Where Do We Begin?
Miranda could not speak and could not walk without the use of an assistive device. She could grasp items and hold them but had great difficulty with writing because her elbows and wrists did not move in a way to allow her to place her hands flat on a table or grasp items. She is a child with an undiagnosed neurological disorder resulting in a variety of issues that make it difficult for her to access curriculum in the routine manner. Miranda could be characterized as a â€œmiracle baby.â€
â€œMiracle babiesâ€ are born every day to families waiting with loving, open arms to embrace the â€œperfect child.â€ Medical technology has made it possible for babies to be born as early as during the fifth- or sixth-month of gestation, and these premature babies characteristically experience developmental delays and physical disabilities that range from mild, to severe, or profound. These babies are taken to Infant Stimulation programs as early as possible and subsequently are referred to Early Childhood Special Education programs. The two- to five-year-old children in these programs are often eager to learn but have had little social experience beyond the home or medical environment. How does our team, consisting of a classroom teacher, a speech therapist, and a computer resource teacher begin to work with students, like Miranda, with disabilities ranging from mild to severe?
In these situations our team must ask some very basic questions. In Mirandaâ€™s case, such questions would be â€œWhere do we begin?â€ â€œHow do we know what Miranda understands?â€ â€œHow do we know what she is thinking?â€ â€œWhere are the opportunities for her to express her ideas, questions, and creativity?â€
It was obvious that Miranda had many needs. The team approached Miranda as we would any student with disabilities, one issue at a time. Our hope in writing this article is to encourage colleagues who work on a daily basis with these students to consider using technology as a pivotal part of the curriculum.
Why Even Consider the Use of Technology?
It has been our experience that integrating technology into curriculum enables students who otherwise could not be reached to make progress toward educational goals. In classrooms that serve students with disabilities, technology provides access to the curriculum. Access to the curriculum is the focus, and technology is the means to that end. When viewed this way, the use of technological devices is not simply a frill that entices students like Miranda into participation; it is a basic need.
Creating activities that use technology may appear daunting at first. After spending time on the first few activities using a specific piece of software, the learning curve will flatten and you will spend less time on subsequent activities. Furthermore, the success of the activities will serve to inspire teachers to create more and more activities that invite full participation from students. Spending hours making costumes and manipulatives, home made access devices, and other such instructional materials to motivate students may not evoke the joy in teachers that computer generated activities command, but, by spending the same amount of time moving methodically through available software and customizing a wide variety of language-based and math-based activities, you will achieve the desired educational outcomes. Access to the curriculum made possible by these technological tools provides opportunities for students with disabilities to successfully complete SOL objectives. Our successful experiences with using technology with disabled students persuades us that it is essential that teachers consider its use whenever possible.
Iâ€™m Hooked! Where Do I Go From Here?
Perhaps teachers might think that incorporating technological devices into the daily routine and curriculum could be overwhelming. However, once a teacher is â€œhookedâ€ by the ease with which lesson plans can be developed using technology, it becomes a joy. The use of the computer is rarely problematic, nor are most of the augmentative devices available on the market today. It is more often the software that causes problems and questions.
Over the years, we have learned one piece of software after another (i.e. Speaking Dynamically ProÂ®, BoardmakerÂ®, IntellipicsÂ®, and Intellitalk IIÂ®). If someone had told us five years ago that we would be using a variety of software on a daily basis, we would have laughed. In actuality, our learning curve started out slowly. The speed with which our team can now create programs has increased tremendously to the point that â€œboards,â€ brief-sequencing activities and functional picture clues, are sometimes developed on a laptop computer â€œon the spotâ€ as they are needed. (See Figure 1.) We prefer to create these accommodations as lesson plans are created; however, there are those moments when we realize that if we had that one simple board or activity, we could reach this student immediately. The software not only serves the purpose of increasing communication options, but it develops language skills as well.
The Use of Technology Simply Overwhelms Me!
Reviewing Mirandaâ€™s needs could have been overwhelming, but we started with Miranda exactly where we begin with every child who is new to the learning environment. Our efforts included learning about what made her happy, what made her sad, and what appeared to best motivate her in a variety of learning environments. In Mirandaâ€™s case, weaving technology into the curriculum took place naturally as her specific needs became evident.
