Sessions 8 Reading

The Foundations of Communication: First Steps
By Linda Lyle

I. Introduction

A. The capacity to communicate is inborn.

B. The skills one needs in order to communicate are learned.

1. Children learn these skills through observation, early game playing, and building relationships with parents and siblings that create a hunger for communication.

2. Much of this learning is incidental, or not directly taught.

C. For children who have deaf-blindness, these skills are not automatically developed. There are many reasons for this.

1. Early life threatening and painful experiences in the hospital create early impressions of the world as a scary place. They may choose to withdraw as a way of protecting themselves.

2. Children, struggling to survive, have little energy to expend in exploring and discovering the joys of relationships.

3. Parental fears and anxieties can prevent parents from responding appropriately to their children.

4. Children with deaf-blindness may fail to respond to their parents or may respond weakly or unpredictably which stops the communication dance.

5. The child's absence of eye contact may give the impression that the child is not connecting to his or her parent(s) resulting in parental responses that include less interaction.

6. One of the primary reasons children with deaf-blindness do not respond to early communication attempts is that they are simply unaware of them, and if aware, unable to make meaning out of them.

7. If a student is unable to tell whether or not someone is present or absent, they may not develop a sense of either connectiveness or separation.

D. By the time the child with a dual sensory impairment has reached your classroom, it is possible that he or she may have either developed some uncomfortable patterns of communication (such as head banging, biting, throwing objects) or has given up and developed what is called learned passivity.

E. These learned behaviors as well as the failure to develop a consistent means of communicating
inhibit ongoing growth and development in a student. To counteract these, specific, consistent instruction
can be used to help a student develop communication, to communicate more effectively, and to reduce
passivity and indifference to the learning environment.

II. Responsive environments

There is a significant difference between a stimulating environment and a responsive environment. Responsive environments are developed by:

1. Attachment

                 a. Signs of attachment:

1. smiles,

2. cries appropriately and stops when comforted,

3. makes eye contact,

4. differentiates people from objects in the environment,

5. vocalizes, clings.

b. Think about the signs of attachment or lack of attachment in your child or student.

c. Importance of attachment in communication:

1. Communication occurs between two partners. In order to desire to communicate, one must feel a connection to another.

2. Ongoing communication requires the development of trust: ex: "my needs will be met; if I cry, she'll come to me; I am safe; I belong; etc."

d. Strategies to facilitate the development of attachment within the classroom setting:

1. Ask those who are familiar wit the student to identify his or her responses to familiar and unfamiliar people.

2. Provide consistent, predictable contact in order to help the student learn to predict accurately what is about to happen. (Ex: provide information at times of transition at a level the student can understand; always identify yourself to the student in ways he or she can understand; etc.)

3. Respect the student's need to feel safe. (Ex: children who have been traumatized, may need to move about in their space in order to feel safe while others may need small spaces in which they can enclose themselves.)

4. Learn specific ways to move and position non-ambulatory students that make them feel safe.

5. Respond quickly to any type of communication that occurs; any type of response a student makes in the environment, in order to help the student understand that his or her behavior produces results. (cause/effect behavior)

6. Give plenty of attention. Include smiling, talking, touching, etc.
   

7. Engage the student's attention by mirroring movements of the student. (Ex: If the child is waving his arms, waving your arms in tandem will frequently catch the student's attention (orienting reflex). When the student has give you his attention, you can turn the movement into a wave "hello.")

8. Respond to any sound the student makes:

   • Again, it lets the student know that his or her behavior changes things (cause/effect behavior); and

   • Responding to random vocalizations by repeating the same sound, then letting the child make that sound creates a back and forth dialogue called turn-taking.

9. A technique call resonance was coined by Dr. Jan van Dijk and is used as a way to initiate early attachment behaviors in the student with deaf-blindness. The techniques of resonance are as follows:

   • The teacher positions the student in a way that offers close physical contact and provides a strong sense of both support and security.

   • Movement patterns called "chains" are then used to create "conversations" or interactions involving turn-taking.

   • Use familiar movements such as rocking and clapping to encourage unison movement.

   • As the child accommodates to this close contact and movement, he or she begins to signal that the movement continue. This is called requesting continuance.

   • For example, move back and forth in the rocking movement with the student. Stop and wait for any kind of response that might be telling you the child wants you to continue.

   • Allow enough time for a response for some students take longer to understand what is expected and may need many repetitions.

   • Some student seem to resist shared movement. In that case, try again later for shorter periods.

   • Establishing a student's trust is vital and trust cannot be developed if a student is resisting.

   • When the student is consistently indicating a desire to move again with you, pair the movement with a sign or another signal that means "start."

   • If your child or student is young, these motor patterns can be played using typical children's songs and hand motions such as "pat a cake" or eensie, weensie, spider." The older student might enjoy dancing or upper trunk or arm swaying using age appropriate music.

   • Another component of resonance is to introduce a related object to let the student know what is about to happen. A shaker can give information about the start of a music or motor game; a spoon can mean "it's time for lunch."

10. Another technique that frequently helps build attachment is called coactive movement.

    • At this level, the motor movements developed with the child are put together to form "chains" of movement.

    • Chains may be of different degrees of difficulty.

    • They can be used to teach daily activities.

    • In coactive movement, teacher and student or parent and child move together through an activity. As the child or student becomes accomplished at the movement sequences, the teacher or parent distances himself or herself from the child and permits the child to perform the activity with increasing independence.

    • At the independent level, the student can imitate the motor activity and can perform it without assistance.

    • This can be used in games such as "row, row, row your boat" or for activities such as teeth brushing or putting on a coat.

