Description of graphical content is included between Description Start and Description End. Transcript Start [Title Slide start: ] >> Audio Description: A slide reads at the bottom are logos for Penrickton Center for Blind Children, Texas School for the Blind and Visually Impaired, and Perkins School for the Blind. [Title Slide start: ] >> Audio Description: Presented by Patty Obrzut, MS, OTR, Assistant Director of Penrickton Center for Blind Children. [Title Slide end: ] >> Audio Description: Patty Obrzut, Assistant Director of Penrickton Center for Blind Children, is seated at a table in a studio. >> Patty: In planning the educational treatment or programming for an individual with special needs, it's important that the child be given an opportunity at least once a day to play at his or her emotional level with an adult present. Educational treatment and programming can be divided into five phases, with a specific technique utilized in each phase. For every phase, the adult will need to identify where you intend on playing near a child. Generally, you're going to want to position yourself on the floor with the child positioned either near you or by you. Sometimes the child might be sitting in front of you, positioned next to you, or even several feet from you. It's going to depend on the child. Now, on occasion you might play next to a child while sitting at a table, but in general any child that's in a wheelchair should be removed from his or her wheelchair. In this manner, the child is going to be able to move his or her body in any manner that they want to independently. Now, the adult also needs to provide objects to play with. You will need approximately 20 to 40 objects, because you never know what this child is going to find interesting. If you know the ability level of your child, you may be able to use fewer objects, but with an unfamiliar child, you will need a large variety. Remember that the object should reflect the emotional level of the child you are playing near. If you don't know the child's emotional level, you will need to select objects that can be used at different emotional levels. Materials must also reflect the gross and fine motor skill level of the child. In phase one of the five phases of educational treatment, the technique used is offering. [ Slide start: ] Description Start: Title: Content: Reference: Description End: Absolutely no demands are placed on the child whatsoever. The only request that the adult is making is that you want to be allowed to play near the child. [ Slide end: ] And when I say "request," I'm not saying that you say that verbally. What you're going to do is grab all of your items, and you're going to play near a child, and your request is that that child allows you to play in that position. The goal is to provide the child with an opportunity to develop a trusting relationship. The trust occurs because the adult will not ask the child to do anything. So if you open your mouth and say, "Do you want to come play with me? Do you want to play with this toy?" you are absolutely not in phase one of the five phases of educational treatment. You are at a much higher level. So remember, in phase one, absolutely no requests are made of the child whatsoever. [ Slide start: ] Description Start: Title: Content: Reference: Description End: The purpose is to promote trust between the child and the adult, and for the adult to observe the reactions of the child. Therefore, the adult is going to learn what the child likes and what the child doesn't like. At this point, the adult is trying to establish what the emotional level of the child is. [ Slide end: ] They're also trying to help this child understand that a person in their environment can be self active. So you are demonstrating that you are a child at that child's emotional level. You are independently playing and being active, and you are making an offer to that child that perhaps they would like to engage in activity, as well. So how does that happen? You simply play with the objects you have. If I happen to have this ball, and I start dropping it like this, what's important is that you have ten balls, because occassionally, my balls going to roll away from me, and possibly roll next to the child who's sitting near me. And now what you do is observe what happens. Does that child reach out for that toy? Does the child grab that toy? Do they start to bang that toy? Maybe they just take the toy and start mouthing it or throwing it. In phase one, you always accept the activity of the child as okay. So just because you were banging it doesn't meant that the child has to bang it. They can lick it. They can mouth it. They can shake it. They can throw it. That's okay, because in phase one, your goal is to promote trust, and the trust is that you're not going to ask that child to do anything. You're only asking that you're allowed to play in that child's space. The focus of phase one is to present the child with the offer of activity. The child must make the decision on whether or not to accept that offer. As the adult engages in activity, the adult must periodically discontinue his or her activity, and observe the child's reactions. These observations help to determine which sensory modalities are the most essential to the child's ability to perceive and comprehend. This will help you to select appropriate toys or objects to play with. If the child accepts the offer and begins to engage in activity, the adult must allow the child to interact with the objects in any manner the child sees fit. If the child throws a toy, mouths a toy, sits on a toy, or bangs a toy, these are all appropriate actions because the child has accepted the offer to engage in self activity. Remember that throughout life, every human being has a need, and that need is to be met with offers from others without any consequences. In phase two of the five phases of educational treatment, the technique that's going to be utilized is imitation. [ Slide start: ] Description Start: Title: Content: Reference: Description End: The purpose of phase two is to increase the child's interest in activities nearby. It's also to increase the child's ability to initiate activities. You want to increase the child's ability to believe in himself, and to