The theory and practice of the use of toys with Individuals Experiencing Significant Learning Difficulties

Teaching Through Switch-Adapted Toys: Theory and Practice

Teaching and Cognition Through (Switch Adapted) Toys.

"One of the most depressing statements to my ears,is the assertion that a child is too disabled to play.Here the focus is on the child’s inability to manipulate toys when alone or in the company of other children." (McConkey 2006 page 8)

"An accessible curriculum means that all aspects of the curriculum (i.e., the environment, the goals, the content, the instructional methods and interactions, the assessments, and the toys / materials) invite active participation of all children, regardless of disability or special needs."
(Missoula 2007)

Toys are fun. Toys are motivating, Toys can be visually stimulating. Toys can produce sounds, Toys can be multi-sensory Toys can be used to teach the concept of object permanence. Toys can be used to teach the concept of contingency awareness (cause and effect). Toys can teach numeracy, spatial awareness, even some aspects of historical awareness (see also history page this website)! Why would we not want to make use of toys in the classroom?!

Some toys can be adapted such that they may be controlled by a switch. Switch Adapted Toys are both motivational and, if used correctly, can provide a means to educate and progress Learners. This section of the website deals mainly with Switch Adapted Toys (hereafter simply called toys) and their use in the classroom with Learners of all ages.

Play is important for children. It helps build cognitive, coordination, communication, and a whole raft of other skills. However, those experiencing the most profound of intellectual and physical disabilities are likely to have restricted access to virtually all forms of play.

"The impetus for the study is a belief that playfulness is an innate drive in all people and is essential to a full and happy life, but children with PMLD experience considerable barriers regarding their opportunities to express it." (Watson 2012)

This is true of Individuals of any age: we don't stop playing when we reach 18 or 21 or 60 although our notions of what counts as play may change with age.

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This page was last updated on 4th April 2014

Age Appropriate Activities

While I would want to see teenagers and adults having access to age appropriate activities for the majority of their day, this does not preclude the use of toys etc for specific purposes. All adults have something of the child inside of them: many keep their teddy bear from their childhood for example, my wife still has hers. I still enjoy playing with toy trains, computer games, marbles, ... I don't find such activities demeaning because:

I have a choice;
The activities I chose are enjoyable;
I don't play with toys all the time... I have access to other (more 'adult') activities.

If a person is besotted with a particular item, even though the item may appear to others as not particularly age appropriate, what right have we to deprive and deny their access to it? While I would agree we should be working towards a stage where the individual is no longer besotted by such an item, I would not simply deny their access to it. I would use the item as a means to ameliorating the Learner's cognitive condition such that they may eventually find other (more appropriate?) items desirable. Thus, the item in question can be used to promote learning such that the individual no longer requires it for support. Simply to remove the item is to deny access to a tool that, if used wisely, can help bring about an improvement in Learner awareness and ability.

Thus, I would argue, a toy can be a useful tool even for adults if the adult in question:

has chosen it;
is motivated by it;
has access to age appropriate alternatives if possible;
is treated as an adult by Staff / Significant Others;
is involved in age appropriate activities for other parts of his/her day;
is not harming anyone else in the process.

I know a man in his sixties whose passion is model trains; he has converted his loft into a miniature world of locomotives and carriages running almost endlessly around track circling around the room. Furthermore, it's not hard to find examples of adults playing with dolls or teddy bears and other toys on the internet. What counts as fun to one person may be anathema to another; providing it's your choice, you are motivated by it, and you are not harming anyone else in the process, who am I to say that it is inappropriate? However, it would be inappropriate if you were telling me that is with what I must play.

I realise that some may disagree with this point of view and wish to read the rest of this page with a mind to battery operated devices that are considered adult: fans, CD players, vibrating mats, light systems etc.

Learning for Fun

"I have not yet found one [child with PMLD] who does not respond to light-hearted playful interactions at some level of pleasure. Even if they cannot initiate in ways understood by most people, and tire easily, there is a response that says ‘more please’, or ‘that was interesting/ I liked that’, even if only for a brief moment" (Teacher cited in Watson 2012 page 7)

We can all have fun, we can all play if given the opportunity. Why should learning be boring; why can't it be fun? Providing access to fun activities is therefore a vital component of any curriculum for people experiencing significant learning difficulties at any age. In some cases, providing access to fun activities in which the Learner him or herself has some form of control (rather than the person being a passive observer of others having fun) might be considered problematic. The advent of microswitch technology since the eighties has made it easier to provide that control for Learners Experiencing Significant Learning Difficulties. However, it does not follow and it should not be assumed that all aspects of such an Individuals's leisure should comprise the use of switches. Even though the focus of this page is switch adapted toys, it should not be assumed Talksense is suggesting all fun and leisure activities should be provided in this way. Indeed, fun and play does not have to involve toys at all:

"We have to begin by freeing our minds from the concept of play as an activity done with toys or equipment. This myth leads to various mistaken beliefs. For example, the more toys children have, the more opportunities they have for play." (McConkey 2006 page 8)

