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Welcome tothe webinar series,whenworlds collide.Perkins webinars are presented throughoutthe year once or twicea month andsometimes weekly. This is part oneof a two-part series presented incooperation with the Western Pennsylvaniaschool for blind children. Parttwo will occur at this time nextweek. If you're interestedabout future webinars or teachingresources our contentincludes publications, in newsletters,webcasts andothers, please visit us at Perkinse-learning network. Every monthwe arejoined by new people. If you arenotnow seems the Perkins welcomingslide on your screen, your Adobemeeting window may have minimized.Look for theAdobe icon at the bottom of yourscreen. If the green icon of peopleina meeting. To keep noise levelsin control we have muted your lines.A question and answer boxwill be provided on the screen shortly.We encourage you to post your questionsas they occur and we will addressthem at the end. If you're seeinga pop-up screen asking you how youwould like to receive a audio youcan click the cancel button onyour screen. We are using thisconference line for audio. You dohave additional controls for yourscreen and you may choose to enlargeand minimize thecaptioning areaor minimized and enlarge video asthey are played on screen. Justleftindividual audio controls for yourspeakers. We findheadsets can be full if your speakers are not very powerful. This introductionis to give you time tomake adjustments as you need them.Computer audio sometimes out ofsync. If you're experiencing echoesor feedbacks or delaysin audio this can sometimes be causedtoyour connection, your wireless connectionis supported by awired connection isbest here this web session willbe available tomorrow foryour use. Thank you for joiningthis event and please note thatwe do our best to ensure you havea good experience.These give us your feedback and suggestions for other future topics.Is now my pleasure to introduceourspeaker, Diane who has been workingat a speech language pathologistfor over 35 years. She is-- she is employed at the Westernschool for blind Tiltonin Pittsburgh and she specializesinteaching communication strategiesto children withvision impairment, multiple disabilities,and dual sensory impairment. WelcometoPerkins, and .
I think you are muted. Beforeyougo few -- further, can you checkyourmicrophone?
Onesecond, everybody.
Can you hear me, Robin?
That's the stress I don't need.I'm excited to be sharing this informationwith everyone and to be collaboratingwith Perkins. Today we are goingto be presenting, I will be presentingthis 1st half on communicationand vision. When worlds collide.The reason for that titleis whenever children have complexcommunication needs and theyhave additional vision impairmentor blindness ontop of it it makes the developmentof June occasion strategies inparticular simple systems for thosekids all the more challengingin something that we have to lookat closely as a team when we'reworking here at the school. Whatwe will be covering today on ournext slide, Robin, we willbecaught -- talking about p re-symbolicand symbolic communication and spendinga lot of timeon that. We are looking at assessingcommunication children -- skillsof children withvisual impairment and otherdisabilities, decision-making andthenmy colleagues will talk about developinggoalsin designing instructional programsonce we make important decisionsaround programming our studentsand teaching them --communication skills.
For our next slide it will behelpful for me to know who I amtalking towork I see we have people from allover the country. It is excitingbut unnerving. But good. If youcan tell me what you do it willbe helpful for me to see exactlywho my audiences and if you willtake a minute todo that, I will go ahead and startthe next slide and talkabout that as the next slide iscoming in.
Robin, I still have the screenovermy poll -- there we go.
We are going to talk about justcommunication because that is whatwe are going to be dealing withtoday. I think a lot of timespeople confuse communication andlanguage. I want to emphasize thatwe are really talking about allforms ofcommunication. The kinds of lowincidence population that we areworking with that the school andI will assume since you are interestedin this webinar you are also workingwith the similar population. Communication is always in language. Languageand speech does not alwayscomprise communication. We are goingto be looking at all thesubtle forms that communicationtakes, both non-symbolicand symbolic. As we are talkingtoday and the focus is going tobe on how to recognize and facilitatethose skills to the stentpossible. Sometimes that leads tolanguage, sometimes it leads tospeech whenever we are usingvoice devices but today we're going to be emphasizing communicationatall levels.
Next slide is going to talk aboutaquote from Phil [ indiscernible] whoI had the opportunity to mentorwith. About five or six years agohe helped us establisha blind deaf classroomhere it was designed around usingthe communication matrix and wedeveloped appreciation ofwhat this quote means. Communicationis not --is not just about the means ofexpression. Too often we set thefocus of intervention place on somesymbolic form without considerationfor the child understanding of thepurposeof communication.
We spent and we are going tospend a lot oftime on those subtle forms of communicationandhow those really serve the underpinningsfor developingsymbolic communication. I reallywant to emphasize that I hope thatwant to emphasize that I hopeeveryone is willing to jump on boardand understand that you have toteach those schools --skills. For our students it is notsomething that they always havethe -- people like bellsand whistles and technology butwe are going to spend a lot of timeon the underpinnings.
