Multiple Disabilities is a broad umbrella term meaning an individual has several different disabilities, for instance, someone with both sensory disability and orthopedic impairment. Usually, they have more than one significant disability, e.g., intellectual disability, cerebral palsy, emotional disability, or visual/hearing impairment. They have difficulty in basic physical mobility, and they tend to forget skills if not practiced regularly. They typically share deficits in five distinct areas of development: intellectual functioning, motor skills, sensory functioning, adaptive skills, and communication skills.
A child who is multiple disabled should receive intervention as early as possible. It’s a myth that the older we get the brighter we become. It’s always easier to teach a younger one than it is to teach an older one.
To develop various functional areas there should be an inter-disciplinary as well as multi-disciplinary approach. This may be enabled by dedicated parents, committed professionals, and effective technological and educational strategies. The collaborative approach broadens the students’ overall learning. Because of having severe cognitive challenges and limitations, they are typically taught using a range of specialized tools and various interventions.
When we take the task of teaching a child having multiple disabilities, our most familiar teaching strategies are put to the test. The child can learn but the question is what and how. We need to discover how he learns, how he understands, and what’s hidden inside their perceptual disability.
Remember: If one method closes the door of learning – sometimes forever, the other strategy opens the door wide open. If learning isn’t happening – STOP, repeating the same plan, again and again, is not going to help your child learn.
Learning Pathways
There are certain learning channels that can be used in isolation or in combination to teach a child with multiple disabilities.
Vision and Auditory sense are the two primary learning pathways that give a child an ability to perceive color, depth, shape, size, volume, pitch, speech sound, environmental noise, etc.
Tactile and Kinesthetic are the secondary learning pathways, if used constructively, can contribute to the learning process. The tactile channel helps in perceiving texture, pressure, pain, and temperature, and kinesthetic involves speed, rotation, and movement.
Strategies for Good Teaching
Teaching should not be done as a duty or obligation rather it should ideally be done as sheer pleasure then both the teacher and the child will be enjoying the sessions immensely.
The first step in the right direction is to teach and work with child’s abilities. It is just a way to start respecting the child’s strengths rather than focusing on his weakness.
Always stop before your child wants to stop, consequently, he will always want more. Never let him reach the saturation point of learning.
Provide an environment that is free from visual clutter, auditory chaos, and tactile distraction. Build a small tent house at the silent corner of your house and make that spot a major teaching area. Sit comfortably with him and try not to miss any response he may give.
Best time to teach is when both mother and child are happy and in good form. Make sure your child is not tired, hungry, sick, upset, or irritable. On bad days it’s advisable to put away the teaching program and find out what is bothering him and handle that. Begin at a time of day when the child is receptive, rested, well-fed, and in a good mood.
Use a nice, clear voice infused with enthusiasm and your child will absorb your teaching like a sponge. Teach at a natural speed with lots of music and expression in your voice. Enthusiasm can have a positive impact on the child’s learning ability, mood, and behavior.
It’s always wise to organize yourself and your material before beginning the session. You should know exactly what you have taught, how many times you have taught, and when it’s time to move on.
An on-and-off program will not be effective. A modest program done consistently brings more success than an over-ambitious program which overwhelms the child. The more structured you are on daily basis; the better child will adapt to it.
Introduce new materials often and don’t bore a child by showing the old materials repeatedly. It is equally important to use materials that do not cause harm to your child. Changing topics frequently is a good teaching strategy for the initial sessions.
Use a clear, simple, and good quality of teaching material, which is easy to recognize and understand and this eventually will increase the pleasure of teaching and learning. Words written neatly by large, red marker are most easily seen and attracts an immature visual pathway. Do not give him words that are too small for him to read.
Choose words that are familiar, interesting, easy, and enjoyable and books that are interesting with lots of pictures as it appeals to the visual strength and develops memory. The audiobook is also a good teaching aid for a child with a strong auditory sense.
Make sure your child must turn the page to see the illustrations that follow the text.
Some low-tech strategies like social stories, comic conversation, visual flash cards, calendars, signs, labels, maps, and price tags can be used effectively as teaching material and high-tech strategies include presenting knowledge through videos, learning applications, and audiobooks, etc. The Internet has opened a never-ending world of pictures, stories, and valuable information.
Avoid saying “NO”. Instead, use a less threatening approach. Allow your child to make mistakes because it gives them a chance to experiment and do self-correction and self-discovery.
Rules for Parents
Never underestimate the power of parental love. Your power and determination expand the child’s opportunities beyond the limit of clinical diagnosis and commonsense reasoning.
