Active Learning study group #3 transcript [ Music ] >>Kate Hurst: So Matt, shall we get rid of this and we'll just take it -- let you get us started out today? >> Matt Schultz: Let's dive in. So Chapter 4, Lilli... sets off to talk to us about coordination of movements. She does this focusing on four movements. The first being midline organization of hands, the second achieving head control, the third unsupported sitting, the fourth independent standing and walking. And Lilli points out -- she looks at what that looks like in development for a typical developing child and then what that looks like for a child with a visual impairment or mobility impairment and she points out that... that those come in order of development. So in order to achieve head control you first have to have midline organization down. In order to sit... unsupported you have to have head control down. All three of those, midline organization, head control and unsupported sitting are prerequisites for standing and walking. That's kind of a general overview of chapter 4, it's really nicely organized, I think. >> Hurst: Yeah. I thought this one was -- I liked her organization because it was like here's clearly what a child without disabilities is doing and then here's what we're seeing that might be happening with our kids that are multiply impaired, and then I like that she gave some real specific things you could do. That was really exciting to me. >> Schultz: Yeah, there's nothing mysterious, right. She spells out what the development looks like, the implications for our kids; and it's like, okay, minus the mobility, minus the vision, we have to bring these opportunities for exploration to the kids. >> Hurst: Right. >> Schultz: We have to figure out ways to motivate them, to have movements, and understand that movements only become meaningful when they are paired with tactile, auditory, olfactory or visual responses. >> Hurst: Yes. >> Schultz: And that, you know, she's introduced that thought I think earlier in the book, she kind of hits that point home and really all of our intervention is based around that central fact. >> Hurst: Exactly, exactly. And, you know, it is the thing that I think it's so important for us to have clearly in our minds, when we're talking to parents and when we're talking to administrators, is that this is foundational for all learning. You can acquire some skills in sort of a fragmented way. But to really have a good foundation for learning and for learning how to learn, you've got to have these basic body movement things down, so that you can be able to interact and manipulate things in your environment. So that you can have enough experience to have a concept that we then can tie language to. It goes like that. So -- >> Schultz: Do we have some video we want to dig into now? >> Hurst: Well, we can do that. One of the things that I had thought I might share with folks before we did that is... as I mentioned, I really liked the way that Lilli went through and organized things and gave us very specific things for what we might do. One of the things that I'm going to work on is a product and I would like the study group to participate in this, as we go along. And we're going to give you an opportunity to do some of that today. But I thought what I would do is start building out a document that would talk about the overriding piece that we're working on, like learning to use hands in midline, that's -- you know, hand organization midline, some of the equipment that we want to be thinking about, that we might be using for that, and then some specific activities that she discusses where we want to get to some of that. So maybe what we can do is get into the hand part. And while you're doing that, I'll quickly go see if I can find this, so I can get it up and share it with folks. >> Schultz: That sounds great. >> Hurst: Okay. >> Schultz: Okay. So the first section of chapter 4 focuses on the midline organization of hands. Which is the simultaneous use of both hands at midline. And discusses how crucial that is in developing the -- the movement patterns and the muscles to get to that next step, which is head control. So for typically developing babies and typically developing fetuses, this sequence starts really early. When the fetus begins to bring its hands to its mouth, and starts to suck the hand, you have the baby experimenting with this midline coordination. >> Schultz: Okay. A few weeks after the baby is born, they become aware of looking at their left hand and then their right hand, you might see them look back and forth at the two as if they're thinking my gosh this looks a lot like this one, right? [Laughter]. And that process of exploration is -- is combining the information that they're getting from the visual system with their kinesthetic modality. So that's a big thing that they're exposed to immediately because they have vision. Later that visual exploration becomes a little more tactile, again bringing the hand to the mouth, holding objects in one hand while banging the object with the other. Again, you have the two hands coming together in exploration that¬† the baby's brain is receiving information from that auditory response of banging the objects together, but also their body is developing that motor pattern and developing those muscles that can -- that can help it do that exploration as well as the next one which is head control. At eight months babies start to rotate their hands when they bring the objects to their mouth. And notice the change of appearance that results in this rotation. And Lilli points out that this rotation is important and necessary for kids to learn how to pour, to open things, to turn knobs. And again if they don't get it, if they don't go through that developmental process, and we're asking them to pour stuff, you know, it's a little bit like asking a fish to climb a tree. You can ask all you want, but it's not going to happen. >> Hurst: That's right. >> Schultz: So again, this midline organization eventually leads to the performance of activities such as eating, dressing, washing and carrying heavy things. It really is the foundational movement and muscular development stage that all babies need to go through. So that brings us to the kiddos that don't develop typically. That