Accessing the World Differently

1. Sensory Learning and Multiple Impairments Accessing the World Differently for learners with visual and multiple impairments Millie Smith and Tristan Pierce American Printing House for the Blind

2. Introduction The program (SAM: Symbols and Meaning) is designed to help learners develop the conceptual foundation, based on experiences with high-quality sensory information, necessary for the use of meaningful symbols.

3. Introduction, cont’d. The program is for students with visual and multiple impairments and pre-school children with visual impairments who are just beginning to use symbols—the late sensorimotor, early preoperational stage of cognitive development.It is designed to be used by TVIs to help parents and teachers create daily learning opportunities and provide direct instruction in naturalenvironments.

4. Introduction, cont’d. The field testing began in the Spring of 2008 when the presenters solicited teachers to participate in what would be a full academic year of testing, August 2008 to May 2009. The field testers participated in a 6-hour long, live, onlinetraining conducted by the presenters.

5. Introduction, cont’d. At the beginning of the school year, all teachers conducted and submitted an Environmental Gap Inventory for their learner(s). This was designated as each learner’s baseline. In late December, the same Environmental Gap Inventorywas conducted and submitted. The final was done in April 2009.

6. Introduction, cont’d. The comparison of the three inventories and the teachers’ evaluation forms were used to determine the effectiveness of the program.

7. Program Need The development of conceptual foundations for the use of meaningful symbols is important to the field. The rationale for this presentation is that for learners with visual impairments, variations in the development of meaning include absent/incomplete concepts, objects experienced out of context without intended function, and words without meaning.

8. Program Need, cont’d. There is strong practitioner evidence that the program is needed and that it is successful. If a learner has a sensory impairment, “the quality and scope of learning may belimited by reduction in environmental interactions” (Barraga & Erin, 1992).

9. Program Need, cont’d. Access to people/objects is limited because search is not motivated by curiosity about things seen. When objects/people are accessed, meaning may not develop because sensory information is insufficient/confusing. Ideas are constructed over time. In early stages of concept development, building blocks are direct experiences with people/objects in the environment (Pogrund & Fazzi, 2002).

10. Program Need, cont’d. As these experiences accumulate, teachers see how learners discover patterns and mentally organize these patterns into “schemas,” which form the internalized knowledge of what the world is and how it works (McLinden & McCall, 2002).

11. Participants Ten teachers from seven states participated in the field test. On average, the teachers had 9 years experience teaching visually impaired/blind learners and averaged 10.5 years teaching learners who have profound disabilities.

12. Participants, cont’d. Twelve learners participated, and 10 teachers completed the Environmental Gap Inventories. Eighty percent of the teachers had never used another program to help learners develop the conceptual foundation necessary for the use of meaningful symbols. Fifty percent of the learners had used APH’s Sensory Learning Kit (SLK) prior to using this program.

13. Participants cont’d. Due to the advanced planning for recruitment and training, and the extended length of field testing, 80% of the learners’ teams (family, friends, teachers, specialists) incorporated the program into their learner’s IEP.

14. Participants cont’d. The chronological ages of the learners range from 1.5 years to 15 years. The cognitive ages range from 10 months to 6 years old. Ideally, the product is targeted for learners with a 2-4-year-old cognitive level or those in the late sensorimotor,early preoperational stage of cognitive development.

15. Participants cont’d. Retinopathy of Prematurity is the most prevalent eye condition of the learners, closely followed by Cortical Visual Impairment.

16. BackgroundCognitive Performance Traditional Levels • Gifted • Average • Significantly sub-average • Mild • Moderate • Severe • Profound • Sensorimotor (Birth–2 years) • Learning about what things are like and what things do • Preoperational (2–6 years) • Learning language • Operational (7+ years) • Using language to learn Developmental Stages

17. Background, cont’d.APH Continuum • Sensorimotor level learners are learning things about language, but language is not the primary focus of their learning. • Preoperational and operational learners use sensorimotor strategies to gather information about new things. Stage boundaries are permeable.

