Active Learning Study Group - September 2018 This video is posted online with the following chapter markers: Chapter 1. Active Learning Space Website Updates Chapter 2. Dynamic Learning Circle Chapter 3. Development of Grasp Chapter 4. Hand Position or Grasp Chapter 5. Discussion Description of graphical content is included between Description Start and Description End. Transcript Start [Music] Fade up from black. Animation: Text for TSBVI transform into braille cells for TSBVI. [Music face out] Fade to black. Chapter 1. Active Learning Space Website Updates Charlotte Cushman: Hello, everyone. And welcome. I'm Charlotte Cushman with Perkins School for the Blind, and I just want to thank you all for joining us this afternoon. This is an exciting day for us, because we were looking at registration, and we saw that we have six different countries and at least 27 states represented, so I wanted especially to thank those of you who are joining us at a bit of an unusual time, people in Italy where it's bedtime and people in Australia where it's not yet time to get up. So thanks so much for being here with us. I also wanted to mention that we are now using the platform zoom, and this is new for us this year. We've used AdobeConnect in the past, so there are a couple of kinks we're working out. Hopefully it will all go smoothly today, but one of the main things I wanted to alert you to is that you'll notice there's a choice between Q & A and chat, and we're asking that you use the chat window, just for technical questions. The initial greetings that we did today, but also just for technical questions, if you're having trouble, someone can help you. Otherwise for content, comments or questions, please use the Q & A link at the bottom of your screen. [ Slide start: ] Description Start: Title: Poll Content: Have you used the Functional Scheme to assess Fine Movement? • Yes • No • I don’t work directly with students. Description End: Okay. We have a poll that we're going to start out with today, and we-- I'm going to read the question, because it's not yet accessible via screen reader. So the question is, how do you use the functional scheme to assess fine movement? And the answer choices are yes, no, or I don't work directly with students. So we'll give people a minute to respond. And it looks like the majority is saying no. So that's interesting for us to know, and we're going to hear a little bit more about that and talk a little bit more about that as we go forward today. So thank you. There is information about the functional scheme and about lots of other things on the active learning space website, so we hope you'll be having a look at that. We're happy to welcome our co-hosts today. [ Slide start: ] Description Start: Title: Co-Hosts Content: Figure 1: Photos of Patty Obrzut and Jessica McCavit Description End: We have Patty Obrzut and Jessica McCavit are both joining us from Penrickton Center for Blind Children. Patty's an occupational therapist and Jessica is also an occupational therapist. We don't have a photo of her, but Kate Hurst is also with us today, she's joining us with outside the studio, and she's with the Texas School for the Blind and visually impaired and I'm sure you already know her already if you've been doing work with active learning. We wanted to remind you about some upcoming webinars. [ Slide start: ] Description Start: Title: Webinar Dates Content: • January 24, 2019: Constructive Play • April 18, 2019: Oral Motor Activities Remember: You need to register separately for each session! https://txtsbvi.escworks.net/catalog/session.aspx?sessionid=39532 Description End: We have a series of three webinars this year. Today's webinar will be focused on the comprehending hand, and we have another webinar also presented by Jessica and Patty, which will be in January on constructive play, and finally in April, it will be on oral/motor activities. We want to just be sure to remind you that you need to register separately for each session, so everything's free, but you do need to register separately for each one. So please go ahead and do that. We also wanted to invite you to look at our prerecorded webinars, or our previously recorded webinars. We have quite a few that are on the site. I'm noticing that the slide that's up is not the connect URL. We've done a lot of changes on our website, but if you go on there and search for webinars, you'll see it. It's actually on the research. Many people have told us it's helpful to get a group together of colleagues or families and maybe watch them together, and then you can have some discussion about that. I also wanted to invite you to subscribe to our newsletter, we send that out once a month, just with highlights of what's new on our website. We'd like to let you know if there's an upcoming training maybe or a new video that's been posted or a new section that's been added, because we're always adding new information. So please do subscribe and encourage your colleagues and your friends and families, anybody that might be interested to subscribe. Of course, it's all free. And those newsletters are posted also on the website. I'd also like to let people know about a really exciting thing that's been happening, which is that Kate Hurst has been very busy creating online modules which are available for free, and they are posted on our website. The link for them is posted on our website. The first one that's up and going is introduction to Active Learning principles. [ Slide start: ] Description Start: Title: Modules Content: Figure 4: Screenshot of Introduction to Active Learning Principles module. http://www.activelearningspace.org/courses Description End: And we've had 200 