Texas School for the Blind & Visually Impaired Outreach Programs W. 45 th St. Austin,

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1 TX Texas School for the Blind & Visually Impaired Outreach Programs W. 45 th St. Austin, 2019 Texas Symposium on DeafBlindness: Resonance February 21-23, 2019 Encouraging Learning through Play with the Young Child with Deaf-Blindness Saturday, Breakout Session 10:15-11:45 AM Tanni Anthony, PhD., Director Colorado Services to Children with Combined Vision and Hearing Loss Project (CO) Developed for Texas DeafBlind Outreach Program Texas School for the Blind & Visually Impaired

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3 Encouraging Learning through Play with the Young Child with Deaf-Blindness By Tanni L. Anthony, PhD Play Strategies are Consistent with Good DB Strategies From our wise leaders: Piaget/ Brazelton / Erickson (all young children) Van Dijk (DB) Barbara McLetchie (DB) Deborah Chen (DB/ EI) Toni Linder (for all young children) Lilli Nielson (DB / BVI+) Marianne Riggio and Barbara Miles (DB) Rowland and Schweigert (MD with sensory loss) Jim Jan and Christine Roman Lantzy (CVI) Millie Smith (BVI /DB with MD) 2019 TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 1

4 Key DB Teaching Strategies Access (sensory, social emotional, cognitive, physical) Communication / (pre/intention / Turn Taking / Joint Attention Touch Cues / Object Cues / Symbols Active Learning / Child as an Active Participant Sign Language / Tactile Sign Hand Under Hand / Tactile Strategies Active Learning Routines / Anticipation / Predictability / Participation Concept Development / Hands On Learning Child Guided Assessment (van Dijk) Keys to Learning: 'Play is often overlooked as the key that helps unlock the doors to learning. (Mary Reilly, 1974). Play is a biological, psychological and social necessity. Current concerns that kids do not have time needed to play TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 2

5 Play is Powerful: A complex set of behaviors characterized by fun and spontaneity. If it is not fun, it is not play! Can be sensory, physical, cognitive & any combination of the three. It involves space and boundaries. Play can happen anywhere! And should! Involves repetition of experience, exploration, experimentation, and imitation of one s surroundings (Florey 1981). The universal language of childhood. It is through play that children understand each other and make sense of the world around them. The Power of Play (Zero to Three, 2004, p.1) An 8-week-old learns about communication and the joy of close relationships as he smiles, coos, and gurgles when his dad talks with him. A 15-month-old uses her body and mind to learn about up and down, high and low, and how strong and competent she is on a trip with grandma to the playground. A 3-year-old playing pretend develops her own ideas, uses her imagination, and builds friendships. Play follows a developmental sequence and, to some extent, continues throughout our lives TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 3

6 Essential Elements to Meaningful Play 1. Children make their own decisions. 2. Children are intrinsically motivated. 3. Children are immersed in the moment. 4. Play is spontaneous and not scripted. 5. Play is enjoyable. THERE IS FUN. (NAEYC) Very compatible with van Dijk child guided assessment Play Works Both Ways: We learn about the child through observing play. We can set up scenarios to advance the child s learning through play. Play can be advanced horizontally and vertically. Both are important. It is both an assessment and an intervention philosophy and methodology for young children TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 4

7 Seven Types of Play (this is one model) 1. Interpersonal 2. Functional / Relational 3. Symbolic / Dramatic Play 4. Games with Rules 5. Exploratory / Sensorimotor 6. Constructive Play 7. Rough and Tumble Play There is a general sequence of the types of play, but there is a great deal of overlap to these types of play. It is important to understand how to encourage play from a cognitive (anticipation, sequence, mentor), symbol use, trial and error, problem solving, and constructive (means end) intent. Interpersonal Play: Social emotional exchange / play interaction between a child and a trusted other. Contributes to attachment building trust and a sense of security. This is a lifelong need. This early security base is critical in the infant s growing ability to interact with others and for self-initiated movement within an ever-expanding world. Exploration / Sensorimotor Play: Play activities that are completed for the enjoyment of the sensory input gained from the task. Child uses his or her body to enjoy the physical world both with expression and reception TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 5