have visual... issues, that have mobility issues. And Lilli points out that environmental intervention is needed to provide the opportunity for these kids to establish midline organization. [Humming] >> Hurst: They're not going to get it without us helping. >> Schultz: So the blind infant, like the sighted infant, will bring the hand to the mouth. However they are unable to combine that with that other sensory modality, that kinesthetic sense, because they're not seeing the two hands and being able to compare them with their vision. They're just getting to move their hand to the mouth and experiencing their hand tactually, but that's just the tactual and there's not really much auditory going on there. So that movement might be interesting at first, but without being paired with another sense modality, it's going to be -- the kid is going to become bored and they're not going to be motivated to repeat it. So what Lilli was saying, which is kind of new to me, Kate, was that some of these blind babies display these normal developmental patterns at first, but then when the responses aren't meaningful enough, aren't there, they start to become stagnated and the movements decrease. >> Hurst: They go away. >> Schultz: I thought that was really interesting. >> Hurst: Well, and I think, you know, that is a real important thing to think about in general with these kiddos, because -- if we don't reinforce anything that they're doing, because they may not be able for a variety of reasons to get enough feedback on their own, you know, or to know that someone notices or that something happens, then, you know, I think this is where all of those delays come in. And, you know, just like we talk about with communication, the way you get communication going is the baby tries to do something, and you read it as communication, and you go, yeah! And you do something neat and that sort of jazzes the kid and then they do something else in response. It's the same thing with motor patterns. You know? When I do something and I get something to happen, it's reinforcing, and I'll try something new, and then I'll get something slightly different to happen. But for our kids, we have to make sure they're building that in or they won't get that differentiated experience. They just won't. >> Schultz: So Lilli talks about how we go about this process of making sure that there are appropriate responses. And she says the first thing to do is to observe the child. Observe where they are in their explorations and what their movements look like. And so that, kind of, is going to inform you on your initial intervention. Makes total sense, but it's nice to hear. This is what you do first; watch the child, take a look at what their movements look like, so that you can plan accordingly. An example that she provides of an initial intervention would be hanging objects over the hands that are placed near the child. And from talking to some folks with more experience in this area than me, they're telling me that this is a common mistake. That objects are hung, but they're not close; they're not near enough. So they're just there, but when the child kind of normal movement patterns, they don't touch that. >> Hurst: Right. >> Schultz: So they don't know they're there. They don't get to explore them, so that's something to think about. Make sure that the objects are near enough for them to touch them on their normal movement patterns, so -- before they start to explore. >> Hurst: Then I would say on this, you know, oftentimes these kiddos are going to benefit a great deal from a lot of time spent in a little room. And that is the mistake that we see over and over again; is when a kiddo doesn't have much in the way of body movement, period, either an individual part like hands or legs or whatever, you need to start out with those objects, literally touching. >> Schultz: On. >> Hurst: Not putting weight, necessarily, but just barely grazing where their typical range of movement is. So like you say, any kind of spontaneous movement that occurs, whether it's a reflex movement or they may be able to move a little bit, they're going to come in contact -- they're going to cause something to happen. And a lot of those kiddos we see, they lay in a little room with their hands either like right up here by their head or sometimes down on their sides. So you've got to get it -- you've got to have objects that are really motivating and really appropriate for those hands in those places on the little room, you know. You've got to really put some thought into that. And I think that's one of the things that I like so much about this chapter, is that she really gives great examples of how you look at what the child is needing to do, where you're hoping to get the child to learn to do, and then when you are setting up that environment, whatever environment you're looking at, you're going to say: "Okay, one of the things I'm wanting to happen for this child, I'm wanting them to bring their hands together. Right now their hands are right here at their head. I'm going to put them in the little room, I'm going to put things that are very interesting to their fingers, that fit the size of their hands, you know, that have the nice tactile quality to them, but also do some auditory stuff, cause it's also up here by my ears." You know? >> Schultz: Thinking about what's going to be motivating, can draw them out. >> Hurst: Right, to get those -- If that hand happens to jerk or move, or I get this one moving, and I have a kinematic motion in the other hand, maybe I'll get it moving, too. That's what you're shooting for with those kids. And so, it really does -- you know, in this chapter, she really lays out how you can think about each piece and part of that child and develop that environment for them to be in an independent exploration. >> Schultz: Yeah. I think that -- the location is obviously something that is very important. But also mentions that -- that once you think about location, and once you do find objects that are motivating for the child to reach out, explore, and once they start to be able to grab the object, they have to be able to bring those objects to their mouth. >> Hurst: Uh-huh. >> Schultz: When is our first area; that midline organization. They have to be able