people so far have registered and are either enrolled or finished with it. And we've had people from around the world. So this is a great way to learn a little bit more, if you don't have time to go to our live conference or training, this is a nice way to get some information and share it with others. We have a couple of upcoming trainings we wanted to let folks know about. Patty Obrzut is going to be preventing at the Georgia educators statewide conference which is coming up October 10th and 11th. [ Slide start: ] Description Start: Title: Upcoming Training Content: • Georgia Vision Educators Statewide: Oct. 10-11 • Penrickton Center: Nov. 5-6 Full calendar: activelearningspace.org/training-events Description End: Penrickton Center is also hosting a training event, November 5th and 6th.. You can have a look at our upcoming training events right through the website. We also invite you if you're doing any kind of a training to contact us and let us know about it, we'd love to include it on our calendar as well if it's something that's open to others. Okay. Well, I think we're ready then to go to the prerecorded section of our presentation today, and we always try to pre-record it, because we have a lot of videos that need to be captioned and a lot of moving pieces, so this is a good way to be sure that we are-- our technical difficulties are hopefully taken care of and that you'll be able to watch things. But we will be monitoring chat, but actually monitoring the Q&A tab, so please go ahead and comment if there's some-- or got questions or things that you want to add, and we'll come back after the prerecorded session and-- or section and respond to any questions that may come up. So thanks for joining us. Chapter 2. Dynamic Learning Circle Patty: Our goals for today will be first, to understand how an infant develops the ability to grasp. Second, identify how various disabilities, such as cerebral palsy, influence a child’s ability to grasp. And lastly, to identify Active Learning strategies and activities that encourage the development of grasp. One of the most important concepts to remember in Active Learning is that a child is a learner. As so, a child learns throughout life. A child learns gradually, according to his or her level of physical, mental & emotional capacity-- no matter how old he or she is, or what type of disability has effected, or is still effecting, his or her ability to learn. If every child is a learner, then what prevents a child from learning? Learning is only restricted by a lack of learning opportunities. Creating an Active Learning environment, and utilizing Active Learning strategies can eliminate these restrictions, and will provide an opportunity for learning. It is so important that every child be given the opportunity to learn to grasp, for a child who is unable to grasp will be unable to make full or sufficient use of the impressions he or she is experiencing. Jessica: Before we proceed further, I think it is important to quickly and briefly review the dynamic learning circle. You can find a more detailed understanding of the dynamic learning circle at activelearningspace.org. [ Slide start: ] Description Start: Title: Dynamic Learning Circle Content: Figure 5: Diagram of Dynamic Learning Circle -- Stage 1: A child becomes aware & interested; Stage 2: a child becomes curious & interested, which leads to activity; Stage 3: A child completes learning with an activity; Stage 4: A child becomes ready for new challenges. Description End: In Stage 1, a child becomes aware and interested in his or her own sensory or motor experiences, objects in the environment, or people in the environment. In Stage 2, a child becomes curious and active and thus begins to explore and experiment. This occurs through repetition of sensory and motor experiences. The child gains a greater understanding of his or her own abilities, objects in the environment, and people in the environment. In stage 3, a child has completed his or her learning. The child masters skills and those skills become part of his or her self-identity. Importantly, these experiences now provide no further challenges to the child. [ Slide end: ] In stage 4, the child is ready for new challenges that will offer an opportunity for new sensory and motor experiences. The child is ready for new objects and activities. This will lead to new interest and awareness, providing a basis to start over again at Stage 1 and repeat the dynamic learning circle. It is important that these new experiences are only slightly different than previous experiences and match the child’s developmental level, or else interruption of learning can occur. Chapter 3. Development of Grasp [ Slide start: ] Description Start: Title: The Development of Grasp Content: Hand Position/Grasp In utero • Development of hands in fluid environment, weightlessness 0-1 Month • Reflexive hand • Holds hand tightly 2 Months • Reflexive grasp • Holds hands un-fisted half of the time Activities of the Hand • Movements of arms/hands o Hand to mouth • Pushing against uterine wall o Open/close fingers • Hand to hand • Movements of arm/hand o Hand to mouth • Scratching motion • Grasp & let go • Releases objects without awareness Description End: Patty: Now let’s apply the principles of the dynamic learning circle, to better understand how an infant learns to grasp. At what age do you believe a child begins to use his or her hand? [ Slide end: ] Many adults may respond that a child begins to use his or her hands immediately after birth. However, the fetus has been gaining sensory and motor experiences while in utero. The fetus is developing in a liquid environment. The fetus can move arms, hands and