Teaching History to Individuals Experiencing PMLD

History for Individuals Experiencing Profound and Multiple Learning Difficulties

This page was last updated on the 30th October 2013

"If children don’t learn the way we teach,
We must strive to teach the way they learn."
Ignacio Estrada

"It is essential for the teacher to convey the structure of his/her subject
in a form which the pupils can readily understand"
Michael Wilson (1985)

"History is a cyclic poem written by time upon the memories of man."
Percy Bysshe Shelley

Talksense has witnessed some brilliantly creative lessons concerning history for Individuals experiencing PMLD. These lessons attempt to make the subject relevant to the young people by making the topic more visual, more sensory, and more 'hands-on'. However, the topic of these lessons was still something from the distant past such as the impact of Romans on Britain or an aspect of the First World War for example. While I have always admired the skills and fortitude of the staff concerned in preparing and delivering such sessions, I still feel that such a strategy is focusing on an inappropriate area of history. From my perspective, history for those experiencing PMLD requires to be addressed in an entirely different way: one that is even more relevant to the needs of the individuals and focused on 'historical awareness'. Of course, the staff concerned with the delivery of said sessions would argue that is exactly what we were attempting to do: make the curricular matter relevant to the needs of their Learners by modifying in such ways to make it much more sensory, for example. While they undoubtedly were succeeding in doing that I am uncertain the process could be really be analysed as teaching an 'awareness of history'. As I hope to demonstrate on this page, there are alternate ways of approaching the topic of history for Individuals Experiencing PMLD (IEPMLD). It is an approach which I believe is extremely important for each individual Learner as the concept of a history is a concept which releases a person trapped in the present tense. A knowledge of a past also makes a future possible. Where then do we start? Michael Wilson has suggested (1985, 1992) history should be taught backwards beginning with the present day. I would want to take this (at least) one step further and suggest that history has to begin with individual awareness of space and time and relationships to POLEs (Persons, Objects, Locations, Events) within those spheres. In other words, we cannot assume to begin even with the present day, we have to begin with an individual's awareness of 'now':

" ... in the early stages of introducing history, relevance and appropriateness to meeting pupils' needs must be the first principle"
Sebba, J. (1994)

Judy Sebba's book 'History for All' (1994) is a book aimed at teaching history to pupils with learning difficulties. However, I think it is more aptly named 'History for Some' as it really does not address those Individuals experiencing PMLD. That is not to disparage Professor Sebba who was one of my early mentors and inspirations when I attended a Cambridge Special Education Summer School run by her back in the 1980s: the book is great but it really does not address the concept of history for IEPMLD. Indeed, I could have said the same thing about Michael Wilson's book 'History for pupils with Learning Difficulties' (1985) or Birt's 1976 article which, again, do not address this specific area of concern although they are also very good in their own right. If Professor Sebba, Mr. Wilson and others who title their tomes as 'all-ability' do not address this issue directly where can we get information on approaches to this area of the curriculum?

In the QCA document 'Planning, teaching and assessing the curriculum for pupils with learning difficulties: History' (2009), page 3 reads:

"The subject materials support staff in planning appropriate learning opportunities. The materials do not represent a separate curriculum for pupils with learning difficulties or an alternative to the national curriculum. They demonstrate a process for developing access to the national curriculum and support staff in developing their own curriculum to respond to the needs of their pupils at each key stage. The materials offer one approach to meeting this challenge. Schools may already have effective structures or may wish to adopt different approaches" and goes on to say (page 5), "Staff should teach knowledge, skills and understanding in ways that match and challenge their pupils’ abilities. Staff can modify the history programmes of study for pupils with learning difficulties by:
• choosing material from earlier key stages;
• maintaining and reinforcing previous learning as well as introducing new knowledge, skills and understanding;
• focusing on one aspect or a limited number of aspects, in depth or in outline, of the age-related programmes of study;
• including experiences that let pupils at early stages of learning gain knowledge, skills and understanding of history in the context of
everyday activities;
• helping pupils find out about their personal history through daily routines and sequences, then helping them find out about recent
and past history by using their senses to explore artefacts, sites and reconstructions."

The QCA document is extremely informative and begins to detail how history could be addressed for such a group of people. The document gives an educational establishment a lot of leeway for teaching history to those experiencing PMLD as well as suggesting some excellent possible practices. However, it does not really put any flesh on the bones: to be fair, that was not its intention. However, this webpage will attempt to put the flesh onto the skeletal structure proposed by the QCA. You are free to adopt, adapt, or abrogate any of the suggestions below. I hope you find them useful if only in part. Feel free to contact Talksense using the form provided at the foot of this page to commend, comment or critique the efforts here or send further suggestions that might be added to this page.

On page eight, the QCA document sets out some ideas for activities at History Key Stage One:

The focus of teaching history at key stage 1 may be on giving pupils opportunities to:
• associate the passage of time with a variety of indicators, such as symbols or pictures;
• recognise themselves and familiar people in representations of the very recent past;
• recall events from their recent past with the help of words or pictures or in other ways;
• identify some distinctions between their own past and present, for example, physical differences, changing abilities;
• experience stories of famous people and events from the past;
• recognise the more obvious differences in the way that people lived in the more distant past compared with their own lives;
• use a range of historical sources.

While these ideas are fine for many individuals experiencing Learning Difficulties, they are much more problematic for those experiencing PMLD. While the ideas are all good, we are not told how we know that an individual experiencing PMLD demonstrates conclusively to staff that s/he has 'associated the passage of time with a symbol' or 'recognised themselves' 'in representations of the recent past'. There is a very real danger that staff will ascribe smiling at a picture or a recording as evidence of such recognition for example when several alternate explanations for the smiling behaviour can be given.

History is important - History sets you free!

The concept of a history, of the passage of time and where we are within time is fundamentally important to us all. Those without a grounding in space and time are truly lost to the world. Being trapped in a single moment in time with an accompanying lack of knowledge of the position you occupy in space is truly frightening to the majority of us and yet it must be the experience of many who are classified with the term PMLD. Of course, an individual has to be aware that s/he is lost in space and time to be frightened by it and, therefore, it could be argued that Individuals experiencing PMLD are (thankfully) cushioned from such discomfort. However, it is still a less than ideal state to be occupying.

Ware and Donnelly's route map (See below)(See also Ware, J. & Donnelly, V. 2004, 'Assessment for Learning for Pupils with PMLD – the ACCAC Insight Project', PMLD Link, Vol. 16 No.3 Issue 49. Welsh assembly Government, 2006, Routes for Learning) has 'demonstrating a brief memory' in the number four position on their chart and although alternate routes are possible to bypass this 'step', an individual Learner cannot progress very far without some awareness of the passage of time.

Having some awareness of things as they happen is fantastic but, once gone, not retaining that knowledge, negates the possibility of real learning. Therefore, not only do we need to establish an awareness of history but we also need to be able to measure how far that awareness stretches (A minute? An hour? A day, A week? ...). If we can help a Learner establish the concept of the immediate past and measure for how long it stretches (and work to increase that period) then we can set the Learner free to build meaningful experiences of life which will be retained. Thus, establishing a history can set an individual free: free to experience, free to grow and, most importantly, free to learn.

The ideas on this page can assist Significant Others to:

- assess historic awareness;
- build historic awareness;
- calculate the length/range of historic awareness.

Click on image below to download pdf copy.

Approaches to the teaching of history for those experiencing PMLD.

"The concept of time as hours and minutes is not one that the PMLD student will ever grasp. What can be taught, however, is an awareness of daily routines and a limited sensory of history - what happened yesterday - and the future - what will happen tomorrow."
Cartwright & Wind-Cowie (2005 p.67)

Below are a number of ideas presented for your consideration. You need not accept them all or indeed any of them but, at least, it is hoped they will stimulate further thought and help develop your own ideas in this area. They will not all suit every Significant other involve with a specific Learner: some will be more applicable to Staff while others more applicable to Parents and/or Carers. You must decide. Your thoughts and ideas on the following ideas are welcome and a contact form is provided at the bottom of this page should you wish to use it.

Where possible, the ideas on this page are supported by citing research evidence or other sources of expert testimony. However, it is important that all establishments evaluate practice (especially new practice) for its efficacy. Thus, Talksense would encourage you not simply to add any of the following suggestions into your routine on faith alone (even if it seems like a 'common sense' good ideas!) but to discuss, trial, monitor, review and evaluate any change to practice. If the Learner goal is to develop historic awareness (for example) then it must be shown that the accommodation of a particular ideas into daily practice has achieved this. Unsupported claims for changes in cognition as a result of new interventions are not good practice: for example, how do you know that an Individual Experiencing PMLD (IEPMLD) has developed such awareness as a result of such an intervention? If you can show that a specific behaviour appeared post intervention and that the behaviour:

- appears to be linked to the intervention;
- does not have an alternate explanation as to its cause (other than the desired state of awareness).
For example, is this behaviour just chance? Is it occurring as a result of unconscious staff prompting?

then it would seem fair to assume that the intervention is valid. Your own experience and experimentation is going to be at least as valuable than academic peer-reviewed research especially if staff are not on top of all that is being published in the educational literature (and who is?!). Carl Sagan once said, "extraordinary claims require extraordinary evidence" (December 14, 1980. "Encyclopaedia Galactica". Cosmos. Episode 12. PBS) and, perhaps, all claims about interventional practice for IEPMLD should be treated as extraordinary and merely taken on faith alone. Thus, I would encourage you to treat any ideas and or claims made on this page (indeed on any of my pages) with some scepticism and evaluate their efficacy for yourselves in as rigorous a trial as you are able to implement within the constraints of your establishment's current working practices.

The ideas are not presented in any special order of merit: the last is as important (or not important) as the first. At some stage I may re-order them but only to put them in alpha order! Some of the ideas have specific references which are then detailed in the bibliography near the foot of the page: this will be updated as and when I am aware of new sources of information. Some of the ideas also contain blue links: these will open other websites in other windows or take you to other locations on this website. If a new window is opened, you can simply close it when you have finished to be back on this page. If you are taken to another page on this website, use the back button to return here.

It is not the purpose of this webpage to persuade you to swap your current history curricula for the ideas below! Rather, the ideas are there to stimulate your thinking. You do not have to agree or use any of them!: select the ones that appear the most useful and make sense for your practice and for your situation. Any idea presented can be adapted to make it more useful for your particular requirements. If an idea sparks a thought within you then Talksense encourages you to explore that particular cognition!

If you aren't quite sure about a particular idea and have further questions or want further information then why not get in touch using the form at the bottom of this page: it's simple!

Please note: no claim is being made that the list below is exhaustive, we are certain that it isn't! No claim is being made that all of the ideas will work for every one of your Learners: they probably will not! NO claim is being made that any of the ideas will reach every Learner: there will be a few that do not respond. However, while we cannot ever prove that an individual has not gleaned at least something from an experience, we can prove that he has. In this instance, working with the ideas provides experiences which maximises the possibility that an individual will make some sense of them and progress just that little bit further.

Idea One: Multi-Sensory Referencing

"While they were saying among themselves it cannot be done, it was done."
Helen Keller

"I do not want the peace which passeth understanding, I want the understanding
which bringeth peace."
Helen Keller

Multi-Sensory Referencing is a didactic system that seeks to develop awareness of self in time and space in order to raise cognition and understanding of the world as it is experienced. It is not a single approach but comprises a range of techniques that are used together to form a holistic system. The techniques include Spatial and Temporal Sensory Referencing, Sensory Cueing (often confused with Objects Of Reference), Environmental Engineering, creating a responsive environment, Tangible Symbol development, and Objects Of Reference.

"I realised that these pupils were at the simplest levels of development and needed an education that gave them the opportunity to reach
out and sense the world around. A more formal education had to wait patiently until they were ready"
Flo Longhorn (2010) PMLD Link, Vol. 22, 2 issue 66 page 2

There is a complete page within this website dedicated to the exploration of MSR, please click on the image above left to move there. MSR assists individual Learners to position themselves in time and space, to recall prior POLEs (People, Objects, Locations, and Events) through a range of techniques. As such, it is a system that can assist in the creation of a personal history, a necessary beginning in the learning of history. Please take a look at this page and return here for more ideas.

Idea Two: Memory Books

A Memory Book is a form of 'diary' that can assist the Learner with the concept of time. However, a Memory Book is NOT:

          -     a scrapbook full of old memories such as pictures of childhood or
                momentous moments of an individual life.
          -     a symbolic timetable of an individual's week.
          -     a home/school diary.
          -     a written log of a Learner's day.

Items are pasted into the Memory Book to represent each session or part of a Learner's day.
Once begun, it becomes possible for the Learner to 'look back' at what happened within a particular period of time.

A Memory Book can utilise an existing (sturdy) diary or can be created from a ring binder with blank pages divided into time periods. When Items have been attached to pages, the Memory Book tends to thicken and so fixed books (such as diaries) are not necessarily as useful as loose leaf books (such as ring binders) which allow for pages to grow in stature! However, it is possible to use existing diaries.

Memory Books are suitable for children, young people, adults and the elderly. Anyone who has severe cognitive deficits for whatever reason may benefit from their use. This website has an entire page devoted to the exploration of the use of Memory Books, please click on the image above left to go there. Please take a look at this page and return here for more ideas in developing the concept of history for those experiencing PMLD.

An individual is assisted to build a memory book during each session of their day. For example:

- At the end of an art class the individual might be assisted to take a piece of what they have create and fix it into their book.
- After a trip to a supermarket, a bus ticket, a piece of a shopping bag, and the wrapping from an item purchased may be affixed.
- Following a food preparation session the individual Learner can attached some dried items of food that were used in the
preparation of the meal.
- Immediately after a game of sport, the Learner can be assisted to paste in a digital photograph of that particular sporting activity.

It is important that:

- the Learner him/herself be involved in attaching the items into the Memory book. Staff must NOT do it on the Learner's behalf;
- the Learner explores the entry in a sensory manner: through, sight, feel, smell, taste and even sound if appropriate!
- entries into the memory book are items that have meaning for the Learner;
- entries into the Memory Book are items that were part of the session which is being referenced.
- Significant Others (parents/carers) review the Memory Book often with the Learner.
- Significant Others (parents/carers) assist the Learner to make entries into the Memory book for periods outside of the
educational day/week.
- each session ends with a five to ten minute period in which the Learner is assisted to make a Memory Book entry.
- staff make use of the Memory Book as a part of a regular review of recent events with the Learner.
- each Memory Book is seen as the property of the Learner and not of the school or college or centre.

It is important NOT to:

- make written entries into the Memory Book (all staff take note!). All writing must be kept to an absolute minimum and must only
be used to explain the meaning of an entry to a Significant Other who may be sitting reviewing the entries later that day.
- simply use a timetable symbol as the entry of a particular session. Adding a time-table symbol creates a copy of the timetable and,
as such, is a complete waste of time and effort.
- make entries on behalf of a Learner. The Learner must be assisted to make entries him/herself.

Memory Books can be used to establish the concept of a history of (recent) events with a Learner using a medium in which the Learner can cope cognitively. It is a diary of experiences referenced through real items and created by the Learner him/herself (with assistance from stance according to individual need).