to make that movement and make that connect if they're going to develop the ability to move on to that next stage. >> Hurst: Yeah. >> Schultz: Again, I think that's really explicit, it's really clear, you know, we've got to think about location and motivation through exploration, but also provide an opportunity for those kids to bring those objects to their mouths, knowing that that's not a bad behavior. >> Hurst: No, no. >> Schultz: It's a necessary behavior. >> Hurst: It's a real critical step. >> Schultz: Uh-huh, uh-huh. She talks about thinking about -- thinking about this stuff in functional routines as well. There's a part where... she tells a story about a student that they placed a buncher, which I think that we have a picture of. >> Hurst: I will show you a picture of that in just a sec. >> Schultz: In the student's hands while they are doing this eating routine. Knowing that this eating routine might provide an opportunity for him to bring that buncher closer to his mouth, because his mouth is being activated, his salivary glands are being activated. It's kind of a natural movement, so when that movement starts to happen, get some food on that spoon of his. Start to see this is what this spoon is for. You know, again, it's someone who hasn't read this book before, I think that I like that Lilli is giving us some direction in regard to functional routine, you know, she's talking about taking movements and opportunities that we're providing the students in an environment like the little room, but also remembering what those opportunities look like during functional routines, as well. >> Hurst: Yeah, you know, that's the thing, too, I think is so important for people to understand. In the way Lilli sets up her curriculum, if you look at the [indiscernible] curriculum, she has an organization of fine motor, gross motor, fine motor, gross motor; kind of throughout the day. And then there's scheduled, within those, adult interaction time. You know, because what you are doing in the adult interaction is tied to all of the things that the child has been doing independently. It may be a care taking kind of activity. As the child moves on up, and is more confident with you, and has concepts down, you begin to make it into one of our very early routines, where they're just helping a little bit but we're watching them and we're aware that they're -- they remember what the next step is, and so they are able to participate a little bit and then sort of the final phase that we get to, before these kids are ready to graduate on to a different educational approach is when they can begin to do it more independently. And they learn that if I don't do this part of the activity, then this next thing won't happen. And a lot of what I felt like Lilli was focusing on in this chapter was -- were those very beginning steps, you know. She mentioned some of the other activities higher up, but she gives a lot of good information for those kids that I think are probably -- I went back and let me just mention this real quick because it ties in as a way as a prop to talk about this. This is a lot of this is from just what she has in her discussion in Chapter 4. But what I did is I went and looked at where some of these behaviors that she talks about with hands come from. And if you look in the functional scheme assessment that she has, these hand things are all in her fine motor checklist and they go up to about six months; is where -- the things that are discussed here -- drop off. And these are kind of in order. I'll probably do a little fluff on these, but you can see that, you know, you're starting out with a child with very passive hands, who's not doing much. Then sort of move to being able to open fingers, wiggle those a little bit, and then they may have clenched hands, some kids will just have clenched hands, but then, like you say, being able to suck on their own fist, and then it just sort of evolves up, until we're getting towards the end of what she talks about -- oops, sorry about that, folks! Do things like reach for their right hand over on their left side. Really getting into much bigger movement and search patterns, being able to surface a table and get towards more functional search patterns and things like that. So in this, -- those -- if you go look in the functional schemes, you will see these. And when you look at her functional curriculum, it's organized so that you can find those fine motor activities, and plug it in their day in a fine motor, gross motor, alternating pattern with an adult interaction. >> Component. >> Hurst: Yeah, component, several times, yeah. >> Schultz: Cool. Well, that makes sense that she's looking for ways to incorporate that adult interaction in as well, knowing that for every human, I think, one of the most motivating things in life is interaction with another person with a trusted person, getting that auditory feedback, that encouragement from a teacher, from mom, from dad. We know what motivating, what a huge motivator that is for students and for children. >> Hurst: Yeah, yeah. >> Schultz: That's cool. >> Hurst: And a lot of times the topics are those objects, you know, and the things that the child can do with that object and that really gives you that topic for interaction and conversation. You know, in those adult, one-on-one kind of situations. But the child knows those objects because they spend so much time to explore them independently and learn about them in their own way. >> Schultz: Without noise or confusing talk. >> Hurst: Or being directed by somebody to do this or do that, yeah, yeah. >> Schultz: So that makes sense, they get the time to explore, to get to know what the topic is, to get to know the movement, where they can focus on it, and then you are looking later at combining that movement with an interaction with an adult, where we provide praise and encouragement to kind of strengthen that connection, to strengthen those neuropathways that have formed in the brain through exploration. >> Hurst: Exactly, exactly. >> Schultz: Do we want to look at some of the pictures, Kate, before we go on? >> Hurst: Let me show you a few of the pictures. I tell you what, before I do this, before I show the picture, let me say one more thing about this and then I'm going to put