fingers. Eventually, a fetus puts two hands together, sucks on the hand, or thumb, and pushes against the uterine wall. These basic skills are just some of the ways a fetus uses the arms and hands as pre-requisites in learning to grasp. [ Slide start: ] Repeat previous slide An infant between 0-1 month of age demonstrates a reflexive grasp. If you place your finger inside the infant’s fingers, the child will grasp on, reflexively. [ Slide end: ] The hand is fisted tightly. Between 1-2 months of age the infant begins to open the hand more. Although reflexive grasp continues to be observed, the infant may hold the hand open with less intensity, for increased periods of time during the day. What activities using the arm or hand can the 0-2 months old infant engage in? An infant can move the arm and hand, bring hands to mouth, make scratching motions of the hand, grasps and lets go, and releases objects such as rattles, without awareness of doing so. Now, let’s take a look at videos of children whose hand movements are influenced by cerebral palsy. If you notice, their hands have things in common with the hand of a child under 2 months of age. To encourage skill development of the hand, the activities these children must be introduced to, should reflect the current ability level of the hand. Therefore, activities should encourage movement of the arms and hands, scratching, grasping, and letting go. Let’s watch a short video of a child on a resonance board with a slinky. [ Video start: ] [slinky rattling] [thump,thump]  Audio Description: A young boy, lies on his back on a resonance board. His right arm is looped through a large plastic slinky. He repeatedly shakes both arms. [slinky rattling] [slinky rattling] [slinky rattling] [slinky rattling] Audio Description: New... video segment. [slinky rattling] [slinky rattling] [slinky rattling] [slinky rattling] [slinky rattling] [ Video end: ] Jessica: Did you notice how this child was moving through stages one and two of the dynamic learning circle. He was aware of the slinky and his own arm movements. By moving his arm up and down, he was actively experimenting in stage two of the dynamic learning circle. There were instances at the beginning of the activity, where this child moved only one arm at a time. He appeared to be experimenting with, and comparing, the different feedback he received from the movement of each extremity, either with or without the slinky. He received auditory feedback from the sound of the slinky on the resonance board. He also received tactile input from the vibration of the board. The various receptors throughout the body received information in relation to his movement. He also took pauses between his activities. This provided him time to process his activity and make decisions regarding how to continue. Did you also notice how this child’s hands were fisted the majority of the time? Did you observe how movement frequently occurred in both extremities, although only one arm had the slinky positioned on it. The thumbs of the fingers were also positioned between the index and third finger. These observations help you make decisions about setting up the next activity for this child. This activity is wonderful to encourage movements of the arm, while other activities will facilitate additional skill development of the arms, hands and fingers. Now, let’s now watch Rylan, who is outside interacting with an activity wall. Notice that Rylan’s hands are more slightly open, however, are still influenced by the effects of cerebral palsy. [ Video start: ] [electronic music note] Audio Description: A young boy, in a wheelchair, is positioned next to a music wall on an outdoor playground. He leans over his lap tray, which has a position board with brightly colored and reflective strings of beads. His right hand touches the music wall, and under his left hand is a paddle drum. He moves both arms. [electronic music notes] [distant wind chimes] Audio Description: He moves both arms. He moves his right hand. New... video segment. He moves both arms. [electronic music notes] He moves his left hand. He moves his left hand. [scratching sound] He moves both arms. He moves both arms. He moves both arms. He moves his left hand. [scratching sound] He moves both arms. He moves his left hand. He moves both arms. [electronic music notes] He moves his left hand. [scratching sound] He moves both arms. [scratching sound] [ Video end: ] Patty: Did you notice the length of time it took Rylan to move his arm or hands? When one body part moved, it caused motion in other parts of the body. The left hand made scratching motions on the paddle drum. It is critical that Rylan be allowed the time to process his activity and to realize that his movement caused a response. Here is another child, Luke, who has the ability to use his hands to grasp, however, is developmentally at the level of a two month old. It should be noted that until the age of 9 years, adults working with Luke were unfamiliar with Active Learning techniques. Therefore, he was frequently exposed to the technique of hand over hand patterning, to prompt him to engage in activities. As a result, Luke frequently hides his hands when approached by adults. Watch, now, how providing Luke with “scratching” activities encourages his participation. [ Video start: ] [teacher & student voices] Audio Description: Luke, is seated in a wheelchair. In his lap tray and on his fingers is green, sticky rice. New video segment. In his lap tray is a shallow baking pan with a tiny sheet of water. Teacher: You're pretty good with that tray, huh? Audio Description: Luke, repeatedly opens and closes his left hand, lightly scratching at the pan of water. [scratching