Miranda came to us using a â€œclock scanningâ€ device, which is also called an â€œAll-Turn-It Spinnerâ€ from Ablenetâ„¢. (See Figure 2.) Miranda used a paddle switch to move an arm around the dial to the preferred response, then she released the paddle. That served her well as long as the options and numbers were limited. The question was, what will happen when her vocabulary expands and her sentence structures move beyond two word utterances? As time progressed, we saw signs that Mirandaâ€™s language skills were developing and her desire to communicate was evident despite her limited physical abilities and lack of speech.
The concern was transitioning Miranda from using the â€œAll-Turn-It-Spinnerâ€ to the device that required her to hold down the switch until the correct response was highlighted on a computer. This functional switch in accessing responses is a monumental transition for many students. Miranda made the transition and began using a laptop computer to scan options until the desired item appeared. We slightly modified the laptop computer to include the use of a paddle switch instead of the mouse so that Miranda could select answers as they were scanned on the screen. (See Figure 3.) At this point we were able to get a better picture of what Mirandaâ€™s comprehension skills were and what information she was receiving and retaining.
Miranda came to us knowing how to use a device, called â€œStep-By-Step,â€ that records simple phrases for the student. As an example, during music class, simple refrains to songs were placed on the device so that Miranda could â€œsingâ€ the repetitive verses with the rest of the students. Short responses such as â€œyes,â€ â€œno,â€ and â€œhelp pleaseâ€ were placed on the device and made available to her at all times so that she could have basic wants and needs met immediately without someone bringing up a page on her laptop. (See Figure 4.)
During guided reading lessons, each page of the book was placed in sequence on the Step-by-Step device. Mirandaâ€™s book was placed on a slant board and â€œpage fluffersâ€ were used to thicken the corner of each page so that Miranda could turn each page and tap the device to read in sequence. It is interesting to note that at the end of the book, she not only closed the book to the back cover, but she also pushed the device aside indicating that she was finished. These are simple yet powerful tools of communication.
I Donâ€™t Have Any Special Software! What Now?
Although a wealth of outstanding software is available, not all of the software we use with special-needs students is special-needs-specific. Often we use standard software in non-standard ways to achieve our goals. Common software, like Microsoft OfficeÂ® can be used to reach special-needs students once teachers begin to think â€œoutside the box.â€ In one instance we wanted the students to scan the computer keyboard and match letters to pictures that appeared on the monitor. We used Microsoft ExcelÂ®, placed outlined cells under the graphics, and locked the worksheet. (See Figure 5.) By locking the worksheet, students were restricted from altering the cells other than those we specified. Each student was then able to come to the computer, type a matching response in the appropriate cell, tab to the next open cell, and continue until all cells were complete. When students were ready, we altered the document to include lower-case captions. Since Miranda did not possess the dexterity to select individual letters on the computer keyboard, we modified the activity for her so that she could scan potential letters and use a paddle to select appropriate responses when the teacher assistant placed the mouse over them. This proved to be a particularly successful lesson for us. (See Figure 6.)
Miranda required assistance in using the mouse, so we created several interactive Microsoft PowerPointÂ® documents in which the teacher assistant opened the file and asked her to click a paddle when the pointer was over a particular item on the screen. (See Figure 7.) By linking each slide to an appropriate response slide and/or sound file, we were able to encourage Miranda to scan the monitor and click to identify a number of different items, including pictures/names of classmates and seasonal pictures. The occupational therapist was particularly helpful with this project. She was able to make suggestions such as changing from a dark background to a lighter one to ensure that Miranda could see the page more clearly. This helped other students as well.
Sometimes, it is possible to easily customize software intended for mainstream students for use with special-needs students. One example of this is the way in which we easily adapted a lesson using The Graph ClubÂ©. The mainstream kindergarten classes were doing an activity in which students matched items in a pictograph by creating a matching bar graph. By changing one setting in the program, we were able to teach the same lesson but with only one item to match instead of the default value of four. (See Figure 8.) You can adapt standard or mainstream software to meet studentsâ€™ needs. Once the initial files are created, it is not a time-consuming task to update and further adapt them for a variety of new activities. It is no different from updating and adapting existing lesson plans to accommodate new situations. By keeping in mind the studentsâ€™ needs and the curriculum goals, the lessons we can create are limitless.
How Do We Integrate Technology Into the Daily Routine?
