Meaningful Moves Toward Independence An expert shared ways to foster literacy in preschoolers with severe and multiple disabilities during a recent ASHA online conference chat. Overheard
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Overheard  |   February 01, 2017
Meaningful Moves Toward Independence
Author Notes
  • Bill T. Ogletree, PhD, CCC-SLP, is a professor and head of the department of communication sciences and disorders at Western Carolina University. His professional interests include the communication abilities and needs of persons with severe disabilities, including autism spectrum disorder, as well as interprofessional education and interprofessional collaborative practice. Ogletree is an affiliate of ASHA Special Interest Group 12, Augmentative and Alternative Communication. ogletree@email.wcu.edu
    Bill T. Ogletree, PhD, CCC-SLP, is a professor and head of the department of communication sciences and disorders at Western Carolina University. His professional interests include the communication abilities and needs of persons with severe disabilities, including autism spectrum disorder, as well as interprofessional education and interprofessional collaborative practice. Ogletree is an affiliate of ASHA Special Interest Group 12, Augmentative and Alternative Communication. ogletree@email.wcu.edu×
Article Information
Development / ASHA News & Member Stories / Normal Language Processing / Overheard
Overheard   |   February 01, 2017
Meaningful Moves Toward Independence
The ASHA Leader, February 2017, Vol. 22, online only. doi:10.1044/leader.OV.22022017.np
The ASHA Leader, February 2017, Vol. 22, online only. doi:10.1044/leader.OV.22022017.np
Participant: Are there any strategies you suggest to try with a student who is blind or visually impaired to help with participation in literacy and writing?
Bill Ogletree: My personal experience has been to use manipulatives. I’m a big fan of repeated story book reading and the use of objects. They work really well with students who are visually impaired. I also like movement. It is really beyond the scope of what we can talk about today, but I love the use of movement in transition all through the day, which would include reading and writing.
Participant: Do you have ideas for working with preschoolers who are nonverbal with a short attention and emerging joint attention skills?
Ogletree: I think the key here is partial participation. You need to know what you need to assist with and what the student can do with independence. I’m a big fan of keeping things very attractive, real and relevant. Try to have expectations that do not exceed the student’s ability to attend.
Participant: When working with a preschool student with a cognitive level of 4–6 months and motor difficulties, what types of activities would you recommend to get the emerging literacy exposure that is meaningful but also developmentally appropriate? I struggle to find meaningful activities for a student I work with because she is so severely disabled and isn’t able to use a communication device at this point.
Ogletree: Exposure to meaningful interactions and experiences is key. As this relates to emergent literacy, you can try simple joint reading opportunities or maybe use the student’s gaze to do some co-construction in writing. Don’t try to decide if they “get it”—make sure you give them the opportunities.
Participant: I think this is difficult for all therapists because it is hard to come up with meaningful activities when a child is functioning at such a low level. Can you elaborate on meaningful activities when working with this population?
Ogletree: Let me suggest a little more help with movement. I am a big fan of the Van Dijk approach (www.drjanvandijk.org), which works regardless of functioning level. It introduces movement and helps providers look for meaningful responses. Let me also emphasize the importance of exposure to meaningful events and objects and consistent attribution of meaning to behaviors you see from children. This is how we all learned to communicate. Students with severe disabilities need this, too.

We can expect to have to assist our students with emergent literacy tasks to some degree. The goal is to move them to greater independence.

Participant: As you work with preschoolers with severe disabilities, have you found that picture symbols are an important consideration for each child? In other words, does the student deliver a more accurate response whether you are using cartoon-drawing icons versus true object-based pictures?
Ogletree: Remember that symbols all have degrees of iconicity. I am a believer that objects and photos are likely the best options with early efforts. That said, of course we are pairing things with print. I have friends at Georgia State University who believe for some it does not matter—that is, print holds the same value as, say, a line drawing. Janice Light at Pennsylvania State University has done some interesting work with looking at how kids differ from adults in their perceptions of symbols.
Participant: Although I am not working with this population currently, I have struggled in the past with judging how much partner participation is the specialist and how much is the student. Can you touch on the use of partner participation, especially in terms of goals and IEPs and how to judge how much the student is doing?
Ogletree: Partner participation, or “partial participation” as some call it, is a critical concept. If I were to tell you that you had to perform a new skill with little practice, you might need help. That is, we do not expect independence all at once. That is what we are talking about. We can expect to have to assist our students with emergent literacy tasks to some degree. The goal is to move them to greater independence. As for how we talk about this with goals and performance, just be honest. Write your goals with steps toward independence identified, and record performance in the same way. This will allow for the greatest degree of student participation in literacy and other tasks.
Participant: When you have a student who cannot consistently access their device, how do you keep track of their participation? Sometimes they randomly hit the joystick or button.
Ogletree: This is an issue for almost everyone I know. I think you first want to see if your access method is optimal. I have been around kids who we hoped could select with their hands, but they were inconsistent. For them, eye gaze was better. I think you also want to do the best you can to support participation as their partner. Record what you do and consistently try to pull away so that the student shows more independence.

Record what you do and consistently try to pull away so that the student shows more independence.

Participant: What is the best reading activity for a small group of students?
Ogletree: It depends on the skill levels of the participants. You basically have two solid options: One would be shared reading. This is pretty simple; you are reading and providing opportunities for repeated line and other responses often through AAC [augmentative and alternative communication]. I think this is likely your best bet. You can also do independent reading—think exposure here. Many of you may be saying, “My students can’t read independently.” That said, they can have print and print concepts all around them in the classroom or home. That is up to you.
Participant: I’m all for interprofessional practice [IPP]. In my school, the preschool, kindergarten and first-grade teachers have a weekly one-hour planning time for each grade level. This is ideal, and I would like to see this extended to our specialists so they can plan consistently. Thoughts?
Ogletree: Patricia, you’re fortunate. Most schools do not have that much planning time. How do we promote it? I think the more we can highlight the successes that come from integrated planning, the more it will sell itself. Try to put together some public offering of school successes in IPP—maybe a newsletter for the classroom. My bet is that success will breed success.
Participant: Could you share a success story that indicates how high a level these kids can achieve?
Ogletree: I have seen a few kids that would be written off by almost anyone—severely physically involved and apparently not together cognitively. Over time several of these guys have learned simple things like identifying the first letter of their name through gaze and co-writing. This made everyone realize the person they could be. That is enough for me.
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February 2017
Volume 22, Issue 2