Pathways to Learning

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Audio Description: A slide reads Pathways to Learning. At the bottom are logos for the Penrickton Center for Blind Children, Texas School for the Blind and Visually Impaired and Perkins School for the Blind.

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Patty Obrzut: So, what are the pathways that a child uses to learn? It's easy. It's the five senses. 

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So, you have sight, smell, taste, touch, and hearing. But Dr. Nielsen like to refer to a sixth sense and that's movement. 

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And whether or not a child can move is so important because if they can't move, they're going to have difficulty getting to an object, or people in the environment to learn from. So, it's very important to that you think about all those six pathways and then recognize how much ability does a child have in each one of those pathways.

So, let's talk about the pathways to learning and how the different pathways affect children with special needs. I'd like to describe two different types of children for you. I work a lot with children who are visually impaired, and I find that many people forget about how much vision loss affects a child's ability to learn. So I'm going to remind you by using examples of children who have visual impairments a lot through my examples. But, in this case, let's talk about two types of children.

One child has cerebral palsy, and they're a child who's in a wheelchair and maybe they can roll over but they can't sit up independently. So, they're going to have a spastic cerebral palsy. They have difficulty in holding their head up. They have difficulty in using their arms or their hands for activities. But, they can roll over. So, this child is visually impaired and has cerebral palsy.

Then we have another child who is visually impaired but has, possibly, autism. So, this child likes to run around the room all the time. He very rarely likes to sit down and play with toys. He likes to, maybe, push buttons on a toy and listen to music all the time.

So, let's discuss how each pathway is affected by that child's disabilities. So, let's start with a child with cerebral palsy and the sense of vision. So, in both of these children, let's say that they have light perception. They can see an object if it's really bright, or if it's really a contrasting color, but they're not going to notice something that's... similar in color.

So, for example, if I take a ping pong ball that's yellow, and a ping pong ball that's white. A child with a... vision impairment, where they can only see light perception, may not be able to notice the difference in the color of these two balls. But, if I hold the ball up against, for example, my shirt which is a dark color, now maybe they'll notice the ball, because it has a different color.

So if you think of a child's ability as a circle. If a child has no vision loss whatsoever, we're going to fill in that circle 100%, because they have 100% of vision, and I can use all kinds of toys that have visual qualities. 

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But, for the children that I'm describing right now that have light perception only, we're going to take that circle and we're only going to color it in, maybe, an eighth or a quarter of the way. And, that's going to remind us that when I'm picking objects for a child to play with and they have a visual impairment, and that visual impairment is pretty severe; I need to look for toys that offer certain kinds of qualities. 

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So, for example, I might want a cup that's really shiny, because the shiny quality allows a child with light perception to pick it up. Or, if I'm looking at balls, this ball might look like... it's kind of a boring color, but what's nice about it is if you push it it changes colors. So, if you're working with a child who can see the color blue, you can change the ball to blue. But if you keep pressing it it goes to all the different colors, or at the very end it also flashes. And, for someone with just the visual impairment of seeing light perception, they may need items that can light up. So these-- you're going to pick, maybe, this ball over the white ball. So, understanding how the pathways are affected in children with special needs determines what kind of toys you're going to pick and play with that child. 

So now, let's talk about the sense of smell. Does the child with autism and the child with cerebral palsy, are they both able to smell? And the answer is, usually, they can. 

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So we're going to color in that circle in 100%. So, what does that mean? That means that you can use the sense of smell in all of your toys. 

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So, what do I have on the table? I have plastic items. I have metal items. What people don't realize is that metal and plastic have a sense of smell to them. You want to be careful though that you encourage all kinds of smells. So, you might include leather, because leather has a certain type of smell. Or, what's really fun is if it's Valentine's Day, or if it's Christmas, and you get a box of chocolate. The inside of a chocolate box has that little crinkle material that the chocolates are usually individually placed in. And, if you let a child play with that, it already has the scent of chocolate to it, and kids will pick it up and smell it, and they'll be putting their little fingers inside of it. And so, that might be a simple thing that you can gather from home, and add to your toy box of things that the kids can play with.