it away. What I would like to do is look at each of these areas and as you see, sort of put some examples of the -- of the movements we're looking for, get a list of equipment that we're typically going to use in doing these things and then start listing some of the activities, because I know a lot of people don't have that [indiscernible] curriculum, they don't have access to all of the books and materials that Lilli has and I figured this might give us a place to start. And this is where I would love to have folks contribute, you know, here's -- here's an activity that I did, or way I set up an environment to achieve, you know, learning midline organization of hands. You know? And... especially if you guys, whether you know -- some of you may not to take video that's fine, but maybe take your iPhone and take a picture of this piece of equipment. What I'm going to show you here in a minute is some that I've done or that we've done together. And then we can share them with each other and also put it up online. Some of these are purchased pieces of material or equipment from -- from Lilli Works, but then there's some also some homemade things in here. This is the famous buncher. And you can buy a buncher, but as you see there's not much to it; just elastic with buttons or use Velcro to be able to attach things to it. So that, you can put the child's spoon in their hand here and then the buncher goes around and holds it. So they can't lose it, you know. so while you're feeding, you know -- and if you watch babies a lot of times like when you go to put food in their mouth, and if they can get their hands and their fist, that hand kind of comes up naturally towards that mouth. >> Is that a reflex, kind of... >> Hurst: I don't know whether it's specifically a reflex or whether that's a movement they can do, and it's coming towards them, and they're going to help get it in -- that I would have to do a little more looking on. If you have got that spoon there, then you might come in contact with the spoon, which you have put in, which is like what you are receiving from the other person. So I think that this, you know, is a really nice way to go with it. The other thing we've done with the bunchers and Lilli talks about this, is, for a lot of kids that have hands where, you know, a lot of times maybe there's partial paralysis or something on one side of their body and they seem to be like unaware that they have a hand. You've seen kids like that, they just don't use them. They just tends to be a one-handed person, you can put something like a vibrating toothbrush, hooked with a buncher on that hand and... it bugs them at first, you know, a lot of times. So they don't really like it. >> Schultz: They're not used to it. >> Hurst: Always, I think oftentimes it's like they're not aware of that hand but it's -- there's a -- they're feeling something that may be weird or feeling a little bit uncomfortable. What happens is that they begin to sort of move that hand down on the resonance board or up against another object, they discover they can make different things happen with that tooth brush; different kinds of sounds. They get different feeling in their body as it touches on different things. And a lot of times they will become very aware in a reasonably short time, "Oh geez, I've got another hand here." And they begin to use that hand more in other situations. It's like it reminds them that that hand is there. >> Schultz: An awakening of sorts. >> Hurst: An awakening! And I think, literally it is that. I think what is happening, as I understand it, is because of whatever injury they suffered, the network that gives this hand and this arm moving has been damaged in some way and so by bringing an awareness to it, you are really sort of recreating a neural network that says, "Hey I've got an arm, and it has feeling in it, and it can move here and there." You know? >> It's an amazing process, and it does seem like that's at the root of a lot of, you know, what Lilli is talking about. We're talking about neural pathways. I think she was ahead of the game. >> Hurst: Absolutely. >> Schultz: All of the science that comes since is confirming, all of these things are possible. The neuroplasticity of the brain, we're not sure where it begins or ends; but we know it happens and we know that it needs... the brain needs opportunities for exploration paired with meaningful responses, and that those pathways will trudge forth in the brain. >> Hurst: Exactly. Exactly. I will show you another couple of things. These are called SPG boards, and they stand for scratch, position and grab, I believe. It's a strange name. But they're -- the picture that you see on the left, this is one that's commercially introduced by Lilli. And what you get is kind of the board with these different tiles that you can attach stuff to, but you have to provide the stuff. Okay? >> Schultz: You just get the board... >> Hurst: You just get the board and those individual tiles. And they're nice, in that, if you have a classroom of kiddos that are going to be using things, you can... you can make a whole variety of different tiles, and then when that kid's trying to go there, you just are switching tiles out, and you can use one board. >> Schultz: Okay. >> Hurst: What we have done, and many, many people have done; I'm sure a lot of the folks in the study group, we made our own boards. And this is one that we made on just that heavy duty Styrofoam board, you know, and it's got things like Mylar ribbon, I think there's some corduroy, there are some pipe cleaners that are metallic, you know, cork; just different things like that for the students to be able to scratch on and experience different textures. After the kiddo begins to scratch and they get those fingers going, you are going for them to be able to grab hold of something and at first you work on grabbing and releasing and then you work on grabbing and exploring; and that's when they begin to rotate their hands, that's when they begin to bring it up to their mouth and explore it with their mouth, and practice banging and doing other actions with it. And the difference between these two types of boards, this is the -- the second -- the first is the scratch, the second step is the grab and release. And if you will