18. Background, cont’d. DevelopmentalModel • Less stigmatizing • Assumes progress is always achievable at any age • Emphasizes characteristics of learning styles so that more appropriate instructional strategies can be provided

19. Late sensorimotor, early preoperational development • Basic concepts emerge, but are based on the learner’s personal experience. • Concepts are one-dimensional and rigid. • Symbols with concrete referents are used to facilitate thinking about things in memory but not present. • Basic concepts are expanded through the assimilation and accommodation of new sensory experiences. • Symbols become more arbitrary and represent things that are more abstract.

20. Graduation levels • Concepts about the learner’s own body • Concepts about people, objects, and actions touching the learner’s body • Concepts about people, objects, and actions, and places beyond the learner’s body • Schemas about people-object-action-place relationships in events beyond the learner’s body

21. Who uses SAM? • Learners who • have poor concepts because of limited sensory experiences with people, objects, actions, and places; • are learning that objects can be symbols used to send messages about each of the above; • are interested in words but cannot associate words and their concrete referents; and • say words without meaning.

22. The SAM instructional strategy • Pairing symbols with concrete referents in direct experiences in natural contexts • Bridging near and distance sensory information in natural contexts to build solid concepts about things beyond the body • Playing games in which whole objects and words experienced in natural contexts are used as symbols in communication contexts

23. Games SAM includes 18 games to help develop conceptual and symbolic skills. The next slide shows the number of students who played each game and whether they were successful, unsuccessful, or did not play the game. Some teachers did not respond to all games, therefore the total does not always add up to 12. Millie’s person symbol Millie!

24. Games Game Successful Unsuccessful Did not Play Body Buzz 8 2 2 Whoopee Clothes 6 0 4 Finger Tag 4 1 6 Hot Potato 5 1 4 Slap 4 4 3 Simon Says 5 1 4 Yours and Mine 5 1 5 Do It Again 5 2 3 Go Fish 3 1 7 Show Me Who 2 4 4 What Do 2 3 6 Sounds Like 2 1 7 Mystery Voice 2 1 7 Scavenger Hunt 2 0 8 Bag Stories 2 0 8 Box Stories 1 2 7 Binder Stories 2 1 7 Clue 1 1 8

25. Watch SAM video

26. Results Prior to using the program, teachers were asked which concept categories their learner(s) understood. At baseline, 66% of the learners understood the category People: The Self and Others. Concepts about people start with knowledge of one’s own body. Self-awareness becomes the core knowledge to which new information is attached. New information includes the characteristics of other people’s bodies first and, then, more sophisticated things associated with the body like its emotional content, what it does, where it goes, its name, and how it relates to other bodies. After using the program, 75% of the learners understood this category. One teacher wrote, “I finally had a strategy/teaching approach to use. No other books gave me the knowledge I needed.”

27. Results, cont’d. Prior to using the program, 42% of the learners understood the category Objects: Tangible Things. Concepts about objects start developing as soon as the blanket touches the newborn’s body. Information about the physical characteristics of objects is acquired through the senses. Acquisition of sensory information leads to recognition of the object and associated information about how it is used and how it relates to other objects (Smith, in press). After the learners and teachers used the program, 83% of learners understood this category. Partner performs action. Learner performs same action.

28. Results, cont’d. Prior to using the program, 50% of learners understood the category Actions: Body Movements of the Self and Others. Concepts about actions start with random movements of the learner’s own body in infancy. The actions become more intentional as certain results are associated with certain movements. Information about the actions of other people’s bodies allows the learner to imitate and expand his range of options in choosing how he will interact with his environment (Smith, in press). After the learners and teachers used the program, 75% of learners understood this category.

29. Results, cont’d. Prior to using the program, no learners understood the category Places: Where Things Are and Contexts for Groups of Things. Concepts about places allow the learner to find things. Simple place concepts include things like knowing where to look or to move the hand to find the cup during mealtime. Things have to be in the same place consistently in order for place concepts to develop successfully. Place concepts build mental maps of how things relate to one another spatially. Places are also contexts—environments or surroundings—that provide meaning. A kitchen is the context that helps to provide meaning to objects like pans, spatulas, strainers, etc. (Smith, in press). After the learners and teachers used the program, 50% of learners understood this category.