Idea Three: Adverse Reactions

Individuals experiencing PMLD often have a strong startle reflex:
- Johnny hits a switch and a toy rocket launcher makes a bang or a stationary toy
suddenly springs into life;
- Johnny startles and his face shows signs of upset;
- Staff notice Johnny's state and remove the offending toy stating that he had an
adverse reactions and they will find him something which will not scare him so.
While, seemingly, the staff are acting in the best interests of Johnny, they are missing a unique opportunity! If Johnny's reaction is not life threatening or likely to bring about a seizure or some other misfortune then it may be a better strategy to encourage Johnny to continue and to monitor his reactions over time.

Let us suppose that Johnny has a switch attached to a POLE event (Person Object Location Event) that causes him to startle as stated above. The first time he hits the switch he startles. The second time he hits the switch he startles. The third time, however, there is an obvious reduction in Johnny's reaction and by the fourth switch activation there is no discernable startle reaction whatsoever. What does this tell us? What can we state about Johnny after observing his behaviour? Surely it must suggest that Johnny has become accustomed to the POLE action caused by activating the switch. If this is the case, how has he become accustomed? It is not by magic! He must be anticipating what is about to happen and if he is anticipating then:

- he must have linked the switch to the event (cause and effect - see cause and effect this page)
- he must be remembering previously encountered experiences.

Continuing with the example of Johnny. Let us suppose he interacts with the switch and the toy for ten minutes during the session, after which the switch and toy are removed so that he might participate in a group activity. Approximately 30 minutes later, the switch and the toy are represented and Johnny begins activates the switch once more. The first time he startles. However, unlike his first experience, the startle response is absent on his second switch activation. Furthermore, when Johnny returns to the classroom after lunch and works wit the switch and the toy for a third session there is no startle response at all. What can we now begin to assume?

Suppose Johnny works with toy the following day still with no adverse reaction then we let two days pass before we reintroduce the same toy to Johnny: still no adverse reaction, Indeed, it seems to require a week of absence form the toy before the startle reflex returns as strong as it was initially. Does this not suggest to you an observable means of establishing the retention of an event for an Individual experiencing PMLD? Not only can we claim that Johnny is remembering but we can also measure for how long he can remember!

Of course, we are not setting out to deliberately startle any individual nor is this being recommended but if it happens in the course of a daily event (and it is my experience at least that it does) then we can turn the situation to our advantage as well as helping Johnny to work with a toy which we believe he will ultimately find pleasurable and also has educational merit.

Idea Four: BRT (BEST Reward Test)

A BEST Reward Test is a means to give some indication the extent of an individual's memory at more than a simple chance level. BEST stands for Best Ever Stimulating Thing.

BEST = Best Ever Stimulating Thing
What is it the the Learner loves? Is it sweets/candy? Is it a particular game, a TV programme, a particular person? In other words, what is the Best Ever Stimulating Thing for a particular individual? Let's start working with this BEST as the motivator.

POLE = Person Object Location Event
The BEST thing will be a POLE. POLE is an acronym for Person, Object, Location, or Event. If we can place a tangible POLE at the end of a Learner action (For example: provide the Learner with a POLE as a result of a request using an Augmentative Communication system) then we have a way of moving forward. Not just any sort of POLE! What sort of POLE? Well, a BEST POLE of course.

Here are some ideas:

For those that can touch: Start with a single BIGmack (or equivalent device). Label it with an appropriate symbol or a sensory surface for the Learner's BEST POLE. By demonstrating, modelling and even accidental access, show the Learner that the activation of the device leads to the provision of their BEST POLE. We want the Learner to make the connection between the BIGmack and the POLE but, even though a particular Learner may activate such a BIGmack repeatedly, it is difficult to establish intentionality: the Learner may be activating the system accidentally for example or just exploring (and thus repeatedly activating) the BIGmack as it has been placed in the Learner's reach.

The use of a single BIGmack is the teaching phase. Once we have a Learner activating a BIGMack to obtain a reward (for whatever reason) it becomes necessary to step up the level of difficulty of the task very slightly to ascertain Learner cognisance. If we add a second BIGmack of a different colour (New BIGmacks come with four different colour interchangeable tops) which says "Please remove the BIGmacks for five minutes" in a voice that is also neutral in tone (such that the sound itself does not become a motivator) complete with a different symbolic label or sensory surface (or a lack of symbolic label or sensory surface) and both BIGmacks are placed within the reach of the Learner, we can now assess if the Learner activates the BIGmack which leads to a BEST reward more than the one which leads to their removal. Thus, as you can see, the activation of the original BIGmack leads to a reward while the activation of the other different BIGmack leads to their removal (and therefore no possibility of BEST) for a specified period of time. Initially, to assist the Learner in achieving success, the BEST BIGmack can be positioned on the preferred side of the Learner such that it is likely that this is the one that will be activated. However, before moving to the next stage, it is important to swap the BIGmacks about such that, in wherever order they are positioned, the Learner still achieves success.

Once there has been success with two BIGmacks, step it up once more to three! Two of the BIGmacks lead to the removal of the system for a specified time period and only the original BIGmack obtains the BEST POLE. If the Learner learns to activate the BEST BIGmack no matter what position it occupies relative to the other two then there are a number of things that we might justifiably claim:

the Learner is retaining and recalling the function of a specific (distinct by symbolic label and colour) BIGmack;
the Learner is discriminating between the symbols and or the colours;
the Learner has remembered an event from recent history

No, s/he's not doing that at all! S/he is just attracted to red BIGmacks and is going for the red one each time - no recall is taking place.
OK, that is a good point. So what should we do about that possibility? If it is known in advance that the Learner is attracted to the colour red then we should not use red as the BEST BIGMack but rather for the distractors!

We haven't got three BIGmacks!
It is my advice that every classroom should have at least three BIGmacks (AbleNet are not sponsoring me to say that!) available for use. However, it does not have to be a BIGmack system, it can be any SGD (Speech Generating Device) or a device that has at least three cells (the other cells can remain blank). Alternatively, you can use the Microsoft PowerPoint system on a touch screen.

It is important that:

the BIGmacks are labelled with either symbols or sensory surfaces (make sensory switch caps for example);
staff model required behaviours such that a Learner can experience the staff member obtaining a BEST through a particular action;
only one of any set of BIGmacks presented leads to a BEST reward: others should lead to removal of activity;
initially, we assist the Learner to succeed. We can position the rewarding BEST BIGmack in a preferred position for example;
the reward follows the rules for BEST as outlined on the fundamentals page (follow link to go there).
should this approach appear to fail, the Learner can be assisted to make an activation through hand-under-hand physical prompting.

You might provide an intermediate stage in which the BIGmacks are presented but only one has a symbol attached as depicted in the illustration right. We are not trying to trick the Learner or make it difficult for him or her: we want the Learner to succeed and therefore you can provide as may intermediate stages as you think fit that will assist Learners on their way. Initially, for example, you might put the 'correct' BIGmack in the Learner's favoured position and then move it one place from there. You may also start with the Learner's preferred colour but this must be changed before the final stage of the procedure.

If a Learner can select (on more than one occasion) the correct BIGmack by selecting a colour and or a symbol out of three choice of symbol and colour then it is party time! It's a momentous achievement. Suppose all three BIGmacks are the same colour and all have symbols and yet the Learner still selects the BEST on more than one occasion and with the BIGmacks in different relative position on each occasion - what can we claim then? The Learner must be discriminating between symbols and if a Learner can do that then the sky is the limit. Pat yourself on the back for a job well done!!!

For those that cannot touch (but can see): One technique is to prepare at least five cards. Each of the cards depicts a different random shape which has no specific meaning. One of the cards is selected to represent the BEST. This is taught to the individual Learner through a combination of association and modelling (see below) until the Learner can select the card (without error) using a their own specific yes/no response in a 'blind' staff presentation.

In a blind presentation, the staff member concerned shuffles the cards and then presents them, one by one, face towards the Learner such that the Learner can see the card but the staff member cannot. In this way there cannot be any unintentional cueing of the Learner as to when to respond. The Staff member continues to present the cards one by one, returning rejected cards to the back of the pack, until the Learner provides his/her 'yes response' to indicate that is the one selected. Only at this point can the staff member look at the face of the card at the front of the pack. If it is the card that has been selected as BEST then the reward must be provided. If it is any other card, then the opportunity to obtain BEST is withdrawn for a specified time (at least five minutes) while something else is done.

You're joking! That's way too advanced. My Learner will simply ignore the cards altogether.
Of course it is! That is why you have to begin with the single BEST card and teach the Learner it's meaning. Once you believe that the Learner has a grasp of the concept then you can add a second card into the mix and see if the Learner can select the one that represents the BEST. Selection of the other card should always lead to the withdrawal of the possibility of obtaining BEST for a specified time period.

You're joking! My Learner cannot associate a card with a BEST. She'll just sit and rock.
You may be correct but what are you doing in place of this? How do you know if you do not try? Each time you give the Learner the BEST for a whole term ensure that the card is presented just before. You could make the card shape tactile by drawing around the shape with a glue gun to raise its borders and then filling the shape with a sensory surface such as sand and glue and, when set, painting it the appropriate colour. After a whole term you could try to ascertain if the Learner goes for that particular card when mixed in with a couple of plain cards. If that works then ad a small dot to one of the plain cards and see if the Learner can still do it. Gradually increasing the distractors.

You're joking! My Learner cannot see.
In that case why not try it with five distinct sounds (or a tactile approach using BIGmacks as outlined above)? One of the sounds you have linked to the BEST.

Not all our pupils have favourites.
Please do not say that! Yes, they do. It is just that with some individuals the BEST may be very hard to discover. I remember a school that told me they had thought a particular Learner was not motivated by anything until one day a group of musicians came to the school. This young man was sat near to the tuba player and every time he played, the young man's face lit up. It was a certain frequency of sounds that proved to be motivating. Talk to Significant Others first - they are likely to know things that may be motivating or, at least, suggest a possible avenue of investigation. I am always concerned when a Learner is self harming as a form of stimulation. Trying to discover something that is more motivating than poking your own eyes or slapping your own face or biting yourself (and other such behaviours) is difficult. I once worked with a young lady who would regularly poked herself in her eyes as a form of self stimulation. I found that a really strong fan placed close to her face was the only thing that appeared to be at least as motivating. Providing her with safe control of the fan through a single switch proved very successful and was a platform for further development.

What if a Learner's BEST is not age appropriate?
So what if it isn't? If it is a favourite, it is a place to start and an entry into their world. It is not that everything in the school day will be age inappropriate or that you will be treating the Learners in an age inappropriate way - it is possible to use age inappropriate items in an age appropriate manner. Furthermore, the goal is not to remain with this item, the goal is to use the item as a springboard for moving forward. For me, providing it's ethical and it's a platform for development then it's an acceptable tool. However, when the inspectors are around - I wouldn't recommend the use of age inappropriate things; they tend not to like them!

My Learner has no reaction to card presentation whatsoever even when paired with his BEST.
Try making the card more tactile. Use a glue gun to outline the shape and then infill it with some appropriate sensory surface. Present the card and assist the Learner to explore it before providing the BEST. Always provide the minimum amount of a BEST that will be still motivating to the Learner. Do this for an entire term! Try repeating the technique in the following term.

The staff are getting around the blind presentation by allowing the Learner to make multiple guesses until she gets it 'correct' and then rewarding this response. Is this wrong?
Yes! It may be OK for a short time in a teaching phase to help the Learner to see that only one specific card gets a reward but that should
be a planned period of time. After this period, the staff must treat the selection of one of the other cards as a request (communicative act by the Learner) to stop the activity for (at least) five minutes and do something else instead.

My Learner's BEST is horse riding and we cannot provide that at any time.
In that instance, there are at least two things that you can do instead: select a second favourite (a second BEST) or see if access to a short video of the Learner horse riding will act as a substitute.

The Learner gets it correct about 50% of the time but can have 'off periods'. What is the procedure in this eventuality?
The procedure is always consistent: if the Learner selects an incorrect card staff should treat it as though the Learner had said, "I'm fed up with this, let's stop for five minutes and do something else instead." If the Learner has had a seizure earlier or is known to be 'off' for whatever reason then perhaps you should not undertake the procedure especially if it is likely that all choices at this time will not be correct. However, if you go ahead. an incorrect choice must always result in the termination of the procedure for a set period of time.

The Learner's BEST is chocolate. We can't keep feeding him chocolate all morning!
You need to review the Limiting Rules on the Fundamentals Page of this website. First, you need to establish what is the smallest amount of BEST that you can provide and yet still be motivating. Thus, it need not be a whole bar of chocolate as a reward but rather one square. Indeed, would a half of a square still suffice? What about a quarter? What about a quarter of a chocolate button? Also, once you have done this four times perhaps it's time to stop and do something else instead. If the Learner has managed to get it correct four times then 'whoopee', what a success! Party time! Furthermore, that would equate to one whole chocolate button! That's not going to make him sick or ruin his appetite. Of course, if he chooses incorrectly, the process is terminated for a period of time and no reward is given. As such, it may take a whole session to get even a fraction of a chocolate button!

Stepping Up

So the Learner succeeds at one of the above techniques after quite a long period of time. What does that prove? What then? Well, it shows that the Learning is capable of recalling - remembering a previous event and applying that knowledge to obtain another reward. Isn't that history? Maybe at a very basic level but isn't that where we are at? What then? Ah! Now we leave an increasing time period between presentations of the technique: first we may do it twice or more a day but then we limit it to once a day. Is the Learner still successful? OK. Now we present every two days, then three days, then once a week, once a month ... what does this tell us if the Learner is successful on each presentation? Suppose we left it an entire year and then we did it again with the Learner and s/he still got it right?!! Unlikely I know but not impossible. What we are assessing is the extent of a Learner's memory for a particular POLE.

You're crazy! My Learner will never manage any of this idea.
OK, I am crazy! If you do not believe that this has the slightest chance of succeeding no matter how it is modified for your circumstances
then what about trying one of the other ideas on this page? Surely one of then has some merit for your Learner?

Idea Five: Historical Awareness the PowerPoint Way

PowerPoint from Microsoft is a great piece of software but more than that it is an exciting tool for use in the education of those experiencing PMLD. PowerPoint:
1. is available! Most establishments already have it and therefore it does not have to be
purchased for use in the classroom.
2. is accessible. It can be accessed through a touch screen or can easily be driven by a
single switch. S/he cannot use a switch? Yes s/he can! You just need a different sort of
switch!
3. is age appropriate. Materials for use withing PowerPoint can be created quickly and are
within the scope of every staff member. Materials can be tailored to the needs of an
individual.
4. is tireless! It will never give up on a Learner, it will go on and on.
5. is consistent. It always does things the same way every time.
6. is versatile! PowerPoint can incorporate sound effects,music, songs, videos, photographs,
pictures, symbols, animated graphics and more which are easily accessible by Learners.
S/he has a visual impairment? No problem, focus on the use of sounds. S/he is deaf/blind? Ah! Now that may be a bit of a problem for
PowerPoint!
7. will work at the speed of the Learner. If the Learner likes things fast then PowerPoint will go fast. If the Learner likes things slow then
PowerPoint will take its time.
8. can free staff to get on with other things.
9. can be used in a vast number of ways to support learning for Individuals experiencing PMLD. You may be surprised just how useful
this software really is.
10. can speak to the Learner - to provide encouragement, to give instructions, to reward excellent work ...
11. can be used to produce individualized computer based programs which research (See Mechling 2006) has shown results in
consistently greater cognitive engagement when compared to working with a single switch to operate toys or commercial cause and
effect software.
12. can be used to assess awareness of history!

