Supporting Infants and Toddlers with Multiple Disabilities: Strategies and Resources
Discover in-depth insights into identifying and supporting infants and toddlers with multiple disabilities, including combined vision and hearing loss. Learn about risk factors, the impact on early development, strategies for improving outcomes, and valuable national and state resources available. Explore the importance of sensory exploration, movement, hands-on activities, repetition, trust, security, and communication in nurturing these young learners.
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Identifying and Supporting Infants and Toddlers with Multiple Disabilities, including Combined Vision and Hearing Loss Barbara Purvis, M.Ed.
Increased knowledge of 1. Risk factors associated with combined vision and hearing loss 2. Impact of combined vision and hearing loss on early development 3. Strategies to improve developmental outcomes 4. National and state resources
Sensory Exploration Movement Incidental learning Hands-on activities Repetition Trust & security Asking questions
Trusting relationships Hands-on experiences Active movement and exploration Predictable, accessible schedules Repetition and consistency Use of residual hearing and sight High expectations Communication, communication, communication!
Anticipation what is going to happen to me, where am I going, who is with me Motivation isolation/withdrawal, lack of interest in environment and people, limited exploration Confirmation this is how things work, when I do this this happens, this thing does this action, this facial expression or tone of voice means this Concept Development objects exist, have names and characteristics, have functions or use
Concepts How we connect meaning to objects, events and people Foundation for literacy and abstract learning Categories Concrete Semi-concrete Abstract S A F V U V G R O
Objects exist Objects have permanence Objects differ Objects have names or labels Objects have characteristics Objects have functions or use Project SPARKLE, 2006 SKI-HI Institute, Utah State University
Children need: Hands on experiences Shared experiences Thoughtful presentation of experiences that enable them to develop a gradually expanding view of the world. Information, materials, and experiences presented in multimodal formats Miles, B. & McLetchie, B. (2008). Developing Concepts with Children Who Are Deaf-Blind. Monmouth, OR: The National Consortium on Deaf-Blindness.
Providers need to: Adopt a holistic approach Attach language to all experiences Build on vocabulary already known by child Use communication appropriate for the child Remove variables that may cause confusion for the child Generalize concepts to varied situations Ensure consistency among team members .
When approaching the learner, always let her know you are there Identify yourself to the learner everytime you are with her, even if she has partial sight Always let the learner know what is going to happen next Use TOUCH CUES Use OBJECT CUES
Whenever possible, allow the learner the opportunity to make choices in an activity Utilize a tactile cue to let the learner know when you are available for interaction Find a way to always let the learner know when an activity is finished Always let the learner know when you are leaving
Greeting/Leaving Rituals Touch Cues Hand Under Hand Active Learning Wait Time Routines Calendar System
For each person who interacts with child May be an activity or a unique identifier Use them EVERY time Child needs them as well it s what people do!
A TOUCH CUE consists of tactile contact, made in a consistent manner directly on the child s body, to communicate with her.
Alert child that something will follow cue May reduce startling, challenging behavior Help focus attention on interaction or event that follows Develop anticipatory responses Help children make sense of their day
Cognitive processing Message received & understood Memory of previous event Association made between two actions Receptive communication Remembered & recognized your signal Responds to cue May try to assist or engage more fully Indicates readiness for more!
Tapping the childs bottom (in supine) - Im going to lift your hips (for diaper change) Gently pulling up on the child s upper arms - Get ready to stand up. Touching the child s left elbow - This is the way I say HI, so you know who I am. Touching the child s ear- Time to put your hearing aids on.
A strategy where the learners hands are gently guided from underneath, which allows them to explore and participate as they choose.
Allows hands to be free Allows hand to be used at the learner s discretion Allows hands to be used for: protection, exploration, self-stimulation, performing functional skills Hand Over Hand as a teaching strategy is often aversive, and may not respect the learner s preferences.
Access to ways people use hands Spatial awareness through tactile experience Encourages authentic involvement Stimulates curiosity Preparation for tactile signing
Guide childs hands from underneath Invite child to watch while partner uses their own hands Offer an invitation to join an interaction Follow child s lead to engage in exploring objects Honor the request, if child pushes partner away Look for opportunities to build in communication
Child is the ACTIVE one! Emphasizes items or activities with sound, tactile elements, movement Provides security and safety Encourages movement & exploration Maximizes engagement & participation Promotes memory & autonomy Demonstrates that everyone can learn!
Encourage discovery and practice Offer immediate feedback Provide sense of familiarity and control Assist in cognitive development (Object permanence, visual memory, cause/effect, properties such as size, weight, temperature, texture, sound, color ) Examples Lilli Nielsen s Little Room Resonance board Stay put play spaces Create your own!
Children with combined vision and hearing loss need more time to process information Amount of wait time depends on child s physical challenges and communication level Consider the pace of your interactions In most cases SLOW DOWN! Illinois, Project Reach 2010
Pause within a familiar routine Watch for anticipation of next step Watch for movement, body posture, facial expression, gestures and vocalizing to indicate desire to complete an activity Illinois, Project Reach 2010
Beginning and ending Outcome oriented Meaningful Predictable Sequential or systematic Repetitious Family Guided Routines Based Intervention, Florida State University, 2014 27
Predictability Provide security Decrease stress Anticipation Sense of control 28
1. Initiation 2. Preparation 3. Core 4. Termination 29
Put meaning to actions & provide vocabulary Introduce new vocabulary in advance Expand related vocabulary Teach concepts associated with routines Pair words with next level objects or symbols Use conversation boxes Introduce new partners & topics
Anticipation schedules Daily schedules Daily Preschool Schedule using Object Cues
Introduction to calendars Represents a single activity Develops understanding that activities can be represented by symbols Can explain changes in a routine, activity or schedule Provides sense of security Introduces concepts of past & future
Need two distinctive containers One for NEXT Another for FINISHED Select an object close (in time and space) to activity Present to child to build association Post written list of what each object represents Can be expanded to 2-3 activities
Finished bucket Actual object represents activity Colored electrical tape delineates edges and draws attention to object
Tactile symbol mounted on lightweight wedge Finished bucket is attached to side of wheelchair tray Adapted for limited range of movement
National Center on Deaf-Blindness Email: support@nationaldb.org Website: nationaldb.org Phone: (503) 838-8754 The National Family Association for Deaf-Blind Email:NFADB@aol.com Website: NFADB.org Phone: (800) 255-0411
NCDB Literacy Website http://literacy.nationaldb.org/ Home Talk: A Family Assessment http://documents.nationaldb.org//HomeTalk.pdf Washington Sensory Disabilities Services Deaf-Blind http://www.wsdsonline.org/deaf-blind/ Video Topics http://www.wsdsonline.org/video-topics/ Perkins School for the Blind Teaching Resources http://www.perkinselearning.org/teaching-resources Webcasts http://www.perkinselearning.org/videos
CONTACT Michael Norman, Project Coordinator Louisiana Deafblind Project for Children and Youth LSU University Human Development Center 504-556-3455 mnorm2@lsuhsc.edu
