Sensory Learning and Multiple Impairments: Accessing the World Differently for Learners with Visual
and Multiple Impairments
Millie Smith and Tristan Pierce
American Printing House for the Blind
The program (SAM: Symbols and Meaning) is designed to help learners develop the conceptual
foundation, based on experiences with high-quality sensory information, necessary for the use of
meaningful symbols.
The program is for students with visual and multiple impairments and pre-school children with visual
impairments who are just beginning to use symbols—the late sensorimotor, early preoperational stage
of cognitive development.
It is designed to be used by TVIs to help parents and teachers create daily learning opportunities and
provide direct instruction in natural environments.
The field testing began in the Spring of 2008 when the presenters solicited teachers to participate in
what would be a full academic year of testing, August 2008 to May 2009. The field testers participated in
a 6-hour long, live, online training conducted by the presenters.
At the beginning of the school year, all teachers conducted and submitted an Environmental Gap
Inventory for their learner(s). This was designated as each learner’s baseline. In late December, the
same Environmental Gap Inventory was conducted and submitted. The final was done in April 2009.
The comparison of the three inventories and the teachers’ evaluation forms were used to determine the
effectiveness of the program.
The development of conceptual foundations for the use of meaningful symbols is important to the field.
The rationale for this presentation is that for learners with visual impairments, variations in the
development of meaning include absent/incomplete concepts, objects experienced out of context
without intended function, and words without meaning.
There is strong practitioner evidence that the program is needed and that it is successful. If a learner
has a sensory impairment, “the quality and scope of learning may be limited by reduction in
environmental interactions” (Barraga & Erin, 1992).
As these experiences accumulate, teachers see how learners discover patterns and mentally organize
these patterns into “schemas,” which form the internalized knowledge of what the world is and how it
works (McLinden & McCall, 2002).
Ten teachers from seven states participated in the field test. On average, the teachers had 9 years
experience teaching visually impaired/blind learners and averaged 10.5 years teaching learners who
have profound disabilities.
Twelve learners participated, and 10 teachers completed the Environmental Gap Inventories. Eighty
percent of the teachers had never used another program to help learners develop the conceptual
foundation necessary for the use of meaningful symbols. Fifty percent of the learners had used APH’s
Sensory Learning Kit (SLK) prior to using this program.
Due to the advanced planning for recruitment and training, and the extended length of field testing,
80% of the learners’ teams (family, friends, teachers, specialists) incorporated the program into their
learner’s IEP.
The chronological ages of the learners range from 1.5 years to 15 years. The cognitive ages range from
10 months to 6 years old. Ideally, the product is targeted for learners with a 2-4-year-old cognitive level
or those in the late sensorimotor, early preoperational stage of cognitive development.
Retinopathy of Prematurity is the most prevalent eye condition of the learners, closely followed by
Cortical Visual Impairment.
Background
Cognitive Performance
•
•
•
•
Gifted
Average
Significantly sub-average
— Mild
— Moderate
— Severe
— Profound
Sensorimotor (Birth–2 years)
Learning about what things are like and what things do
• Preoperational (2–6 years)
Learning language
•
Operational (7+ years)
Using language to learn
Background, cont’d.
APH Continuum
Sensorimotor level learners are learning things about language, but language is not the primary focus of
their learning.
Preoperational and operational learners use sensorimotor strategies to gather information about new
things.
Background, cont’d.
Less stigmatizing
Assumes progress is always achievable at any age
Emphasizes characteristics of learning styles so that more appropriate instructional strategies can be
provided
Late sensorimotor, early preoperational development
Graduation levels
 Concepts about the learner’s own body
 Concepts about people, objects, and actions touching the learner’s body
 Concepts about people, objects, and actions, and places beyond the learner’s body
 Schemas about people-object-action-place relationships in events beyond the learner’s body
Who uses SAM?
Learners who

have poor concepts because of limited sensory experiences with people, objects, actions, and
places;
 are learning that objects can be symbols used to send messages about each of the above;
 are interested in words but cannot associate words and their concrete referents; and
 say words without meaning.
