Before You Begin
Develop developmentally appropriate activities:
When selecting activities, it is important to consider the following:
- Materials that are appropriate (if possible, materials should be naturally occurring in the environment, age appropriate and adapted to increase use, engagement and learning).
- The best setting for teaching the skill.
- Teaching strategies which are appropriate (strategies should promote independence and allow integration of skills across settings).
- The level of assistance that is needed.
- Cues and reinforcement that will be used.
Consider Likes and Dislikes
Once you have a clear picture of how your student communicates, consider the kinds of activities that are needed to teach communication. Explore activities that your student will find motivating and enjoyable. Before developing a communication activity, consider which items the child both likes and dislikes. Using the "Likes and Dislikes Log" to note items the student reacts to either favorably or adversely. For example, this list can consist of objects, activities, textures, flavors, and smells.
Children are more likely to respond to things they like or that interest them. When designing communication activities, consider using topics from the student's "Likes" list on the Likes and Dislikes Log.
You have established a present level of communication for your student. You have a list of the things she likes. The third step in the process is to develop motivating communication activities that are developmentally appropriate.
Consider the Child:
In developing communication activities, keep in mind the child's vision, hearing, motor, and cognitive skills, as well as the child's age and with whom the child will be communicating. It is important to remember that communication development is progressive. It may progress
(a) from easy to hard,
(b) from few ways to many,
(c) from few wants and needs to many,
(d) from a few reasons to many, and
(e) with few people to many.
You will need to consider the child's vision, hearing, motor, and cognitive abilities and disabilities in order to strengthen current communication, develop new ways to communicate, and plan for more efficient ways to communicate in the future.
Hearing and Vision Abilities
- When was the onset of the vision or hearing loss?
- Can the child hear (with hearing aids) and imitate some sounds?
- Can the child see shadows or color?
- Does he see objects well enough to reach out for them?
- Is the child ambulatory?
- Does he have full range of motion of his arms and hands, or is movement limited?
- Can she grasp objects or extend her arm to point?
- Is there a tray on the child's wheelchair for attaching objects, switches, or electronic devices?
- Does the child seem to learn things quickly?
- Does he indicate that he knows where he is going and what is about to happen?
- Is she motivated to do things and to practice or repeat when learning new things?
- Does he smile when he has accomplished a task?
Tips For Sending Effective Messages
Let the child know:
- You are present. You might touch his hand or shoulder. The child always needs a reference point. We use our eyes or ears to determine this.
- Who you are, perhaps using your ring, watch, perfume, or hair.
- What is about to happen. For example, touch his lip before giving a bite of food.
- When he will be going somewhere. For instance, give him a set of keys to indicate "going for a ride."
- When an activity is over. Use a gesture or sign for "all gone" or "finished" or let him help put the objects away.
Give Cues About the Expected Response
It is often difficult for individuals who are deafblind to understand how they should respond to communication. This is especially true when a child has limited understanding of speech cues. For example, when you gesture or sign, "eat," the child does not know if it is a command or a question. The following are suggestions that may help the child understand what his response should be:
- If you want an answer, keep your hands in contact with him and wait.
- If you are giving a command, tap twice on his shoulder.
- If you are giving a comment or reinforcer, rub his shoulder.
- If you want him to imitate you, tap twice on his hand.
It is up to you to find a way for the child to receive your message. After that, you can expand the his understanding to higher forms.
Activities to Enhance Communication
There are a number of strategies and activities that are used to achieve communication goals. For this tutorial, we will discuss the Van Dijk Method, calendar activities, and others.
Van Dijk Method
The primary objective of the Van Dijk method is to encourage the development of nonverbal communication as an essential foundation for language learning. Interactions are built upon the student's spontaneous movements in order to teach the student to use the body as a tool to affect and explore the environment.
This approach is based on a normal developmental model, with the assumptions that communication skills are acquired in a fixed sequence and that certain prerequisites for language development exist, including the development of social interactions and representational capabilities.
Major areas of emphasis within the Van Dijk methodology include the following:
- Building a primary relationship
- Developing dialogue or conversation through movement
- Developing anticipation and higher level representational abilities
- Teaching imitation
Van Dijk and others have suggested a hierarchy of teaching, based on the developmental level of the student. The steps in the hierarchy are briefly described below.
Activities in the Van Dijk Method
REFLEX/RESONANCE LEVEL ACTIVITIES
These activities are most appropriate for the student who demonstrates little response to the outside world, and who seems to be disinterested in communicating. These activities are something parents do naturally with their children. The purpose of the activities is to build a relationship with the student. It is very important at this stage to work on developing trust between the child and the adult, so that the student will allow and enjoy the interactions with a primary caregiver. Resonance level activities are based on the student's spontaneous movements. They involve repetitive sequences of movements, with pauses built in to give the student an opportunity to signal for continuation by continuing the movement, pulling the adult's hand, etc. All resonance activities involve close physical contact between the student and teacher, such as a student sitting in the teacher's lap and rocking back and forth or from side to side or the teacher and student jumping together arm-in-arm. Another example would be to jump on a trampoline with your student. Come to a stop and wait for the child to signal.