The next slide looks at Dr. VanDyke when he talks about childrenwithsensory impairments -- impairmentsestablishthese connections at a pre-symbolic level, bonding, social interaction,and gauge meantare all elements that we have toconsider prior to introducing symbolicmodes of expression forour children.
The next slide emphasizesthis visually. As Isaid earlier, we live as cliniciansand educators and we live in a techsavvy world we tend to get caughtin the trap ofmore isthat her. More isn't always betterif you don't havethese under ---- moreis better. More isn't always better.Our students are at a higher riskbecause theydon't move they don't seeand theycan't hear as well as other childrenthat helps to establish those bondsand thosepre=linguistic interactions thatreally is what moves you to thenext slide which is honest and anyonelanguage medication, it in yourmet, understanding and interactingwith friends, peers,parents, everyone you need to. Let'stakea look.
I called these foundational communicationskills. They really are cognitiveand receptivelanguage skills that when I am doingmy assessment with children andwhen I am working withmy team we really have to look atall of these things before we talkabout where we are going to takethem symbolically. Let's take afew minutes and talk about the importanceof these skills.
When we are talking about causalitywe are really talking about notjust cost affectif ice press a switch the toy willgo one.If I hit this busy barracksdocs-- busy box something will happen.Those are importantthings butas a speech language pathologistI look at the progressionof causality and the levels of causalitybecause eventually using foundno impact momor dad, it will gain attention,you'll know that a child is interestedin something when they use theirvoice or word approximation andcost affect at its highest developmentbecomes an executive function ofproblem solving, understanding thatif I pulled that cat tail it isgoing to turnaround and scratch me. If Iget this chair here I can get upand get the cookies I wanted. Itends up beinga cause effect in terms of makingsocial connections influencing peopleand things in your environment.The next bullet isobjectpermanence. Object permanence ischildren with visual impairmentshave. It is a challenge for themdepending on the extentof their loss and if they have totalblindness. Object permanenceis important in the terms of whatI do becausewhen children understand somethingis out of sight hecan still ask for it. This is alot of timeI teach. Sometimes we hide or partiallyhide things. Sometimes I think behaviorthat we speculate mightbe trying to develop cause affectif they throw things and they hearwhere it lands and where mighthave gone and we bring that thingback to the child's. Of course wedon't want that -- the kids throwingthings everywhere but it's not anunusual behavior thatwe see and we understand it mightbe a way that child is trying toget a better understanding of theirworld and where things go and howthey can get them back. Ithink when you're talking aboutobject permanence, that can alsoprogressto making associations about signsand know that thingsare happening. The child at home,if the parents tellme they hear the garage door openingthey know daddy is home. They hearthe microwave going and they knowthe bottle is coming upbehind that. Those are allthekind of associations that Tommythat itemthat person isn't in that child'simmediate space but theyare able to understand it will bethere eventually so it is animportant skill.Joint attention is simply definedas two people focused on an entity,shared attention, you'dshall regard. It is that intensifiedshared attention onsomething, a toy, and itto be, another person or childin theroom and right on the heelsof that we are talking about ChayaNick gavewhich is something lastyear -- triadic gays and that simplyas I can look at you and look atsomething and look back at it andyou look back at me and we knowthat that has completed thatinteractive loop and it is simplyusing I gaze. We will talk laterabout the variations invisual skills and one that is doableand one that isn't. When you canteachit and it doesn't mean they can'thave joint attention butwhen possible we try to get thathappening as well. Turn taking isanother early skillthat I try to include into all ofmy activities with my students.They are really the early conversationsthat children have throughplay. It could be focal play, itcould be taking turns with singingfingerplay songs, it could be usinga step-by-step to have partial songsand messages taking it backand forth turned. The idea is Ido something then I listen, youdo somethingand then you listened.It really is where that very earlyreciprocity takes place in whatshould you need for communicationtooccur symbolically at a later time.
Communicative intentis the foundational skill that Itake a look at and it probably isthe mostimportant one. There are three hardmarkers that I'd like to considerwhenever I am looking at communicativeintent. First is that the childis waitingfor adult attention -- attentionand taking it out. If theydo not get it they will persistuntil they get it and if they donot get it they have analternative plan toget it. That's why we think sometimesthe behavior starts to escalateand the child is starting -- tryingto tell us something using a subtleform of communication. If we don'tpay attention plan B kicks in andit tell us the children whoare non-verbal often have communicativeintent and that it's critical forthe development of symbolic language.Ournext slide takes a quick lookat it and I will let youguys take a look at it issomething that Poland andPhilip Schweigert did back in2000 and it shows children thatare pre-communicative are goingtoneed enticing to moveinto the realm of intentional communication.You'll see that when you look atthe slide all of the children whohavehad some kind of p re-intentionalcommunication in place went on todevelopsymbolic communication. I won'tspend a lot of time there but itis veryrelevant to what we are talkingabout today.