introduce activities or movements that are not yet performed by the child. [ Slide end: ] A child's first interest in the adult's play has the characteristics of curiosity, rather than a desire to perform the same activity. A child that has been afraid of physical contact with objects may display a tendency to withdraw immediately or to reach tentatively toward an object or discreetly. It's as if the child doesn't want you to realize that he or she is actually interested in the object at all. To give the child the idea of imitation, remember to always start by imitating the child's actions. [ Slide start: ] Description Start: Title: Content: Reference: Description End: Try to imitate the activity as exactly as possible. After time as gone by, try to slightly vary your activity from the activity of the child, and observe what the child does or how they respond or react. [ Slide end: ] If the child doesn't respond or continues to play in a manner that he or she already knows, the adult should allow the child to continue that activity. You never correct the child or ask the child to perform a child in phase two. Remember that you have to accept the activity of the child. If the special needs child you are working with is visually impaired, it can be very difficult to get that child to imitate you. Remember the auditory and tactile modalities are the main pathways for achieving the ability to imitate in the visually impaired child. While using the techniques of offering and imitation, the child's trust is built up. He is given time to discover that playing near an adult can be a pleasant and exciting experience, and it may include new experiences. [ Slide start: ] Description Start: Title: Content: Reference: Description End: The goal is to enable the child to initiate activity, which leads to the mastering of something in his surroundings. The more a child is capable of doing, the more he can contribute. [ Slide end: ] Remember that throughout life, every human being has a need to imitate the activity of others. The skills learned through offering and imitation give the child new abilities that will encourage greater contributions in the next phase. The technique used in phase three of the five phases of educational treatment is that of interaction. [ Slide start: ] Description Start: Title: Content: Reference: Description End: The purpose of phase three is to help the child learn dependency on one or several people. Also, to help the child learn to initiate interactions between themselves and the adult. You want to enhance the child's self development of self identity and to give the child the basis for social development. [ Slide end: ] So for example, you might perform an activity where each of you has to help with the activity. Just having a simple bowl with balls inside, so I have ping pong balls and golf balls, and let's say you have that bowl, and you shake it... so that it makes noise. And maybe I push the bowl toward the child, and the child takes the bowl and pushes it back toward me. So then I take the bowl and push it back toward the child, and the child pushes it back toward me. Now we're actually engaged in an interactive activity. Another example might be stacking objects. So let's say you have cups and saucers. So I might go ahead and put the cup down, and the child might put the saucer on top, and I might put the cup on top of that, and the child might put the saucer on top of that. We're each interacting with each other to perform a simple task. It is a child's reactions that help an adult to determine whether to introduce interaction. If the child responds by turning inward, moving away, or returning to activity that you previously saw in phase one or phase two, then the adult has proceeded too quickly, and you should return to the phases of offering or imitation. [ Slide start: ] Description Start: Title: Content: Reference: Description End: In phase one, two, and three, offering, imitation, and interaction, we establish a child's emotional level. This is done by an exchange and balance between interaction and self activity, independence, and dependence. Phase four of the five phases of educational treatment is sharing the work. [ Slide start: ] Description Start: Title: Content: Reference: Description End: The purpose in sharing the work is to increase the child's experience of success, to involve the child in new social experiences, and to increase the child's interest in acquiring new abilities. [ Slide end: ] In using the technique of sharing the work, a child is given the opportunity to learn that dependence and independence can be displayed through interactions with others, [ Slide start: ] Description Start: Title: Content: Reference: Description End: that to be one who does something does not mean that one has to do everything or that one has to do everything perfectly. [ Slide end: ] In the beginning, tests are chosen that can be performed in a few seconds or a few minutes. The way the child performs the task is accepted, no matter how perfectly or how imperfectly it is done. The adult must tell the child which parts of the task the child is going to perform and which parts of the task the adult is going to perform. For example, I might say to the child, "You open the door, and I'll close it," or, "I'll open the jar, and you put the ping pong balls inside it." If the child does not perform the task, then you suggest that maybe you can do the task together. Remember, if you do this, you've returned to the stage of interaction, and there's nothing wrong with changing techniques in the middle of an activity. It shows that the adult is observing and assessing the information that the child is providing, and you're assuring that the appropriate phase of educational treatment is being introduced. During phase four, it is a good idea to let the child know about how much time the adult is going to have to play. The child is beginning to understand concepts of time, like what will happen next. It's also beneficial to talk about concepts yesterday, today, tomorrow. A good example of sharing the work is a craft project that I worked on with a little boy who really likes Sesame Street. I decided to have him help with making puppets from paper bags and construction paper. So