So you are not confident in using PowerPoint in the special needs environment? No problem! Book a Talksense training course and learn how to use PowerPoint to support learning difficulties. Contact Talksense using the form at the bottom of this page for further details.

Let's take a look at one idea for using PowerPoint to establish historical awareness in an individual experiencing PMLD.

So how can PowerPoint help to establish whether or not an Individual Experiencing PMLD (IEPMLD) has an historical awareness? We need to look at the research that has been undertaken with very young babies (and, no I am not suggesting that IEPMLD are akin to babies!). As babies cannot report back to the research scientists, how do they know whether the babies are aware of particular stimuli? It comes down to:

preference and choice (the babies repeatedly make choices for specific items); also here
attention (The babies attend to one stimulus more than another):

"I have spent my career trying to figure out what’s going on in
the minds of pre-linguistic infants. And it’s a fascinating puzzle.
We can’t peer directly into the mind. What we need is evidence
that we can use to make inferences about what’s happening
in the mind. Infants don’t speak and they’re also limited in the
kinds of coordinated behaviors they can perform. But they’re
quite good at controlling what they look at and how long they
look at things. So a number of researchers over the years,
including me, have developed ways to use visual attention
as a measure of what babies understand in a situation."
Amanda Woodward (2013) Also Here
and Here
and Here

suction (the babies suck on a pacifier more when they see, for example, familiar faces)

(see for example : Gopnik, Meltzoff & Kuhl 2000).

Assuming, we are not going to condone sucking on pacifiers in the classroom, we still have the options of preference and attention as indicators of cognition. With PowerPoint we can assess attention by observation of how interested and for how long a Learner works with a particular screen before moving on. If a Learner repeatedly spends more time focusing on one screen from a set of screens within a PowerPoint presentation it is unlikely to be by chance alone;, something on or about the screen must be recognised or of interest.

Powerpoint can display a photographic image as a slide in a presentation. Thus, we can quickly create a presentation of perhaps six slides of people one of which is an earlier photograph of the Learner or a member of the Learners family. All the others are similar photographs but completely unknown to the Learner. The PowerPoint program is set so that the final slide cycles back to the beginning to form an endless cycle and the slides are controlled by a single switch attached to the computer through an interface such as Sensory Software's 'Joy Cable' which plugs into any available USB socket and allows an attached switch to act as any key or mouse activation through an accompanying piece of software. Each time the switch is activated, PowerPoint will move to the next slide. If the Learner in question is not going to explore the switch (and thus activate it repeatedly), it may be that, initially, we permit accidental Learner movements to activate the Joycable system. This might be achieved by using AbleNet's string switch attached to a wrist band by means of a strong elastic band such when the Learner moves his/her arm (or a leg) in any direction the switch is activated. Thus, each time the Learner moves a particular body part, the slide on the PowerPoint changes. It may take some considerable time for an IEPMLD to connect body movement to the change but perhaps ten minutes each day can be given over to this activity. Each slide could have a recognisable voice calling out the Learner's name every five to ten seconds to focus the Learner's attention on the images.

After a few weeks of work staff notice that the Learner is consistently moving through the slides more rapidly than was the case at the beginning. Furthermore, they notice that the Learner is spending more time on one particular slide than the others and it happens to be the picture of the Learner with mother as a child. What does this tell us? It suggests at least two things: The Learner -

is making a connection between movement of a body part and the control of the screen;
is more interested in the picture of him/herself and mother and therefore has some recognition of a past time.

You are crazy! That's far too advanced for my Learners
OK, Perhaps we can have a different starting point. As we know that individualised computer program produce more cognitive engagement than off the shelf software ((See Mechling 2006) perhaps we can start with six slides ALL of interest to the Learner coupled with familiar family voices and favourite music etc such that any activation of the switch moves PowerPoint to another interesting slide. We do this until we have some evidence that the Learner is making the connection between body movement and slide progression and, yes, I realise this may take some considerable time. Only then do we move to phase two and have one slide of the set of six which is interesting because of some historical event which we hope the Learner will recognise. Would that be a better approach?

Your joking. My Learner will never make a connection between movement and slide progression.
How do you know? Have you tried this?

That may be fine for some Learners but mine does not move his arm or his leg.
OK. There is an AbleNet switch known as a SCATIR switch which can work from an eyeblink or a facial twitch. Somewhere there is a switch which is compatible with your Learner which will allow accidental activation.

Suppose the Learner repeatedly spends more time on another slide and not on his picture?
S/he must be doing that for a reason. If you can discover that reason you may have a tool to promote further progress.

I have a young lady who rocks back and forth but does not appear to attend and certainly does not make a choice. I am not convinced that what you are suggesting will work for her.
Perhaps we can turn the rocking into a means of switch activation. There are at least two methods for doing this: push and pull. In the 'push methodology' the Learner activates the switch by rocking into it. Thus we need to use a suitable switch and mount the switch such that it is in the line of the rocking motion. I would suggest a wobble switch from Ability-World mounted on a Sensitrac slider and Magic Arm using Ultramate Velcro (its incredibly strong) form the same company. Now some Learners with whom I have previously tried this technique have simply adapted their rocking motion such that they do not rock into the switch. However, I am pleased when this happens! Why? Because it shows awareness of the switch and I know that if they are aware there is cognition with which I can work. If the Learner rocks into the switch, it will be activated from time to time. If we can provide the BEST POLE for that Learner on switch activation then we might have a means of moving forward. The 'pull methodology' requires a safety pin and a length of cotton. The safety pin is attached to the Learner's jumper or other item of clothing and the cotton is threaded through the safety pin. The other end of the cotton is attached to a firmly mounted switch such that when the Learner rocks forward sufficiently the switch is activated. Either a string switch or a wobble switch might be used here. If the Learner gets up and walks away (if the Learner is ambulant) then the cotton will snap and no danger or damage ensues. There are of course other options:

Proximity switch: if the Learner rocks close to it the switch is activated.
Placing a cushion or pillow switch at the back of the Learner such that the reverse of the rock activates the switch
Tilt switch: A tilt switch activates when it is in a certain orientation and therefore it may be possible to attach to a Learner who rocks such that it will activate at specific times only.

Sound Operated Switch - which, as its name implies, operates by sound only. Does the Learner make occasional sounds or can we attach something to them so that they make occasional sounds?
Other? There will be other possibilities too!

What we need to do is to turn part of the rocking motion into a means of switch activation and then make the switch activate something which the Learner will find motivating. If you do not yet know what a particular Learner's BEST is then talk to Significant Others and see if they can suggest anything to trial. It may be a case of trial and error for a very few Learners.

Talksense offers a complete day's training for staff on the use of PowerPoint for Learning difficulties. You will be amazed at just what is possible with a bit of imagination and a little know how. If you would like to know more use the contact form at the bottom of this page.

Idea Six: Establish Cause and Effect

"These results suggest that from a mental age level of 2 months children are equipped to detect cause and effect relationships and build up a picture of their world based on expectancies about such relationships; and that violations of these expectancies can lead to negative effects." O'Brien, Y., Glenn, S., & Cunningham, C. (1994)

A cause is the reason something happens. An effect is that which happens as a result. If A causes B, we may or may not realise it depending on the circumstances and our level of understanding. We know that sunburn is the effect caused by staying out in the sun for too long without adequate protection. There must have been a point in history when mankind made this connection. At some point, someone must have made the connection between walking out in the sun without clothing and the sore sensation that followed. However, if our cognitive capacity is severely diminished then we may have great difficulty in making such a connection.

If an Individual experiencing PMLD can be shown to have cause and effect skills then s/he must be aware of things occurring in a sequence, one prior to another. Isn't this the basis of historical awareness? The problem is that staff sometimes attribute cause and effect skills to Learners when there is scant evidence. Activating a switch to operate a yapping dog or pressing a BIGmack to turn on a fan do not, in and of themselves, evidence cause and effect skills. Why not?

Some Learners will interact with anything that is placed in an accessible position in their personal space;
Some Learners have learnt to 'fly-swat'; That is they have learned to activate that coloured thing that staff occasionally put in front of them. It seemingly makes the staff happy and they go away and leave them in peace.
Some Learners may be just trying to push it away;
Some Learners may be doing it by accident from time to time;
Some Learners may like the clicking sound made by the switch and find the yapping dog stimulating but are not making any connection between the two;
Some Learners may be attracted to the colour, or the shape, or the sound, or the symbol.

it is only if we can eliminate these other possibilities that we can can state that the Learner is making a connection and understands that his/her actions that are controlling some aspect of the environment. If we have previously established cause and effect cognition in a separate activity with a particular Learner than we are on safer ground in assuming the Learner is making a new cause and effect link here. However, the more evidence we can gather to establish beyond reasonable doubt that a Learner is making such a connection the better.

How then do we establish cause and effect beyond reasonable doubt? The answers lie in the Learner's behaviour. If the Learner acts in certain ways then it is logical to assume, unless we can prove otherwise, that cause and effect is established. What are these 'certain ways'? They include:

the Learner makes repeated attempts to activate the switch but ceases all further attempts when successful and the POLE (Person Object Location Event) event is operated / achieved;
the Learner only reactivates the switch when the POLE has ceased in order to make it work once again. The Learner makes no attempt to activate the POLE while the POLE is active.
the Learner goes out of his/her way to activate the switch in order to achieve the POLE;
the Learner locates a 'hidden' switch in order to operate a POLE;
the Learner is consistent in the above.
other possible explanations for such behaviour have been considered and eliminated.

The 2005 study by Lohaus et al appeared to showed that early contingency awareness and development is directly related to the competency to detect non-social action-consequence contingencies: that is, an awareness of a Learner initiated act (such as kicking a leg) and a non-social consequence such as a toy moving. While such competences may be impaired in Individuals Experiencing PMLD (IEPMLD) it is by no means a lost cause. The 1994 study by O'Brien, Glenn, & Cunningham showed that when presented with a situation in which IEPMLD were in control over a toy responses increased and, in addition, some 'positive emotional effects were seen' (op.cit.). However, if the situation was manipulated so that the same Learner were subsequently unable to control stimulation, it leaded to negative effects in emotional, motivational as well as self‐stimulatory measures. Thus it is important not only that we offer contingency awareness development via good practice but also that we maintain good practice and ensure continuation of the control experiences.

Take a look at the YouTube video below of young Wade using a BIGmack to participate in a repeated line story with his mother. How do we know that Wade has cause and effect skills?

It should be evident that, in the video above, Wade only activates the BIGmack at the correct time and ceases to activate it once he has been successful. He makes no attempt to activate the BIGmack until it's his turn once again. Mum does not appear to prompt him in any way.

Idea Seven: Create Consistency and Regulate Routine

While variety might be the spice of life it is not such a good thing for those who do not have firm footing in time and space. In order to begin to understand that there is an order to one's world there must be an order in one's world. If every day is different, every session irregular, and things get changed often then there is little likelihood that any individual experiencing PMLD will begin to make sense of his/her world. What is required is a regular routine and for management to create consistency across the curriculum and the working day and beyond. That might seem a little boring to some, however it will assist a Learner to anticipate what is coming next if what comes next happens every day and in a consistent manner. That does not mean we cannot have a special event such as a birthday party for a particular Learner but it does mean that the majority of experiences should be designed to be as consistent as practicality will allow.

We need to find ways of promoting consistency in this field of education. A timetable is one obvious means to do this that is already in use. However, the timetable may have a weekly (or even two-weekly) rotation and that may be too long a time period for some Learners: what may be required is repetition on a daily basis. Several ideas for promoting consistency in Special Education are given below for your consideration.

Empowering Expectations: Expectations of all staff are set out clearly (see also Policy and Procedure below). For example, it is good practice in some special education settings that all staff should be able to sign. If we want signing to happen routinely (see 'Routine' below) then we must empower the staff which necessarily means good initial training and then regular 'top up' training sessions. It is also important for management to 'catch someone doing something right' and tell them so. Recognition at work is a big part of job satisfaction. Happy and contented staff are more likely to be consistent.

SCP: Staff Centred Planning: A lot has been written about Person Centred Planning (PCP) but the 'Person' in question is the Learner. I am also in favour of SCP as a strategy for promoting consistency. If we can make it easy for staff to do something and, indeed, more pleasurable for them to do it then that thing is more likely to occur and is more likely to be done well. It is a truism that modern educational practices make great demands on staff: on their skills, on their patience and particular on their time. So much so, that to introduce new practices can add a great deal of stress or be a step too far such that something has to give. There is still the widely held opinion that staff in education have very short working days, are on holiday for the most part of any year, and the job is something of a walk in park! If you are reading this, I guess you know that nothing could be further from the truth. I have worked in both schools and colleges and also in businesses outside of schools and I know which is the more demanding both physically and mentally and it isn't the business world! If ways can found to ease the burden on staff to promote consistency then the beneficiaries are the Learners: it's a simple equation!

Policies and Procedures and Protocols:
"Define clear and specific expectations for what success looks like in any given job. Then, treat employees as adults by giving them as much autonomy as possible to choose when they work, where they do their work, and how best to get it accomplished." (Tony Schwartz)

All schools and colleges have to have and maintain Policy and Procedure documents. Besides being a legal requirement it is also good practice and educational establishments should look to producing Policy and Procedure documentation for all that they do and require staff to be familiar with them: indeed, a copy of said documentation should be kept in the staff room as well as being available on line accessible only by staff members. The Policy and Procedure document should out the protocol for the delivery of any particular scheme or strategy: for example, there should be a Policy and Procedure document for the use of Objects Of Reference within the curriculum. This document should be reviewed at least annually by a nominated person. Such Policy and Procedure documents should also make reference to (and perhaps contain copies of) and checklist to be used as a part of the scheme, strategy, or practice. It is important that, once a Policy and Procedure is set, staff follow its instructions. If staff are deviating from its guidance then consistency is not ensured. If staff are deviating because the Policy and Procedure is unworkable then it should be reviewed and amended such that consistency is restored.

Small is beautiful: The book 'Small is Beautiful' is a set of essays on economic strategies and decentralisation by E. F. Schumacher. The phrase came from his teacher Leopold Kohr. I am borrowing it and adapting it here for use in the promotion of consistency in Special Education. There are a number of ways in which it applies; later (see below) we will look at the delegation of responsibilities but, here, we will focus on 'starting small'. When a new technique is encountered which is considered beneficial by the management team it can be implemented in a number of ways; it can be rolled out across the curriculum for all pupils from day one or it can be introduced in smaller stages gradually building to a full implementation. I normally recommend the latter approach. For me, there are at least five reasons for this:

It gives staff chance to take new practices on board in a less burdensome manner;
It allows both Management and Staff to evaluate and tweak each stage, ironing out any issues, and building on success;
Training can be done in stages;
Staff can have a voice in saying how the system develops;
It is more cost effective;

For example, when introducing an Objects of Reference scheme, I always advise that the team should pick one or two Learners who are likely to grasp the system quickly (so that staff see success) with whom to begin implementation and, furthermore, to begin with only three to five objects (and not objects for every item on the curriculum). Thus the staff are beginning with only two Learners and have to mange very few objects. The situation is manageable and will not be too much too soon. Staff can also begin to evaluate the new process in action and make suggestions as to how it might be improved as it is rolled out across the establishment. They can feel that they are an integral part of the process, helping to decide what happens and when.