notice, the cords on these objects are just slightly shorter than they are on these. And the reason that is -- they're just -- they're not going to be able to do a lot with these, so you want them to be able to go back very easily and locate that object again on that board when they turn loose of it. >> Schultz: That makes sense, even the short cords, I would think, would help facilitate the whole release thing. [Multiple voices] >> Hurst: Right, it's going to pull back, exactly. But it's not going to go way down here or get tangled up. It's just going to go right back in that spot. And then, of course, the longer one allows for more ability to bring it up, wave it around and bang it and stuff like that; then, let's look at a couple more things. She talks a lot about the importance of using things with -- that have finger holes. It's one of my new favorite things to do -- well not so new now, a couple of years -- watching babies out and around. There is a distinct point when babies discover they can isolate a finger, and they will go and find holes and stick them in any hole that they can find. And it is the coolest thing when they start doing it. And so giving kiddos opportunities -- when they're at the right place, when they're ready for it -- to have objects that they can put fingers in. So, these are just a variety of different objects that we have there. The ones on the left are just some that we collect at random, have around. Often take them out. And then we have developed for our team, because we often go out and see a kiddo; we don't have much information; we don't know what kind of materials will be at the school or the home. We've made kits and in it we have included some things that have specific properties. So out of our bag that has properties about things that fingers can go in, we have the little Chinese finger cuffs, finger puppets are really good. These are little snap blocks. What I like about them, they're small and they have a hole in the center that's just the right size for a kiddo and then there's things like a -- just a plain old hair curler. Those are great to get fingers in, you know, they're real easy to get fingers in. But, you know, using your imagination and looking for those things is fun. This is the famous Sensitar. >> Schultz: The groovy sense star. >> Hurst: The groovy Sensitar. This one is a homemade one that has rubber bands that we use. There's also one, and I think this is the one that Lilli makes, but you can also get it and make it yourself; that they use springs there. So you can get different qualities. The rubber bands are much easier for the kiddo to pluck on. But... the springs make neat sounds, too. So it's nice to kind of have both. And they are not that hard to make. It's a matter of sort of having tea cup hooks that you put in. This one has like a shiny background, sort of to attract any residual vision that the child might have. And then this is another one that's good to get kids whose hands are sort of frozen on their body. A lot of kids we see them, they're just like -- they may have a little bit of movement in their hands, but it tends to be right around their stomach or chest. And you can put these cummerbunds, which are just these little bands with Velcro on them, get different objects and Velcro them to the cummerbund. And what's nice, is that, like with these, if you get a finger in or a hand, you can kind of grab or bat it, there's just enough resistance from that Velcro that you have to kind of work at it. It pulls a little bit on the muscles. >> Schultz: I think that's a really good illustration of the point that we were talking about earlier, intervention should come from observation. So like Kate just described, if you are observing a student whose hands are always at his abdomen area, you are looking for a way to move beyond that, the cummerbund would be the intervention for you and for him -- [Multiple voices] -- to start the exploration; where he's at. >> Hurst: Right. Another thing that she talks about, and anybody can get these, you know, tins or boxes that have lids on them, some are harder than others to remove. I love the little cigar boxes that are on a hinge. Especially when they kind of get worn out because you can open them real easily, they don't go away and make a great sound. But things like the old disc boxes from videos, those are good ones, too, to have. But just anything like that. And I think that's all that I had time to stick up. >> Schultz: It looks like most of those objects are relatively cheap. >> Hurst: Oh -- >> Schultz: Readily accessible at your local five and dime [Multiple voices] >> Hurst: Flea market or whatever, yeah, yeah, they're great that way. You know while we're here, just because I know folks like video, let me share a neat little video with a kiddo doing stuff with his fingers. And I think that I have another one, too, that you all might enjoy looking at. >> Video: [Infant noises in the background] >> Hurst: Those are not huge movements. But those are important movements.[laughter] >> Schultz: Very purposeful, yeah. >> Hurst: It's nice to see like how this index finger is starting to is slate and come up really well; to isolate and come up really well. >> Schultz: At first the left land wasn't engaged but then it is engaged at the midline. >> Hurst: Moving at midline, exactly. This is the child with no vision. See, that was -- the interaction piece. I mean, again, at phase 1 you offer it, if they play, then you imitate what they're doing. >> Schultz: To communicate to them without words... >> Hurst: Without words. "I see what you're doing. I know what you are doing." You know, it really is a conversation about what they're doing and then giving them the option of -- of letting you do it again with them. >> Schultz: Yeah. >> Hurst: Then maybe showing them something different. Okay, let me show you one other little video of -- of -- of grab and release kind of activities. Okay. You see this is that second stage of the SPG boards where the things are not very long. What she's primarily doing with this is -- this thing is freezing up¬† some -- she's using her fingers to sort of scratch on it, but then she can grab it, she does a little bit of banging with it and also on it. >> Schultz: So lots of tactile