It is self-evident that Individuals Experiencing PMLD are unlikely to be able to set up toys and other play things themselves or, in some cases, communicate to others their desires in this area. Neither are they going to take themselves to places of fun such as the park. It will require the support of Significant Others (parents, relatives, friends, teachers, therapists, and other front line staff) to enable access to much if not all of the available fun activities:

"All children can play but some profoundly disabled children need support to access their 'playfulness" (Watson 2012 page 10)

"If children with PMLD are well supported, they can learn to understand and control at least a limited environment" (Watson 2012 page 11)

"We owe it to the children and young people with PMLD that we support to ensure that they continue to have a wide range of play experiences which are appropriate to their needs and interests" (Watson 2012 page 12)

The Goal is Control

"...opportunities should be given to the child for them to control or effect their environment to some extent, for example by allowing the child to lead an activity ..." (Watson 2012 page 14)

The aim of Special Education should always be moving towards Learner independence. A large part of that should be to create an environment in which the Learner has the greatest degree of control possible: in other words, the goal is control. Staff should rarely be doing something 'for' a Learner. While, on occasion, they may be doing something 'with' a Learner, the goal should always be to put the control in the hands (or feet or other body part) of the Learner with staff members acting as facilitators, engineering opportunities for and enabling Learners to achieve control.

As Control is an important factor in independence,building an awareness in the Learner that s/he can control every aspect of his/her environment (including the people in it) is an important function of Special Education. Thus staff should be asking themselves how they can hand more control over to the Learners they support. How can they change the things that they now do for the Learner to enable the Learner to control this for himself or herself?

Interaction with Toys

"In their discussion with the mothers of children with Down syndrome, Vietze et al. (1983) discovered that at least some of the children rarely interacted with toys, and in response to the children's lack of interest, mothers ceased providing them with the opportunity. The authors hypothesised that differences in timing (i.e., the children with Down syndrome took longer to begin to engage with the toys) interfered with the communication between the parent and the child about her/his interest in the toy." (Cuskelly, Zhang, & Gilmore 1998)

The promotion of interaction with toys and other objects is of vital importance in the cognitive development of the Learner.

What is a Switch Adapted Toy?

"Thankfully the advent of modern technology and easily operated switches gives lots of opportunities for even the most profoundly disabled child to initiate play – be it with objects, lights, music or people." (McConkey 2006 page 9)

A switch adapted toy is an item that can either be controlled through the action of a single switch or a part of its process can be controlled through the action of a single switch. Perhaps the title of this page should be 'Teaching Through Switch Adapted Devices' because I would include such things as fans, bubble blowing systems, vibrating mats and tubes, and lights in my broad definition of 'toys'. A toy, therefore, is defined as an item that a person uses for recreational pleasure, a plaything, something that serves for or, as if, a diversion, rather than for its primary practical use. Thus, as we are not using the lights, fans, etc) for their primary purpose, they are included in the definition of toys for the purpose of this web page. Even if you disagree with that point of view, the majority of what follows applies equally to such items when used in any special learning environment.

Not all toys are switch adapted and the vast majority are incapable of being switch adapted: try switch adapting a Lego brick, for example! It is the battery operated toys that can be switch adapted although there are some that require expert conversion an are better left alone. Generally speaking, those toys that come to life when an on/off button is set to the ON position and stop when set to the OFF position are the ones that can be easily switch adapted. Toys that have multi-functions and required a complex control system are best avoided unless you are an expert in electronics or have access to such a person. You may, however, want to contact Mike Taylor at Excitim for advice on this matter.

Some toys can be purchased ready switch adapted. Generally speaking, these toys have a lead coming out of some part of the toy which ends in a 3.5 mm jack socket into which you can insert the switch's jack plug. However, if a toy is not switch adapted, it does not follow that it cannot be converted. In fact, it is normally very easy to turn a standard off-the-shelf toy into one that is switch adapted in just a few easy steps in a short period of time. Anyone can do it (see the following section for instructions).

Adapting a Toy

Many toys and appliances that are battery powered can be easily switch adapted providing the toy or appliance is controlled by and on/off switch and immediately begins to function when this switch is in the on position.

You will need to purchase a Battery Device Adapter (BDA). The supplier of your switch will probably be able to supply such an item. They cost a few dollars/pounds only. A BDA comprises a short length of cable on one end of which is a 3.5 mm switch socket. On the other end is usually either a round or square, small, copper plate. The plate typically comes in two sizes both large and small. The plate is designed to be placed in between the battery and the battery terminal inside the toy or appliance. Its function is to break the current flow from the battery and divert it down the cable and through an attached switch. Thus, activating the switch completes the circuit and allows the current to flow from the battery to the device which activates it.

Turn the toy or appliance off and then remove the battery. Replace the battery with the copperplate of the BDA in between the battery and the terminal. It does not matter which end of the battery you decide to use ... whichever is easier.