Mothers know more about children than anyone alive and mothers are the first and they remain the best teacher for their child. Train the mother and she will prove it.
Parents who love and respect their children give them the gifts of knowledge and abilities however difficult the task may be. Your child can sense your respect in your attitude and behavior.
There is a magic element in praise, so often praise your child and his smallest achievements which will motivate him to learn more. Your child’s efforts are heroic. Treat him like a hero.
Mothers and kids are the most exciting learning combination possible, and the process of learning should be joyous for both. With positive attitude dive in deeper to teach the child. Your teaching begins when he wakes up and doesn’t end until he is sound asleep. Give your child an opportunity to learn at every moment by exposing him to various experiences and sophisticated thoughts and simply remove any physical restrictions placed upon him.
Increase his vocabulary by labeling the objects in your house, label students’ personal spaces and belongings, label where things belong, label the environment, and teach your child to recognize these labels and give them the information that occurs with them. By modifying the environment, it gives them more opportunity to learn efficiently and it maximize their learning time.
Introduce at least 5 new words belonging to a common topic, write it boldly on a white laminated sheet with a red marker and do fast flashing of these visual word cards in front of his eye level.
The door of the refrigerator can be used as an information center about fruits, vegetables, food, and its ingredients.
Talk to your child in every situation to associate language and words to every event or thing in his visual field.
Give your child exposure to language and information through education without waiting for speech to develop. This gives them a greater understanding of their surroundings.
It is wise to make a simple diary of your child’s day using illustrations of his photographs doing activities. This book is naturally loved by every child and eventually, it builds his interest in other books.
Try to spend both quality and quantity time with the child because there is no substitute for mother and father for each child. If you are not spending a wonderful time and your child isn’t enjoying your company, then stop. You are doing something wrong. Relax yourself.
Your child trusts you completely, always tell him the truth accurately and answer honestly. You can teach your child absolutely anything that you factually present to him. Never try to fool the child.
Do not ignore your child when he is trying to communicate and do not interrupt while he is speaking. When the child feels accepted and safe, his brain turns into a powerful learning machine.
Anxiety, fear, and fatigue affect our attention. Parents need to understand the effect of sad emotions on a child’s learning process. If your child cries and resists a particular session because of some pain, then try to avoid such painful sessions.
Look for any opportunity you might use to help your child discover his abilities, refine these abilities, and learn new ones. Build upon the present abilities rather than focusing on disabilities.
Expect miracles. The brain can reorganize itself and gain new knowledge and skill by forming new neural connections.
Provide the child with the richness of experience from which he will gain knowledge and form abilities to learn and grow with a sense of accomplishment.
Start by making a long-term goal and break each goal into smaller steps and do what is needed to reach that goal successfully. Know when to back off with a goal if it creates discomfort for your child.
Rules for Teachers
The sound should be clear enough for the ears to hear and words big enough for the eyes to see so that brain can interpret them easily.
Never test the child. Testing is the opposite of learning, and it takes away the child’s natural love of learning. Everybody loves to learn and everybody hates to be tested. The duty of the teacher is to help her students learn not to test.
When working in a group make sure you talk to the child, not to each other. The key to teaching the child is your own attention and it serves as a model to the child’s brain to begin paying attention. Switch off your mobile and your only agenda should be to attend to the child.
Keep every teaching session brief but regular. Their brain accepts high frequency but low duration schedule better. Don’t overdo the session and reach the threshold of the tolerance level of child which may fluctuate from one session to another. A visual timer works effectively.
Don’t pressurize the child. Teaching a child is a very positive thing and it must never be made negative. If the child doesn’t want to learn, put the whole thing away for a few days. Remember you have absolutely nothing to lose.
Teachers must identify the learning pathway of the child to successfully teach them.
The teacher should build the lesson step by step around the interest of the child.
Each lesson should be developed and customized according to the level of the child. An individualized Education Program (IEP) should be created through a team of the child’s parents, therapists, psychologists, and educators. Lesson planning should be done before starting the session with the child.
If there is any difficult situation, the teacher should not try to win him by force or put any kind of pressure on the student, it will lead to bad cooperation in future sessions.
Principles of Learning
A child’s brain grows by use or fails to grow as a product of disuse. What we do not use, we lose. The more we put into the brain, the more it will hold.
We can grow a child’s brain by giving visual, auditory, tactile, olfactory, and gustatory information regularly keeping in mind the individual’s present state of competence. These are the pathways by which we gain all information. Use them and their brain will grow more mature and competent to learn.
