Assistive Technology: Promoting Infant/Toddler

Learning In Natural Environments

Session Objectives

• Understand the ways in which embedding AT in activities and routines of early intervention can help infants and toddlers learn and participate.

• Identify the types of AT -- what is AT for infants and toddlers?

• Identify strategies for adaptations

10 Things We Know from Research• Infants and toddlers learn and develop best when provided with

nurturing relationships with a minimal number of caregivers.• Most learning is not the result of “targeted” goals -- children

learn a great deal incidentally -- from watching, doing, experimenting, listening, and feeling.

• There is more research about children’s learning within the context of educational/group-based activities than within context of activities that occur in home and community settings.

• Instruction & therapy can be provided successfully when strategies -- adaptation & intervention -- are embedded within naturally-occurring activities and routines in educational or child care settings.

• Parent(s) of young children with disabilities value inclusion oftheir children to a greater degree than do professionals.

• Approaches such as Motor Learning show that practice facilitates motor skill competence. Providing multiple trials (opportunities) for practice that are distributed (or spaced) throughout the day is more effective than providing massed practice opportunities.

• Children (and adults) learn faster when motivated to do so.• Skill learning is easier and more rapid when done within the

context where the skills will be used (rather than under contrived circumstances).

• Both parents and generic community program personnel report that children with disabilities make learning and developmental gains in natural settings.

• Expectations set the stage for learning -- expectations are both culturally & experientially based.

What Do Infants and Toddlers

Learn in Natural Environments?

How Do They Learn What They Learn?

OpportunityRoutine

Watching/ObservingListening

“Experimenting” - Trying it Out“Discovering”

Copying Someone ElseDoing & PracticeBeing Shown How

Being Told About Something

What do we know about AT & infants & Toddlers?

• AT is a tool that allows infants and toddlers with disabilities to “engage in everyday activities that promote development” (Mistrett, 2001)

• Less than 4% of infants/toddlers nationally have AT listed on their IFSP’s (DOE Report to Congress, 2002)

What comes to mind when you think about AT and infants

and toddlers?

AT is More Than ---

• Battery-operated toys and switches• Communication Devices • Special eating utensils• Computers

AT Can ------------• Promote children’s participation in

activities and routines at home, in the community (or neighborhood), and in child care or other group-based programs

• Enhance opportunities for children to learn in natural environments/settings

Assistive Technology Devices

…..Are tools that result in personal change in human

functions carried out within the context of environmental

settings & demandsBlackhurst & Lahm, 2000.

Human Functions

• Existence (eating, etc.)• Communication• Positioning• Travel and Mobility• Environmental Interactions• Education and Transition• Recreation

Blackhurst & Lahm, 2000

Availability

Readily ------------------------------------------------- Low(General) (Targeted)

Movement

Interaction with Materials

Communication

Mistrett, 2001

AT -- anything introduced into a child’s life or the places where a child spends time that aids a child in accomplishing a task or participating in an activity or routine.

⇓ Low Tech: items that can generally be purchased in any store and are used by families with their infants and toddlers generally.

⇑ High Tech: switches, communication devices, computer software, --devices generally not readily available, purchased through special companies, and may require a specialist of some type to help you and your child use the device.

Strategies for Using AT

• Take the purpose & concept of what we know & fit it into the routines & activities of various places

• Work from a top-down perspective

• Build on children’s strengths & abilities

• Work with families from their point of strength

• Don’t forget that adaptations are a form of intervention

• Think of limitations -- not as roadblocks --but as challenges to be taken on by creativity, reflection & problem-solving

Steps

• Find out where families spend time and what they do

• Figure out what activities and routines are going well and which are not going well

• Use a top-down process to merge outcomes with activities/routines

• Identify Strengths (Environmental & Child)

• Think About What Children Will Learn

• Use an Activity Framework

• Develop Adaptations --collaborate with families to work out reasonable solutions

• Embed AT into Everyday Activities & Routines

• Learn by using resources for AT -- websites, centers, catalogs, etc.

