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Orientation and Mobility for Functional Programs

February 19, 2015 • sensorytravel

 

General Orientation and Mobility Recommendations for Functional Programs

(Note: This document was intended for all members of a student’s IEP Team. The pronouns are intentionally varied; “student” will be used at times and “child” will be used at others. Though it may appear that one section is intended for a parent and another for an education professional, all strategies can be implemented both in the home and the educational setting.)

Encourage Purposeful Movement:

Having times in the day that allow the student to practice moving independently will help them to develop skills that can be generalized to new areas and longer duration travel. Purposeful movement can be as simple as bringing a hand to a preferred toy that is next to or even on the body. When there are structures in place to support and encourage this movement at home and at school, the motivation to travel and begin moving with purpose will increase. Examples of establishing a supportive environment for purposeful movement include having a location for preferred toys that the student can access at any time and reliably find favored objects there. This strategy can be enhanced or extended by using tactile markers that show certain areas are “their” areas, such as marking a cubby and coat hook with a texture or small object that will help them to know where their own things are at school. The marker can also include a braille label so they begin develop the concept that braille is associated with names of things. Other places where it would be helpful to include “their” symbol or tactile marker are their chair, desk, door to their room at home, etc. With an expectation of predictability and control in the environment, the student is more likely to initiate travel on their own and also begin developing a sense of self-mastery and confidence for travel as they receive their own, earned reward when they reach their favored objects or destination of choice. This natural reinforcement perpetuates the motivation to move.

Another helpful strategy is to plan some “free exploration” time into the student’s day, just a brief period (e.g. 10 to 20 minutes) where they can practice navigating in the school and or home environment (even outdoors when the terrain and other conditions are safe for doing so). This gives an appropriate and educationally beneficial opportunity to satisfy and encourage curiosities they may have about their environments. If they become disoriented or find something unexpectedly, it becomes an excellent opportunity to develop problem solving skills. An example might be finding a hallway in the school that allows them to take a new route to class, or finding a library cart in the hallway and learning how to navigate around it safely. During this time, an adult is nearby to assist as necessary, but the student is deciding what to do and where to go, rather than the adult providing the agenda and directing their actions.

Developing Sensory Efficiency:

Encouraging the student to become aware of all of the sensory inputs they have the physical ability to attend to in the environment will help them begin nurturing the skills related to sensory efficiency. Remember to include tactile, auditory, kinesthetic, proprioceptive, olfactory, and if there is the ability to receive visual information, then vision as well.

One way to think of the difference between kinesthetic and proprioceptive is how you feel on a hill. When walking up or down a hill, you feel different muscles being used; and, if you are walking up the hill you certainly feel the additional strain and effort needed to ascend the hill. This muscle sensation is kinesthetic. This is a way to tell whether there is an elevation change on a path regardless of vision. Proprioceptive would be the sensation that you feel in your joints, such as in your ankle as you flex forward or backward to be upright while standing on a hill. The same sensation can be recognized while standing on a foam roll, or while leaning on the edge of a step or curb. These are not typically “taught” to children as most children have already recognized they are on a hill with their vision, it is considered incidental learning. When we take the time to deliberately draw attention to these other sensory inputs available to our children, we help them learn tools that they can use to access information about their environment at any time.

When teaching, we will often say “look at this” or “do you see how…”; these visual representations are often the way that adults learned and they convey the information they are teaching to students in the same manner. By thinking about the other senses available to our students we can help them to “visualize” their environments through these other, or additional sensory channels. It might be clapping hands in the gymnasium to hear the echo and then comparing the same clapping sound in the smaller and often more auditorily reflective bathroom; or, listening for the sound change while passing interconnecting hallways in a quiet main hallway. As adults likely learned about the world in a wholly different manner, it may take some additional thought and creativity to introduce sensory exercises, but the dividends returned in independence in the children is tremendous. Once they begin recognizing all the sources of information available to them and continue attending to the sensory information, their ability to visualize (visualized through a variety of sensory channels, such as sound waves that make a picture for sonar) their world continues to develop.

Here are some activity examples to practice:

  1. Localizing sounds, such as identifying the location of dropped object or pointing at a person who is walking and following the sound of their steps. 

  2. Aligning with sounds

  3. Walking toward, away from sounds

  4. Walking around sounds to circumnavigate something

  5. Identifying patterns in sounds

  6. Using echoes and reflected sound (passive and active echolocation)

  7. Distinguishing sources of sounds, such as car, lawnmower, airplane

  8. Estimating distance of sound

  9. Estimating direction of sound; is it coming toward or going away from

  10. Understanding when one’s own ability to use sound is impacted by changes within the environment, or within one’s self

  11. Finding other sensory means to verify or confirm what is being received or interpreted through the auditory channel

Tactile could be touching different textures or temperatures. It might be a lesson in feeling the sun on the skin for maintaining alignment along a route and determining direction of travel by knowing the location of the sun.

Olfactory sense can aid orientation and connection with the environment to provide clues for what might be happening in the environment, such as smelling the aroma of a bakery, or recognizing a strong smelling dumpster that you have to walk past everyday in the parking lot as you approach the school.

Advancing Concepts:

Rough and smooth, inside and outside, more and less, fast and slow, these are all concepts that can be developed across educational settings and in the home. It is best to present these in natural settings wherever possible such as finding the rough brick next to the smooth glass in the hallway while transitioning to an activity. The more concepts that are developed and used in varied places and settings, the greater the power and connection of the concepts. Those that are originally introduced at a desk activity might later be used when matching textures of clothing, discerning landmarks, etc. 