The destruction of motor or sensory pathways results in a lack of functional performance and these are restored to function until new pathways are established. When we improve one function of the brain, we improve all functions of the brain to some degree. And developing the brain is the most important and challenging job for a child with multiple disabilities.
Our brain is subjected to continuous change. Little positive neurological change achieved each day can represent great progress over the course of years. There is a revolution called “neuroplasticity” and the child who has multiple disabilities can especially make great use of their brain plasticity to evolve their learning pathways.
When learning anything new child’s brain needs a slow pace till they achieve full command over it. Waiting is an essential part of learning, and it gives the child time to receive the information, process, and formulate a response. Give a pause time of 30 – 45 seconds before repeating the instructions. Otherwise, any stimulations coming their way continuously will agitate them. When we ask the child to do any task quickly that he can’t do, the child is left feeling guilty for not meeting our expectations which often ensure failure. At such moments of failure, just slow down your pace of speech and slow down your child.
Building self-esteem is an important teaching strategy. Teach them with confidence, communicate with intelligence and substance, and don’t talk down about them.
To learn, the child must grow his motor skills. It may sound simplistic but the ability to point involves many joints, muscles, and motor planning which is difficult for a child. Pointing is a critical skill for learning which can be achieved through practice.
A child with multiple disabilities often has challenges in generating variation. It should be our job to introduce variations in learning that they can’t get on their own. Variation should be given intentionally which will help the brain to grow and they become more alert and a better learner.
Communication is the foundation for learning, and it enhances the teaching goals. It is important to consider the development of communication skills as an integral part of the teaching program. If a child is nonverbal, teach him other means of communication and understand his gesture and facial expression. Pointing, sign language, and picture exchange communication system (PECS) should be taught to communicate, and later children can be shifted to augmentative and alternative communication (AAC) methods built specially to develop efficient and effective communication skills. Pictures have the potential to unlock meaningful communication if the child has not been given the gift of speech.
Building Attention
Teaching becomes a herculean task if the child lacks focus and attention. It’s always advisable to start with strategies that will help the child in developing these skills before progressing to actual teaching.
Emotions guide our attention which is necessary for learning.
You should intentionally become a performer or singer for the child when he seems disconnected from himself which will awaken his attention and guide him into possible alternatives.
Touch has the power to awaken and increases the child’s attention ability. Prompting is a powerful strategy to teach and communicate with the child. If there is no response due to no prompting, then it is considered a bad teaching technique. Some prompts may be faded over time, but some children need more prompting than others. Prompting should not be done with excessive force, just guide him gently with less force.
Using a light board or x-ray viewer machine in the darkroom is one of the most successful strategies in developing attention span. Lots of activities and teaching can be done on a light board.
The use of torchlight in a dark room again helps in building focus. You can make the child identify each household object through the light and teach them too.
Facts You Need to Know
Regardless of the severity of the diagnosis children want to learn because they can learn, and they should learn.
Brain growth and development is a dynamic and ever-changing process. It’s an ongoing process that involves continual changes, additions, deletions, and modifications as life evolves.
Movement increases intelligence, develops vision, and improves brain function. Give your child with orthopedic impairment an opportunity to move as much as possible.
The level of learning is not the same for every child, and it depends upon the severity of the condition, the intensity of the teaching program, and the highly stimulating home environment.
The needs and demands in the environment of home and school are entirely different.
Non-academic Strategies
Pretend Play is one the most common ways to activate the child’s imagination, any opportunity to turn learning into a game makes it more effective. Pretending can be difficult for them but there is always a scope for development in this area.
Storytelling is an ultimate strategy to introduce imaginary ideas, morals, and suggestions. You can introduce movement and music to the story which brings life to it. Act out the stories using different props and items, and modulate your voice to a different pitch. Become animated in your approach and expression and your child’s brain to awaken to new possibilities of learning.
Art and Craft activities provide lots of opportunities to learn how to plan and create.
Colors attract a child’s vision and many of them have an eye for pattern and painting. Design an idea for paintings that appeal to your child’s imagination and interest.
Building and Constructing games help in developing motor skills. e.g., Lego, wooden blocks, magnetic puzzles, slime, playdough, marbles, etc. are excellent training tools to enhance fine motor skills.
Remember
There is No One Right Strategy to Teach, there is No Simple Formula.
Teach Your Child the Way He Wants to Learn. Happy Teaching!
Zeba Hashmi
(P.S: The article was published in the book “Trials of Hope”)
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