The cable of the BDA will probably prevent the battery compartment door from shutting correctly. As most battery compartment doors are made from plastic, it is easy to file a small triangular notch into them to permit the BDA cable an easy exit. Any small triangular file will serve for this purpose, Such a tool can be purchased very cheaply from DIY stores or supermarkets if you do not already possess one.

With the BDA in place and the battery compartment door now shut, you can connect a switch to the socket on the exposed end of the BDA cable. Set the toy or appliance's on/off switch to the ON position. The system should NOT operate until the attached switch is activated because the flow of current from the battery is being interrupted. The toy or appliance should operate only when the switch is activated and stop when the switch is released.

Typically, BDAs come in two sizes; one with a small copper plate for smaller battery sizes and one with a large copper plate for the bigger battery sizes.

The plate of a BDA is not a single piece of copper but, rather, two identical pieces separated by a thin non-conducting membrane. Each of the wires from the cable is attached to one of the plates (see diagrams right). Thus placing the plate between the batteries and the terminal breaks the circuit and forces the electric current to flow down the cable to the switch (when the switch is attached). Only when the switch is activated can the electricity flow back down the cable to reach the terminal and thus turn on the toy. Once the switch is released, the flow of electricity is interrupted and the toy ceases to function. It does not really matter where you insert the plate, it can be between the batteries (if there is more than one) or between a battery and a terminal providing the late makes a good contact on both sides to allow the electricity to flow when the switch is activated by the Learner.

Note: where the toy requires the user to press a paw to activate it a peg or a bull dog clip can overcome that issue allowing the toy to function from the switch alone. However, if you have the necessary skills, time and patience, the video below shows another way of dealing with such toys although a little more complex than the method above!

Toys with multiple control features cannot easily be switch adapted and should be avoided. You may, however, want to contact the guys at Excitim for advice on this matter.

Excitim and Others

If you don't want to do it yourself, you can either source ready switch adapted toys from suppliers or contact Excitim to see if they can adapt a toy for you. Click on the logo to open the Excitim Website.

Among the suppliers of Switch adapted toys in the UK are:

ABILITY WORLD
EXCITIM
ILT
INCLUSIVE TECHNOLOGY
LIBERATOR
TFH

AbleNet have also introduced a range of switch adapted toys and, thus, your local AbleNet supplier should also be able to supply you with toys.

Making your own switch adapted toys: advanced

Good and Bad Toys

While there are not really devilish toys, there are some that are better for teaching purposes than others. If we are trying to teach the concept of cause and effect, for example, toys that do not stop on release of the switch are not as useful as those that do. Some toys run through their entire repertoire on one activation of their paw (on/off switch). The repertoire can be several minutes long, during which time the Learner only has to sit and enjoy the fun. A 'better' toy would be one that only worked when the paw was pressed or the switch activated and, at any other time, ceased functioning.

If Learners are to learn the connection between their action and the POLE (Person, Object, Location or Event: In this instance an Event) the action needs to stop when a Learner ceases to activate the switch. Take a look at the video below for example: the toy is only operational when the child is operating the switch on her bed. When she moves her hand away, the toy ceases to function.

A lot of toys travel all the way through their routine on a single activation of the switch. Unless, this is specifically what you want, these sorts of toys should be avoided. Of course, if you are a parent and are not purchasing a toy for its educational benefits (in teaching concepts such as cause and effect) then it would seem it does not matter which sort of toy is obtained. However, while the toy that stops when the switch is released can easily be made to travel all the way through its repertoire on a single switch activation, the opposite does not hold: the toy that does not stop cannot be made to stop on switch release. In other words, it is my view that the toy that stops on switch release is better than the toy that keeps going as you can make the former work either way.

Toys that only work on switch activation (and stop on release of the switch) are called Direct activated toys.
Toys that begin working on one activation of a switch but stop on a second may be described as Latched activated toys.
Toys that run all the way through their repertoire on a single activation of a switch may be called Totality toys.
There is, at least, one other option for a 'toy type' and that is a Timed toy. A timed toy will operate for a predetermined amount of time only when the switch has been activated. This period of time is normally measured in seconds.

It is my opinion that direct toys are the most useful. Direct toys can be adapted to work as all the other types. However, none of the other types can be adapted to work as direct. Thus, in selecting a direct toy, you are getting the best of every world. The least useful toy for educational purposes is the totality toy. Do not purchase toys of this type of toy unless that is specific what you are seeking.

Toys may also be rejected for other reasons:

unhygienic the toy may be fluffy and may become contaminated after a while and may not be easily cleaned;
unsafe the toy may have parts that pose a choke hazard for example;
too small the Learner may not easily be able to see the toy's actions;
too big the Learner may be overwhelmed by the size and not be able to focus on a particular aspect;
too fast the toy may move too fast for the Learner to comprehend what is happening;
not timely the toy may not respond immediately on press of the switch (necessary for cause and effect);
boring while the toy may be initially interesting, the interest can soon fade and the toy becomes boring.
other

USB Toys

There are a number of inexpensive USB toys on the market. These are usually desk top toys for executives and the like that plug into a computer's USB socket and provide a little amusement during working hours! They can be gadgets, toys, lights or sounds; indeed, all manner of things. If you search in Amazon (or other on-line suppliers) for USB toys and gadgets you will find a whole raft of such things. Most are quite inexpensive.