Lists:
In Episode Nine of the 2012 -2013 series of Horizon, Dr. Kevin Thong looks at ways of promoting consistently good standards in environments where there is pressure and stress. Dr. Thong states that in unexpected emergencies the weakest link isn't usually the equipment but rather the staff themselves: they make mistakes and forget to do things or do things in the wrong order. "In fast moving situations we are horrible fallible" (Thong op.cit.). Professor Nilli Lavie has shown that (2012) when we have have to focus intently on one task it can blind us to the other things going on around us and have an impact on our decision making abilities. When staff are involved and concentrating on working with particular students and they are under pressure because some staff have had to leave the classroom to provide personal care, they can miss situational demands and interactional opportunities with all Learners not just those experiencing PLMD. I have witnessed on several occasions a Learner clearly indicating a need in some part of a classroom but being 'ignored' by staff working in other areas of the same classroom. While for many, a missed opportunity is not such a crucial thing (as there will other opportunities) there are some pupils when such a failure to act is a significant loss.

One strategy that can help staff maintain situation awareness as well as significantly improve consistency is the use of simple checklists. A checklist is an ordered list of procedures that guide staff through particular practices in specific environments. The checklists are created prior to their use by a team working together without the pressure of the real event. They can focus on the 'bigger picture' and ensure everything is covered, in the correct order, and good practice ensues. The checklists thus produced should be laminated and placed in a clearly visible and accessible position such that staff do not have to go searching for them. A checklist in a file on a shelf is not going to get used! Checklists are used extensively throughout the business and commercial world: pilots use them before a plane even takes off to ensure that safety is maintained and even during takeoff checks are still undertaken. It is my experience that Learners often fail to make progress in a particular area not because they are some incapable but rather through staff Learner interactions or lack of interactions. On more than one occasion I have personally witnessed, the staff member concerned was not really at fault but could not locate a necessary piece of equipment and therefore decided to skip that part of the process as time was pressing. Had the piece of equipment been to hand then the operation would have been undertaken smoothly and successfully without error. For example, I have witnessed staff accompanying Individuals on an Object Of Reference course travelling to a new event without the necessary object. When asked why this was so, the staff members virtually all said they were unable to find the necessary object as it was missing from its normal place on a hook within the classroom. As they couldn't find the item they simply told the Learner where s/he was going and went with them to the new session. How would a checklist have prevented this? In one of the environments in which I worked we designed a checklist that was kept in our Object Of Reference bags. Several members of staff had a delegated responsibility for checking (up to three) bags each morning and reviewing the checklist. The checklist, in this instant was an itemised listing of the supposed contents of the bag for a particular Learner. If any item was not present, it was their responsibility to pay a visit to the Speech and Language Therapy Assistant who held a locker full of additional OOR and could supply a replacement. This meant that every day, each Learner started the day with a complete bag of objects and during that day no member of staff had to go looking for one or decide to go to a new session without an object because one was missing.

Another facet of the use of checklists which featured in the Horizon documentary was the empowerment of all staff. While there may be a senior member of staff in charge, a checklist means that all staff can take responsibility in the educational environment as they know what has to be done and can say if something is missed or performed incorrectly: a checklist can help make education more of a team effort. Successful Special Education isn't likely to be about the performance of a single individual but more about consistently good team work. The checklist can assist is promoting this.

Checklists should be kept in plain view in the areas in which they will be needed. They can also be kept attached to pieces of equipment: for example, attached medical equipment that may not be used every day but requires a specific procedure for use. In an emergency staff are even more likely to make errors of judgement, checklists can not only help with consistency they can save lives.

Handy is Dandy: In order for staff to have a chance of acting in a consistent manner they have to have access to the right tools and equipment at the right time. It's no use if they have to go searching for necessary equipment or the equipment just isn't there to be had. The establishments policy and procedure documents should make reference to the desired methodology for any practice and, if that methodology requires specific items to be used, what those items are and where they can be found. Talksense recommends adopting a 30 second rule: that is, staff should be able to begin to implement any requirement of a policy and procedure document within thirty seconds. As such, the necessary tools/items for the job need to be handy. In order for this to work somebody has to have responsibility for each policy and procedure: if possible, one policy and procedure to one person, although it generally requires that some members of staff have responsibility for more than one area. Having said that, it is also good practice for those members of staff to be able to delegate some part of those responsibilities to others such as Learning Support Assistants such that every single member of staff has a responsibility for overseeing some part of the curriculum and ensuring it can run smoothly.

If lists are to be used (see above) then it is equally important that the lists are available in the places where they are relevant and staff do not have to go searching for them. A checklist laminated and fixed to a wall in the personal care area using a large and clear font such that it is easily read is probably better than a piece of printed paper which is kept in a plastic wallet in a file on a shelf or in a drawer. A checklist attached to a hoist stating the correct procedure for hoisting of Learners is likely to be observed much more than one kept with the policy and procedure document.

Staff have a voice:
"More than 100 studies have now found that the most engaged employees — those who report they're fully invested in their jobs and committed to their employers — are significantly more productive, drive higher customer satisfaction and outperform those who are less engaged." (Tony Schwartz)

If staff feel an active part of any task then they are more likely to perform it with due diligence and care therefore I always recommend that we do not simply impose any one or more techniques on a staff but involve them in the training and the design and the implementation as much as is possible. Staff should always have an official channel through which they can make their feelings known and one in which they know that any expression of concern will not come back and bite them. One of my old employers used to say 'do not just bring me problems but bring me solutions too'. This is a good idea for staff to grasp: yes, they will have concerns about certain aspects of the curriculum for specific individuals but they should not just be critical of current practice rather suggest ways in which practice might be improved. The channels through which staff can air there ideas and opinions might include:

a slot on in regular staff meetings for concerns and issues (some staff may not want to air their concerns publicly however);
regular reviews of policy and procedure including (at least) annual updates of these documents;
a well structured management hierarchy: staff are aware of who they should initially talk to about any concerns;
an 'ideas box' which is not just for ideas but also for concerns. Items placed in the box can be anonymous if a staff member wishes.

Routine Practice:

"The less routine the more life."
Amos Bronson Alcott

"When we get in a routine we can become zombie-like and shut down."
Tori Amos

While both the above quotes may hold some truth there is nevertheless a place for routine in special education. If one thing regularly follows another it is predictable. If it is predictable then Individuals experiencing PMLD are more likely to be able to anticipate what is going to happen next. While it may be boring and dull to some, it may also be exactly what is needed for others. If the sun did not rise tomorrow it may add a little excitement to our lives but, my guess is, it would be a frightening event for the majority. We all need some order: that is not to say that every now and again we cannot let our hair down and do something wild and crazy (but preferably safe!). A timetable imposes a routine. If we can make that timetable as consistent as possible on a daily basis then it will enable some to anticipate what is about to come. Anticipation requires memory and memory is what history is all about!

"Repeated occurrences of the same sequence of events, create by regular scheduling of the same activities at the same time, may help the development of anticipation, which is an important step in learning to communicate. It ma also help the development of a sense of the passage of time. Additionally, one study found that children spend more time on task when consistency is maintained. A timetable in which there is little consistency from day to day is therefore unlikely to be the most appropriate for pupils with PMLDs"
Ware, J. (199) page 115

Responsibility:

"By imposing too great a responsibility, or rather, all responsibility, on yourself, you crush yourself."
Franz Kafka (1918)

"A problem shared is a problem halved"
Proverb

If too great a responsibility is crushing and if sharing a problem is halving it then it follows we can ease the burden of responsibilities by sharing with others. If responsibilities are shared among staff we not only reduce stress but we empower people. If one member of staff has too many responsibilities something usually has to give. If, however, some of those responsibilities are delegated to others then they become achievable. Sharing responsibilities can help promote consistency. Everyone should have a part to play. Everyone should know their role and what it involves. Everyone relies on each other. Everyone is important. Of course, the delegator has the responsibility of ensuring those to whom s/he has delegated are taking their responsibilities seriously!

Idea Eight: Set Sensory Sequence Sessions

Establishing a Sensory Sequence is a matter of deciding:

how many steps will be involved;
which body part will be involved with each step;
what sensory event will go with each body part;
how the sequence will be ordered;
when the Sensory Sequence will be undertaken and how often;
who will be allowed to perform the Sensory Sequence;
how the sequence will be monitored;

A Sensory Sequence is a set of sensory stimulations of differing parts of a Learner's body. It should involve at least five different stimulations. At least one of the Sensory Sequence should involve some aspect of body placement that is under the Learner's control or to which a Learner might react in advance of the stimulation actually occurring. For example, we may choose a Sensory Sequence involving the foot or lower leg, followed by the hand, then the face, then the ear, and then the arm only to return once more to the foot again to begin over. A Sensory Sequence may be repeated once or twice during any one session. Initially, the Sensory Sequence should be established by working with the Learner at least once a day every day. Ideally, two or more sessions a day will help establish the sequence of events for the Learner.

Each Sensory Sequence for a particular Learner must be identical. It must be performed with the same body parts in the same order and, preferably, at the same time of each day. As has been noted, at least one part of the sequence should be something with which the Learner can assist by manoeuvring a body part into a particular position or by reacting in some fashion in advance. For example, a Sensory Sequence might involve:

getting the Learner to lay his/her hand flat (palm up) on a desktop, table top or on his/her lap. The Staff member uses her/his index finger to gently rotate around the Learner's palm in a sort of 'round and round the garden motion';
tickling the Learner in an area that is known the Learner is particularly ticklish;
blowing gently through a straw onto the Learner's neck requiring that the Learner lifts his/her head;
shining a light or moving an interesting object across the line of vision of a Learner from left to right and beginning out of sight;
using a sterile swab providing the Learner with a favourite taste onto his/her tongue;

The different parts of a Sensory Sequence do not have all to be tactile. Indeed, there should be a mixture of sight, sound, smell, taste, as well as tactile occurrences. Thus the Sensory Sequence could involve seven or eight small steps. Obviously, if an individual Learner has a particular sensory deficit then this sense can be excluded from any sequence: a Learner with an acute visual impairment would not benefit from a visual stimulus unless the Learner could detect light in some way.

It is vital that every Sequence be performed in exactly the same way on each occurrence. NO variation in this procedure is permissible. This is because we are expecting the Learner to become so familiar with the Sequence over time and eventually show recognition and awareness by modifying his/her behaviour in preparation for what will happen next. There is no one set amount of time in which such awareness will occur, this time period will be different for each individual Learner: some will require much longer than others.

If a Learner alters his/her behaviour and adjusting a particular part of his/her body without assistance from a member of staff in advance of a particular aspect of the Sensory Sequence what can we now claim? Suppose for example a Learner in advance of a particular part of a Sensory Sequence:

holds his hand palm up;
opens her mouth and sticks out her tongue;
tenses his body in preparation for being tickled;
turns her head in anticipation of an expected sound;
...

If such things happen (and your team should have tailored at least some parts of the Sensory Sequence to the abilities of a particular Learner such that the Learner might demonstrate such behaviours after a period of time) then we might claim that the Learner is anticipating what is going to happen next based on prior experience which has been established over <period>. If a Learner's behaviour demonstrates anticipation of a future event then s/he must hold a memory of the Sequence. We have evidence of a history!

We have to be cautious! Staff may claim an anticipatory response when, in fact, none has really occurred. Staff are naturally passionate about helping their Learners and may interpret things in a more positive light than is actually the case. Therefore, it is good practice to video a Sensory Sequence taking place when a Learner begins to display anticipatory behaviour. The video can be shown to others to confirm or deny a claim of prior awareness.

Not every part of the Sensory Sequence devised for a particular individual needs to involve a possible controlling aspect from the Learner. There only needs to be a single part through which the Learner can demonstrate awareness at some future point. However, if more than one part of the Sequence does have a controlling aspect then so much the better.

It is important that staff allow time for a Learner to indicate a particular awareness: rather than quickly and immediately moving from one part of a Sensory Sequence to another, they should adopt a slight delay to allow the Learner to demonstrate an awareness of what is coming. How long a delay? That will be different for individual Learners but it takes time for an IEPMLD to process information and act upon it and therefore it is important that we make allowances for such cognitive processing leading to potential anticipatory behaviours. See Pause and Play below for further information on this aspect.

What if we have a Learner that demonstrates no physical reactions to any stimulus?
Hmm, that is a tough one! Please check to see if this Learner has any reactions to any such stimulus no matter how slight. Does he shut his eyes? Does she make a sigh? Does he react to an adverse stimulus? Is there anything at all with which you can work no matter how small? Even if there is no external observable response, the establishment of Sensory Sequences for such an individual may help then 'discover' that one event follows on from another and, as such, is a valuable approach. If this Learner does react to an adverse stimulus then its use as a part of a Sensory Sequence must be discussed and approved by:

parents;
establishment's management team;
therapy team.

and must obviously not be harmful to the Learner in any way.

How are Sensory Sequences best monitored?
I have always been in favour of video monitoring of IEPMLD. If videos are taken at regular intervals (say every month) then these can be reviewed objectively outside of the classroom environment for any nuance of behaviour that would indicate an anticipatory action from the Learner. Such videos can also act as training material for Significant Others such as Parents and Carers.

We have been working with a Sensory Sequence for over a year now with no Learner response. When is it time to terminate this practice?
Hmm, again, that is a tough one to answer. For some Learners it can take a long long time for them to make a connection and that time period may be measured in years rather than weeks or months. However, if staff feel that a current practice is not worth the effort, their
heart will not be in it and it may not be undertaken consistently which will, almost certainly, guarantee its demise. So while I cannot give you a definitive answer to that particular issue I would urge you to continue with the practice especially if the Learner appears to be deriving some pleasure from the process. I always used to ask my staff when they came to me with an issue, "What shall we do instead?" In other words, what will work more effectively for this particular Learner? Replacing one strategy with another, which itself is undertaken for about a year before staff begin to complain because no obvious results are forthcoming, is not good practice.

Sensory Sequences and Care Constants

Sensory Sequences do not always have to be performed in exactly the way outlined above, they can be accommodated into care routines. Significant Others will be assisting Learners throughout the day with their personal care and with eating and drinking. It is possible to adapt these times to incorporate Sensory Sequence. In fact, many care routines will already be a sequence of sensory experiences and therefore little adaptation will be required. Significant Others need to consider several aspects:

Repetition:
The care routine needs to become a Care Constant such that individual aspects of the routine take place in the same manner and same order each time. This will enable the development of anticipatory behaviours in the Learner. If varying people at different times are involved in care routines then there is more potential for the routines to become dissimilar. As such, good practice suggests that an ordered checklist is available to expedite matters as well as meetings between all involved to compare notes and ensure consistency.
Enjoyment:
Such routines should be enjoyable for the Learners and those working with and assisting them. If either are not enjoying the process then something is lost and positive outcomes may be lacking. A routine is not something that another is doing to a Learner rather it is a process which another is sharing with them.
Sensory:
As far as is possible, each aspect of the routine should be a sensory experience for Learners in which they can participate. Significant Others may ask themselves, 'How can I make (each part of) the experience more sensory?'. For example, 'Could I use a perfumed wipe during personal care?'
Time:
The routine should never be rushed or stressful. It should be considered as a part of the educational curriculum for each Learner, as important and as valuable as any other timetabled session. Staff must not feel pressured to speed through an activity in order to return a Learner to another place / session / lesson. Others must see what they are doing as a valuable contribution to the Learner's Education. It is also important that staff make use of the cloze and pause techniques detailed in other sections on this page to enable and encourage Learners to demonstrate anticipation through their behaviours. Such behaviours must always be recorded such that progress can be monitored (and reported) and success celebrated.
Social:
Each routine is a social activity for the Learner and should be seen by those involved as such. Those involved should not be chatting with each other over, above, and beyond the Learner. The Learner should be central to the social aspect of the experience.