Critical to the success of weaving technology into the curriculum is the fact that ideas are implemented one at a time, one day at a time, and one unit at a time. Our initial interest in using technology started when we realized that we were serving several students who were pre-verbal or who had such poor articulation that speech was unintelligible. These students needed a simple way to communicate that would lessen frustration and encourage participation. We introduced augmentative communication devices during the functional times of day first, such as snack time, restroom time, and other daily living skill moments of the day.
The first device of this kind that we used with Miranda presented only two options. It is commonly referred to as a â€œCheap Talkâ€ device. (See Figure 9.) She basically touched a picture, and the device would verbalize the request. It was a great cause/effect activity that eventually had functional meaning to her.
Students who can speak are encouraged to repeat the verbal model and couple that verbal expression with sign language. We encourage them to communicate simple requests like â€œmore drink please,â€ â€œtoilet please,â€ etc. We couple the device with sign language. For many children who have the potential for speech, requiring the use of the device connected to the sign with a verbal approximation of the request results in total communication. Over time this proved to be highly successful in developing functional language for the child. From the start, the child is required to verbalize two word requests. The device never replaces verbal utterances; it is only there to enhance and provide an opportunity for basic needs to be met without frustration. In this case, the device serves multiple purposes. It eases the communication process and reinforces discrimination of correct sound and word production. This is a particularly vital skill for students who are experiencing significant speech disorders.
When the student relates with ease to a two-option device, we move the student to four-options, and then eight. There are devices that provide many options such as a â€œBlackhawkÂ©.â€ (See Figure10.) As the student becomes familiar with touching a pad or a paddle switch, we move him or her to scanning responses on laptop computers and larger computers with paddle switch activation in the classroom.
How Do I Move Beyond Functional Skills Using Technology?
It is never enough to rest on the success of seeing a student learn functional skills. There is always that moment when a teacher realizes that this is just the window opening to a host of educational opportunities.
In dealing with all the students in Mirandaâ€™s class, the team found that we were faced with a â€œmelting potâ€ of varying disorders (Downs Syndrome, Cerebral Palsy, Autism, Language and Communication Disorder, and children born prematurely). The speech therapist realized that we needed to provide more opportunities for our students and composed a number of nonsense rhymes that were placed on a software program called Intellitalk IIÂ® to meet the needs of this varied population. (See Figure 11.) This program provides picture clues, which are coupled with simple written language and auditory reinforcement. Once again, with the special expertise of one of our team, we addressed a vital pre-reading skill required for understanding where print is associated with verbal output. In addition, we reinforced sound play through rhyming, another necessary skill for successful reading skill development.
Given a sound basis in a variety of pre-reading skills, a student like Miranda is ready to attempt a kindergarten level curriculum. The kindergarten curriculum includes excellent literature as the basis of all unit work. Students are required to begin sight reading of high frequency words and to sequence stories; they must be able to tell a story with a beginning, middle, and end. With many of the topic books, we created at least one sequencing activity using a software program called IntellipicsÂ©. When that sequencing activity was used in the classroom, we found that "on task" behavior was at 100 percent for each and every student in the learning environment. They were â€œgluedâ€ to the computer screen! The students were absolutely mesmerized by the activity and had up to 80 percent retention of the sequencing following participation in the activity. Miranda was able to access Intellitalk IIÂ© programs using a paddle switch connected to the main computer. She could select the item she thought should come first, second, third, and so on when it was highlighted and verbalized on the screen. This provided her with success oriented feedback and provided the teacher with the information necessary to assess her sequencing abilities. In addition, it provided Miranda an equal opportunity to retell a story.
Story sequencing activities often provide the threshold for opportunities to incorporate technological activities into the curriculum. Realizing this, we moved from sequencing activities related to the language arts curriculum to a large variety of activities introducing nouns and action verbs. We were able to use the computer activities to extend the curriculum and to encourage clarity in articulation. Functional movement activities were connected to verbs and prepositions, and a multitude of fine motor and cognitive objectives were connected to entire story lines. This provided the opportunity for students to tell stories with a beginning, a middle, and an end with ease.
At the same time that we were working on story sequencing, we needed to incorporate phonemic awareness. We decided to leave a blank for some of the rhyming words in the nursery rhymes. Then, we placed many of the nursery rhymes on the Intellitalk IIÂ© and IntellipicsÂ© software programs. This provided wonderful animation to familiar rhymes and encouraged verbal participation on the part of the students. They loved singing and saying the rhymes with the program. The speech therapist has subsequently taken some of what she initiated in the preschool classroom and provided the kindergarten classroom with lessons on the laptop computer that reinforce literacy skills at that level. These skills include beginning sound development, association of printed letter with an individual sound, and songs and stories connected to â€œthe letter of the week.â€
How Do Related Services Personnel Work With Technology?