The SAM instructional strategy
Pairing symbols with concrete referents in direct experiences in natural contexts
Bridging near and distance sensory information in natural contexts to build solid concepts about things
beyond the body
Playing games in which whole objects and words experienced in natural contexts are
used as symbols in communication contexts
Games
SAM includes 18 games to help develop conceptual and symbolic skills. The next slide shows the number
of students who played each game and whether they were successful, unsuccessful, or did not play the
game. Some teachers did not respond to all games, therefore the total does not always add up to 12.
Games
Game Successful
Unsuccessful
Body Buzz
8
2
2
Whoopee Clothes
6
0
4
Finger Tag
4
1
6
Hot Potato
5
1
4
Slap
4
Simon Says
4
5
Yours and Mine 5
Do It Again
Go Fish
Show Me Who
Did not Play
3
1
1
5
3
5
2
1
2
4
3
7
4
4
What Do
2
3
6
Sounds Like
2
1
7
Mystery Voice
2
1
7
Scavenger Hunt
2
0
8
Bag Stories
2
0
8
Box Stories
1
2
7
Binder Stories
2
1
7
Clue
1
1
8
Watch SAM video
Results
Prior to using the program, teachers were asked which concept categories their learner(s) understood.
At baseline, 66% of the learners understood the category People: The Self and Others. Concepts about
people start with knowledge of one’s own body. Self-awareness becomes the core knowledge to which
new information is attached. New information includes the characteristics of other people’s bodies first
and, then, more sophisticated things associated with the body like its emotional content, what it does,
where it goes, its name, and how it relates to other bodies.
After using the program, 75% of the learners understood this category. One teacher wrote, “I finally had
a strategy/teaching approach to use. No other books gave me the knowledge I needed.”
Results, cont’d.
Prior to using the program, 42% of the learners understood the category Objects: Tangible Things.
Concepts about objects start developing as soon as the blanket touches the newborn’s body.
Information about the physical characteristics of objects is acquired through the senses. Acquisition of
sensory information leads to recognition of the object and associated information about how it is used
and how it relates to other objects (Smith, in press). After the learners and teachers used the program,
83% of learners understood this category.
Results, cont’d.
Prior to using the program, 50% of learners understood the category Actions: Body Movements of the
Self and Others. Concepts about actions start with random movements of the learner’s own body in
infancy. The actions become more intentional as certain results are associated with certain movements.
Information about the actions of other people’s bodies allows the learner to imitate and expand his
range of options in choosing how he will interact with his environment (Smith, in press). After the
learners and teachers used the program, 75% of learners understood this category.
Results, cont’d.
Prior to using the program, no learners understood the category Places: Where Things Are and
Contexts for Groups of Things. Concepts about places allow the learner to find things. Simple place
concepts include things like knowing where to look or to move the hand to find the cup during
mealtime. Things have to be in the same place consistently in order for place concepts to develop
successfully. Place concepts build mental maps of how things relate to one another spatially. Places are
also contexts—environments or surroundings—that provide meaning. A kitchen is the context that helps
to provide meaning to objects like pans, spatulas, strainers, etc. (Smith, in press). After the learners and
teachers used the program, 50% of learners understood this category.
Results, cont’d.
Concept Categories
Pre
People
The Self and Others
8
Objects
Tangible Things 5
10
Actions
Body Movements of
the Self and Others
6
Places
Where Things Are, Contexts
for Groups of Things
0
Post
9
9
5
Results, cont’d.
Fifty percent of the learners learned to successfully use sensory bridging (sound, smell, or impaired sight
paired with associated tactual information to create a concept at a distance). Teachers’ comments
included:
She learned a symbol meant to go to the gym to play ball, to eat lunch at a table, to feed herself without
prompting.
In the games we did not get further than the body but one student knew when he heard my voice from a
distance that it was time for Whoopee Clothes.