We are going to look at modesof communication and I have thesebroken down into aided andon needed. Atthe simplest terms areof neededis anything that you don't needan outside object or picturefor. That would be facial expression,localization or speech, wordapproximation, body movements,body language, gestures, sign language,I gaze, all of those things areconsidered on aided modesof expression. Aidedcommunication includes things likeobjects, will a child take thisand give it to you and say I needsomewater. Will a child use a partialobject that perhaps we know thatunderstand that a straw needsa drink and we will have just astraw onsomething. Do they understand pictures?Photographs,line growing, symbols, what do theyunderstand about pictures? Speechgenerating device is, everythingfrom thesingle message big Macs to stepbysteps to midrange communicationneeds to height tech devicesthat havedynamic display. IPads, leisuredevices, we might get a chance totalk about that later. I am biasedas a speech language pathologist,I like dedicated communication systemsbut I think that the home of thediscussion that we won't get intotoday that iPad certainly-- wedo use prole acute twoand we do have those things hereas an option for many ofour students. Thereare many dedicated systems and onesthat can serveasboth.
When we lookat our next slide which is communicativefunctions work our pictures showthat I can protest something, Icould try to get your attention,I can reach a point that I needto make choices and of course Ialways wantto socially interact with peersand friends and my family therethat really is the communicativefunctions that all those modes ofexpressiontake on. In their more sophisticatedforms they also serve togain information,not many of thestudents on my caseload currentlyare able to ask questionsor even at the point where I canmove themthere. However, that is certainlysomething later downthe road. There are students atour school who usethe high-tech devices and useiPads communicatively and they areable to go ahead and ask questionsto gain information. They correspondemotionally and develop relationshipsas they gain skills.
We are going to start some --talking about the levelsof communication and I think whatwe are going to do is go througheach one. This is my favorite partbecause I get you to-- I get to introduce you to someof the students I work with. Wewill startwith pre-symbolic and we will moveonto symbolic. The thing Iwant you to notice as we are lookingat the videos is that sometimesthe levels are purefor lack of a better wordbut not so often. Almost allof the kids I work with splintersthrough. They splinters throughintentional medicationsome concrete symbols, if they'retired to go back to intentionalbehaviors, so it's kind of itendemic fluid process dependingon how the child is feeling, whatthey are able todo that day. I kind of see themshift. To the best that I was ableto I wanted to -- show some videosof students who are working on thesevarious levels. I do not have avideo of any children working ata reflexive level, those typicallyof the students at our school whowe consider bio-behavioralstate childrenthat our intervention with themis to raise their level of alertnessand increase their state of arousalor ash arousal's we can start introducingand doing things thatmove them towards more intentionalkinds ofbehavior. I don't have any of thosekinds of behaviors -- any of thosekinds of children but fromhere on and I have video to sharewith you.
Intentional behavior, the childis currently working on things andworking on people but they are notdoing it intentionally tobe communicative. These are kidsthat will acton the bubbles, theywill touch bubbles they will nothand me the bubbles and say I needthose. They arekind of in rudimentary kinds ofplay activities that is justvery cause-and-effect am hittingon things andpulling strings, beads, playingwith bead toys, that kind of thingso that you know that they are interestedin them and they might lean towardsthem but there reallynot doing any of the shared mutualregard attention types of behaviorthat we want that wouldmake it communicative.
Let's take a look at Alayna.Alayna is the first video we willlook at. This is going to be a fewseconds of Alayna. We havesome of our favoriteso I'm justgoing to keep talking.We have a lot of toys. Sheloves bubbles and beads but as youcan see herplay with them is not creative.She is not tied to make a necklaceout of it or putting it on her wristare anything like that.That little strip container in frontof her as atoy that I made that I put toysin that she can pull them out soit works on partially hidden objectsand because she likes beads theymake sound when it comes out. Youcan see there is herfavoritetoys, opals. She's not looking atme and I'm looking directly acrossfrom her.She really isn't making a lot ofconnection and terms of what todo with that.
The next video is Alayna againand it will be me interveningwith her, not intervening butdoing some into venture and picksome we know she likes those bubblesand I'm goingto see if I can get her to givethemto me.
If you give them to me I canhelp youwith bubbles.
I purposely bring them up tomy eyes because I want her to understandthat I'm thecommunicative partner usingan object that she Billy, really likes.
Or body language istelling me I love this, this isso much fun and she's looking forthe bubblesthat popped.
Alayna, should I get more? Okay.I will get more. So yousaw her touchthe bubbles. What I want her todo is touch the bubbles and lookat me. She's at the point that justtouching the bubbles isn't whereI want her togo. I want her to understand theneed fora partner.
Her body language is tellingme I am donewith bubbles .
Are you done withthe bubbles? Yes, lady. My backis to you and I am done withthe bubbles.
She was not going to pick somethingnew to play with and she was goingtocompletely turn away. She is a briefattention span atthis point. That is my responsibilityto beat her cues into move on andgive her a new toy.