ahead of time, I prepared the activity, getting out the supplies, cutting out basic shapes, getting out glue and scissors. To begin the activity, I started out in the technique of offering, and the child accepted the offer and wanted to engage in the activity. While gluing construction paper, I demonstrated how to use a glue stick, and using the technique of imitation, the child learned how to glue parts of the puppets on. I used the technique of interaction to share supplies back and forth, and that introduced the stage of sharing the work by asking the child to help with certain tasks. I would ask the child to glue the eyes on the face or to pick out the next color for the nose. I occassionally reverted back to imitation, to show him how to use scissors, but returned to sharing the work frequently. Throughout the activity, I asked the child to perform many small tasks so that he could be successful at the project. In the end, he was proud of his accomplishments, and he even asked if he could take the puppets home that he created, so he could show his parents. Remember that throughout life, every human being has a need to be successful and contribute to relationships. Human beings that are excluded from relationships for whatever reason usually demonstrate inappropriate behavior. The last phase of educational treatment uses the technique of consequences. [ Slide start: ] Description Start: Title: Content: Reference: Description End: It is only possible to introduce the phase of consequences when a child's emotional level has reached the age of two years or older. The purpose of the phase of consequences is to help the child to endure meeting demands, to help the child endure changes in life, to help the child feel self-confident, which is fundamental to being able to make your own decisions about your own life, and to establish a sense of responsibility. [ Slide end: ] When a child feels secure and has gained confidence in perform different activities, and the child has been informed about consequences in activities, then it should be possible to let the child experience consequences. The activity should include skills that the child is already able to perform. Take, for example, pouring a glass of milk. If the child has been introduced to the skills of holding the cup, pouring things into a container, being allowed to spill, of course, picking up heavy items independently and wiping up spills, then maybe it's time to let the child pour his own glass of milk from a gallon container independently, when the child wants to have a drink of milk. If the child is unsuccessful and spills, then he also learns the consequences, that he will need to clean up the spill. Another example of the phase of consequences is we had a child who wanted to go for a walk to McDonald's next door to our building to get some ice cream. This child is able to either use a wheelchair or to use a walker, so before going to the McDonald's, I asked him if he wanted to take his walker, if he wanted to take his wheelchair, and he said he wanted to use his walker. So before we left, I explained to him that it was going to be a little bit of a distance to walk, and so if he decided to use his walker, there was no way that we were going to be able to come back and get his wheelchair if he changed his mind. And I said that because in past experiences, he sometimes has done that. He was sure he wanted to walk, so I said, "Okay, but just so you know, I won't be able to carry you, because you're so large, I can't pick you up. But I will wait for you if you get tired." And he said, "No problem, let's go." So we got halfway to McDonald's, and sure enough, what did he do? He said, "I'm tired, I want to go back. You have to help me and carry me." And then he was like, "Go get my wheelchair." And I explained to him, "I can't go back and get your wheelchair, because I can't leave you alone, and I can't pick you up, because you're too big, and I can't carry you. So what can we do? We're going to sit down and wait until you feel strong enough to get back up and walk again." So we sat down and waited for a few minutes, and after about five minutes, he said, "Okay, I'm ready to walk again." And before we continued, I asked him, "Do you want to turn around and go back to Penrickton Center, where you can go back, but we're not going to get the ice cream. Or do you want to continue to walk to McDonald's? But it's going to be about the same distance that we had already gone," and he said that he was able to go on to McDonald's. So sure enough, we walked down to McDonald's, and he made it the whole way, and we got the ice cream, and we sat down and had a good time, and then I told him we had to walk back. And you knew it was going to be a little bit of a distance, so I told him, "If you get tired, just let me know. We can take a break." So we got about halfway, and he just turned to me and said, "I'm a little tired. Can we take a break?" So we did. We sat down, took a little break, and then he said, "I'm ready to go again," and we walked all the way back to the center. So in this example, this child learned how to handle a problem, instead of just relying on an adult to solve his problems. So, it was perfectly fine for him to go ahead and say he needed to take a break, and he also learned that he was too big for me to carry. So the next time we go to McDonald's, he can make an educated decision about whether or not to take his wheelchair, or a walker. As a child is able to fulfill more and more requests, he's going to be able to become more and more independent. It will be easier for the child to tolerate that sometimes he's unable to succeed in what he intends to do. The child will be able to accept significant changes in his life. New materials, new requests, new human beings, new housing, new schools, and so on, without breaking down emotionally. He will be able to make new friends. He will be able to make decisions and be a more independent individual. [Title Slide start: ] >> Audio Description: A slide reads, Active Learning Space, www.activelearningspace.org. January 2017. At the bottom are logos for Penrickton Center for Blind Children, Texas School for the Blind and Visually Impaired, and Perkins School for the Blind. [Title Slide end: ]