Results, cont’d.
Learners developed the ability to use objects as symbols in four steps.
1. Prior to the use of the program, 75% of the learners used touch to discriminate tactual
characteristics of an object. After using the program, the percentage increased to 83%.
2. Learners who used objects in natural contexts went from 33% to 75%.
3. Learners who formed associations with other things related to the object went from 8% to 50%.
4. Learners who used objects as symbols went from 8% to 42%.
Again, all students improved.
Results, cont’d.
Object Symbols Steps
Pre
Post
Tactual learner uses touch to discriminate characteristics of an object.
9
10
Learner uses object in natural context.
4
11
Learner forms associations with other things related to the object.
1
6
Learner uses the object as a symbol to receive or send messages.
1
5
Assessment Forms
There are four assessments in the program.
•
Symbol and Referent Analysis: Common Words
•
Symbol and Referent Analysis: Academic Vocabulary
•
Environmental Gap Inventory
•
Curriculum-based Gap Inventory
Assessment Forms, cont’d.
Comments
Environmental Gap Inventory
POSTIVE: I gained a new perspective on areas that need to be taught to the student.
RECOMMENDATION: I think it should be broken into functional levels or set up for student individuality.
Many students’ issues are not addressed in homes that are addressed at school and vice-versa. I have
many parents who don’t want to implement what is done at school into their home environment
although it may be very successful.
Assessment Forms, cont’d.
Comments
Curriculum-based Gap Inventory
I gained a new perspective by reading the additional explanation.
I can write additional teaching interventions from the ideas discussed on these pages.
Assessment Forms, cont’d.
The Environmental Gap Inventory consisted of 14 environments. Not all teams were able to observe all
environments. However, they all submitted the school environment. While some learners improved
more than others, all learners improved. Improvement was shown in all environments submitted by the
teachers.
Environmental Gap Inventory
Learner
Sept
Dec
April
HW
AM
SF
31.64% 45.73% 70.82%
8.60% 10.60% 11.50%
9.10% 10.30% 11.50%
TV
RD
SM
SM
JO
CR
GWR
VE
GG
Average
3.60% 7.20% 57.00%
20.50% 52.60% 54.90%
46.60% 48.00% 49.20%
30.70% 33.50% 49.80%
20.70% 41.10% 41.20%
10.80% 16.00% 11.90%
0.00% 10.40% 17.20%
3.10% 64.80% 64.80%
47.00% 69.00% 90.00%
19.36% 34.10% 44.15%
Comments
Saw great growth in my student through this project! She went from a beginning Level 1 to a middle
Level 2, (in my opinion). I already have other students in mind to implement this program with who
would benefit!
I look forward to using it in the future with other students. The training was great but I could have used
more time to understand the product before implementing the program. I understand the reason for the
need to get going on the field test, however. Thanks so much for including my school district and me in
this research.
I think it is a good program and was very useful in the classroom with the teachers and assistants who
were working with the students.
Look at Assessments
Conclusion
It is rare that The American Printing House for the Blind has the luxury to field test a program for a full
academic year. This proved to be very beneficial for the field testing teams. Many teams were able to
prepare and include the program in the learners’ IEPs. All learners demonstrated improvement on
•
the Environmental Gap Inventory.
•
the four concept categories (People, Objects, Actions, Places).
•
the ability to use objects as symbols in four steps.
The games were deemed useful to the teachers, and they proved to be successful experiences for the
learners.
References
Barraga, N., & Erin, J. (1992). Visual impairments and learning. San Antonio, TX: Pro-Ed.
Fazzi, D. L., & Klein, M. D. (2002). Cognitive focus: Developing cognition, concepts, and language. In R.
Pogrund & D. Fazzi (Eds.), Early focus: Working with young children who are blind or visually impaired
and their families (pp. 107-153). New York: AFB Press.
McLinden, M., & McCall, S. (2002). Learning through touch: Supporting children with visual impairments
and additional difficulties. London: David Fulton Publishers.
The End