Or this is a handy dandy little tool that we picked up. It's actually something you insert into a lemon or an orange or a grapefruit. And then what you do is you pump the end and juice will squirt out. And so you can actually add a squirt of lemon to a plate or to a cup, if you wanted to, just to add a little bit of a sense of smell.

However, be really careful. What people tend to do is they take this and they spray everything with lemon. Now, all of a sudden, the child thinks that the world smells like lemon everywhere they go. And, you don't want to do that. Lemon has a smell. An orange has a smell. Grapefruits have a smell. Beads have a smell. Wood has a smell. And, it's very important that the kids understand that things smell differently. You know, there's good smells and there's bad smells. It's important that children learn what a fire smells like, or what grass smells like, or even if you go to the farm, you're going to figure out what manure smells like. Those are all different smells that a child can be exposed to, and learn what's a good smell and what's a bad smell. 

So, now let's move on to the sense of taste. And can children who have cerebral palsy taste? And can children with autism taste? And the answer to that is, usually, yes they can. 

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So, that circle is filled in, again, 100%. So, now you've added smells to things, but do you want to add taste to things? 

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So, if kids are chewing on plastic, it tastes a certain way. You might even add a little peanut butter to something to encourage somebody to actually grab a spoon or a cup, and bring it to their mouth. If you add a little flavoring to it, maybe they'll lick the flavor off of that item. And now they're bringing a cup up to their mouth, and maybe learning to drink from a cup, because you added a little juice flavor to a cup. So, remember that the sense of taste and the sense of smell are two examples of pathways that a lot of people forget about and they don't tend to use those pathways in their selection of toys. And, I'm going to encourage you to go ahead and do that. 

Let's say you have a child who has a gastro-tube and they don't eat by mouth. You know, can that child still smell and can they still taste? And the answer is yes. But whether or not you're going to be able to use those pathways is going to be dependent on whether or not the child's physician says that it's okay for them to be able to go ahead and, maybe, lick something. So, for example, if I take a piece of licorice and hold it up to a child's mouth. They may start to stick their tongue out onto the licorice to explore it. And, in doing so, they're learning to use the motor skills of their tongue. And, that could be really important to teach a child to be able to chew, or to be able to handle food again. So, if their doctor says that licking something which produces a little more saliva is still okay, then you're absolutely going to want to do it. But if you have a child that's at a severe risk for producing saliva, and that might cause them to aspirate, then of course you're not going to be able to do that as much.

That's why each child is an individual person and you have to think about each child and the objects you're going to use for that child.

So, now, let's talk about the pathway of touch. Let's take the child who has cerebral palsy and, again, I'm going to describe that child to you as someone who can roll over but maybe they don't use their hands very much, because the hands is fisted. So the thumb is at the palm of the hand and then the fingers are over the thumb. So, does this child have a sense of touch? They do. But, it is slightly impaired because they can't really explore items, because their hand is fisted. 

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So we're going to go ahead and take that circle and instead of filling it in 100%, we're actually going to fill it in about a quarter or an eighth again. And that's to let us know that the objects we pick have to be graspable.

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And what do I mean by graspable? Well, if I take two toys from the table. So let's say I take this ball which is a goosebump ball that's used for giving massages, and I take this ping pong ball. Which one is more graspable? The answer is it's the ping pong ball. And why? Because it smaller. Someone with cerebral palsy whose hand is fisted has extreme difficulty in opening up their fingers. And it takes a lot of movement and a lot of energy to be able to do that. So, if you give them this big orange ball, they can't get their hand open to grab onto it. When they do, the ball just pushes away. But, if you give them the small ping pong ball, they might be able to get their fingers around that one, and actually keep it in their hand. And so, now this ball becomes more graspable than this ball. So, you would always want to choose your items for this type of child extremely carefully.

So, if we go to a cup, which of these two is going to be more graspable? So, you have this cup or this cup. The white cop is more graspable than the gold cup. And the reason is that it has a handle. So again, a child with cerebral palsy might be able to get their finger around that little handle, and hook onto it, and hold on to it. Where this cup has nothing to do that, so they can't really grasp the cup in this manner. They might be able to get their finger around the rim of the cup and hold this way. But in general this cup is usually a little more graspable than this one.