sound] Teacher: [whispering] Pour some more water. Luke: [laughing] [student laughing] Teacher: You want some more, huh? Luke: [laughing]  Audio Description: The teacher adds more water to the baking pan. Luke: [laughing] Audio Description: Luke continues scratching at the pan of water. Teacher: Luke, is that wet? Luke: [laughing] [teacher & student voices] Audio Description: Luke grasps a washcloth positioned over his chest. Luke: [laughing] [student laughing] [loud knock] Teacher: That was a loud noise, Luke! Audio Description: He continues touching his left-hand to the pan of water. [student laughing] Audio Description: New… video segment. A wet washcloth covers Luke's left hand. He splashes in the pan of water. [splashing] [ Video end: ] Jessica: At the end of the video, did you observe how the washcloth was placed on top of Luke’s hand? He was not grasping the washcloth, however, Luke continued to make scratching motions with his hand, receiving feedback from this movement. This activity provides an opportunity for Luke to move through a variety of developmental levels, such as potentially grasping the rice, the washcloth, or moving one hand to the other. The possibilities are endless. Finally, let’s watch Kassidy on a support bench. She demonstrates a grasp that is at a 2-3 month developmental level. She uses her muscle tone to grasp objects, but releases objects without purpose. Kassidy’s muscle tone is so influenced by spasticity, that without positioning on the support bench, her hands would be trapped below the weight of her body, and she would be unable to use them in prone. [ Video start: ] Patty: Here, if you want it in this hand, open up, I'll put it in there. Wait, you got to open up a little further. There you go. Got it? Okay. Audio Description: Kassidy, lies prone on a support bench. Her hands rest on a resonance board. Her Occupational Therapitst, Patty, holds a metal bowl for Kassidy to explore with the massager. [metal vibrations] [metal vibrations] [metal vibrations] [metal vibrations] [metal vibrations] Audio Description: New... video segment. [metal vibrations] [wood vibrations] Audio Description: Kassidy holds the massager on the metal bowl, or rests it on the resonance board. [metal vibrations] [metal vibrations] [wood vibrations] [metal vibrations] [wood vibrations] [metal vibrations] [wood vibrations] [wood vibrations] [metal vibrations] [wood vibrations] [wood vibrations] [wood vibrations] Patty: Got it? [metal vibrations] [wood vibrations] Patty: That's it. Here you go. Got it again? Let me get it for you. There you go. [metal vibrations] Audio Description: Kassidy raises her hand, and the massager falls. [bang] Patty: Whoa! Dropped it big time, that time. Here, you want it back? Here... there you go. Got it? Do you want one in this hand, too? I've got two. No, okay. [ Video end: ] Patty: Kassidy was actively grasping the massager in her hand and moving her arm to contact the metal bowl. This activity allows her to practice grasping and releasing. Kassidy is making the transition to the next developmental level. She can open her hand purposefully, but has difficulty controlling her grasp for any length of time, due to the influence of cerebral palsy. [ Slide start: ] Description Start: Title: 0-2 Months Content: Activities must allow for: • Movement of the arm • Movement of the hands and fingers • Scratching • Hand to mouth • Grasp and release Description End: Let me stress that children with the hand and finger movement of a 0-2 month old child, require activities that allow for movement of the arm, movement of the hands and fingers, scratching activities, hand to mouth activities, and grasp and release activities. [ Slide start: ] Description Start: Title: Hand Position/Grasp Content: 3 Months • Voluntary grasp begins • Hands un-fisted most of the time 4 Months • Reaches • Engages hand in supine • Clutches objects • Retains objects 5 Months • Transfers object hand to hand • Palmer grasp with thumb adducted Description End: Chapter 4. Hand Position or Grasp Jessica: At three months of age, an infant’s hand is typically un-fisted, and they begin to grasp voluntarily. Around four months of age, the infant begins to reach for objects; he or she will also clutch objects and keep them. The infant will also engage with objects while lying on his or her back. By five months of age, an infant can move an object from hand to mouth. The child begins to use a 'palmer grasp,' with the thumb still adducted, or against the palm of the hand. [ Slide end: ] Remember that the activities presented during this time frame build upon the skills learned previously. Grasping becomes more purposeful and less reflexive, and the movements of the arm and hand are more directed. [ Slide start: ] Description Start: Title: Activities of the Hand (0-2 Months) Content: • Puts hands together • Grasp & let go • Grasp & keep • Release objects purposefully • Uses thumb while grasping • Turns wrist • Bangs on items with fist • Crosses midline • Grasps with both hands • Pushing motion/batting Description End: Between 3-5 months of age, an infant puts two hands together. The infant can grasp, grasp and release, or grasp and keep. The infant begins to use his or her thumb while grasping, starts to turn the wrist, and can bang on objects using a fist. The infant also begins to bat at, or push at objects. [ Slide end: ] Let’s watch the same child who had the slinky on his arm while he is positioned in the little room. You will observe the same movement patterns of the arms, that he used while exploring the slinky, However, occasionally this child also accidently, or purposefully, grasps and keeps, or grasps and releases an objects. On