11. One technique that has proved highly successful with moving coactively with a student is called hand under hand assistance.

    • In this activity, the student is invited to place his or her hand on top of the teacher's or parent's hand and together, they move through the activity.

    • The strengths of this type of movement over hand over hand assistance is this: the hand on top has the power to control the activity. If the student's hand is on top, he or she may say "No more, not so fast, etc. by moving his or her hand away." This position is very empowering for the child who has deaf-blindness and is unsure what reaching out in space will result in.

2. A student's ability or inability to handle a variety of sensory information:

a. Students with dual sensory impairments may have difficulty regulating their own responses to environmental stimulation.

b. Some may have extremely high or low thresholds which impact their response to their world.

c. Strategies

1. Ask those familiar with student to identify the student's preferences for different types of sensory stimulation.

2. Make a list of all of the things you discover that calm this student.

3. Use optimal positioning and handling techniques to avoid triggering adverse responses. (Working with motor therapists in this area is extremely helpful.)

4. Experiment to find out which type of sensory experience is positive in each of the follwoing categories:

   • touch: light, firm, how, when, etc.

   • movement: swinging, spinning, rocking, slow, fast, variable, how much, etc.

   • positions: What positions help the student be more alert? Relax? How much support

3. The temperament of the child or student.

a. Everyone has a specific temperament that helps determine their response to their environment. This is true of students with deaf-blindness as well. Learning about your child's or student's temperament and then tailoring sensory and learning experiences to match the temperament of your child or student can increase the chances of response.

b. Temperaments

1. Easy: have predictable patterns of eating, sleeping, etc.; can tolerate change without falling apart; have mild reactions and pleasant moods.

2. Slow-to-warm: low to moderate activity levels, vary in regularity of physical needs, slowly accept changes and initially withdraw from new and unfamiliar experiences; need prompting to respond to changes.

3. Difficult: irregular physical needs, slowly accept the new or unfamiliar, have unpleasant moods and intense reactions; sometimes called "challenging."

c. Temperaments of teachers and students combine to create the climate of the classroom and may or may not be a good fit. (Ex: an enthusiastic, energetic teacher may frighten a placid, subdued student)

d. It is easier for a teacher to adjust his or her own behavior to fit the temperament of his or her student than it is for the student to change. The teacher has more skills.

e. Strategies: The following are a list of considerations when thinking about your student's temperament. Making changes in the classroom that reflects the student's needs in one or more of these areas can create a more responsive environment for your unique student.

1. Activity level or amount of motor activity

2. Rhythmicity or regularity of physical needs

3. Distractibility from ongoing activity

4. Approach or withdrawal response

5. Adaptability to changes in the routine

6. Attention span and persistence in an activity

7. Intensity of reaction

8. Threshold of responsiveness to stimulation

9. Quality of mood or general disposition

III. Program development

a. Gathering information about your child or student

1. Review information with others who also serve this child or student.

2. Be aware of the conditions that help this child or student to be most responsive.

b. Adapt your own interactions with the child or student to suit his or her needs and preferences.

c. Use the above strategies to develop program plans.

D. Refer to the Child Demographics where you gathered information about your child or student in Session 4.

E. Other considerations:

1. Organize the room to encourage movement, exploration, and involvement in activities.

2. Orient student to physical environment initially and gain each time the room is re-arranged.

3. Use objects that encourage two individuals to use.

4. Directly teach interaction with peers.

5. Facilitate active participation in all activities.

6. Increase the amount of time for the child or student with deaf-blindness to process information.

7. Adapt activities so child or student can understand. Example, provide real objects for the student to handle when talking about the cooking project; provide appropriate hands on objects when telling a story, etc.

8. Model good interaction and communication strategies.

9. Provide opportunities for problem solving, asking for help, etc.

4. Classroom environments that promote communication

Responsive classrooms include the following:

1. Consistent and predictable exchanges between student and teacher.
   

2. Identify yourself in the same way to your child or student before every exchange. Do not assume they will recognize your voice or your face. Consider using physical contact in your greeting.
   

3. Clear information provided to each student at his or her level at all times of transition.
   

4. Interpretation of a child's or student's behavior as a signal of communication. Develop list of all signals child is known to use and what they mean.
   

5. Predictable patterns help build communication skills because students learn to predict "what comes next."
   

6. Engaging students using sensory cues. Engaging is not enough. When the student is engaged, information must be given so that learning occurs.
   

7. Developing routines for daily living tasks, cognitive skill building tasks, relaxation routines.
   

8. Consistent cues used by all adults who are a part of the student's team will encourage a more rapid assimilation of communication skill by the student. Develop list for team of all cues used.
   

9. Use gestures that have specific meaning. "I am going to reposition you" can be said and combined with a touch to the rib cage at the arm pits where the student is typically lifted." A pause after the touch cue can give the student an opportunity to organize a response (perhaps pull the trunk forward as a way of saying "I'm ready.")
   

10. Create multiple opportunities throughout the day for turn taking by pausing and waiting for a response.
    

11. Imitate a student's sounds or actions and then add a little more.
    

12. Provide opportunities for choice making.
    

13. Use touch cues and real objects to give student information. How do you let your student know what is about to happen? Make a list of touch cues that you can try with your child or student around your home or classroom routines. Remember, cues and sign work when they are:

    • Useful: there are frequent opportunities for their use.

    • Motivating: they relate to the child's or student's interests.

    • Easy to use: available quickly, easy for the child or student to form the sign; touch the child's or student's body in some way - tap on hand, shoulder or cheek.

    • Easy to understand: look like what they represent.