Often concepts that would be learned through exploration by children who are visual learners must be taught more deliberately to students who are blind and visually impaired as they may not otherwise recognize learning opportunities that are in the environment. This might include feeling the glass windows and discussing the qualities of glass; it holds temperature and is hot in the summer and cold in the winter, it is very often smooth and hard yet is makes a different sound than either wood, metal, or plastic. Each of these materials can be explored, and new concepts related to their qualities introduced, compared, and contrasted.

Consistency in Learning Environments:

Regular repetition and having all Team members working on the same concepts and skills, with the same language for these, will facilitate the acquisition of the concepts and skills. Keeping the number of new concepts and skills to a minimum level that is represented and reinforced in multiple areas across settings (i.e. in the classroom, with each related service, and at home) keeps the new information at the center of attention and learning and allows for a maximal number of occurrences to connect the concepts with different situations and environments. The more the concepts are experienced the quicker the acquisition, and the more they are encouraged the stronger their resiliency and meaning.

Routines in the student’s day provide natural repetition and opportunities to learn new concepts and practice others that have already been introduced. Ensuring that the child has the same routine presentation will help them achieve increasing levels of independence within the activities of the routine; photographs with descriptions of the steps for the routine and its set up can be laminated and placed near the routine area so that whomever is working with the student will set it up the same way. This allows the student to focus on learning the routine itself and any concepts that are being deliberately included rather than having their attention distracted by differences in setup or preferences of the adult they are working with. 

An example for the early stages of purposeful movement is an activity mat or rug, where toys are placed in consistent locations (e.g. the musical toy always goes in one corner, the vibrating toy diagonal to the first, a plush toy in the third, and a squeeze toy in the final corner). With the toys being placed in consistent locations, regardless of the adult the student is working with, they will be more inclined to explore, as they will be able to predict where their favorites will be, and then successfully achieve getting what they want independently. These skills can then be generalized to larger areas, such as travel within the classroom, the school building, and ultimately the school area, including the outdoor recess area.

Value Sharing:

Interactive games and value sharing time where the student is met at their own place and level of interest is the best place to begin developing rapport. This rapport development is a foundation for later expansion of skills when students are presented with possible fear at learning new skills (e.g. entering loud environments, crossing streets, etc.) and can rely on the trust they have developed with the adult they are working with.

As adults we often forget to be truly listening to the student, especially when the child is non-verbal. We need to remember to join them in their moment whenever possible rather than starting by trying to coax them into the moment we would like them to be having. We are much more apt to get their “buy in” to the activity we are proposing for them to do if we have first met them where they are and shared what they are involved in. In this way, we are already connected and communicating before offering what we would like them to consider doing. 

Motivators and Communication:

Keep track of what is motivating and aversive to your child. These items or sensory experiences can then be used as “carrots” or motivators for other activities if they are positive motivators for your child; or, if they are aversive stimuli they can be helpful for demonstrating choice and conceptual understanding with preferences. This can be during a choice sequence with a calendar system, etc. to verify that an item that is expected to be viewed as aversive by the child will not be chosen, and a preferred item will be selected. Once these items are consistently communicated using the actual object, they can then be transitioned to a symbol or piece of the item, such as the chain from the swing to represent the activity of swinging. Eventually the symbol will become even more abstract, such as one link of the chain or even a raised line drawing, just as print and braille words are an abstraction of the physical and concrete things they represent. 

Once the child is demonstrating the ability to use symbols they can be used to communicate planned activities, make choices, and express preferences. They can also be used to create functional routines and reasons for practicing routes, such as going from the classroom to the playground to reach the swing, or visiting the office to deliver a daily attendance record as part of a job routine. These activities can then be reviewed with the symbols to “talk” and communicate about the experiences of the activity; this further develops concepts, literacy, and a sense of understanding and control within the environment as well as the social benefit of sharing about an event.

Experience is the best teacher:

Let safe accidents happen. We learn from mistakes and if we prevent a child from having accidents occur, we are depriving them of the opportunity to learn from the mistake or accident. If a child is walking on the playground and tumbles on the ground due to a change in elevation, they learn what it is to fall, they learn how to get up, and with enough occurrences they learn to shift their balance and prevent themselves from falling. It has to be lived, to be learned. Certainly there are some accidents that are beyond the scope of safety, such as the fall from the top of the swing set or stepping into a street with moving vehicles. These are indeed areas the adult should intervene. But, if an accident will not result in bodily harm it can be an opportunity for learning to occur. Sometimes we pre-teach a skill to a child, such as a protective technique that includes bringing the hand up and in front of the head to prevent bumping into a table when bending down; generally the skill is only truly acquired when the child bumps the table with their head and is able to make the connection within themselves that bringing the hand up before bending down could prevent the bump in the future. If as adults we always provide the prompt or cue to implement the protective technique for them to avoid bumping their head, we are interfering with the natural learning process. There are certainly times we have to help the child to process the event and connect the technique with the desired outcome, but eventually they must learn to self-initiate the technique for it to be effective and having the “safe” accident happen is truly the best teacher.

Celebrate the Successes:

There are many “milestones” that are printed in books but it is important to keep track of personal “milestones”. The first time your child rolls over and is able to get to a toy, it is a milestone. Reaching an arm out to touch something that draws their attention is a milestone; it warrants celebration and a note in a family journal. These celebrations of successes in life are at least twofold. They help us track the succession of accomplishments that your child has and they help us to see how far they have come. Sometimes, in the day to day challenges we forget how far we have come, how many challenges we have in fact overcome. The awareness of growth helps us to have confidence that we will continue to move toward greater levels of independence and to remember “the best is yet to come!”

CHRIS TABB
STATEWIDE ORIENTATION AND MOBILITY CONSULTANT