What is happening in families’ lives?

What is going well -- or not so well?Where and HOW have they been

successful?What else would families like to

be doing?What did they do before the child was born

that they are not able to do now?What situations are they uncomfortable

with and WHY?

Ways to use AT to promote participation & learning

• Adapt the environment, task, materials to promote participation to increase opportunities for children to learn from other children, their environments, & experiences

• Use specific devices or adapted materials to address individual learning needs resulting from structural impairment in order to improve basic physical function

• Use specially-selected materials (high availability) or devices (low availability) to strengthen developmental competence

ASSESSMENT

Identification ofChild and Environmental

Interfering Factors

Strategies to Bypass Interferers

Strategies toImprove Performance

INTERVENTION PLANOBJECTIVES & STRATEGIES

ASSESSMENT

Identification ofChild and Environmental

Strengths

Desired Participation in Activity/Routine or Desired Skill

Environmental AccommodationsAdapt Room Set-UpAdapt/Select EquipmentEquipment/Adaptations for Positioning

Adapt ScheduleSelect or Adapt ActivityAdapt MaterialsAdapt Requirements or InstructionsHave Another Child Help --

Peer Assistance/TutoringCooperative Learning

Have an Individual Child Do Something DifferentHave an Adult Help a Child Do the ActivityHave an Individual Child Do Something Outside

of the Room (with an Adult)

Facilitating Children’s Participation and Learning

Activity Framework

Environment Playground

Subenvironment(s)

SwingsSlideWading PoolJungle GymSandboxPlayhouseRiding Toys

Activity: Playing in Water Pool

Playing in Water Pool

•Go to Pool

•Climb Into Pool

•Sit in Water

•Play with Water Toys

•Climb out of Pool

•Go to Another Playground Activity

Adaptation & Intervention Planning Grid

Steps Potential Adaptations/Use of AT

Go to Pool

Climb Into Pool

Sit in Water

Play with Water Toys

Climb out of Pool

Go to Another Playground Activity

Environment Grocery Store

Subenvironment(s)EntranceFood AislesBakeryPharmacyBankDry CleanersVideo Rental

Activity: Participate in Shopping by Sitting in Cart/Reaching Toward Objects

Adaptation & Intervention Planning Grid

Steps Potential Adaptations/Use of AT

Get Out of Car

Go to Store

Sit in Grocery Cart

Participate in Shopping By- - -

Communicate Preferences

Go to Checkout

Checkout & Go to Next Activity

What about Addressing SpecificNeeds?

•Opportunities for PracticeSpaced Out Throughout the Day WithinNatural Opportunities

•Verbal Direction:Following Directions

•Modeling An Adult Doing by Watching and Imitating

•Adult-Directed Strategies (Selected Examples)

•Contrived Activities Therapist-designed activities in which to embed strategies (such as reaching for a toy from a ball)

•Physical Guidance or Assistance•Therapeutic Facilitation

•Imposed Activities (Exercises or Protocols): Things done to a child without any activity context

•Passive Range of Motion•Brushing Program

Instructional and Therapeutic Interventions

Addressing Physical Impairments (Body

Function & Structure)

Philippa Campbell, 6/02

•Child-Directed Strategies

What about Strengthening DevelopmentalCompetence?

•Opportunities for PracticeSpaced Out Throughout the Day WithinNatural Opportunities

•Modeling Another Child Doing by Watching and Imitating

•Verbal Direction:Following Directions

•Cueing with Natural or Contrived Cues

•Modeling An Adult Doing by Watching and Imitating

•Prompting

•Adult-Directed Strategies (Selected Examples)

•Physical Guidance or Assistance•Therapeutic Facilitation

•Passive Range of Motion•Brushing Program

•Contrived Practice (Discreet Trial Training)

Instructional and Therapeutic Interventions

Addressing Developmental Concerns

Philippa Campbell, 6/02

Least Intrusive

Most Intrusive

•Child-Directed Strategies

What Did You Learn Today?

How Can You Learn More?

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