Idea Nine: Create a Responsive Environment

"A growing body of evidence conclude that infants who experience a more responsive environment make faster social and cognitive progress (Ware 1996). There is no reason to doubt that this is the same for children with PMLD but it has been found that these students receive only very few responses to their attempts to communicate and express choices. For example, Goldbart (1980) and Ware (1987) both found that 50 percent of interactions in PMLD classes lasted less than a minute." Marvin C. (1998)

"The caregiver confronted with signals from the child that may be difficult to interpret may produce fewer and fewer responses to the child's behaviours. The prospect for developing effective communicative exchanges is bleak indeed."
Schweigert P. (1989 page 194)

Back in 1978 John Newson said "It is only because he (referring to a child) is treated as a communicator that he learns the essential art of communication" (see page 42). The problem is, as Evans and Ware showed back in the same year (1978), that Individuals experiencing PMLD are not really seen as communicators by staff and therefore it is something of a vicious circle!

At around six months of age, as Piaget (1952) and others have shown, children develop what is known as 'intentionality'. That is, they begin to recognise that they can have an effect on the world around them; that they can make things happen through their own efforts. Such a connection, between what I do and what happens externally to my body, may be problematic to some people especially those experiencing PMLD. As intentionality is a fundamental ability, it is important that staff working with Individuals Experiencing PMLD (IEPMLD) adopt practices that will encourage and support its development. Creating a Responsive Environment is one such practice.

A Responsive Environment is one which fosters emergent communicative abilities where seemingly none existed through specific Staff-Learner interactions and involves, at least, three separate strategies:

Nind (1993) and Hewett's (1994) 'Intensive Interaction'
Ware's 'Responsive Environment' (1996)
C.A.N.

"I asked if I could get him out of his chair and was warned that he would probably pinch and bite me. I started by telling him what I was doing (despite not knowing if he could understand my words), touching him firmly on the shoulder to let him know I was there and lifting him from his chair onto the decking outside the classroom. I kept in physical contact with him all the time I was with him. Not only did I want to help him to know where I was but I wanted to get as close as I could to him to give him less room to swing at me! From the moment I began mirroring his sounds, rocking him, singing ‘row the boat’, and rolling around with him, he stopped all attempts at the behaviour that was challenging. Not once did he pinch me. He didn't shout and he didn't try to hit me." (Lacey P. 2011)

Much has been written (see for example bibliography below) and so much is available on the web on Intensive Interaction that it seems futile detailing the technique here. Simply follow the blue links for further information or google 'Intensive Interaction'. Needless to say, Talksense recommends the technique to you!

Jean Ware's 1996 book set out the parameters for creating a Responsive Environment for IEPMLD. The basic premise requires that staff consistently respond to selected pre-intentional behaviours as though they were communicative and intentional. In so doing, staff shape pre-intentional Learner behaviour such that it becomes communicative as the Learner begins to understand that this action has meaning. As staff are working with an existing Learner behaviour, there is no requirement for the Learner to perform/learn some new action only to start to associate a particular existing action with a specific staff behaviour over a period of time such that pre-intentional becomes both intentional and communicative. IN DEVELOPMENT

C.A.N. stands for 'Creating Active eNvironments and is fully detailed on a further page on this website which can be reached by following this link and therefore will only be outlined here. An Active Environment is one which attempts promotes 'cognitive engagement' with the curriculum offered. It is not a single technique but rather a philosophy that utilizes range of techniques including 'Intensive Interaction' and 'Responsive Environments'.

In environments that are not active Individuals acquire what is known as Learned Helplessness. Learned Helplessness is acquired by children through their interactions with Significant Others; they learn to be passive, it is not a congenital condition.
"Children enter school as question marks and leave as periods." (Neil Postman)

For children who grow up with motor disorders, the difficulties they experience in moving and speaking and the influence from their environment both contribute to the development of a passive style. These children often place great demands on their parents. Training, feeding and washing take up a lot of time, and there are few activities that the children and their parents can take part in together. Even when the children are small, their parents consider them to be happiest when they are passive. ‘She's as quiet as an angel', and, ‘She is so good', are typical remarks made by mothers about their small children with cerebral palsy (Von Tetzchner S. & Martinsen H. 1992) (See also Shere B. & Kastenbaum R. 1966)

Active Environments provide the IEPMLD with the best chance of making progress and beginning to make connections between what they can do and what happens in the world around them to people and objects and in determining where they go or what they do (POLE: People, Objects, Locations, Events). Emergent historical awareness requires a recognition of connections between yourself and POLEs. Without such awareness there is no history.

Idea Ten: Create Cognizant Changes and Conscious Cycles

History is an awareness of change and how that change impacts on our lives. For the Individual Experiencing PMLD an awareness of change over a long period of time may be problematic: we need to focus on change over a very short period of time.

I have taught young people who did not know that a chip (french fry) came from a potato or that toast when overdone was black. They had not experienced these things because others had done these things 'on their behalf' and, obviously, threw away burnt toast such that the Learner never got to experience it. The fact that a chip starts out as a potato is something that can easily be demonstrated in a short space of time - the chip has a history ad we can demonstrate that history and, at the same time, teach a young person something relevant about their world. Thus, the teaching of history can be enabling cognizance of the sort of changes that many of us take for granted. How do we enable cognizance in Individuals experiencing PLMD? We include them! Inclusion here is used to mean involvement and experience at a level commensurate with the needs of the individual. Thus we need to get the individual to grow potatoes, buy potatoes, take them to the classroom, wash potatoes, smell potatoes, feel potatoes, peel potatoes, cut (safely) potatoes, fry (safely) potatoes, and eat (taste) potatoes. At every step, the individual needs to be as involved as safety will allow and as aware of the process as possible. Thus, preparing foodstuffs is teaching history! Eggs turn in omelettes, scrambled eggs, poached eggs, fired eggs ... Flour turns in all manner of things (including play dough which can be used in a sensory session).

How about experiencing change through the medium of the art class? Paint in a bottle becomes a picture on the wall. Indeed, we could make our own colours out of natural things to paint. Clay become a pot. Paper becomes papier-mache, play dough becomes ..., a face becomes a tiger with face paints ... These are all very sensory things but they are not simply sensory they demonstrate the concept of change over short periods of time which an individual can observe.

In the music class, the individual could be given an instrument and then be assisted to make music which is videoed. The video is made available to the Learner through (for example) PowerPoint such that s/he can observe the process in action.

Nature changes over time - If a collection is made of items from the natural world which were once living such as fruits, leaves, shells, branches, vegetables and flowers, etc. these can be displayed on a table top and can form the basis of a discussion and sensory exploration about change from one state (living) to another state. The Learners can experience their history. The Learners can be encouraged to explore such items using their active senses: to see, feel, hear, taste (such things as fruits) and smell. Staff can ask prompting questions such as, "Is this item alive?", "Was it alive?", "When was it alive?", "What did it look like when it was alive?", "How do we know that it is no longer alive?" for those that can cope with vocabulary at this level, However, there are lots of sensory experiences are available to those with the most significant Learning Disabilities:

Fresh fruit, dried fruit, and petrified fruit can be compared and contrasted. Some can be tasted.
Feel a shell. Hold a sea shell to your ear - what can you hear? See a living snail in a shell.
Crush dry leaves in your hands; listen to the sound they make. Compare with live leaves.
Make a collage from dry leaves.
Make a leaf life chart. Several leaves from the same tree at different stages in its life cycle.
Taste a fresh fruit and then taste the dried fruit but only look at and smell the rotten fruit.
Notice that new fruits are smooth but old fruit is wrinkly;
Make a rubbing of a piece of bark;
Feel a potato, peel a potato, cook a potato, eat pieces of cooked potato;
Make potato prints;
Make a shell picture;
Create dried flowers, make pictures and cards using dried flowers and other natural items such as nuts, berries, and seeds.

The natural world provides lots of opportunities to develop some awareness of the history (life cycles) with possibilities for all levels of ability.

What about going out and getting some tadpoles and watching them turn into frogs or toads? Yes, of course but, and here's the issue, it does not happen quickly enough! The Individual with PMLD will not be able to experience it as a whole and hold it all in memory and therefore may not appreciate it in the same way as a peer might be able. It is necessary to think of 'cognizant changes'; that is change that a Learner can experience in a single session. Preparing food and drinks and art based activities are just two such examples. Ice melting, building with Duplo (the form changes), water and soap becoming bubbles which can float and then burst, cleaning items which are dirty to reveal the item underneath the grime ... anything which is possible within a single session which illustrates change and with which the Individual can interact. The teaching of history through the Creation of Cognizant Changes.

Conscious Cycles is a variation on Cognizant Changes. Many things in life are a cycle and, as such, have a history. Some of those cycles we can illustrate practically in the classroom. Frogspawn turning into tadpoles and tadpoles into frogs which then create more frogspawn ... has already been mention. However, as has already been pointed out, this cycle is just too long for our individual to grasp. We need to make the Learner aware (conscious) of the cycle and to do this we must select cycles that happen in a much shorter time-frame. That is not to say that we shouldn't have some frogspawn in the classroom and monitor it on a daily basis: it just might be possible our Learner will glean something from the experience if not a sense of History. However, what cycles can be shown within a single session? Dressing and undressing, becoming dirty and getting clean, building and then knocking down, ... All these things and more (you can probably think of many other examples) demonstrate a history at a very basic level

Idea Eleven: Play and Pause: Gap filling as an indication of historic awareness

"The opposite of talking isn't listening. The opposite of talking is waiting."
(Lebowitz, F. 1981)

"A learner in the early stages of communication needs help to develop an understanding
of cause and effect, including communicative actions and subsequent responses. If the
learner sees something to communicate about or respond to, this essential stage is more
likely to be reached. By building 'pauses' into familiar routines and activities the adult can
create opportunities where the pupil can 'fill the gap' to make something desirable
continue. This gives learners the opening to make a communicative response." CCEA - Quest For Learning (2006)

Since it's introduction in 1953 (see Taylor W.L.), the use of the Cloze technique has long been an established methodology in education. Initially, cloze was used as a method of measuring the “readability,” or difficulty, of a text, and later (1956) as a measure of reading comprehension for native speakers. The method was simple, systematically or randomly delete words from a particular passage and ask the Learner to restore the missing words—and so, it quickly gained in popularity and its momentum has not stopped. So why don't we use 'closing the gap' as a means of indicating a particular cognition in an IEPMLD? If we build pauses into regular routines (see regular routines above) and wait and see if the Learner does anything to indicate an awareness of what is to follow by:

moving a body part in a particular way;
moving (if ambulant) towards a particular point;
eye pointing to a particular POLE (Person, Object, Location, Event);
vocalising, seemingly to remind us there is more to do;
other.

If such behaviour cannot be explained by another means then we can begin to assume (initially we cannot know for certain until there is more evidence: i.e. there is more observable behaviour) that the Learner has anticipated what is about to happen and responded accordingly. In order to do this, s/he must be recalling prior experiences and, as such, can be claimed to have some historical awareness.

If the practice is some form of play (for example) that appears to give the Learner pleasure (such as rocking back and forth with a member of staff), the staff member can build in an initiation process using a vocalisation, a sign, a symbol or a simple communication aid (such as a BIGmack). The staff member performs the activity with the Learner repeatedly. During the activity the staff member stops every so often and demonstrates the initiator for more of the activity. The initiator could be:

a particular vocalisation that it is known the Learner can make;
a particular movement of which it is known that the Learner is capable;
a specific Makaton sign that the staff believe the Learner could manage;
a glance at a symbol positioned clearly nearby: the symbol representing 'more' or 'again';
touching a switch attached to a BIGmack or touching a BIGmack itself to say 'more' or 'again'. The BIGmack should carry the symbol for more or again OR have a sensory surface which represents 'more' or 'again'.
some other initiator which is known the Learner can produce.

There are four stages:

Stage 1

When the staff member stops, s/he models the required behaviour to start the activity again.

Stage 2

The staff member assists the Learner to produce the required behaviour. Staff and Learner work together as a team.

Stage 3

The staff member stops and pauses for a set amount of time (decided by a staff team) to allow the Learner to initiate the activity him/herself. The staff member then uses decreasing hierarchical prompting to assist the Learner but doesn't actually return to Stage 2 unless it becomes obvious that Stage 3 is not being met.

Stage 4

The staff member stops and pauses for a set amount to allow the Learner to initiate the activity him/herself. The pause continues without prompting for a much longer period of time. If this stage is unsuccessful, staff and Learner return to stage three.

Movement from Stage One to Stage Four can take days, weeks, months or even longer. Staff should not be led to expect rapid results (although rapid results are possible) as they can become demoralised with a specific technique if they perceive it to be failing. The point is for both Learner and staff to have fun. If they are at stage one and two for a long time, what does it matter? They are still having fun!

"most of us simply like to be with other people and enjoy each other, talk, laugh, be companions"
Nind, M.,& Hewett, D. (2001)

"His handicap prevents him from learning through play in a natural way, so, unless he has help and encouragement,
he will not be able to learn as he plays or to reach his potential"
Finnie, N.R. (1974)

Such an activity can be undertaken for a specific time period every day.

In addition to the above, we can also provide a means for the Learner to request the activity. This can also use one of the methodologies outlined above. For example, a symbol for the activity could be placed on a classroom wall. Prior to beginning the activity each time, the staff member and the Learner could visit the symbol and touch it and then go off to where the activity is normally performed and begin. This would also be an ideal use for an Object Of Reference.

Idea Twelve: Start a Life Quilt

A Life Quilt (Grove, N. 1996) is actually a real quilt comprised from sewing pieces of material together. The materials used can be anything that has real meaning for the Learner from different periods of their life. For example: bits of clothes, curtains, cushions, duvets covers, etc from early childhood through to the present day. Objects can also be sewn into/onto the quilt the quilt: indeed, it can utilise anything that the Learner will recognise and may enable them to recall an event or a particular period. Obviously, to work properly, it is better if such an item is started early in the Learner's life (unless the materials have not been thrown away and are still available). The Learner can then be encouraged to interact with the quilt as it continually develops with new additions continually adding new levels of interest. There is no reason why some sections of the quilt could not incorporate images of friends or pets (pets may come and go), etc. The quilt can also be used as a bed cover!

Things such as old fabric purses can be sewn onto the quilt. Not only do they remind the Learner of a prior time when that was their purse but they can contain other items of interest. Sections of the quilt can have pockets. Into the pockets can be put cuttings from comics (laminated so that they will last, or photographs, or anything which is evocative or a previous time. Even small teddy bears etc could be sewn onto it such that it becomes a living, on-going, three dimensional object of reference for an entire life.

