Mobility Expressive Communication
Creating adapted scanning routines for individuals with CVI or multiple disabilities
This article outlines how to create adapted scanning routines in Open Office (free, open source software) for choice making, expressive communication and conceptual measurement activities. The scanning routines are highly customizable down to the last detail and are ideal for complex adaptations such as making the visuals accessible for individuals who have Cortical Visual Impairment.
This is a very easy to set up introduction to scanning and uses free software, and basic, inexpensive hardware. It may also interest support teams who have tried scanning small picture symbols but found the individual had a hard time focusing on the selection items.
Open Office allows for full screen, moving (with video) selection elements that are clear and easy to connect conceptually to the real objects they represent. Give it a try and feel free to contact me with any questions.
Note that modern computers should be able to run the videos at full screen.
Transferable Contextual Signs (Case Study)
In one setting where I provided support, there was a young person who had severely limited mobility, little fine motor and a small amount of gross motor range in one arm. They were not able to use gaze reliably as a selection method due to their visual impairment and were not able to reach out or point. This person was able to reach anywhere from their face to their knees but only in one path of movement and each sign needed to be resting on their body for support. The individual could manipulate their fingers slightly to make a “k” and “b” hand shape or put out their index finger. I quickly found the number of possible locations that could be reached and the fatigue caused by making different hand shapes or reaching new areas limited us to about 13 adapted signs. These included some signs that were in the same location with a different hand shape. These potential locations and hand shapes were used up very quickly with vital care or emotionally important signs. We had about four sign spaces left and needed to get creative with what meaning to assign to these adapted signs. I wondered about how we could leverage these signs to increase the number of meanings. The individual learned to create four adapted signs that resembled the colour signs for red, pink, orange and blue. The individual was then able to use these signs across a variety of activities and environments to express a meaning greater than simply selecting colours. The staff could create context by assigning colours to objects, places or selections the individual could indicate. An example of creating context were the coloured boxes pictured on the left.
Identifying a choice from tangible symbols resting in four coloured boxes which allows for the selection of activities or anything linked to a symbol
Initiating a conversation with friends about an activity from the morning by indicating the colour from the choice box they had selected
Narrowing down desired objects or activities based on colours placed on the four walls of the classroom (e.g., indicating the swing by signing the colour of the wall it resided on)
Selecting activity partners by indicating the colour attached to that person's photo
Learning the cardinal directions and referring to them as red, pink, orange or blue allowing them to navigate the school and community with colour coded maps and compass (discussed below).
Identifying information during adapted lessons (such as identifying colour coded shapes by signing their colour or inserting a colour into a pattern)
Demonstrating comprehension and expressive communication opportunities when using experience books (discussed below) by attaching colours to elements of an activity (e.g., What size of measuring cup do we need, red, orange, blue or pink?)
This was a very specific case and this skill may not be functional for most people but it demonstrates how a small adaptation can provide significant possibilities for access.
Colour coded Maps and Compass
This section is a continuation in more detail of the colour coded compass and maps discussed above. I made the compass so the student could participate in some lessons on mapping and cardinal directions. It consisted of a salad bowl floating in water with two large magnets running parallel to each other in the bottom supported by some Unifix cubes to hold them in place. The magnets would turn the red colour north like a compass. On the top, the four colours were cut out of craft foam ensuring the whole thing could get splashed.
The compass helped us to explain how cardinal directions work to a child with acquired deafbliness and almost no movement. The four colours allowed her to express the directions with her limited mobility (as noted above in the contextual sign case study). Those colours could also be placed on maps like the ones pictured below. We started out with a small map of the classroom and hallway. The student enjoyed using the maps to explore the school and enjoyed the control of telling people what direction to turn. The four colour signs became important later when she realized she could use them to tell people what direction to turn as they were guiding her. Giving her more control and independence of travel.
As it became clear that she understood the concept we expanded to making maps of the other school floors, the room, the neighbourhood and more. These maps allowed her to talk about where she wanted to go ever further afield and helped to expand her world concepts.
The Colour Coded Pudding Experience Book
These are a few pages from the pudding experience book I created for an individual who enjoyed baking activities. She wanted to lead an activity but found it challenging due to very limited mobility and expressive communication. The individual could indicate a desire for continuation, and use sign language to express three colours.
Once the book was created with the individual, she could participate in steps such as selecting the appropriate size of measuring cup after reading the instructions independently and requesting the appropriate colour. The individual was also able to choose a flavour, and even indicate the appropriate utensils by reading the book independently and using her gaze to indicate the tool used for each step. In addition to increasing her ability to be involved in the process of the activity, the expressive communication adaptations allowed her to communicate while reminiscing about the activity or reading the book for fun.