feedback, lots of auditory feedback, some visual feedback. >> Hurst: These are terrific when, you know, you've got to have a kid in a standing frame or they're in a wheelchair, or you need to sort of just get them in a place where they're safe and positioned in an upright place or even lying down. And have them engaged in something. These are wonderful to have around. And a lot of parents will create things like this to have with their kiddo. One mom, that we knew, when she had to take her kiddo to the -- to the doctor and there was time in the waiting room that made the child very nervous, because they could smell that they were in the doctor's office; and they were not happy about being there. She took the thing that goes around the floor of a toilet, you know, the rugs that are sort of that U-shaped, have the cut out, and she got ones that had the big loops on them. She would hang objects on that and then she could just fold it up. When they go to the doctors office, she unfold it, lay it around the kiddos lap, and they had stuff to be engaged with in their lap while they were waiting. And it dropped their anxiety level down just a whole lot. >> Schultz: Well, anyone that uses their iPhone while waiting in line knows why it's nice to have something to do while you are waiting. That makes sense. >> Hurst: Okay. Donna says I do like the boards using everyday objects that are meaningful. >> Hurst: Yeah, I think that's the thing. Getting things that the kiddo is going to come across in their home life, in their school life. Being mindful that we don't put everything plastic in there, but very functional things. Because, you know, for our kiddos getting those functional skills is where we're headed with a lot of kids at this developmental level. But you also can do things when you think about units that are covering, you know, we have our units that we do in school. Any unit that you are doing, if you are doing Halloween and you know the kiddo likes certain sounds, find toys that make that sound maybe, you know, as part of it. Or they like a certain texture. You know, find Halloween decorations that are things that are made out of wood or made out of something besides plastic -- there's crazy things that you can get. >> Schultz: What I like that idea of using seasonal things or units that occur in your classroom, as like impetus to make changes and provide more opportunities with different objects. Because as Lilli talked about in the book, we know that providing exposure to different types of materials, different types of textures, different types of auditory feedback is really important in keeping these kids motivated to explore; and you never know what you're going to put there that's going to be really exciting to them; and without that kind of moving things in and out. >> Hurst: Yeah. You want to -- always have a base of things that are familiar to them that they know and love. It's not like you want to totally swap things out. >> Schultz: Good point. >> Hurst: But what they're in independent play. You can take some time to do an offering activity, where you just sit on the resonance board with them and maybe introduce, you know, four or five or six new objects that maybe are related to the season and just see how they respond to it. It may not end up being in their best hits collection, you know. >> Schultz: right. You never know until you try. >> Hurst: You never know until you try. If there's something they particularly get into, then, as you start to change out your little room, or building a position board, you know, or adding more materials to it, you can include one of those things in, you know, or a couple of those things in. >> Schultz: Yeah. Kate, I used to know a teacher who had an apron that she would wear during like an offering time; that occurred once a week; that she would -- you know, there were four or five things Velcro-ed to the apron. They were objects that she knew the kid might have some interest in, but it was an opportunity to rotate one new one in every now and then, to see how the kid responds. >> Hurst: Exactly. As you are picking those objects think about what skills the hands are doing, what's going on and kind of pick according to that. >> Schultz: So, Lilli points out that infants without disabilities begin working toward head control in that first month of life. As soon as they lift up their heads from the prone position they are starting to develop the movements and muscles needed to get full head control. Literally their world... and their body are built to respond to that stimulus, right. They have that vision. They're lying down in a prone or in a supine position in their sleeper, mom walks in the room, the baby's head moves up, immediately. It just happens naturally. Full control over head movement occurs at just five months... >> Hurst: That's pretty amazing. >> Schultz: For typically developing kids. So that tells you just how rich that environment is for a typically developing child, that that head control occurs in just five months. Not so for our students with visual impairments and multiple disabilities, right? That lack of sight or low vision means, that in order for them to learn to hold their head up, they need opportunities where that movement is combined with auditory feedback, with tactile feedback, with olfactory feedback; to replace those opportunities that are missed because they don't have that vision. Possibly intervention that Lilli talks about is, propping the child up on blankets; so that they are closer to other objects or just that their body's up in a position that's more ready to receive information. She mentions a tray with marbles being placed close to the child or Ping-Pong balls; sound box that only plays when the lid is pressed, so that the student has motivation to reach out there, press that sound box and create that auditory experience. She also mentioned some tasty treats, or different smelling materials that can be presented to the student on plates. If the child is vocalizing, she talks about placing him in a prone position, on a resonance board or support bench, and a container near them that will allow for good echo if, again they're vocalizing, to encourage that vocalization, that exploration. And that learning midline organization of