babies and toddlers with visual impairments. It is very popular in Israel because it originally had Hebrew voices and symbols from Israeli culture and lifestyle. I have decided to make an English translation with vocals in hopes it may contribute to other babies and toddlers around the world.

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Light Activity App to Improve Visual Functions - Paths to Literacy

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Professional tools for practicing the functions of the visual system at the critical age of its development. This free web based app was designed by an OT (occupational therapist) student in Israel and has worked at Eliya Association for the Blind for the past 10 years. It is widely used there.

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Scavenger Hunts

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Jenette (@primaryplayground) * Instagram photos and videos

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Jaime Pack-Adair, MA, cTVI, who is the Director of Early Intervention for FOUNDATION FOR BLIND CHILDREN, writes about creating experiences using a multi-sensory approach for students with multiple disabilities by using real objects, sensory components, with meaningful activities.

Vision is a motivating sense. Therefore, when a student has a visual impairment, teachers need to offer experiences that utilize students' other senses to increase engagement, participation, and support their concept development. It can be difficult for a student with a visual impairment to understand their environment. By offering multi-sensory learning experiences, students learn more about their environment, learn concepts from part to whole, and improve their level of active participation. Three techniques to consider are providing experiences with real objects, considering the sensory components, and selecting activities that are meaningful to the student.
Using Real Objects
Students benefit from using real objects and materials that they can touch, manipulate, and explore. The use of real objects supports students' concept development as they learn all the characteristics of the object. The use of real objects can support students' understanding of part to whole.

For example, consider using real food instead of play food when teaching concepts in a story, grocery shopping practice, or identifying foods for a recipe. Using play food as a prop does not provide accurate information for the student. The toy orange may look the same as a real orange, yet it lacks other critical features such as the correct weight, texture, and smell. A real orange can be peeled and sectioned. An orange with the peel is dry and once the peel is removed the orange is cold, wet, and sticky. Students need all the information about the orange to understand it.

Student petting and then holding a real bunny.

Sensory Components

A second strategy is to consider the sensory components of the activity. Identify the sounds, textures, and smells the student may encounter. Create a big picture of the experience. Identify any sensory hesitations the student may experience such as if sounds are startling and if touching certain textures causes the student to resist the activity.

It is important to present prop box items that represent essential components of the story. Focus on all the sensory information of the activity. Consider sounds, tactile, and smells. Sounds may include your voice, the sound of the pages being turned, and the sounds of the materials from the story box. Consider touch- what is the student touching in their chair- a hard table or tray, squishy arm rests, the material of their clothes. Other things they may be touching are braille, textures in the book, the book and pages, and the various textures of each object. Finally think about smells- the paper, plastic, rubber, fabric etc. Each object has a scent. As you are working your way through the activity, attend to the amount of sensory information the student is receiving and comprehending, and whether the student demonstrates any preferences or sensory hesitations. Adjust the activity to encourage their engagement and respect their aversions or resistance to the sensory input.

Student strolling through a garden with blooming flowers.

Meaningful Activities
The third strategy is to select meaningful activities for the student. Think about the goal of the activity, why you want to teach it, and how it will benefit the student. Identify the sensory learning channel you will focus on during the lesson. Consider if sounds or touch are important. To create meaningful activities, put the activity or lesson within a meaningful context.

Take the student on a sound walk- through the activity, the classroom, the school, and outdoors. Identify sounds and put them into context for the student. When appropriate, have the student recreate or touch the object making the sound. Sounds that may be of interest are the doors opening and closing, chairs being moved, a swing, a toy, running water etc. It may be helpful if you as the instructor walk through the space with your eyes closed and listen to the various sounds. This can help you focus on the sound without relying on your vision for identifying information.

Student looking, touching, exploring, and picking a strawberry.

Many students are working on identifying and naming objects. Instead of sitting down to work on the goal by having several objects to name (such as a book, cup, ball or shoe) use those items within context. For example, a student may need to identify and/or name a ball. Play ball with the student repeatedly. As you are playing, emphasize the word ball and provide descriptive information. Talk about the experience while you are playing. As the student becomes more familiar with the activity you can use different types of balls. If you want to assess the student to determine if they can identify and/or name the ball by touch, have a ball and an unrelated item(s) near them. As you introduce the activity, ask them to touch or pick up the ball so that you can play. The student may need time to touch the items in their defined workspace to select it. Learning about a ball within a ball activity is more meaningful than being shown several objects and asking the student to pick up the requested object.

Visual information provides a significant amount of information to any learner. However, when a student has a visual impairment and multiple disabilities, it is critical to teach compensatory skills to improve sensory integration. Touch, taste, sound, and smell also provide meaningful information that can be engaging and interesting to a student. When students have the opportunity for frequent, repeated multi-sensory activities, they learn to use their other senses to process and comprehend information.

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Non-Visual Multi-Sensory Experiences for Students with Multiple Disabilities - Paths to Literacy

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Jaime Pack-Adair, MA, cTVI, who is the Director of Early Intervention for FOUNDATION FOR BLIND CHILDREN, writes about creating experiences using a multi-sensory approach for students with multiple disabilities by using real objects, sensory components, with meaningful activities. Vision is a motivating sense.

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CVI Link

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Melissa | Special Ed | CVI (@specialachievers) * Instagram photos and videos