Grove, N. (1996) Life quilts, Talking Sense, Volume 42 (2) http://www.sense.org.uk/publications/allpubs/magazine/tsarticles/1996/lifequilts.htm

Idea Thirteen: 'This Is Your Sensory Life'

A further idea, in addition to life quilts are 'life-boxes'. A 'life-box' can be used to collect important objects from each period of a Learner's life. Such as drinking vessels, a teddy or doll or other favoured toy, old footwear, birthday cards, as well as (laminated!) photographs. Using these items it is not only possible to tell a story of the Learner's life but they can also be used to illustrate a sensory story concerning the Learner's life because they are 'known' to have meaning for the Learner. It may be the sensory story is only the story of the Learner's life at school especially if items from prior times are not available. The sensory story can be shared with the learner by a staff member on a regular basis. The same staff member should also have the responsibility for updating the life-box with important items from the Learner's school experiences.

If possible, the same staff member could also produce a 'This is your sensory life' book which details a Learner's entire school career (or longer) which includes lots of sensory items affixed to its pages. The book needs to be resilient enough to be handled by the Learner without coming apart. While this might seem a daunting task, if the staff member begins a book at the beginning of the Learner's school life and updates it regularly an entry at a time it should not be an arduous task and, over time, it will grow into a sensory record of a Learner's experiences.

Isn't this just a Memory Book in disguise?
No, not really. A Memory Book (see earlier this page) is a daily record akin to a diary: a sensory diary if you like. A 'TIYSL' doesn't cover daily events but rather focuses on special events over a longer time frame.

Isn't it just a Record Of Achievement?
No, it's not that either nor is it a sensory ROA. An ROA focuses on achievements whereas a TIYSL focuses on memorable events such as a visit to a zoo or a first pet or a trip to dentist. These sorts of things do not appear in ROAs.

Idea Fourteen: Sensory Switch Caps Support Historical Awareness

To promote active engagement and discourage fly-swatting the use of Sensory Switch Caps is recommended. Switch caps are clear plastic tops that fit snugly over switches to hold symbolic labels as cues to the functioning of a switch. However, symbolic labels might not be the most appropriate item to use for the Individual Experiencing PMLD (IEPMLD), s/he might not have the visual acuity necessary to see the symbol or, and this may be the more likely, may simply not attend to the symbol on the switch supposing a sufficient level of sight. Therefore, Sensory Switch Caps are a more practical alternative. Not all switches come with switch caps but generally they can be purchased separately. AbleNet switches come with a range of interchangeable tops of different colours; any one of these could be adapted as a sensory top for a switch rather than purchasing a clear switch cap. Each sensory surface that you create will be used to represent a particular POLE (Person, Object, Location, Event) and, thus, should be placed atop the switch only and when necessary. For example, a sandy textured surface could be used to represent any location or event concerning 'music', Thus, when an IEPMLD is working with a walkman or music playing apparatus of any description, his or her switch would be covered with the sandy switch cap. Over time, it is hoped that the Learner would come to make the connection between the haptic sensation and the musical POLE. Of course there is no real life connection between sand and music and therefore you might be thinking of a completely different sensory surface for this POLE. It does not really matter as long as the same sensory surface is used consistently across the curriculum by all staff and all times.

To aid staff and to make the process consistent, a label can be attached to the underside of the cap (which will not be seen as the sensory surface will obscure it when the switch cap is righted). The label can detail the Learner to whom the switch cap belongs and also the POLE for which it is to be used. Thus, the label might say 'Johnny Briggs : Music'. In this way, misplaced switch caps can be returned to their rightful owners and staff will easily learn which sensory surface goes with which POLE. Each Learner will have his or her own set of sensory caps which can either be kept in their classroom (if they spend the majority of their time there) or in their Objects Of Reference bag or in some other suitable container that always travels with them. The important point to note is that whenever a member of staff is going to do something with a particular Learner that involves the use of a switch, the staff member must not have to go searching for a cap - the cap must be available otherwise the system will fail.

Simple Sensory Switch Caps can be constructed using some spray glue, a piece of circular card cut to fit the shape and size of the switch cap, and some materials that can be attached with the glue to the top of the cap.

Take the card and create a template by piercing and cutting a circular hole approximately 15mm in from the outer edge;
Place the switch cap on top of some old newspaper;
Place the card template on top of the switch cap;
Using the spray mount glue, spray a film of glue onto the switch cap through the template;
This will create a circular film of glue on the surface of the switch cap;
Now attach a substance to the glue. For example, you could sprinkle dry sand over the surface;
Allow to dry and shake off the excess.

You now have created a Sensory Switch Cap. It is better practice to have sets of caps for individual Learners rather than share them amongst a group.

Below are some ideas for the POLE and the surface:

          POLE                    SUBSTANCE

          Music Sand, raised musical note
          Greeting Furry material / Smiley shape
          Water/bubbles Sponge (could even be made to be slightly damp)
          Toy (animal) Fur / Feathers, Leather, Suede, ...
          Toy (vehicle) Wheel
          Light source Electric wire shaped into a particular pattern
          Vibration Stick-on feet (Maplins sell such things) to create
domed bumpy surface
Fans Wire mesh (fans are normally protected by a wire cage)

Here are possible other everyday and inexpensive substances that could be attached to represent other POLEs: coins, rice, fishnet, matchsticks (spent), key, paperclips, chain, string, tin foil, washers, dried peas, sections of plastic straws, plastic scouring pads. Some of these will require stronger glue. Where the substance may require washing it can be attached by velcro so that it may be removed. Where an Objects Of Reference scheme is in operation, it is important to liaise with the staff concerned with its management such that conflicts are not created.

It will be noted that fur is offered twice as a suggestion in the above listing. Obviously, this cannot happen. When a substance is used for one particular POLE it cannot then be used to stand for another! I have used fur for all social greetings because it was warm and friendly and because I would wear a furry glove with which I would either shake hands with a Learner or interact with them in some appropriate way so they could feel the fur on my glove as the greeting was made (Good morning, Hello, Hi, ...). However, fur is also a good surface to represent a toy animal if it is made from a furry substance and so a choice has to be made.

It is also important to note that the Sensory Surface idea should be extended to cover the use of BIGmacks, LITTLEmacks, BIGsteps, and LITTLE steps where appropriate. These devices come with a cap included as well as interchangeable switch tops.

Hot glue is a relatively easy way of creating a raised line on top of a switch cap. As the switch cap is clear, a design can be placed underneath and then traced with the hot glue gun leaving a raised surface line that adheres to the cap and can be felt by the Learner in interactions with the switch.

If you don't want to use hot glue then silicon sealer comes in tubes that can be placed into a dispenser (available from DIY stores) and piped onto to the surface. After a short time the silicon will set to provide a continuous raised line on the top of the cap.

If desirable, you can combine both the above ideas, infilling the area enclosed raised line with a sensory surface (Cloisonné). For example, one could create a simple musical note shape outline and fill the inner surface with sand.

Raised lines need to be as distinct from other patterns used as possible to raise the potential of Learner cognisance.

Do not be tempted to create hundreds of such items:

Start simply with just a few Sensory Switch Caps for regularly occurring POLEs (at least daily).
Keep surfaces distinct and simple.
Consult as may Significant Others as possible on your ideas for designs for links to POLE items.
Ensure that you are not conflicting with other schemes in operation.
Ideally, each Learner should have their own set of caps.
Ensure that caps travel with the Learner.
Ensure that staff know which cap goes with which POLE!

Creating and using Sensory Switch caps in a consistent manner across the curriculum will assist an IEPMLD to make a connection between a surface, a switch, and a particular POLE. In making that link, the Individual is establishing a cause and effect and can begin to anticipate what will follow. Connecting events is a part of historical awareness!

Idea Fifteen: POLE Position

As has been detailed earlier on this page, POLE stands for Person Object Location or Event. If a Learner has a particular BEST POLE (see earlier this page) then we can use a technique devised by Jones (2000) called POLE Positioning. To illustrate this technique let's assume a particular Learner loves rocking with a particular member of staff and another loves going out for a walk around the school garden. An object (one which the Learner can manage) is used as a form of Object Of Reference and each time the Event (the E of the POLE) occurs, the staff member concerned goes with the Learner to a particular place/position in the room to collect the object before beginning the Event. After the Event is completed, the staff member goes with the Learner to return to object to the place where it is kept. This might have to happen a hundred or more times before a Learner makes the association between the object and the POLE. Furthermore, it may have to occur may more times before a Learner takes the initiative to present the object to a member of staff to request the Event.

In order to assist the Learner to move from Staff initiated behaviours to Learner initiated behaviours, it may be necessary to introduce an intermediary step: after the staff member has accompanied the Learner to get the object on lots of occasions (How many is lots I hear you ask? Some big number is my response!), then the staff member can ask the Learner to go and get the object on his or her own and bring it back before they start the Event. Thus, the Staff member, is scaffolding the learning experience for the Learner in order to move him/her forward to an independent action; the use of an object to make a request.

A further assisting technique has already been covered on this page and that is the pause; the staff member must eventually allow a portion of time (How much is a portion of time I hear you ask? Something more than a bit of time is my response!) in which the Learner has to wait before the Staff member initiates the activity. In this time, the Learner is afforded the opportunity to act independently. As days go by, the staff member can delay the start of the activity by a few seconds such that it takes that bit longer each day before the Event begins or the Learner is prompted to go and get the object in order for the Event to begin.

I like the idea BUT my Learner is not independently mobile and could not pick up an object and return with it even if he were.
Yes, that is an issue but one which can be overcome by encouraging the look. We adapt the idea for the specific requirements of each individual Learner. Thus, in this case, we might say the name of the Event and encourage joint looking at were the Event object is located. To facilitate this further we could make the Event object big and bold and bright and, rather than placing it in a drawer or a cupboard hang it on a wall where it can be easily seen. We still travel together to get the object off the wall before we begin the Event and, after the Event, we go together to put it back. However, the Learner initiated Event is simply a look at the object in its location.

Isn't this simply an Object Of Reference?
Yes, it is behaving like one and, as James Whitcomb Riley is supposed to have said, "If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck.". Thus, as it looks like an OOR and behaves like an OOR then it probably is an OOR especially if it were to be used by more than one Learner. On the other hand, it is likely that individual Learners have specific BESTs and therefore using different objects in different position around the room. Are all of these OOR? Depends on your definition of an OOR! However, most people would say yes.

OK. What if the Learner is not ambulant, cannot manipulate the object and has a severe problem with visual acuity?
Well, that makes it even more difficult to work with this idea: if not impossible. If you can figure a way around the obstacles or modify the technique in some way all the better. However, every idea on this page is not for every Learner and this may not be for the Learner as you describe.

How is this history?
The use of the object as an expressive act demonstrates contingency awareness: a causal connection between an object and POLE. History is about making connections. Furthermore, the Learner has to remember past events to make such a connection. History is about remembering the past.

Idea Sixteen: That's Rubbish!

This idea is a variation on the previous idea but without the OOR involvement. The stimulus is rubbish! The idea is to make a particular Individual responsible for putting the rubbish in the waste bin (taking out the trash). The waste bin must be positioned in exactly the same place in the room such that the individual can learn where to find it. Thus, the individual is given the role of 'Waste Monitor' and charged with the responsibility of taking any rubbish to the waste bin and putting it in. Obviously, this can only be undertaken by an individual with the necessary physical skills. Initially, a staff member models the behaviour with the Learner but fades all physically assistance and any prompting over time. The goal is for the Learner to take the rubbish to the waste bin when asked so to do by a member of staff without that member of staff giving any additional physical assistance or prompts of any kind.

When an Individual Experiencing PMLD (IEPMLD) is able to do this without assistance and prompting, what do we know? S/he is performing a task which requires memory of what to do and where to go (spatial memory). The rubbish itself becomes the initiator of the action together with the staff member's request. While we could not claim that the IEPMLD has an understanding of the staff member's language, we can tell from the Individual's correct response that a particular behaviour has been triggered and the behaviour was learned.

You may be able to think of other simple chores / responsibilities around the classroom / home for which you can make a particular Learner responsible. Putting a certain away after use, for example. As long as the process involved is:

within the Learner's physical capabilities;
consistent over time and space (the waste bin does not move position, for example);
Staff are willing to work patiently over (perhaps) a long period of time in assisting, prompting and teaching the Learner

there is a reasonable chance that the Learner will eventually succeed in mastering the responsibility independently. Such task mastery is evidence of simple historical awareness.

Idea Seventeen: Tactile Timelines

I often see Individuals Experiencing PMLD (IEPMLD) with symbolic timetables. It would appear that these are being used in an effort to make the structure of the week more inclusive. I applaud the effort. However, I am one of those people of the opinion that, at this level of cognition, the concept of something happening on a Thursday afternoon when, presently, it's Monday Morning, is a little beyond the understanding of an IEPMLD. Is it doing any harm? No, I do not think so, so long as staff are not assuming understanding and working with individuals at this level of cognition. If I am not advocating a symbolic timetable (for some Learners) then what do I advocate? Actually, I'm not convinced a personal weekly timetable is (at this point) of any use and could be left out! However, staff need to know where Johnny should be on a Wednesday Morning and where Jane should be on Friday after break and, as such, I am not saying that the Individuals should not have a timetable: of course they should but they do not necessarily need a copy of their own (well, not just yet). As awareness of space and time starts with the individual and moves forward in concentric circles (I am hoping to expand on this further in yet another section on this page), a timeline for the IEPMLD has to begin with the here and now and gradually work outwards and backwards and forwards and sideways and ... Thus, we need to begin with the Learner and their understanding and build upon it.

"These responses illustrate that personal history provides a strong starting point for pupils whose cognitive level
may suggest that the subject would be of limited relevance" Sebba 1994

As such, I would support the notion that identifying what is coming next is more important than identifying what is coming a week on Tuesday. For you, at a more developed level of cognition, what is coming a week on Tuesday might be extremely important and may even be colouring what is coming next. However, John and Jane are not at your level of cognition and, thus, we must approach at their level of understanding and ability with an intention of expanding those further.

Forward Timelines

Forward timelines need to begin with what is happening next assuming that the individual is aware of the 'me' in the 'here and now' (if not established then this is where we need to begin). 'What Happens next' can be addressed via the use of Objects Of Reference (see this website), Sensory Cueing (see this website), and developing contingency awareness (see this website). When the Learner is ready to move beyond the 'What happens next' stage a tactile timeline might be one strategy that we can employ. Tactile Timelines might begin with what is going to happen in this session (as opposed to what is going to happen on Thursday afternoon next). At the start of a session, the Learner together with a member of staff build a timeline for the session from a number of available options (each session may have differing options available). Each option could be a square of stiff laminated card to which a sensory surface has been applied. The surface can be sprayed with adhesive onto which a sensory surface is sprinkled or otherwise affixed. Alternatively, a hot glue gun can be used to outline a particular shape leaving a raised tactile surface. Combining both means that the raised outline is infilled with a particular sensory surface. It is important that each separate card must be distinct from each other. As each card represents a particular aspect of one session of a Learner's timetable, it can be labelled on the reverse with its referent and it is also especially important to name the Learner to whom the card belongs as such things tend to get 'misplaced'! Self adhesive velcro circles or squares can also be attached to the rear of the cards such that they can be kept in a ring folder. I tend to use old carpet squares trimmed down to A4 paper size and punched with a hole punch to make pages to which velcro cards can be attached. Suppose the first order of the session is a greeting time for everyone. The staff member can layout two cards in front of the Learner (one of which is card representing 'greeting time') and encourage/assist him/her to explore them to pick out the one that represents 'greetings'. Of course, at first, the Learner will have no clue which card is representative of which part of any session (indeed, it may take a very long time to establish any such awareness) but the staff member can assist the Learner to select the correct one which is then placed at the beginning of a long strip of carpet tile or some other velcro friendly fabric board. Each section of the session is undertaken in this way until all parts are represented in a tactile timeline on the strip in front of the Learner. Thus, the Tactile Timeline is assembled by the Learner at the beginning of each session. That is not the end of the matter, however: As each part of the session is reached, the Learner feels his/her timeline and removes the first one and travels to the part of room where the activity is to take place. This area can have a larger but otherwise identical tactile square such that the Learner can compare surfaces before beginning the activity. Once this has happened, a staff member can replace the Learner's tactile square back into its storage book/box ready for the next session. In this, way, the tactile timeline strip gradually reduces one square at a time as the session progresses and the Learner moves from activity to activity until finally the strip is completely bare or a 'it's time to move to your next session' square is reached and an Object Of Reference is presented.