the hands and coordinating that midline movement with the ability to move the head, is getting that body ready for that next step; that learning how to sit, which eventually is going to take us to standing and walking. >> Hurst: I have a question. I wonder if many of you out there, and you can just say in the chat yes or no, have had experience using the support bench? Because I think that is one of the very coolest things for working on head control and being able to get that head up. So I'm just curious. If you've had any luck work -- or students that you are using the support bench with, just let me know. Or if you haven't, I would just be curious. So, Donna, no, hasn't. Okay. Denise is putting in some answers there. So, you know, if you haven't ever used a support bench that is something that you really should consider. It's not in, some ways different from a bolster, you can do things with bolster, but what is nice about the support bench is it really provides some great stability, and it gets those -- not only the hands and the arms and the legs freed up, but you really, they really learn to pull that head up and work on getting that head up; and do some nice things with it. If you haven't and you -- Oh, good, Denise says, "We recently tried the support bench. It's wonderful. However very costly." It is very costly. But, you know, I think the nice thing about a support bench is you can get one piece for a school and use it for a bunch of kids. It's not so much like a lot of the other pieces of equipment that are kind of tied to a specific child. Yeah. And for some of you guys, you know, checking with Lions clubs and stuff like that to see if they would be willing to do a fundraiser to buy one to donate to your school might be a possibility. >> Schultz: Yeah, I know some teachers that have approached local churches to get some of these materials that are costly. It's definitely an obstacle, you know. >> Hurst: Well, and for families, sometimes buying one for their child to have at home for the big Christmas present, you know. I mean, a lot of families buy a lot of little presents, and I know for a lot of these kids, they are always looking for something that's a really good present for them, and a lot of the stuff that are normal presents are just not that meaningful, you know. I say tell all of the grandparents, tell all of the aunts and uncles that instead of sending little things that maybe the kid won't be that into, send money for a support bench. [laughing] >> Schultz: And I think, be mindful of pairing that request with an explanation of what you're doing... >> Hurst: Of what you are doing yeah, and sharing some videos of what the kiddo's is doing with it, yeah. Having said that, if you guys haven't gone on LilliWorks, there are short video clips there that are kind of handy, if you are trying to explain a little bit, in a two or three minute segment, what active learning is about for family members, extended family members, administrators, whatever. There's some nice things on there that show examples of some of the equipment and why you are doing what you're doing, that are handy -- so check that out, too. >> Schultz: That sounds like a good resource. Let's jump into learning to sit unsupported here. Again, the typical child learns this step somewhat naturally. We have all seen babies that like to pull their legs up and grab at their feet and kind of gyrate back and forth. Those movements, that they begin to experiment with naturally, help develop all of the muscles in the abdomen and the legs and the hands... >> Hurst: Super crunches! [laughing] >> Schultz: Super crunches! Yeah. And again, they come to those exercises very easily. And they do them for a very long time. You know, the amount of repetition that is involved is really incredible before they ever learn to sit unsupported. They have a lot of opportunities. When they drop objects, they use their vision to locate before reaching out to grab that object. Again, think of all of the body movements that are involved just because they are motivated to get that object, and they are motivated because they can see it. >> Hurst: See it. >> Schultz: Can see it, yeah. Lots of kids when you hold them -- the babies before they can sit up -- you might hold them on your lap, they will put your feet on your thighs and they like to bounce. They like to move the right leg up, the left leg up. Again they are exploring those movements, it's fun, a lot of times the person holding them is going to be smiling, giving them a lot of auditory feedback; but really at the core level, it's exercise. >> Hurst: Yes. >> Schultz: You know. It's movement patterns and muscle work that are needed to get to that unsupported seated position. A lot of times those kids when they are in that position, too, they will start to lose their balance one way and start to fall a bit and then the adult withhold them. They get that opportunity to feel like what -- to feel what it's like to lose balance and gain balance. Their bodies, their muscles that are involved in... developing balance are really -- it's every muscle in your body. And again, through those natural opportunities for those kids, they get to work on that muscle development that are going to be needed to sit and stand; which takes us to our kids with visual impairment and multiple disabilities. They don't come to those opportunities naturally. They don't see where the toy they dropped went, so they don't reach out across their body and pick it up, right? We have to find opportunities for them to reach out across their body, learning how to roll over on one side. You know, thousands are times before we can expect them to sit unsupported. They have to go through that process. Lilli talks about a 19-month-old blind child, who is placed in a net hammock with an Essef board. >> Hurst: Essef board. >> Schultz: Thank you, Kate. Placed near his feet and he explores the board with his feet and later with his hands and fingers, eventually pushing off the board, swinging himself. And she talked about how he went through this stage rather rapidly. Almost miraculous, what happens when these kids are given these opportunities, you know, it really boils down to that. That our job, as teachers, is to provide them with the opportunities and