several occasions, he also grasps and brings an object to his mouth. All of these movements are increasingly higher developmental skills. [ Video start: ] [shakers & rattles] Audio Description: A young boy lies on his back, on a resonance board, in a little room. Using, both his arms and fisted hands, he bats at objects, suspended with elastic, in a little room. [teacher & student voices] Audio Description: He opens his hands slightly, and snags an object in each hand. He snags and holds an object with his right hand. He grasps separate objects in each of his hands. He grasps and holds an object with his left hand, tapping it on the wall of the little room. Using, both his arms and hands, he bats at objects. Twice, he grasps and holds an object with his right hand, then brings his left hand to join it. Using, both his arms and hands, he bats at objects. He opens his hands even wider, and repeatedly grasps and releases separate objects in each of his hands. He grasps and holds an object in his right hand. He pauses. Using, both his arms and hands, he bats at objects. [ Video end: ] Patty: This child’s pushing and batting motions, with increased opening of the hand, allowed grasping to occur. This little room was well equipped with materials that would respond appropriately to pushing and batting. Next let’s watch RJ. You will notice that his muscle tone is causing flexion of the wrists and elbows. However, observe what happens when RJ is given materials that motivate him to explore. [ Video start: ] RJ: [mouth clicks] [vibration] Audio Description: R.J. lies on his back on a large drum. His music therapist, Karen, holds a massager near his left hand. A wind chime is positioned near R.J.’s right hand. [soft wind chimes] RJ: [mouth clicks] [soft wind chimes] Audio Description: R.J. repeatedly pushes his arm to touch the massager, with the back of his hand. [soft wind chimes] Audio Description: At the same time, his right arm and hand moves the wind chime. RJ: [mouth clicks  and verbalizing] [soft wind chimes] [soft wind chimes] [soft wind chimes] [soft wind chimes] RJ: [mouth clicks] [soft wind chimes]  Audio Description: R.J. slightly opens the thumb and index finger on his left hand. RJ: [verbalizing loudly] [mouth clicks] [soft wind chimes]  [soft wind chimes]  Audio Description: R.J. grasps the massager, with his thumb and index finger. [soft wind chimes]  RJ: [mouth clicks] RJ: [verbalizing loudly] Patty: [chuckles]  You working hard over there? Yeah, you are! You're opening up your hand,  and touching the massager. RJ: [mouth clicks  and verbalizing]   Patty: And you have  the chimes with your right hand. [soft wind chimes]  RJ: [mouth clicks] Audio Description: New… video segment. [soft wind chimes] RJ: [mouth clicks]  Audio Description: R.J. grasps the massager, with his thumb and index finger. RJ: [mouth clicks]  Audio Description: R.J. repeatedly pushes his arm to touch the massager, with the back of his hand. [soft wind chimes]  RJ: [verbalizing loudly] Patty: It's a lot of work,  isn't it? RJ: [mouth clicks] [soft wind chimes] RJ: [mouth clicks] [soft wind chimes] Audio Description: R.J. grasps the massager, with his thumb and index finger. RJ: [mouth clicks] [soft wind chimes] [ Video end: ] Patty: RJ initially uses a pushing motion to explore the massager, then opens the index finger and thumb, in an attempt to grasp the massager. The adult should not move the massager, or “chase” the hand. Instead, allow the child to move the hand independently away from, and toward, an object, like the mini massager. A child with cerebral palsy faces many challenges. Although the mind may know what it wants the hand to do, physically, a child may have difficulty controlling the actions of the body. In this video, Zain initially uses a raking motion to explore the objects in front of him. As Karen, the dance and movement therapist, alters the objects, notice the slight changes in the way Zain uses his hands and fingers. The kinetic sand on the mirror tray allows the objects to stay in place, so that Zain can more easily find the objects. [ Video start: ] Zain: [laughing] No, no, no. Audio Description: Zain, is seated at a mirror tray with kinetic sand. His therapist, Karen, embeds ping-pong balls in the sand. Karen: [giggling] Zain: [laughing] Audio Description: Zain rakes a ball off the tray, with his left hand. [both laughing] Karen: You got 'em. You got 'em. Audio Description: Zain rakes a ball off the tray, with his left hand. [both laughing] Audio Description: Karen places a plastic ring in the sand. Zain slightly opens his thumb, and index finger. Zain finds the ring and attempts to grasp it, between his thumb, and index finger. It slips away. He alternates between grasping and raking motions. Zain: More balls. More balls. Karen: Are there  more balls on here? Yeah, I think so. I think so. Zain: No more balls. Karen: [laughing] There on here. Audio Description: New video segment. Zain rakes a plastic shape off the tray, with his left hand. Zain: [laughing] Audio Description: Zain rakes a ball and shape off the tray. [both laughing] Audio Description: Zain rakes a ball off the tray. Zain: [laughing] Karen: [Indiscernible] Zain: Yup. Karen: Are you counting them? [laughs] Audio Description: Zain grasps a ball, between his thumb, and index finger. It slips away. Zain rakes a ball and shape off the tray. Zain: [laughing] More balls. Karen: Yes, there's lots of balls. There's lots of balls mister Zain. Audio Description: New video segment. Karen embeds plastic pegs in the sand. Zain: More balls, more balls. Karen: They're on there. Reach out and find them. Audio Description: Zain rakes objects with both hands. Zain: More