Suppose you could take a USB toy and switch adapt it easily? What have you got? A switch adapted toy that did not cost a great deal of money! Well, the good news is... you can! No, you don't have to mess around with wires and things you just have to make one purchase in addition to your toys and the job is done! Well, almost! You will also need an AbleNet Power-link or an equivalent device, for example Pretorian's Energise system. Most special education establishments will already have several of one of these mains controller systems.

Here is what you need to do:

Purchase your USB toy; let's assume it is a set of fairy lights (search for USB fairy lights on line);
Purchase a USB charger plug (as shown left): these can be bought from Amazon (click on the image to go to Amazon website. If link does not work search for USB charger plug on Amazon) for about £1 in the UK. You can also find them in electrical stores on your high street. The plug depicted is the UK type; obviously you will need to purchase a plug that suits the sockets in your country. The plug has its own USB socket. You can buy such plugs with more than one USB socket but unless you want to operate more than one thing at the same time it is an additional expense.
Plug the above into your PowerLink or your Energise (see links above).
Plug your USB Toy into the USB socket on the plug.
Plug your PowerLink/Energise into the mains.
Plug your switch into the PowerLink/Energise (or use a remote switch (jelly-beamer) with the PowerLink)(The energise system also has wireless capability).
Set your PowerLink/Energise to the setting you require (momentary for example).
When you operate the switch you will operate the USB toy! In our example, the fairy lights will illuminate while the switch is activated.

Some warnings!

Such USB toys come and go. If you buy one and you like it then go out and buy some more! Otherwise, if it breaks down in a year or so then you may not be able to replace it.
Some USB toys will not operate straight from the USB port. Some require some keys to be activated on the computer keyboard before they will work. Avoid these (unless you specifically want to make use of them). They will not work when the switch is activated. Purchase ones that work as soon as they are plugged in to the computer's USB socket. I made the mistake of buying a few toys that did not do this (it wasn't clear on the advertisement) and, while they are nice, they do not operate when I activate the switch: I have to activate the switch AND type randomly at the computer keyboard for my toy to work!
There are many things that plug into a computer USB that are of no use whatsoever! If it isn't sensory in some way or doesn't move then it is probably of no use to you! Be careful what you buy.
Always check such gadgets for safety. Generally they are operating at very low voltages and therefore they are electrically safe but they might have small parts that could pose a choking hazard etc.

I found the USB toys and gadgets below quite easily ... I have purchased lights and sound emitting devices from the web which all work well. Avoid the fibre optic Christmas tree unless you are working in a very dark environment!

Reactions to Toys

Some children may startle at a toy's sudden movement or sound especially if the sound is loud. One possible result of this is for the toy to removed and no longer used. However, this may prove to be a lost opportunity. If it is believed that:

the toy is motivational and;
the Learner will enjoy its function and;
the Learner's reaction to the toy's sudden movement or sound will not be life threatening or serious in any other way ...

then stick with it and observe what results. Let us suppose that on the first press of the switch, the Learner startles but, after several goes, the startle reflex has subsided. What does that tells us about the Learner? Does it not follow that the Learner must be becoming accustomed to the toy's habits? If that is the case, what else follows? I would argue that it demonstrates the Learner has memory of what went before and is able to recall what happened. Suppose now, the toy is removed and, two hours later, given back to the Learner for a further period of play. What if the startle reaction is absent or diminished? Does it not follow that the Learner has retained the information on the toy for this period? What if twenty four hours passes and there is still no return to the first reaction level? All this from an observation of a behaviour in response to the use of a toy! For me, this is an important first step in the teaching of history to a Learner experiencing Significant Learning Difficulties; an awareness of the immediate past. There are other ways of addressing historical awareness for Individuals Experiencing Severe or Profound Learning Difficulties. These have been addressed on the history page on this web site.

Timing Toys

If a toy works only when the switch is activated and stops when it is released (direct toys), the Learner may not be provided with enough reward. If the Learner:

cannot maintain switch activation and;
does not understand that the toy is controlled through the switch,

little progress will be made. In this instance it would be preferable to provide a short spurt of toy activity on a single activation of the switch. How long is short? Approximately ten seconds is about correct: anything less and it may not be motivating; anything more and the Learner has to make fewer repetitions to learn the connection between the switch and the POLE (although some Learners may require a slightly longer time span to make sense of the toy).

How do we make a toy operate for just ten seconds on one brief press of the switch? There are, at least, two solutions:

Use a BIGmack (or similar);
Use a toy timer such as a SLAT or the timer on the receiver of the Jelly-Beamer

Each of these is explained in the following sections.

Timing with a BIGmack

People are often surprised to discover that the BIGmack (LIITLEmack, BIGstep and LITTLEstep) can act as a timer to control an external, battery-powered toy or appliance. When the toy is connected to the BIGmack and the BIGmack is activated, the toy or appliance will remain in the on state for the length of the recorded message If the message is short the toy will only stay on for a very short period. If the message is long then the toy will remain active until the message is complete and then stop.