30. Results, cont’d. Concept CategoriesPre Post People The Self and Others 8 9 Objects Tangible Things 5 10 Actions Body Movements of the Self and Others 6 9 Places Where Things Are, Contexts for Groups of Things 0 5

31. Results, cont’d. Fifty percent of the learners learned to successfully use sensory bridging (sound, smell, or impaired sight paired with associated tactual information to create a concept at a distance). Teachers’ comments included: She learned a symbol meant to go to the gym to play ball, to eat lunch at a table, to feed herself without prompting. In the games we did not get further than the body but one student knew when he heard my voice from a distance that it was time for Whoopee Clothes. Millie’s voice (sound picture)

32. Results, cont’d. Learners developed the ability to use objects as symbols in four steps. Prior to the use of the program, 75% of the learners used touch to discriminate tactual characteristics of an object. After using the program, the percentage increased to 83%. Learners who used objects in natural contexts went from 33% to 75%. Learners who formed associations with other things related to the object went from 8% to 50%. Learners who used objects as symbols went from 8% to 42%. Again, all students improved.

33. Results, cont’d. Object Symbols Steps Pre Post Tactual learner uses touch to discriminate characteristics of an object. 9 10 Learner uses object in natural context. 4 11 Learner forms associations with other things related to the object. 1 6 Learner uses the object as a symbol to receive or send messages. 1 5

34. Assessment Forms There are four assessments in the program. Symbol and Referent Analysis: Common Words Symbol and Referent Analysis: Academic Vocabulary Environmental Gap Inventory Curriculum-based Gap Inventory

35. Assessment Forms, cont’d. Comments Environmental Gap Inventory POSTIVE: I gained a new perspective on areas that need to be taught to the student. RECOMMENDATION: I think it should be broken into functional levels or set up for student individuality. Many students’ issues are not addressed in homes that are addressed at school and vice-versa. I have many parents who don’t want to implement what is done at school into their home environment although it may be very successful.

36. Assessment Forms, cont’d. Comments Curriculum-based Gap Inventory I gained a new perspective by reading the additional explanation. I can write additional teaching interventions from the ideas discussed on these pages.

37. Assessment Forms, cont’d. The Environmental Gap Inventory consisted of 14 environments. Not all teams were able to observe all environments. However, they all submitted the school environment. While some learners improved more than others, all learners improved. Improvement was shown in all environments submitted by the teachers. Assessments help identify missing concepts in common environments.

38. Environmental Gap Inventory Learner Sept Dec April HW 31.64% 45.73% 70.82% AM 8.60% 10.60% 11.50% SF 9.10% 10.30% 11.50% TV 3.60% 7.20% 57.00% RD 20.50% 52.60% 54.90% SM 46.60% 48.00% 49.20% SM 30.70% 33.50% 49.80% JO 20.70% 41.10% 41.20% CR 10.80% 16.00% 11.90% GWR 0.00% 10.40% 17.20% VE 3.10% 64.80% 64.80% GG 47.00% 69.00% 90.00% Average 19.36% 34.10% 44.15%

39. Comments Saw great growth in my student through this project! She went from a beginning Level 1 to a middle Level 2, (in my opinion). I already have other students in mind to implement this program with who would benefit! I look forward to using it in the future with other students. The training was great but I could have used more time to understand the product before implementing the program. I understand the reason for the need to get going on the field test, however. Thanks so much for including my school district and me in this research. I think it is a good program and was very useful in the classroom with the teachers and assistants who were working with the students.

40. Look at Assessments

41. Conclusion It is rare that The American Printing House for the Blind has the luxury to field test a program for a full academic year. This proved to be very beneficial for the field testing teams. Many teams were able to prepare and include the program in the learners’ IEPs. All learners demonstrated improvement on the Environmental Gap Inventory. the four concept categories (People, Objects, Actions, Places). the ability to use objects as symbols in four steps. The games were deemed useful to the teachers, and they proved to be successful experiences for the learners.

42. References Barraga, N., & Erin, J. (1992). Visual impairments and learning. San Antonio, TX: Pro‑Ed. Fazzi, D. L., & Klein, M. D. (2002). Cognitive focus: Developing cognition, concepts, and language. In R. Pogrund & D. Fazzi (Eds.), Early focus: Working with young children who are blind or visually impaired and their families (pp. 107-153). New York: AFB Press. McLinden, M., & McCall, S. (2002). Learning through touch: Supporting children with visual impairments and additional difficulties. London: David Fulton Publishers.

43. The End • More Videos or Questions?