in a well thought out, kind of mindful way; and once given those opportunities they will... >> Hurst: They'll do it! >> Schultz: They will move to that next step, I think. Listening to her kind of talk about her case studies in the book is really powerful testimony towards that. >> Hurst: Absolutely, absolutely. >> Schultz: Yeah, she said one month later that boy was able to move from a supine position to the sitting position. >> Hurst: It goes very quickly. It really does, it really does. >> Schultz: She points out another way of motivating a child to coordinate movements with the hands and the feet, both together, are exposure to the little room. And we kind of talked about that throughout the broadcast today. Using interesting objects. She also talked about the support bench, again, a lot. How important that is in providing opportunities for these kids to explore and experience feedback; and thus learning to move to the next developmental stage, which is learning to stand and walk independently. She points out that all of these opportunities for these movements provide opportunities for the kids to have their self-esteem and sense of independence grow. Which I think it's wonderful that she is talking about that, and I think as educators it's important that we realize how important that is for all of us to feel that we're individuals that can accomplish things. We can make progress, we can do things on our own and what... amazing things that does to our emotional development, you know, as we proceed through school. And, you know, that's -- that's added fire or fuel to the fire I think for us as teachers to provide these opportunities. >> Hurst: Well, and you know I have to confess -- and this is sort of a sad confession. For me, I could see it in babies, you know, when I'm working with a really young child, I can see and it's real easy for me to recognize the importance of their successes and their own self image and I can do it myself. Where I have run into difficulty and really had to confront some values in myself, is when I was working with older kids who were still at that lower developmental level. I kind of forgot how important that emotional... state is and that sense of accomplishment is for those students as well. I think a lot of times -- and maybe it's just me, but I think we -- there's a tendency to forget that even though they're 18 years old, developmentally they are still very, very young. And emotionally and socially they are -- and so they need to have those successes as well as the young child. And I think that we forget how powerful that can be for them. And growing. >> Schultz: And if we know that that's true -- that when performing tasks and skills, that they can be successful at, we know how that helps them, we also have to realize that the other side of that coin is ,that when we're asking them to repeatedly perform tasks or skills that they can't do, that that's going to tear down that self-esteem. >> Hurst: Exactly. >> Schultz: So that, again, I think is something for us to think about when we're planning what our instruction looks like for our kids and how important it is to provide opportunities that they can be successful based on where they're at. >> Hurst: Yeah. >> Schultz: Two minutes now. >> Hurst: Okay. >> Schultz: Is there a video maybe? >> Hurst: Well, let me think. We have a couple of videos still left, I believe. We've got one about the... balloon interaction, and then... I think that's the only other video that we've got. Do you want to take a look at balloon interaction? >> Schultz: Let's do it. I think it's kind of nice to close on a video. >> Schultz: There's that midline coordination with both of those hands. >> Hurst: There's auditory and tactile feedback that's so good. Video: [balloon squeaking noises and children vocalizing in the background] >> Schultz: His communication partner is providing an opportunity for the student to reach that balloon out, which again is an opportunity for those stomach muscles and those -- those shoulder muscles to become activated; that we know are going to be required down the line. Video: [balloon squeaking noises and children vocalizing in the background] >> Hurst: What I love about this one, too, this child is so much superior to the adult in making these great sounds, you know. It's kind of -- it's a really neat thing to -- >> Schultz: He kind of gets to play the role of director. >> Hurst: Of the teacher, yeah, that's what I like about it, yeah. >> Schultz: He's leading the discussion. He's a little better at it, like you said. >> Hurst: He is, he's got a lot more skill with that. But that is a lovely interaction, you know? Very simple, child... child led. Now, for some reason the videos want to freeze up today a little bit. Video: [balloon squeaking noises and children vocalizing in the background] >> Hurst: Okay. I hope everybody has been able to see it. It runs at different... different rates on different computers. Exactly. Before I forget, one of the things I wanted to mention to you folks, when we're talking about the support bench, in Outreach we do have a number of different pieces of Active Learning equipment, the more expensive pieces, available for loan through our tech loan program. So if any of you are ever wanting to try the support bench, and I'm thinking of... of you, Donna, if you are ever interested, or if anybody else that might need one, or you know of someone that might need one; with the school, we can do loans -- through tech loan -- to give you a chance to try it out and see if it will work and also maybe help make a case for investing the money and going ahead and paying the price to get one. And you can get information about our tech loan program on the TSBVI Outreach page of our website. Or if you want more information, just get a hold of me. You can email me or email Matt or call either of us. Our contact information is on your handout, but it's also on the staff page of the outreach tab. So just check it out. Because, you know, it is -- it is -- this equipment is very expensive and I know that, you know, it's a hard commitment for schools to make if they don't know if it's really going to pay off. So, you know, get in touch with us, let us know. 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