Thus, to turn your BIGmack into a timer simply record a message or a sound of the length of time required and attach the toy or appliance. While the message is playing the toy is active. If you do not want a message or sound simply record silence into the BIGmack for the desired time interval.

Plugging an external switch into the BIGmack will now operate a toy or appliance for a period of time up to two minutes (the maximum recording time on a BIGmack. If you are using the toy or appliance to teach cause and effect skills then you should use timings of between 5 and 15 seconds as the reward for a single switch activation. Anything longer is too much and anything less is too little.

This will work even with an old or broken BIGmack (one that has stopped speaking). The BIGmack can be hiiden away if distracting.

Timing with a SLAT

SLAT stands for Switch Latch And Timer and is another AbleNet device that allows latched and timed control of a battery powered toy or a battery powered appliance. In other words it is the battery powered equivalent of the PowerLink. As we have seen (above), the BIGmack can already act as a timer up to two minutes, the SLAT provides for a time up to 60 minutes. The SLAT can also be set into latched mode which means that it will turn a device on permanently (if an attached switch is activated) and, on the subsequent activation of the switch, turn it off permanently (think of a light switch . Thus, by routing the switch through a SLAT, a battery-operated device can be turned on permanently and then, with a further activation, turned off. The SLAT is NOT for use with mains-powered items, that requires a PowerLink.

Please note: this form of SLAT is being phased out and will soon no longer be available. However, you can still use the wireless SLAT receiver (see section below) which will pair with any Jelly or BIG Beamer.

Timing with a Jelly Beamer

A Jelly Beamer SLAT from AbleNet comes in two parts: a transmitter switch and a wireless switch latch and timer receiver (depicted left). It should be noted that not all Jelly Beamers have the switch latch and timer section so, if you are intending purchasing, please ensure you order the correct type. Both parts of the Jelly Beamer require a battery to work. Each part must be switched on via a little black slide switch on the side of each device.

To link the transmitter to the receiver:

with wireless transmitter and receiver turned on, press and hold the receiver's Mode button until the indicator light turns green (this takes about five seconds);
Activate the transmitter. The receiver's light will now flash once when the link has been established;
Press and release the receiver's Mode Button to exit the linking set up procedure.

To select the operating mode for the receiver:

You can select the operating mode of control by repeatedly pressing the Mode Button. The receiver has four round panels which illuminate to indicate which mode is currently selected.
For the timed mode, twist the timer knob. The greater the turn the greater the time set (1 - 60 seconds OR 1 - 60 minutes).

Modes of Control:

Direct: The toy will remain activated as long as the switch is pressed;
Timed (seconds): The toy will operate for up to 60 seconds with each switch activation;
Timed (Minutes): The toy will operate for up to 60 minutes with each switch activation;
Latch: The first switch activation turns the toy on and the second switch activation turns the toy off.

Best Thing In The World.

"She doesn't like doing anything" and "He just isn't motivated." ... such remarks are a little perturbing. Significant Others should not be so negative: rather than saying "S/he doesn't like doing anything" they should say "We haven't yet discovered what s/he likes to do but we will keep on trying until we do". If a Learner appears to be unmotivated, whose responsibility is it to motivate them? It is ours! If motivation is not going to be intrinsic then let's make use of the extrinsic form.

What will motivate? Every person has something that, for them, is 'the best thing in the world'. BEST stands for Best Ever Stimulating Thing. The BEST is different for different people: what I consider to be the best thing in the world is probably not the same as you. Some people love chocolate, some football, some a walk on a deserted beach on a sunny day. We need to discover what is the best thing in the world for the Learner and try and present it at the end of a switch. On this page, the BEST is a toy or some aspect of a toy - perhaps the toy performs a favourite song, for example.

The idea is to provide a motivating reward for a short period of time at the end of a switch. The Learner then begins to understand that the activation of the device leads to the activation of a thing that s/he really enjoys. The Learner also begins to understand that s/he is in control of that BEST.

Flyswatting

What is fly-swatting and what problems arise from it? Staff members sometimes use a single switch and move around a group offering it in turn to each Learner. The Learner is required to activate the switch which performs some action with a toy. The teacher makes a comment and then moves away. The switch often does not carry a symbol. What do we make of such an activity? What is the Learner actually learning? If staff were to be asked "and you are doing that because?" What would be the response?

In such situations, the Learner is (most likely) presented with switches throughout the day; maybe the same colour and type of switch or BIGmack several times. Each time it is presented, the switch does something different and, without even a symbol to give some cue as to what is about to happen, what is the Learner to make of it all (especially if that Learner is experiencing PMLD)? A Learner may learn to 'fly-swat' the switch as it is presented and views the staff member's response as a desirable reward to that behaviour. The switch becomes a stimulus which promotes a particular response. However, such 'fly-swatting' activity is viewed entirely differently by the staff member concerned: Staff may assume the Learner's 'co-operation' equates with an understanding of their objective(s) for the session. This may be far from the truth. Of course, some Learners may understand the intent of the session but how do we sort those that do from those that don't as both activate the switch when it is presented?