When Miranda came into our lives, we could have panicked, resulting in grasping for just about anything that would help us through the day, but we did not. Teaching is not a solitary endeavor. We asked mentors, teachers, teammates, volunteers, and related services personnel to collaborate with our efforts in serving the needs of this student. We looked for input at every turn. We worked cohesively as a teaching team.
Sometimes this input comes to us from sources we hardly expect. â€œNurse Bobbieâ€ accompanies Miranda to school every day to ensure that health issues are addressed minute-to-minute. She is an outstanding professional resource in the classroom because, besides being a skilled nurse, she is a natural teacher. She has developed any number of accommodations for Miranda to provide access to activities and to extend learning opportunities of presented materials. Many students love to play Concentration, and for Miranda, any card game is of high interest. Nurse Bobbie created the idea of using small color cards to place on the back of the Concentration cards. Miranda could then decide which card she wanted to choose by scanning her choice using her laptop computer and a paddle switch. Once the two options were chosen, Miranda was asked whether or not her choices were the same or different. If they were the same, she could keep the cards. If the choices were different, they were turned over and the game proceeded to the next student. This simple accommodation made the difference between independent access to the game or reliance on others to continue to make decisions â€œforâ€ Miranda. Miranda loved the freedom and challenge of this Concentration game.
Certain activation ideas and creative access tools would not have been available without the expertise of our occupational therapist. It is easy to attach switch activation to the computer, but how does the classroom teacher make the switch accessible to the student? That is where the occupational therapist comes in. In one case, the occupational therapist made a small â€œstool-likeâ€ stand for one switch so that Miranda could access the switch from a sitting position on the floor. (Miranda was working on sitting independently as one of her physical therapy goals. We blended that goal into circle time academic goals and provided access to her switch.) We were able to integrate seven objectives from her Individual Educational Plan into a fifteen-minute block of time. Without the creative practicality of the occupational therapist, this access may not have been possible.
Outstanding volunteers in the local community provide faithful service to classrooms. Cynthia, a high school student volunteer, is an incredibly talented natural teacher who shares her compassion and joy with all students. Cynthia loved to create enjoyable activities for the students that highlighted the alphabet letter for the week. When we studied the letter â€œQ,â€ Cynthia took it as a personal challenge to find an activity that the students would enjoy and participate in fully. We played with â€œQâ€ words, and the word â€œQuestâ€ seemed to catch the studentsâ€™ interest. Then, Cynthia used the knowledge that earlier in the year the students enjoyed reading a book called Treasure Chest, connected it to the fact that we were studying positional words such as â€œon,â€ â€œoff,â€ â€œunder,â€ â€œover,â€ â€œaround,â€ â€œthrough,â€ etc., and created an activity using Microsoft PowerPointÂ® to combine all of these experiences into one.
First, she caught the studentâ€™s interest by inviting them to participate in her computer-generated lesson. Then, she created cards that led them on a quest to find a treasure. Each card read, â€œlook under table,â€ â€œlook on desk,â€ etc. The students would read the card and, based on their participation in the PowerPointÂ® activity, they were able to find the next clue card. Finally, when they actually found the treasure chest, it was filled with books that Cynthia had purchased from a dollar store for them to keep. The students were enthusiastic, and they loved the wonderful books they took home.
Every day of every school year, students with disabilities like Miranda may be unintentionally denied access to the curriculum. Teachers diligently work to facilitate life skill development but are frustrated when a student is unable to reach instructional goals. As a consequence, these students become observers of the curriculum with little opportunity to participate in it. It is a mistake to think that they cannot learn the same information as their less disabled peers because they are poor communicators. Students with disabilities are entitled to every opportunity teachers can create to learn academics. Many students, such as Miranda, can function and thrive in inclusion settings with technological assistance. More and more, professionals are consolidating efforts, collaborating, and creating dynamic teaching situations. By using technology effectively, the teacher is able to provide education for a broader spectrum of students with disabilities and reach greater numbers of students in need. The use of technology with students with disabilities is no longer a creative gesture but an imperative response to their educational development.