balls. Karen: What did you find? Zain rakes a ball off the tray, with his left hand. Zain opens his left hand. Zain grasps a ball, in his left hand, and brings it to his chest. Karen: You got it. [ping pong ball bouncing] [both laughing] Audio Description: New video segment. Zain grasps a plastic ring, between his fingers, on his right hand. It slips away. Zain: [laughing] [both laughing] Audio Description: He rakes a ball off the tray, with his right hand. Zain: [laughing] [ Video end: ] Jessica: Notice that Karen does not instruct Zain to pick up the ping pong balls or rings, instead of pushing them off of the tray. She understands that it is easier for Zain to push or rake objects. Because of this, Karen sets up the environment with slightly greater challenges that will promote the development of grasp. At the end of that video, you noticed Zain could pick up a peg and a ring with a hole in it, more easily than the ping pong balls. The end of this thirty minute video, which was edited to less than four minutes, demonstrates how when in the right environment, Zain was able to work to pick up a ping pong ball for a brief few seconds. [ Slide start: ] Description Start: Title: 3-5 Months Old Content: • Provide opportunities for pushing, batting, scratching to explore environment • Motivating feedback will provide further movement • Encourage any kind of grasp, grasp and release, grasp and keep Description End: A child with the fine motor skills of a 3-5 month old, must be given the opportunity to use pushing, batting and scratching to explore his or her environment. Therefore, objects must respond to this type of movement, in order to provide motivating feedback, which promotes further movement. Any grasp should be encouraged, as well as grasp and keep, and grasp and release activities. Appropriate materials such as the little room, elastic boards, position boards, SPG boards, Velcro vests, scratching boards, support benches, and other Active Learning environments, will help a child independently engage in his or her surroundings. At six months of age, the infant is raking small objects the size of a pellet. The infant can also transfer objects from one hand to another. Around seven months, the infant can rake the pellet into the palm of the hand and can grasp an object using a radial 'palmer grasp.' He or she can also pull a peg out of an item. At eight months, the infant can hold an object in both hands at the same time. He or she can also hold the pellet between the thumb and curled index finger. [ Slide end: ] During this time frame the infant adds these activities to his or her knowledge base. The infant can bang with objects, grasp his or her feet, make shaking motions, hold two objects at a time, and bangs objects on a table. In this video, Jordan is placed in the sitting-up little room. Notice his ability to hold two objects using both hands. He also explores the features of the objects with greater dexterity of the hands. [ Video start: ] [radio playing] [student and staff voices] Audio Description: Jordan sits on a resonance board, in a little room. He grasps a set of castanets in his right hand and pulls them to his mouth. His left-hand grips a metal table spoon. He releases the castanets. He grasps a toothbrush, and brings it to his mouth. Jordan: [verbalizing] Audio Description: It falls away. He grasps another toothbrush, and brings it to his mouth. He releases the toothbrush, and grasps a set of castanets, with his right hand. Jordan holds the castanets, and brings the spoon to his mouth. New… video segment. The castanets slip from his right hand, and he startles. He reaches his right hand out, and grasps two toothbrushes. With his left hand, he keeps the spoon in his mouth. He releases the toothbrushes and grasps the spoon with both hands. New… video segment. He has a pacifier in his mouth. He releases the spoon and grasps a large castanet with both hands. He maintains his grasp, while pulling against the elastic. [loud clack] [clacking] [loud clack] [ Video end: ] Patty: In this next video, watch as Desmond transitions from banging on noise making surfaces, with an open hand, to utilizing a tool to bang on various drums. You will observe that whether or not Desmond uses his hand, or the end a drum stick, to contact the surfaces, often depends on the length of the stick, and where the stick is positioned in his hand, as he is still refining this skill. [ Video start: ] [dulcimer cords] Audio Description: Desmond holds a drumstick. His hand and stick hit at the same time when he drums. His teacher drums holding the end of a drumstick. [drumming] [drumming] Desmond: [verbalizing] Audio Description: Teacher drums. [drumming] Audio Description: Desmond drums. [drumming] Audio Description: New… video segment. Desmond holds a drumstick in each hand. He drums with his left hand, holding the stick in the middle. Desmond: [verbalizing] [drumming] Desmond: [blowing raspberries] Audio Description: Desmond drums. [drumming] Teacher: Well, hello! Audio Description: Desmond drums. [drumming & dulcimer] Teacher: There you go. You're drumming. Audio Description: New… video segment. [drumming] Teacher: Beat the drum. Beat the drum. Beat the drum. Teacher: [laughing] Yeah! [drumming] Audio Description: Desmond drums on a large base drum, holding the end of a drum stick in his left hand. Desmond drums. [drumming] Audio Description: His teacher drums with him. [drumming] [ Video end: ] [ Slide start: ] Description Start: Title: Hand Position/Grasp Content: 9 months • Radial digital grasp with cube • Inferior pincer grasp with pellet 10 months • Isolates fingers and pokes • Clumsy release of cubes into box • Pincer grasp 12 months • Neat