If a Learner does not activate a switch or BIGmack when it is presented what will staff members do typically? They will prompt the Learner to use it. Such a staff response to non-action will eventually resort to physical prompting; the staff taking the Learner's hand and 'assisting' him/her to operate the switch. Staff will do this until the Learner does it independently. In other words, we teach Learners to fly-swat!

Fly-swatting is a feature of passivity not activity, or inclusion or involvement, although it may be proffered as evidence of such by some staff. A Learner may have to go through some form of fly-swatting stage in the beginning to interact with any switching system. However, once we have that interaction, we must ensure Learner:

cognitive engagement;
contingency awareness;

How do we do that? The following sections begin to address that question.

Switches for toys should use a symbol

I have observed switches being used in fly-swatting activities: being presented to one Learner after another without a symbol to signify the POLE. The Learner enters one classroom and is presented with a switch; s/he hits it and a dog begins to move. Later in the day, another switch is presented, the same colour as the first; something different happens than the first time. What have I learnt? Well, if I had a theory that the dog moves when I hit the switch it is not reinforced by the actions later that same day. I have learnt that, when a switch is presented, I am supposed to hit it and then the teacher will praise me. In order that the Learner can begin to make some sense of his or her world we need to provide as much (sensory) support as possible, structuring learning in such a way so that it promotes understanding. One of the things we should ensure is that we label switches. The label (symbol) can be held in place on the switch the use of a clear plastic switch cap.

You may use your own symbols or you may download the TalkSense SwitchSym set which is completely free of charge for use in educational establishments and for any non-commercial purpose. The download is a Word document containing a set of TalkSense's own symbols that cover a range of activities that may be used with a big switch. There are different size downloads for the 'Jelly bean' size of switch. Cut around the dotted line and they fit perfectly under the snap on switch cap. Do NOT laminate the symbols (or, at least make a separate set that are not laminated) as they will then become too thick to sit under a switch cap and tend to force the cap off during use. If a switch cap isn't available however, laminating symbols will make them last longer.

You may also want to link the colour of the switch top with the activity. For example, music (auditory) could always be addressed with a green switch (or whatever colour with which you associate music).

Download big SwitchSyms Download switch cap symbols from the Switching Skills page

Download small SwitchSyms Download switch cap symbols from the Switching Skills page

Attaching labels

Attach symbols to switches using a clear plastic snap on switch cap. Laminated symbols tend to be too thick to fit underneath the cap easily and may even force it off during use. as such, it is best to use unlaminated symbols. If such a set of symbols is prepared in advance and kept in a clear plastic wallet that is, perhaps, hung on a classroom wall, then, all have easy access and cannot claim they couldn't find one or that it was too time consuming to set up.

Ensure that the orientation of the symbol is correct from the Learner's perspective as we want the Learner to begin to associate the symbol with a particular POLE (Person, Object, Location, Event).

Sensory Switch Caps

What do you do about those Learners who have problems with visual acuity and cannot see a symbol? As yet, Sensory Switch Caps or even Sensory Switch Tops are not available from AbleNet. However, it is not outside the bounds of possibility that one day they might market something like this. In the interim, why not make your own?

Extra switch caps can be purchased from your AbleNet vendor, Do not modify the screw on switch tops but, rather, the clear plastic snap on caps as this is both easier to do and significantly less expensive. As the caps are clear it is possible to trace out designs through them which makes for some interesting possibilities as described below.

Simple Sensory Switch Caps can be constructed using some spray glue, a piece of circular card cut to fit the shape 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 15 mm in form the outer edge;
Place the card template on top of the switch cap on top of some old newspaper;
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 then amongst a group.

Having created a sandy Sensory Switch Cap, we now must associate it with a POLE (Person, Object, Location, Event) by using it only in conjunction with that particular activity. For example, the sandy cap could be used every time the Learner is engage in something to do with music. There is no connection between music and sand (apart from the musical - the Sand of Music!)(Sorry!); we make the connection by using it consistently every time the POLE features music. To this end, Sensory Switch Caps must be made for switch use as well and, therefore, if we are using Big Reds and Jelly Beans, two sizes of switch caps need to be adapted.

Once adapted, stick a label on the inside/underside of the cap, which won't be seen during use, that will serve to identify its POLE link (music) and the owner of the cap(so it can be returned to rightful Learner should it be misplaced).

Do not be tempted to create thousands of such caps: start simply with just a few. Below are some ideas for the POLE and the surface:

          POLE                    SUBSTANCE
          Music                    Sand, raised musical note
          Greeting                 Felt circle (the looped side of Velcro is also good)
          Water/bubbles        Sponge (could even be made to be slightly damp) (use a blue BIGmack?)
          Toy (animal)           Fur
          Toy (vehicle)           Wheel
          Light source           ??? (use a yellow switch?)
          Vibration                stick-on feet (Maplins sell such things) to create domed bumpy surface

Here are possible other everyday and inexpensive substances that could be attached to represent other POLEs: coin, 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 objects of reference are being used, it is important to liaise with the staff concerned with the management of the scheme such that conflicts are not created.