It is important that:

Tactile Timeline Squares are very distinct from Objects Of Reference. An OOR refers to what is going to happen immediately next and not what is going to happen several steps into the future. Thus, it is better not to use mounted OOR if you are working with Tactile Timeline Squares (stick with three dimensional unmounted OOR).
Tactile Timelines are not used as Objects Of Reference and Objects Of Reference are not used as Tactile Timelines.
Learners are allowed to make 'choices' in the set up of the Tactile Timeline at the beginning of the session. That is if they 'choose'a particular square, that is what they get to do. Staff must understand however that this may not be a real choice by the Learner; the Learner may have simply touched/looked at one of the squares first simply at random without any understanding whatsoever. However, we are attempting to teach the Learners that what they choose is what they get. Of course, as the choice of square and the receiving of the activity are deferred (that is one does not immediately follow the other), it is unlikely that the Learner will easily make the connection. Thus a Learner may be offered a choice between 'switching with a toy' and 'switching with a computer program' at one point in the timeline. Perhaps the two tiles/squares would both have a circular raised line (to represent switching) but have a different infill for the different activity.
the design and use of Tactile Timelines is consistent across the curriculum.
if timelines are to be useful they have to be accessible; that is accessible both physically and cognitively. If timelines are to be used in the classroom they must also be readily accessible to staff. Staff will not spend minutes in a session locating and preparing such materials, they are already too busy with other matters.

Backward Timelines

Backward timelines must begin with or, at least, include the Learner's awareness of self. Once that is established then we can begin to chart events (about self) during a session, a specific timeframe, a morning, an afternoon, a day, a weekend, and beyond. There are varying ways in which we could chart a personal timeline: for example, we could keep a video record, a photographic record, a symbolic record or an objects record (see section on Memory Books above as an example). If we are using a left to right approach for the layout of Forward Timelines then perhaps we should use a right to left approach for the ordering of Backward Timelines. In the case of Memory Books, the Learner may turn back pages to see/interact with what they were doing on previous days.

IN DEVELOPMENT

Idea Eighteen: Dr. Who?

Ever since that unearthly child Susan Foreman walked from 76 Totter's Lane through the doors of Barbara Wright's history class at the Coal Hill school back in November 1963 children have been fascinated by the exploits of the ever changing good Doctor.

This section is not specifically about 'Dr. Who' but rather any TV programme or advertisement that attracts the attention of an individual Learner. Is there a TV programme, an aspect of a TV programme, or an advertisement or aspect of an advertisement which parents, Carers, or any Significant Other have noticed that appears to attract the attention of a Learner? If so, is it some thing that we can utilise in the classroom?

The answer to that question is - yes we can! How might we turn an aspect of a TV programme or an advert into something accessible by an Individual Experiencing PMLD (IEPMLD)? There are, at least, three possibilities:

Package it in PowerPoint. As we have already seen, PowerPoint is an immensely versatile and useful classroom tool that can be easily driven by a single switch. It's not difficult to do. If there is some programme or advertisement that stimulates a Learner then we can put it into PowerPoint and provide the Learner with an easy means of independent access. See PowerPoint section above.
If it's auditory and not visual, we can put it into a BIGmack (or equivalent) such that the activation of a switch causes the BIGmack to replay the sound / song / music. However, a BIGmack can also operate another switchable device (pretty much any piece of mains or battery operated equipment with certain limitations) and, as such, we can use one motivator to teach another.
Object Choice: allow the Learner to choose between three objects on of which is a DVD of the programme. The Learner can either reach out and touch / take or eye point or give a positive response to an object scan by a staff member ... If the DVD is chosen the Learner gets a minute or two of the item before it is timed out and another selection has to be made. Once successful over several sessions, step the Learner challenge up by either adding more items or making the other choices more similar in shape and colour. If the Learner chooses one of the other objects then s/he should have to do another task related to the object for a similar amount of time. We could teach the connection between the DVD and the programme by attaching the DVD (case) to a string switch. The DVD case could be dangled in front of the Learner such that when s/he holds and pulls on it the string switch will operate and PowerPoint will play a portion of the programme. The DVD becomes the switch! The same thing could be achieved with a toy version of a favourite TV character (cartoon or otherwise). The toy becomes the switch.

We are teaching cause and effect using a TV programme or advertisement as a BEST (Best Ever Stimulating Thing). TV Advertisements are particularly good because they are usually short, designed to be appealing to specific target audience, easy to capture, and often repeated on our TV screens so that an individual Learner is given opportunities to get to know them. While the Learner may associate the ad with being at home, it may make a considerable impact if it is presented in the classroom! Furthermore, I have always found the companies advertising more than willing to help with materials (and they usually have them) to do with the specific product once they know its intended use. It is surprising what you can for free get if you dare to ask!

IN DEVELOPMENT

Idea Nineteen: Ensure your Learners drink water

As research has shown that simply drinking supplementary water improves cognitive performance (Fadda, Rapinett, Grathwohl, Parisi, Fanari, & Schmitt, (2008); Fadda, Rapinett, Grathwohl, Parisi, Fanari, Calò, & Schmitt (2012)) in children it would seem advisable that we ensure that water is provided to all Individuals Experiencing PMLD at regular intervals. While it's not going to turn PMLD into PhD, our Learners need every bit of help to take that little step forwards.

It's not only water but diet in general that can help improve cognition and memory:

"A link has been established between diet and cognitive function. Some animal products contain aluminum, copper and arsenic that have been linked to Alzheimer’s and neuropathy. Plant foods, on the other hand, such as green leafy vegetables, blueberries, and soy beans, may help improve memory." (Greger, M. 2013)

As such we need to monitor the intake of food in Learners to ensure their diet is supporting health and cognition and not attacking it.

Idea Twenty: Story Time

We can assist Learners to develop anticipatory behaviours by involving them in repeated story telling. The story is repeated and repeated over several weeks if not months such that the Learners have a chance to recognise and anticipate specific parts of the action and join in spontaneously where possible. Anticipatory behaviours noted by staff can act as evidence of Learner cognition especially if such behaviours are repeated (it is always a good idea to video such behaviours as proof of claims of Learner cognition). There are at least two forms of Learner involvement in story telling: Passive and Active. Passive involvement means that the individual experiences the story through means that are supplied by Significant Others: for example, a staff member might create a water mist from a spray bottle to illustrate a shower of rain in a story. Active involvement means that the Learners themselves are producing the story, the effects, in full or in part. Such passive and active involvement of an Individual Experiencing PMLD (IEPMLD) in such story telling can be achieved in a number of ways. Indeed, many of these methodologies can be combined for even greater effect. The methodologies could include (there is no pretence that this list is comprehensive) the use of:

Sensory Stories;
Personal experiences:
Bookworms or BIGsteps;
Projected PowerPoint;
Repetitive story lines and or actions.

Sensory Stories
Sensory stories, Sensory Journeys, multi-sensory stories, multi-sensory sensitive stories, tactile stories, bag books, and story sacks are all ways of bringing a story to life for Learners who are experiencing cognitive difficulties. They are presented in an inclusive and interactive manner for those who cannot presently read for themselves. They are told with an emphasis on vision and sound and movement, action and interaction (in other words through the Learners 'senses') rather than on text. The staff might use Learners as characters within the story and toys to illustrate any animals for example. Sound effects, symbols, smells etc are all included to give the story meaning at a level that the Learners might understand.

Simple AAC can assist in telling a Sensory Story. Better still, it can be the Learners themselves who are in control of the story through the simple AAC systems (see Bookworms below), telling the story and producing the sound effects and even the imagery (using a switch to control a projected PowerPoint for example (see PowerPoint below)). Simple AAC could help to:

empower a Learner or Learners to tell (part of) a story;
provide sound effects within the story line;
link to projected images and video;
assess Learners' awareness of the story line.

In my story below, a Learner's name is used (in the example Jane). The story has lots of repeated lines (see Repeated Lines below) and works with things of which the Learners may have some experience and can easily be provided as tactile objects. Some can make sound effects such as plastic bottles filled with peas. The story can be told, at least in part, using a simple AAC system and other Learners can produce sound effects or say a particular story line:

Jane lost her special cup.
"Where is it?", said Jane.
She looked in the ... kitchen drawer
but all she found was ... knives and forks
"It's not here", said Jane.
She looked in the ... front room cupboard
but all she found was ... books and magazines
"It's not here", said Jane.
She looked in the ... bathroom cabinet
but all she found was ... plastic bottles
"It's not here", said Jane
She looked in the ... Bedroom wardrobe
but all she found was ... clothes and shoes
"It's not here", said Jane.
She looked in the ... Kitchen Sink
"There's it is!
Mum is going to wash it"

Personal Experiences
Creating a sensory story around the personal experiences of a Learner or a group of Learners is a good idea. As this page deals with
history, one idea would be to create a sensory story around the recent history of the group, the school, an individual, etc. Thus while the
story itself addresses history, the didactic approach also addresses historical awareness in other, more subtle ways. I am always
concerned when I witness a sensory story about a topic of which the Learners can have little if any awareness. I once witnessed a
fabulous sensory story session on a trip into space. The staff had put a great deal of thought and effort into it and they were to be
applauded. However, to me, the topic of the story was far removed from the everyday reality of the Learners present. I would have wanted to put the same effort into a story about going to the shops or a trip to the woods or the park or the seaside.

Creating a sensory story around the personal experiences of a group provides a greater chance for Learners to recognise and respond to familiar features. As such stories should always be repeated on at least a weekly basis there is a good chance that some Learners will begin to anticipate forthcoming events and act accordingly. Indeed, we can make Learners active in the story telling as they are anticipating by providing them with simple AAC devices to create sound effects or say a particular word or line or with a musical instrument to create an effect at the appropriate point, for example.

Bookworms, BIGsteps, LITTLEsteps
A Bookworm is a device from AbleNet that allows you to record and store books of up to 32 pages onto interchangeable memory cards
that can be kept for future use and eventually form a library. Bookworms can be driven by a remote switch! Thus, a Learner who is able to manage a single switch could read a story line by line. The Story does not have to be from a published book of course, it can be a story that was created in class by a member of staff for a particular group of Learners.

If the lines to a story are not longer than two minutes then a BIGstep (or LITTLEstep) could also be used, Indeed, it would be possible to
use both devices in the same session for retelling different parts of a story. Each line of the story can be recorded onto a BIGstep. Each
time the surface is accessed the system will repeat one line and move to the next line ready for the following activation. The BIGstep can
also be operated by a further switch and can also be used to operate a toy or other device when a specific line is spoken.

For repeated story lines it might be a little simpler to use a BIG or LITTLEmack. Please see the section on repeated story lines and actions in the section below.

Projected PowerPoint
PowerPoint is a fantastic tool for education whose potential, I believe, is underused. PowerPoint can be driven by a single switch.
PowerPoint can display videos, photographs, animated images, play music, produce sound effects and more. Photos, video and sound recordings taken during a field trip can be arranged into a set of multimedia slides that can be projected as a part of a sensory story and be directly controlled by a Learner or Learners through a single remote switch. A personal story of an Individual's life can be projected together with familiar (family) voices and music from the relevant periods. Indeed, if you can imagine it you probably can create it as a PowerPoint program. As PowerPoint can be projected it can be shown large on a white board or a suitable wall or even create specialised visual effects in a white room (even a black room can be used if you hang a white sheet!). PowerPoint can help to bring a story to life and, as consistency is important for the development of anticipatory behaviours, it is always consistent: you can guarantee that one presentation is going to be the same the next time it is used. Furthermore, when completed, PowerPoint presentations can be banked' for future use by other individuals and groups building into an entire library on all subjects. One other important benefit is that almost any member of staff can run the session and it will still have some chance of being very similar to the session run by another.

Repetitive story lines and or actions
Books with repeated story lines are typically good to use with Learners who are developing emergent literacy skills. The Reader can provide the Learner with a means to say the repeated line (Simple AAC system) and then encourage the Learner to use the system to say the line at the appropriate time. It may be that the Reader pauses, looks expectantly at the Learner, then at the AAC system in order to prompt for the line until the Learner is doing it for him/herself.

Generally, the rule is that, such ‘prompts’ should go from the least intrusive to the most intrusive: therefore, physically taking the Learner’s hand and facilitating him/her to access the AAC system should be among the very last strategies adopted.

While Individuals Experiencing PMLD are typically not ones developing emergent literacy skills, it does not follow that the use of repeated story lines have no use or place within sensory stories. Repeated story lines can be stored onto a BIGmack (or other such device) such that an IEPMLD can speak out a particular line at given points within a sensory story. This will require a lot of staff assistance at the start but it is hoped that staff prompts can be faded over time such that the Individual is able to be responsible for the task independently. It may be wise to make a repeated story line follow something else that is repeated such that the Learner has a 'peg' which can be used to demonstrate anticipatory behaviour (the activation of the BIGmack at the appropriate point). Such 'pegs' might include a particular sound or an action by another or another repeated line.

There are lots and lots of books with repeated story line. Spend some time browsing in your local children's book store! Take a look at the 'That's not my ...' series by Fiona Watt. The AAC and literacy web page on this site has a list of over 300 books that have such repeated story lines. However, I would encourage you to create your own sensory stories with repeated lines and repeated actions around the personal experiences and needs of the Learners. Such repetition in an already repeated sensory story (at least weekly) provides a real opportunity for a Learner to exhibit anticipatory behaviours that staff can recognise and which provide good evidence of Learner awareness.

Story Telling as History
As anticipatory behaviour is indicative of recall of past events, we can say say that inclusive sensory stories are another means of teaching history. As we can also make the story about some 'historical' topic, we can double the attack although I am not certain that individuals operating cognitively at this level will be that aware of the overall story topic unless we make it personal and local to them: even then it may be problematic.

There are a number of important factors in the use of sensory stories as a means of promoting the development of historical awareness in IEPMD. These include:

Repetition:
We need to repeat the same story in the same way many times. The Learners need to experience the story at least weekly, if not more
often.