8 Functional - Relational Play: Simple manipulation of objects. Functional use of objects Learning through observation of these objects in daily routines or, more importantly, through hands-on opportunities to act upon these objects within daily routines. Play Begins with P Preferences -> Pathways -> Presentation Partnership (Communication) Participation Pacing Positioning / Proximity / Predictability Practice Preferences -> Pathways -> Presentations Internal / External Sensory Abilities And Needs Enjoyment Likes (within likes) / Dislikes A lure for reinforcement this builds motivation TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 6

9 Sensory Preferences Include: Hearing Vision Touch Proprioception Vestibular Olfactory Gustatory We have Inside and Outside Body Senses Our sensory abilities are tied to both internal and external factors. T / P / V must work very closely together to perception / planning / execution. Sensory experience in the first 8 years of life prepares a child for higher learning. How we process our sensory system tells us if we are safe or not. What stimuli: Attracts the child s attention? Holds the child s attention? Calms the child? Overwhelms the child? 2019 TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 7

10 Tool Consideration Learning Sensory Style Assessment LMA Sensory Learning Channel Individual Sensory Learning Profile Interview Appetite / Aversion Form Every Move Counts Sensory Learning Kit Likes and Dislikes Form Sensory Stimulation Inventory Recommended with an overlay of the Communication Matrix Example: Learning Style Assessment This includes the following: Interests, motivation, preferences Processing time Likes / Dislikes Self-regulation Exploratory strategies Attention to activities TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 8

11 APPETITE/AVERSION FORM (Texas School for the Blind) Fill one sheet out for each child. Over a period of time through listening to stories from others and through observation of the child, simply list things the child likes and doesn t like. We all enjoy things that we are good at and that we understand. The child s Likes will be his areas of strength and indicates sensory channels that are working. His Dislikes will be areas of weakness and indicates sensory channels that may not be working efficiently. The information gathered on this form will give you underlying themes that you can use for adaptations, teaching strategies, topics for communication, and activities. Child s Name: Date: Appetite (Likes) Aversion (Dislikes) rough housing with dad Fire alarm outside-swing People touching her face tickles from peer in class battery operated toothbrush bumble ball riding in car/bus rocking chair eating Summary Information: What sensory channels is the child using the most? Vestibular, kinesthetic What are possible topics for communication? Things that vibrate, food, rocking 2019 TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 9

12 What are some activities that the child might find aversive? Fire drills, large group activities in noisy places, people touching her face What other adaptations or strategies are suggested by the above information? Include movement or vibration during activities Likes and Dislikes Likes Dislikes People Object Places Clothing Sounds / Music Touch Styles / Movement Vibration / Rhythm / Resonance Colors / Lights / Reflection Scents / Tastes (Kathee Scoggins) Adapted Sensory Channel Form What calms the child? (describe) V T A M S What alerts.? (describe) V T A M S What stresses.? (describe) V T A M S What activities does the child V T A M S anticipate? (describe) 2019 TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 10

13 Individual Sensory Profile Building a medical history. Learning about sensory support equipment. Identifying key sensory modalities. Identifying sensory feature preferences. Using sensory features as motivators. Determining environmental supports. Anticonvulsants and Side Effects Phenobarbital: photophobia, constriction /convergence problems Dilantin: convergence problems, focus problems, esotropia Clonopin: abnormal eye movement, diplopia, nystagmus, glassy eyed appearance Tegretol: photosensitivity, blurred vision, visual hallucinations, oculomotor disturbances, nystagmus, conjunctivitis The purposes of the Phase of Offering are to: promote trust between the learner and the adult observe the learner's reactions identify what the learner likes/dislikes establish an understanding of the learner's emotional level introduce self-activity TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 11

14 Increase Visual Contrast Some Effective High Contrast Color Combinations Black/White Yellow/Black Red/White Yellow/Red Blue/White Yellow/Blue Illumination Needs (Langley, 1998) Low Lighting Bright Lighting Variable Lighting Achromatopsia Aphakia Amblyopia Albinism High Myopia Hyperopia Corneal Opacities Macular Macular Pathology Degeneration Glaucoma Optic Atropy Uveitis Colobomas Retinal Detachment Aniridia Retinitis Pegmentosa Posterior Cataracts Retinopathy of Prematurity Cone Dystrophies Cataracts Iris 2019 TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 12