If you have other good ideas in this area, why not contact me so that I can add them into the site? CONTACT

There is another method of making sensory switch caps which involves ...

Raised Surface Sensory Switch Caps

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) that will set to provide a continuous raised line on the surface of the cap.

If desirable, you can combine both the above ideas, infilling the area enclosed raised line with a sensory surface. 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. Again, do not be tempted to create hundreds of such items: start simply and consult as may others as possible on your ideas for designs for links to POLE items.

Associating symbol/sensory surface with POLE

POLE stands for Person, Object, Location, Event. Typically a switch will activate an item that relates to one of these areas. Saying 'hello' for example relates to both Person and to an Event.

While some may argue that the link between the sensory surface and the POLE must be concrete, my experience shows that it need not necessarily have a direct link (sand and music?) as long as it is used consistently over a period of time such that an association is formed in the Learner's mind. Of course, if there is an obvious choice for a sensory surface that relates directly to the POLE then it would be foolhardy not to use it. However, failing such an obvious solution ... it is not wrong to create your own! Consistency of approach in such circumstances in of great importance.

Research into the development of memory consistently shows that repetitions and rehearsals of an action help to form long term memories. For example, Huppert and Piercy showed that an increase in the number of times an item is presented at study enhances recall and recognition in individuals with amnesia (see also Strauss et al 1985 and Weingartner et al 1993). Therefore, to make any memory impression lasting and enduring, it is necessary to review it frequently, going over it again and again, until it is firmly fixed. As such, the more we can promote repetitions of interactions with sensory surfaces on switch caps,the greater the likelihood that the Learner will begin to form an association between the surface and the POLE. Thus, the POLE should not be longer that 15 seconds in duration (10 seconds is more than enough) and be motivational enough to prompt repeated activations.

At some later point, when such associative bonds have been formed, they can be utilised to promote awareness, anticipation and the development of communication skills.

Don't say switch say POLE!

As the switch is being used as the interface to a Person Action Location or Event (POLE: for example turning on a toy) then the focus should be on the POLE rather than on the switch itself. Thus, staff should not prompt by saying 'Come on Johnny, hit the switch' but rather:

          'turn on the fan'
or
          'play the music'

or perhaps ask:

          'What do you want to do?',

where a BIGmack provides an answer.

Cueing/prompting a Learner in this way may turn the Learner's focus away from the task in hand. This, in itself could be problematic ...

Prompting hierarchies and techniques

In the above, it was suggested that any verbal prompt should focus on the POLE and not on the switch or the BIGmack. While this is considered good practice it should not always be the primary method of prompting or cueing a Learner. If the Learner has been (t)asked to do something that is controlled through a switch, a number of things have to happen. The Learner has to:

attend to the request;
listen to the words in the request and try and make sense of what is being asked;
figure out a respond to the request;
send commands to the muscles in his/her body to perform and action ...

For some Learners this may take a little time. If in that period of time, when the Learner is focused on the task, a staff member begins to speak to the Learner, where is the Learner focus moved? It is moved from the task and on to the staff member! The Learner is is now engaged in making sense of a new command! Therefore, we should NOT interrupt a Learner who is focused on a task once the original request has been made unless we believe that the Learner has lost focus. Hence, a period of (at least) ten seconds should be allowed before any prompt is given. Many Learners require even more 'thinking time'.

When prompts are delivered, they should begin with the least invasive or intrusive (unless there is a reason to begin with the most invasive or intrusive). That means we should begin with a prompt that is specifically designed not take the Learner focus away from the task in hand but, rather, draw specific attention back to it. Such an Increasing Hierarchy prompting mechanism might begin with the staff's use of a laser pen (for Learners who have no problem with vision) moving the point of light around the general area of the BIGmack or switch. Laser pens are ideal for this purpose and are readily available cheaply over the internet from such stockists as Amazon for example. Some laser pens even can be set to provide a spread of multiple points of coloured light to highlight a surface area. If a Learner would have a problem with seeing the laser light(s) then another sensory area must be considered. What is going to be the least intrusive for this Learner that will prompt to interaction with the switch. Perhaps some form of clicker device could be used from the proximal area of the switch.

Increasing & Decreasing Prompt Hierarchies

Prompting is a method of helping Learners in acquiring a skill. Prompts should only be used when necessary and, then, only for a period that is sufficient to assist the Learner. There should always be a plan to phase out all prompts over a period of time otherwise the Learner may become prompt dependent which is yet another feature of passivity. Prompts should only be used after (at the very minimum) a delay of ten seconds to allow the Learner time to process the initial staff request, form and act upon a response.

An increasing prompt hierarchy is primarily used where a Learner has already learned the basic skills involved in the task. It involves Learner cues that become increasingly more invasive with time until perhaps, finally, the facilitator uses hand-under-hand techniques (see below) to guide the Learner to the desired action.