pincer grasp • Stacks 2 blocks • Precise release of cube into box • Clumsy release of pellet into bottle Activities of the Hand • Handling of objects • Releases objects into air • Rotates the wrist • Throws toys appropriately • Picks up objects within reach • Pulls heavy objects • Bangs objects together Description End: Between 9-12 months, the infant moves from using an inferior 'pincer grasp,' to developing a pincer grasp, and finally, a neat pincer grasp. The infant now releases objects into a box- first without precision, but then with more accuracy. The infant isolates his or her fingers, and pokes them in holes, and also begins to stack two objects on top of one another. [ Slide end: ] At this age, the infant begins to manipulate and handle objects. Rotation of the wrist now occurs, with a child releasing objects into the air, or throwing objects appropriately. The child is grasping objects within his or her reach, and pulling heavy objects. Watch in this video as Jevarias demonstrates difficulty rotating his wrist in order to activate the rain stick. Jevarias is Autistic, and he prefers to carry beads in his hands throughout the day. Notice how Jevarias compares the sound of dropping the beads in the steel drum versus the ping pong balls, and eventually puts the beads down to engage both hands in dropping ping pong balls in the steel drum. [ Video start: ] [beads pouring] Audio Description: Jevarias is seated on a resonance board. In his right hand he holds a string of beads. In his left he holds a rain stick. Jevarias hands the rain stick to his teacher. She turns it over, and waits for him to grasp it. [beads pouring] [beads shaking] [beads pouring] Audio Description: Jevarias hands the rain stick to his teacher. She turns it over, and waits. [beads rattle on wood] Audio Description: He shakes the beads in his right hand. He grasps another rain stick, cradles it in his right arm, and grasps the rain stick from his teacher, with his left hand. [beads pouring] Audio Description: He hands the rain stick back to his teacher, and places the other, back on the floor. Teacher: Does that make a noise? Audio Description: He grabs the rain stick from the teacher. Jevarias hands the rain stick to his teacher. She turns it over, and waits. [beads pouring] Jevarias: [Indiscernible] Teacher: Yeah. Audio Description: Jevarias hands the rain stick to his teacher. She turns it over. Jevarias: [Indiscernible] Teacher: Yeah. Jevarias: Yeah! [beads pouring] Audio Description: New video segment. [musical notes] Audio Description: Jevarias repeatedly drops a ping-pong ball into a musical steel drum. He holds a string of beads in his right hand. [musical notes] [musical notes] [musical notes] [musical notes] [musical notes] Audio Description: The teacher rolls a second ball into the drum. [soft musical notes] [musical notes] Audio Description: Jevarias removes the second ball. [musical notes] [beads on metal] Audio Description: Jevarias places his string of beads in the drum, and draws them out slowly. He drops a ping-pong ball. [musical notes] Audio Description: He draws his beads across the drum, twice. [beads on metal] [beads on metal] Audio Description: The teacher rolls a second ball into the drum. [soft musical notes] Audio Description: Jevarias releases his string of beads, reaches into the drum with his left hand, and drops a ball. He reaches into the drum with both hands, grasps a ball in each hand, and drops them together. [musical notes] He drops one ball. [musical notes] He drops two balls, repeatedly. [musical notes] [musical notes] [musical notes] [musical notes] [musical notes] [musical notes] [ Video end: ] Patty: In order for a child to isolate the finger movement necessary to develop a pincer grasp, the child must be given objects with grooves and contours to explore. Watch in this video as a child isolates a finger to find the hole at the center of a massaging brush. Using only the hand and fingers, the child also learns how to stop the brush or slow it down. [ Video start: ] [electric motor] Audio Description: A child holds his thumb in the center of a circular, massaging brush. [staff & student voices] Audio Description: He pinches the brush between his thumb and fingers, to slow and stop the brush. He places his fingers on top of the bristles, and pushes hard, to slow and stop the brush. He holds his thumb in the center of the brush. He attempts to put his index finger in the center. He holds his thumb in the center. New video segment. He places his fingers on top of the bristles, and pushes hard to stop the brush. [staff & student voices] Audio Description: He places his index finger in the center. He repeatedly lets the brush move slowly, then stops it with pressure from his finger. Holding his finger in the center, he lets the brush run faster and faster. He holds his thumb in the center. He pinches the brush between his thumb and fingers, to slow and stop it. [electric motor] Audio Description: He places his palm on the brush to slow and stop it. He puts his finger, then his thumb, in the center of the moving brush. [ Video end: ] Patty: Finally, Dureyea is putting it all together. In this short clip, Dureyea is taking things apart, putting things together and banging objects with two hands. If given the correct environment, Dureyea will start to use his hands for more and more constructive activity. [ Video start: ] Dureyea: [laughing] Audio Description: A toddler sits on the floor with his teacher and a stacking toy. Dureyea: [verbalizing] Audio Description: He pulls rings off the stacking toy. Teacher: Yeah! Audio Description: He places the ring in a special cup. Teacher: Oh, I didn't have that turned on, did