"It is important to plan for a high level of repetition. Repetition both within the same setting then across a range of other environments
and contexts is crucial for your student to internalize and process a skill or experience."
Cartwright & Wind-Cowie (2005 page 59)
However:

"But the feeling grew that the pupils' day was becoming predictable and boring. Some pupils were working on skills that they
would clearly never master to a satisfying degree, and which did not seem to have , for them, any intrinsic satisfaction."
From Watson, J. (1994 page 150)

Thus, not all repetition is good, desirable, and valuable. From the above quote it would seem that staff perceptions of the situation also play an important role in successful implementation (see section below on training). It is thus important that what we do is:

relevant to the needs of the Learners;
repeatable (but not boring);
predictable for the Learners (otherwise, what is the point?!);
accessible for both Learners AND staff!

Consistency:
Consistency in the order in which we retell a story is important otherwise anticipatory behaviour is somewhat negated. The use of technology such as the Bookworm or PowerPoint can help with this but is not essential. Also, as was pointed out in the section above, consistency requires relevance; there is no point in being consistent if what you are doing hasn't a chance in a million of succeeding. It is also important that the staff believe that it is relevant. If a technique is relevant and requires a consistent approach but staff cannot understand its relevance or over a period of time become disillusioned with its effectiveness then they will cease to enjoy its application. The ramifications for future progress using the technique will be obvious.

Involvement:
It would be wrong to focus just on Learner involvement here although crucially important. Staff need to be involved as well. In both cases,
involvement goes beyond being merely present and going through the motions; it means inclusion and a relevant and consistent approach
which fosters understanding for Staff as well as Learners. Learners must not be passive recipients of education but active in the process
and create their own learning opportunities.

Enjoyment:
Once again, it is important that this technique is pleasurable for both Learner and Other. If it isn't then it is being undertaken in a less than
satisfactory manner and the process should be analysed to discover what, if anything, can be done to remediate and ameliorate the
situation. There are some things that are enjoyable but have little educational value and equally there are some things that have
educational value but are not enjoyable. The wise person takes the middle pathway!

Idea Twenty One: Talking Photo Albums

A Talking Photo Album (TPA) is, as its name implies, a photograph album that can play back a simple recorded message. Typically they are available with either one or to pockets per page and thus one or two messages per page respectively. Recording is usually a matter of pressing a button on the page together with a recording button and speaking a short message. They were not designed for the special needs market but as a means of adding sounds to a photograph collection such that, for example, grandchildren could make a special album for grandmother as a Birthday or Christmas present.

There are both advantages and disadvantages to using Talking Photo Albums (TPAs) with Individuals Experiencing Profound and Multiple Learning Difficulties (IEPMLD) as a means of developing historic awareness.

Advantages:

TPAs are relatively inexpensive to purchase;
TPAs are low technology systems. It is unlikely that any Significant Other will be confused by them;
TPAs can be set up with one image per page / One message per page.
TPAs can be used for many other things. They are versatile.
TPAs can be used with (digital or non-digital) images of the Individual from their past.
TPAs can also be used to display non photographic items from a Learners past such as a bus ticket, bag from a shop, etc.
TPAs are consistent: picture and message/sound effect are always the same. The pictures arrive in the same order when working from page to page as though reading a book.
TPAs can be used for picture schedules.

Disadvantages:

TPAs tend not to be too well made and are not robust enough for the special education environment.
The recording activation mechanism for playback of a message is typically a small button on each page. Many Learners find it difficult to access.
The playback button does not always work consistently.
The playback button can be difficult to depress.
The pages do not open flat and therefore they are difficult to access by an IEPMLD.
If the pages are creased to enable them to open flat the recording button on the page may cease to operate.

If TPAs are set up to contain a record of a particular outing or the passage of time in a particular area for a specific Learner, they may be used as a historic record of events which is accessible to Learners with the aid of Significant Others. As TPA pages are somewhat difficult to turn and do not open flat, they are not recommended for direct use by the Learner him or herself.

Of course, a Talking Photo Album is not the only way to do this; standard photo albums will do nearly as well and pictures can be switch driven and be sound enabled using PowerPoint (see section on PowerPoint above). Furthermore, the iPad (and alternative touch tablet devices) also make excellent talking picture albums. These may overcome many of the disadvantages of the TPA system although they will inevitably be much more expensive. For lots of uses for the iPad and other simple AAC systems with IEPMLD and others experiencing Learning Difficulties see 'Simple AAC' here on this website. For example, iPads could be used to display schedules as shown below:

However, while this might be useful to those functioning at a higher cognitive level of learning difficulties I am yet to be convinced such a schedule representation serves the needs of those Individuals Experiencing PMLD.

Idea Twenty Two: Training and Environmental Engineering

In her 1994 book, page 148, Jean Ware says,

"organizational factors at both a school and classroom level play and important part in ensuring that an appropriate interactive environment is provided for pupils with PMLD and this needs to be take into consideration in the organization of provision and in staff and volunteer deployment."

and goes one to say that,

"We are well on the way to being able to train staff to provide a contingency-sensitive environment for children with PMLDs, but unless we provide the conditions in which those skills can be exercised effectively the children will not benefit fully." (page 149)

Thus, not only to do we have to make staff aware of techniques that can assist the development of further awareness in Individuals Experiencing Profound and Multiple Learning Difficulties (IEPMLD) but, once trained, we must engineer the environment in a way which makes the implementation of such skills practical and achievable. Training and staff awareness is the first step. It must be followed by a period of reflection in which the team decide:

what, if any, portion of the training should be implemented within the establishment;
the best way in which to implement the selected material.

Talksense always has strongly supported the notion of 'small is beautiful'. That is, we should begin small and learn to walk before we attempt to run. It is better to target a specific individual Learner (for whom the selected approach has a good chance of success) and a selected group of staff implementers (who will give the approach their best efforts) and then build on that success as staff begin to see the value and start asking why other named students are not also be assisted with such a technique:

"Additionally it seems possible that attempts to increase staff responses could be more successful if individual child-staff pairs
were targeted initially, and then generalised to overall classroom practice." Ware J. (1994 page 148)

Beginning with all Learners across the entire curriculum and involving all staff is simply making a rod for you own back! It becomes difficult to implement, monitor, evaluate and to adjust to problems as they occur and they will occur. In my experience, the majority of issues are didagenic (see Kohl 1973); that is, they are caused by the staff themselves. Thus, it is imperative to be able to reflect on practice and amend and adjust it before rolling it out across the entire curriculum. Indeed, it may need tweaking for specific Learners to meet needs in a more appropriate way. My advice, therefore, is to begin with one or two selected individuals together with an appropriate and practical number of staff over a predetermined time frame culminating a full appraisal of practice and results. It also may be valuable to build in several interim reviews of progress prior to the final review such that tweaks can be made to direct the approach towards success. It is important that the selection of staff for this process mirrors what is both practical and possible in any full implementation. While 5 staff to one Learner may support the success of any new approach, unless a ratio of 5:1 is possible should the technique be fully implemented, then a lower ratio should be adopted. This applies to all aspects of the new technique under scrutiny; is the trial realistic? Could such an approach be rolled out across the curriculum. While we may strive for the ideal reality is the pragmatic. Often, if it works for the staff then it is more likely to produce positive effects for the student. That is not to negate a child/person-centred approach - just one in which there is a view to staff-centred abilities and environmental, temporal and other possible constraints.

Talksense supports the notion of regular and informative staff training. Unfortunately, it would appear that, presently at least, staff are finding increasingly more difficult to get funding for training especially if such training involves them leaving their responsibilities in school for a period of time. Indeed, as Mount and Cavet noted back in 1995, it may be easier to get funding for novel specialist equipment than to get adequate training (see page 54). Talksense offers training in the majority of the techniques, ideas and strategies outlined on this page. Please use the form at the bottom of the page for contact.

Idea Twenty Three: The What's in the Box Game?

You do not need a fancy box as is illustrated in the accompanying image left; you can use a cardboard box if you wish for this technique.

First, you must establish at least three things that the Learner likes and can identify. To establish a preference a Free Operant Preference Assessment is a useful technique. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Once you have established three preferred items then the Learner must be able to identify each of them. This could be achieved:

by using another set of three matching items. Can the Learner match them: same to same?
by using three photographs of the items. can the Learner be taught to pair the photograph with the object?
by using three symbols: one for each of the items. can the Learner be taught to pair te symbols with the objects?
with any simple AAC device. The Learner has three BIGmacks (for example) each programmed with the name of one of the items.

The game involves A) a member of staff, B) another person (pupil or staff member), and C) the Learner. B is given the three objects and asked to chose one at random but NOT to tell A what it is. Leaving the other two objects in their storage space (so as not to confuse the Learner C) A presents the chosen object to the Learner C. C is allowed to see it, feel it, hear its name, and see its sign before having to place it in the box. The box is closed (or turned over) such that the object inside cannot be seen. B calls A over and B departs leaving A with the Learner and the box. A does not know what is inside the box. A asks the Learner C, "What's in the box"? C's task is to tell A the name of the object in the box via one of the methods that where established before hand. For example, the Learner could pick one from the set of three identical objects which are placed out in front of him or her.

Can the Learner identify what has is concealed inside the box? After the Learner has identified what is inside the box, A can open/lift the box to see if it is correct. If the Learner is correct then s/he should be given some small reward. IF not, then A can put the symbol or photograph or object against the boxed item and say something like, "These are NOT the same!". NO reward is given. Right or wrong the game continues.

If the Learner continues to get them all wrong (or most of them wrong as s/he will get a few right by chance alone). Then the game should be stopped and tried on another day. It may be that the Learner is having an off day. You may want to try with a different person selecting and showing the item each time. A peer is a good idea as it will add to fun aspect of the game and may be more motivating.

If the Learner continues to choose the wrong item even when played over several days, you may need to return to the earlier step of ensuring that s/he can match symbol/photograph/item to object. You can also try another intermediate technique: leave the box open but turn it on its side so that the Learner can always see the contents BUT staff member A cannot. If the Learner is successful in using this approach then return to the closed box technique and see if the Learner is now able to cope with the task.

If the Learner gets them correct then whoopee! That is great. The Learner is demonstrating an ability to remember, albeit for a short time but s/he has remembered what was placed in the box. We can now put a small delay between B showing the Learner the item and placing it in the box and A coming over to ask about the contents. Suppose we start with a delay of just five minutes. When A's arrival was almost immediate the Learner could manage the task. Now there is a delay, can the Learner still state the boxes contents? If s/he can then brilliant! If s/he cannot then reduce the delay a little until there is a positive result.

We now have a way of measuring the memory of our Learner. We can keep extending the delay until the Learner cannot remember what was put in the box: a few minutes? An Hour? A few hours? A day? More than a day?

Idea Twenty Four: What did you ...

What did you have for lunch?
What did you have to drink?
What did you do in art?
What did you do this morning?
Where did you go before break?
How did you get there?
Who helped you to go to ...?
Which colour did you use?

Immediately following any Learner activity, a Staff Member or Significant Other can ask the Learner to tell them what, where, which, who, or how they did/had/... during the activity. For example, if the Learner chooses different drinks at break, the Staff Member could ask, "What did you have to drink at break?" Can the Learner tell them? It is better if the staff member does NOT know what the Learner had or did such that they cannot unconsciously 'cue' the Learner. If they do not know what the answer, how can they tell if the Learner has given them a correct response? They can make enquiries to find out.

In asking such questions, we are establishing if a Learner can recall a previous (historic) event. Obviously the Learner must have some means of telling the person the answer. The Staff member could provide a range of possible answers from which the Learner can select, for example.

That's crazy! The Learner may think that s/he is being offered another choice of drink to have and therefore get it wrong.
Sure, that is a real possibility. Providing the incorrect response tells us nothing because, as you rightly point out, the Learner could be just getting confused about what we are doing. However, while an incorrect response tells us little, a correct response tells us a lot! Especially, if the Learner can do this consistently such that pure chance is ruled out (we should also rule out questioner cueing of the Learner response: if the questioner does not know the correct response then this possibility is eliminated. If I was present at break when the Learner had his drink then I know the answer. I could ask another member of staff to talk to the Learner and discover what drink he had at break and then report back to me.

If the Learner can do this consistently immediately following an event, The we could delay the questioning for a measurable period of time such that we can measure the Learner's ability to recall: it it just minutes or is it hours or even longer (what did you have for dinner on Sunday?)?

That's far too abstract a concept for my Learners.
How do you know that? What's abstract about asking what drink you had at break time? Obviously, if the Learner always has orange juice then the question is not as meaningful as if the Learner picks different things. However, even if the Learner always has the same drink, his/her response to the question may tell us something about his/her skills. If s/he gets it right, it may be that the Learner believes we are asking what s/he wants to drink rather than what s/he had to drink. As s/he always chooses orange juice then in choosing what s/he WANTS, s/he has also answered what s/he HAD and we can read little into it. If she gets it wrong, it may be that the Learner does not understand our questionin and we may need to work on developing this skill.

Summary

Has Talksense convinced you that the concept of history is possible for an Individual Experiencing Profound and Multiple Learning Difficulties (IEPMLD)? We hope so! Talksense does not believe that any IEPMLD should be excluded from such knowledge. Indeed, it is only with such knowledge that, the Individual can be freed from the prison of the present tense to move on and no longer remain at the profound level thus making it a history.

Once Profound always Profound? Talksense does not believe that. It is why we use the term 'experiencing' rather than 'with' (Individuals with PMLD) as is common in the literature. 'With' suggests a permanence, a congenital acquisition from which it is impossible to break free. 'Experiencing' imposes no such enduring burden, allowing the individual to move on to other, better experiences. Many schools are giving an heroic effort to make the subject of history inclusive for their pupils. I have witnessed such endeavours and marvelled at the staff's ingenuity and commitment in transforming a concept from the dim and distant past into a festival of colour, texture, sound, and experience. However, I have often left that same session thinking, 'What did it all have to do with history'? It was a sensory experience of quality of that there was no doubt and it appeared that the young people were having fun but were they really learning about the Romans or the Great War or ... Talksense also questions the relevance of teaching such topics to people at this stage of ability. We do not question the right of any IEPMLD to such sessions but having a right to something does not mean that you have to do it. People are not being denied the right simply because we do not teach them about the Romans, no more than a young child is denied the right to a knowledge of differential calculus because we see mathematics differently for very young people: we simply do not begin to teach it to them until they are ready to acquire the knowledge, we teach them other things first. Talksense would invoke the old Marxist principle of 'to each according to his need' and 'from each according to his ability': be the lion as Wittgenstein would have it (see earlier). Perhaps a better way of putting this point would be we need to provide 'Inclusive Education'!

Does it follow that schools should stop staging the performances of the Romans in Britain? No, not at all. If staff want to do that then fine but Talksense would not call it 'history' for we feel that history looks somewhat different at this level of ability and awareness. Therefore, we would want to see some of the above ideas implemented instead under this banner or, at least, some other ideas of your own not covered on this page but which can be shown to develop historical awareness.

Talksense has looked/suggested several ways in which the concept of history can be taught and developed. We do not claim that the list is exhaustive; we are sure it is not and equally sure that, in time, we will be adding to it. We do not claim that you should adopt them all or, indeed, any one of them. However, we hope we will make you think about this area of learning and how you have decided to approach it.

"We hold these truths to be self-evident: that all men are created equal;
that they are endowed by their Creator with certain unalienable rights;
that among these are life, liberty, and the pursuit of happiness."
Thomas Jefferson

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