Now, remember grasp is subjective. Some kids can't grasp with their fingers, but they can use their whole hand. So now this cup, the white cup, is actually a wider rimmed cup, then this gold cup and maybe a child can actually get their whole hand inside the cup and they're grasping it that way. Where I can't get my whole hand in the gold cup, and it's going to fall off my hand. So, graspable is a really important characteristic in almost all the Active Learning equipment that I'm going to show you.

So now, let's talk about the child with autism. Can they grasp toys? They can grasp anything they want to. They just may not choose to. 

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So, we going to take their circle and we're going to color it in 100%. And pretty much we can use anything with someone with autism. 

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So, now let's move on to the pathway of hearing. And can a child with cerebral palsy hear? And can a child with autism hear? The answer, usually, is yes. 

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So, we're going to take, again, that circle and color it in a hundred percent for both of those children. 

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Now, some children will want to listen to certain types of sounds, and so you might have to pay attention to the items you're playing with. So, again, the seed pod rattle [rattling sound] makes all kinds of noise very easily and if it's graspable, a child with cerebral palsy can get their hand on it, shake it, or just move their hand through it and activate the sound. So, this would be a good toy for that child. The autistic child could shake it, throw it, put it in their mouth if they want to and they can activate this toy.

So, what about a child who has a hearing loss? If they have no hearing whatsoever, then you're going to take that circle and you're not going to color it in at all. And, that's going to remind you that sound qualities really are not going to impact the children, and you don't have to look for objects that have sound characteristics. You can pay attention to vibration, because a lot of children with hearing impairments actually enjoy playing with vibration. But remember that's a tactile pathway. And it's perfectly fine to use that pathway as a way for a child with a hearing loss to be able to participate in activities.

So now, let's talk about the last pathway which is movement. Again, we're going to talk about the child with cerebral palsy. This child was able to roll over. They could use their hands a little bit, but they're fisted. And, maybe they can move their head around, but they don't have the best head control. 

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So we're going to take that circle and we're going to color it in, maybe a fourth or an eighth of the way. 

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And, that's to remind us that the objects that we pick for this child have to require the smallest amount of movement to be activated. So, something that takes a large movements, we shouldn't be using. So, for example, the seed pod rattle, again, is a great rattle for children who have difficulty in moving, because the slightest movement will make something happen. If you place this by a child's hand, and they move it just slightly, you're going to get that sound. So, this is a great toy for a child with spastic cerebral palsy.

Okay, some other toys come with adaptations made to them. This is from a musical instrument catalog, and it has a little tubing onto it, so that I can actually slip it on a child's finger. And, again, the littlest movement might make the sound happen. Some balls have chimes in them, so if a child grabs it and shakes it, it's going to make a sound. So, you want to look for the slightest movement causes something to happen.

Now, let's talk about the child with autism. Can that child move? Absolutely. That's a child who's running around. They can sit up. They can stand and they can walk.

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So, typically, you're going to fill in that circle at at 100%.

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So now, let's take an overall picture of each child. If you look at the child with visual impairments and spastic cerebral palsy, what type of toys should you be picking? 

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Well, the things that are 100% available to them are the sense of smell, the sense of taste, and the sense of hearing. So, you really can use anything in those categories. But, you have to pay attention if you're going to use sight, touch, or movement. You have to look for things that light up or that are bright. That are easily manipulated and that, when the slightest movement happens, those toys can be activated.

Now, for a child who has autism and visually impaired, you can use everything in your arsenal with the exception of sight. 

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If that child has a vision impairment, you're going to need to look for things that are shiny, or things that light up to get their attention. 

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But, remember, you don't have to use all six pathways at one time. 

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You could spend an hour playing with a toy that just is with the sense of touch. Okay. So, just because you work with the visually impaired, doesn't mean you should be working with visual items all the time. You need to pay attention to tactile qualities and auditory qualities. And, just because you're a speech pathologist doesn't mean you should be working on speech all the time. You want to be looking at the entire child, and looking at all the pathways that they have open to learning.

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A slide reads Active Learning Space www.activelearningspace.org May 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.