I? [sonic noises] Audio Description: Dureyea puts the ring in the cup, again. [sonic noises] [wood tapping] Audio Description: He taps the ring and a block together. The teacher mimic his tapping. Dureyea: [verbalizing] Audio Description: Dureyea lifts a ring. Dureyea: [verbalizing] Audio Description: Another ring gets stuck. He lifts a block from a different stack. Dureyea: YEAH! Teacher: [giggling] Audio Description: He graps the previous ring and successfully removes it. Dureyea: YEAH! Teacher: Good job. Audio Description: New video segment. Dureyea lifts a ring and taps it with another. [wood tapping] Audio Description: He drops a ring into the cup. [music rift] [growl] Teacher: [growling] Teacher: [laughing] [ Video end: ] [ Slide start: ] Description Start: Title: Conclusion Content: • All children with multiple disabilities, including autism, cerebral palsy, cognitive delays, and visual impairments can benefit from an Active Learning approach. • Activities should be presented at current developmental level and provide new appropriate challenges. • Avoid using hand-over-hand to make children participate. • Next webinar: how children utilize their ability to grasp to engage in more constructive activities Description End: Jessica: All of the children in these videos have multiple disabilities including autism, cerebral palsy, cognitive delays, and visual impairments. The activities they participated in reflected their current developmental level, and challenged each child to move toward the next milestone. None of the children required hand over hand assistance to engage in any activity. [ Slide end: ] By providing an Active Learning environment each child was happy, engaged, challenged, and most importantly learning to develop the ability to grasp. A simple one page handout on how a child develops the ability to grasp can be found on the activelearningspace.org website. Our next webinar will continue this discussion, focusing on how children apply their ability to grasp to engage in more constructive activities. Chapter 5. Discussion Charlotte: Well, that was a lot of fun. I could see a lot of comments in the chat window about a lot of people wanting to have that drum or having the [ Inaudible ] drum, but I wanted to point out that even though it's easy to feel a little discourages if you don't have the money or the space for special equipment, there were a lot of fabulous examples using less expensive materials, like the kinetic sand or the massager. Be creative. You can make things, there are a lot of directions on our website or find ways to raise money. I also wanted to mention a couple of other comments that came up in the chat. [Lost audio.] To hearing Zain's laugh was maybe the most fun thing to watch, but just watching the adult sit and follow the child's lead and the child's pacing and not to interrupt and not to be, you know, telling the child what to do, but just kind of there as a partner. That was really noticeable. And I also wanted to mention, we had a little conversation in the chat window, but I wanted to mention that Zain who was-- actually, it was Luke who was the one with the green sticky hands, he's been labeled as being tactilely defensive, he just doesn't want somebody grabbing his hands. So, it's important to really be sensitive to all of that. Anyway, I put my e‑mail address on there if people still have questions. We really invite you and encourage you to visit our website. A lot of these videos will-- are already on there or will later be posted with this webinar, be archived and up there before too long. Again, please sign up and join us for our next webinar in January, and visit the Facebook page, put that link in there as well. And I'm just going to see if there was anything else we should be including. I guess. Kate Hurst: Charlotte, this is Kate. Charlotte: Did you want to say something? Kate: Yeah, this is a question from Janet, I believe it's Janet. She was questioning about the brush activity, and she said is it that the brush provided the grooves and the small bristles to grasp tactile input which encouraged the pincer grasp, so she's asking, I guess, if that-- if it was the tactile input from the brush itself that encouraged the pincer grasp? I'm going to ask Patty and Jessica to respond to that. Patty: I think he just-- because there was a hole in the center of the brush, he started by isolating his finger by putting his finger in the hole and feeling the motion of the brush going around his hand encourages a pincer grasp. I don't think it was necessarily the bristles itself, it was the entire-- the setup with the brush with the spinning, with the vibration, with the hole in the center that encouraged the pincer grasp. Kate: Great. I just want to make a plug for folks, if you have not been on activelearningspace.org recently, there really are-- we've been hard at work, and there's some amazingly new and wonderful videos there. There will be more going up soon. Please go and check things out. We've tried to organize things a little better, because we're getting more and more things added, and we want to make sure you can find it. But if you have any feedback or questions about that, there's now a new feature on each page where you can put in comments or questions at the bottom of the page. It works a little bit better than our old forum approach to things, so please go there and put your questions there, put your comments there, share your ideas there. It would be terrific. Charlotte: Okay. Well, our time is up. Thanks again for joining us, and we hope to see you again next time. [Silence] Fade up from black. Animation: Text for TSBVI transform into braille cells for TSBVI. Fade to black.