SIGNAL/COACTIVE LEVEL ACTIVITIES
This level is similar to Reflex/Resonance in that it involves movement. This can be introduced when the student has demonstrated consistent signaling for continuation of movement in a variety of activities. Coactive movement involves moving through space with the student in a defined area. It differs from resonance-level movement in the gradual increase in distance between the adult and student and in the complexity of the movement sequences used. Coactive movement activities can be introduced with the adult and student in close physical contact (e.g., side-by-side). As the student becomes more responsive to the adult modeling, the distance can be increased; however, the adult and student continue to perform the action simultaneously. No true imitation is required. For example the teacher and student stamp their feet at the same time, bounce while sitting on a swing or hit drums.
Other examples include the teacher:
- Rolling the child over a large therapy ball, then pausing and waiting for a signal from the child.
- Pushing the child in a swing, then pausing and waiting for a signal from the child.
Educational toys are not recommended. It is better to use toys or objects that have some action. The action should be such that the child NEEDS you to make it happen again.
IMITATION LEVEL ACTIVITIES
In these activities, the student imitates the adult action after it is performed. The student who can imitate activities maintains mental images of actions after they are completed, and maintains contact with partners with increasing time and space. Imitation begins with immediate imitation of simple, visible actions, and continues through activities that require deferred imitation, role-play, and imitation of complex, multi-step or novel actions. Simple imitation activities could include:
- Clapping games
- Turn taking with the teacher hitting a musical toy and then waiting for the student imitate the action.
NONREPRESENTATIONAL REFERENCE ACTIVITIES
Until the child knows that her body corresponds to a graphic representation of a person, he/she will not fully understand pictures. To get to a point where the child understands pictures, the child should be first able to:
- Imitate your limb movement
- Imitate the limb movement of large doll
- Imitate a large cardboard figure with brads at the joints
Children with multiple disabilities frequently have problems understanding that a picture represents a real object or person. This can be due to various visual problems or visual processing problems. Spending time working with this child in front of a mirror during this stage can be helpful. Here the child is exposed to "pictures" of himself and the toys. Use the mirror as a surface to manipulate objects.
REPRESENTATIONAL REFERENCE ACTIVITIES
In these activities, the student relates one representational form to another (e.g., picture to similar picture, stick figure to doll). These activities require an understanding that both forms represent the same referent.
Dr. Jan Van Dijk initiated the use of calendar systems with children who are deafblind and have additional disabilities. Calendar activities can begin at the resonance level, with anticipation boxes, and are continued through the levels of symbolic representation and interactive skill development. The calendar is used to develop anticipation and to provide a frame of reference for teaching a wide variety of communication skills.
Calendars come in many forms. The selection of a specific type of calendar is based on the needs and capabilities of each student. They may be as simple as a single basket containing an object that represents "What I am going to do now." They may have a series of compartments that contain objects, parts of objects, photographs, line drawings or tactile symbols representing the activities of the day. Some calendars include a symbol for choice-making that allows a student to select a favored activity. Others may look very much like regular calendars consisting of months, days and dates with information in large print or Braille.
Although calendars are used to teach communication, they ARE NOT communication systems. Like a routine, a calendar is a strategy to provide structure and predictability for students who are deafblind. Calendars also provide an opportunity to "converse" with a communication partner that speaks the same language. The communication partner is the person who uses the calendar activity with the student. This can be a teacher, intervener, or in the home setting the family. Calendars teach communication by:
- Supporting a child's transition from concrete to abstract forms of communication by showing that a symbol represents an activity.
- Teaching appropriate ways to request or reject activities or people and increase the number of topics about which a student can communicate.
- Teaching conversation rules such as turn-taking and comfortable pacing.
- Providing a communication partner that understands the student's method of communication.
Types of Calendars
As the name suggests, calendars teach time concepts and clarify the meaning of vocabulary about time. Calendars are designed to accurately reflect a student's internal concept of time and can be individualized to accommodate the unique sensory modification needs of each student. There are 3 different levels or formats of calendar systems that progress systematically across a range of time frames:
- Anticipation calendars
- Daily calendars
- Expanded calendars (weekly, multi-weekly, monthly and annual)
Ordering information for: Calendars for Students with Multiple Impairments Including Deafblindness by Robbie Blaha.
Three Kinds of Calendar from TSBVI contains links, video resources and information about time piece calendars, sequencing calendars, and choice calendars.
Activity Calendars by Millie Smith.
- Memory boxes, books, or bags. This could include an "All About Me" bag. The child takes the bag home and brings it back filled with 4-6 special items that tell something about him or her. The child shares the contents with a conversational partner or classmates.
- Experience books (items from an event experienced by the child are placed onto the pages of a simple, sturdy book along with Braille and print text).
- Remnant books. Remnant books are a visual/tactual way of helping students record important events in their lives. The books can be used to facilitate face-to-face communication or writing topics.
- A Story Box is a way for young children with visual impairments to experience a story. These can be made by carefully selecting commercially available books, or by creating stories about the child and people around the child. Story boxes or bags contain a collection of items that correspond to things mentioned in a story.
What is a Story Box? From: NAVPI newsletter - Awareness - Summer 97Story boxes, story bags and story telling from "Learning Through Talk in the Early Years at Sage Publications.
Story Boxes or Bags Handout by Lyn Ayer.
Creating and Using Tactile Experience Books for Young Children With Visual Impairments by Sandra Lewis and Joan Tolla.
Using an Experience Book from TSBVI.