15 Minimize Visual Clutter Excessive Visual Clutter Can Be Distracting and Confusing and Can Cause Sensory Overload. Toy/Learning Areas Should Be Kept Organized Divider Can Be Used to Block Extraneous Stimuli Curtain Sheet Hung to Hide Unused Toys/Materials Some of the Many Possibilities Olfactory Vibro/Tactile: rhythm, resonance, ridges Tactile: air, pressure, wet, temperature Auditory: tones, volume, fast / slow, on/off, speech, a particular voice / environmental / music sound Visual: light, reflective, color, form, contrast, simplistic, one at a time, background Movement: fast, slow, rhythmic, with resonance /vibration Pacing Processing Time AND Response Time registration of sensory input orientation and attention (to CNS by neural pathways) Interpretation organization of a response execution of a response SENSORY IN / MOTOR OUT TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 13

16 Partnership through Communication: All behavior is communication. Sometimes it is our job to determine what the message / conversation is despite the mode of delivery. Communication includes behavioral states Communication includes what changes behavioral states how is this evidenced. Levels of Communication I. Pre-intentional Communication II. Intentional Communication III. Unconventional Presymbolic Communication IV. Conventional Presymbolic Communication V. Concrete Symbols VI. Abstract Symbols VII. Language The Power of Intentional Communication Implies Intentional or deliberate behavior and purposeful direction toward another person with intended meaning. This leads to deliberate play exchanges. Requires dual orientation to both the communication partner and the topic (joint attention) 2019 TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 14

17 Pivotal Juncture of Coordinated Attention: The transition from pre-intentional to intentional communication is a developmental milestone second to none! (Phil Schwiegert). It marks children s entry as full participants in the social milieu around them and triggers other transactional processes that in a short time lead to symbolic communication. This is a BIG DEAL! (Warren & Yoder, 1999) The act of reference emerges not as an individual act, but as a social one. (Kaplan, 1963). Figure 1 Venn diagram - Three circle overlap: Object, Mother, Child. Positioning / Proximity / Predictability: Sensory Attention and Needs / Physical Contact; Cognitive (Object Permanence) / Spatial Skills; Body Needs For Comfort / Alignment / Control; Reach Range / Volitional Ability To Move / Interests Supersede Therapy / Material Needs Dictated by Interests / Access 2019 TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 15

18 Assessment of Voluntary Movement Component Adapted from Every Move Counts Child: Date: Observer: Location: Positio n State Le g Mout h Ey e Ea r Chee k Chi n Nec k Hea d Ar m Should er Foo t Othe r #1 Supine Initial Change s Main #2 Prone Initial Change s Main #3 Initial Side lying Change s Main #4 Sitting Initial Change s Main 2019 TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 16

19 Summary Position Voluntary / Intentional Movements Possible in this Position Supine IFSP / IEP Activities for this Position Staff State Observation Prone Side Sitting Sensory Learning / Cognition Figure 2 An image of an infant with an arrow pointing upward on the left that read "symbolism" and one on the right point right that reads "proximity". Play Vests TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 17

20 Predictability /Practice: Routines / Anticipation Routines based learning is a fundamental approach to early childhood learning. Routines have also been a long standing approach to working with children with deaf-blindness as a means of protecting predictability, consistency, and a known sequence of events (beginning, middle, and end). Anticipation = memory. Participation = learning is integrated /explored / experienced / cemented Define Activity/Play Area Predictability Spatial Boundaries Can Be Defined Using Rug/Blanket/Tape Contrasting Color to Flooring Low Bookshelf or Multi-Shelf Unit Against Wall Play Furniture Arranged Accessibly in Corner Laundry Basket/Box/Container to Hold Like Items Play Tray Keeping Objects Close/No Rolling Away Participation (in Social Play) Trust Engagement Turn Taking Reward Practice Routines / Sequence Reactivity of Environment Opportunities for Repetition Proximity for Practice Placement to Encourage Practice Videos for Discussion 2019 TX Symposium on DeafBlindness Encouraging Learning through Play Anthony, T. 18

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22 Texas School for the Blind & Visually Impaired Outreach Programs Figure 3 TSBVI logo. Figure 4 IDEAs that Work logo. This project is supported by the U.S. Department of Education, Office of Special Education Programs (OSEP). Opinions expressed herein are those of the authors and do not necessarily represent the position of the U.S. Department of Education.