A decreasing prompt hierarchy is primarily used where a Learner has not yet been taught the basic skills involved in the required task. Thus, it might begin with the most invasive
technique and plan to fade all cues and prompt over time.

Hand-Under-Hand technique

When working with a dog, it is generally known that it is of no use pointing to something to which you want to draw the animal's attention. The dog does not understand the conventions involved and will typically attend to the pointing hand itself rather than at the thing to which the hand is pointing. People experiencing learning difficulties also may not understand such conventions and, if a hand is used to assist their learning, may attend to the facilitators hand and not to the task. If your hand is over the Learner's then it your hand that they are watching performing an action. If your hand is under the Learner's ten they see their hand carrying out the action - that is, they are doing it not you.

Thus, it is important to make the use of a facilitator's hand in assisting a Learner's movement as non-invasive and non-intrusive as possible. When performing such actions it is considered best practice to:

ensure that the Learner is aware that you intend to assist them by moving into their personal space and touching them;
work with bony structures such as the wrist, elbow, shoulder rather than flesh or muscle which can be more painful;
work hand under hand: that is, support the Learner's wrist (for example) from underneath NOT from above as is typical in interactions of this type.

When working hand under hand in this manner, the Learner is not focusing on the facilitator's hand and will not find it painful. The Learner can be 'facilitated' to promote success with early switch interactions.

And You Are Doing This Because ...?

We would all do well to ask ourselves this phrase everyday; not just with switches but in all we attempt to do with and for Learners. I have often questioned the use of switches to say 'hello', for example. Such phrases may, on occasion, be a legitimate use of the switch but one wonders what the Learner understands from it and whether s/he is just fly-swatting on some prompt or other. The same is true of other social greetings: such vocabulary as 'Good morning' are quite abstract for Learners experiencing PMLD. If a system is presented to each Learner one after another that repeats such a message, isn't it likely that the Learner is simple fly-swatting in response to staff approaching, smiling, speaking and presenting such a system? What are they really learning? The correct use of social greetings? If the entire session had other legitimate aims and objectives but included saying 'Good Morning' and the staff were able to state these further objectives, then they would be answering the question "and you are doing this because?".

If the Learner really does understand the concepts involved then I would be questioning why s/he is working with a single switch connected to some simple VOCA to provide Augmentative Communication and why s/he isn't working on a system with multiple message outputs instead.

Of course, not everything we do with switches has to have a sound educational motivation .... just the majority of the things! Having fun is a legitimate reason, although I would want to argue that we can have fun AND have sound educational reasons underlying what we are attempting to do. Staff should avoid teaching fly-swatting and question what they think the Learner is understanding from the action; that is ... ask themselves 'and I am doing this because ...?'

Cause and Effect

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.

In order that we might make sense of the world we experience there are a number of developmental milestones that we must reach and pass. One of these is the concept of Object Permanence and another is the concept of Cause and Effect.

Contiguousness is not synonymous with causality

"Contiguousness is not synonymous with causality" What does that mean?

Put simply, it states that because B follows A it does not mean that A is the cause of B.

A butterfly is sitting on a flower on a bush and Sam appears to be looking at it. The butterfly moves its wings and Sam seems to smile. We naturally assume that Sam is cognisant of the butterfly and the motion of its wings and, it is this that is causing Sam's joy. However, that is not necessarily the case. Sam could be smiling at something else entirely, or at something that happens at the same time that the butterfly moves its wings. Sam could even be smiling in response to our smiles. Of course, Sam could be aware of the butterfly and be attracted to its movements but we cannot simply assume all of this. What evidence would be further proof of Sam's awareness?

every time that the butterfly moves its wings Sam smiles;
the staff with Sam are not standing such that Sam can see them and the butterfly;
when the butterfly flies away, Sam stops smiling;
if another butterfly lands subsequently and Sam begins to smile once again.

Does it matter? Yes, it does! If we assume a cause and effect relationship, and we build further learning on such 'knowledge', then Sam may be confused. Our task will be the greater and there is a risk that we may make further 'assumptions of understanding' which will only serve to compound matters even further.

A switch is placed in the personal space of a Learner such that it controls a toy dog. The Learner activates the switch. The dog moves and barks. Does the Learner understand that:

s/he is controlling the toy?]
the switch is controlling the toy?
both the above?
none of the above?

None of the above! Cognition simply cannot be assumed on the basis of a single interpretation of a Learner's actions even if that action is repeated. There are other interpretations of the Learner's actions which produced the same results:

it was an accident. As the switch is in the Learner's personal space, s/he is going to activate from time to time simply by chance alone.
the Learner is attracted to the shiny object in his/her personal space and is exploring it. The Learner likes the sounds it makes. The Learner makes no connection to the barking dog.
the Learner has learnt to fly-swat the switch when it is placed in personal space.
the Learner does not like this thing in his/her space and is trying to push it away;
the Learner is being prompted by staff;
other.

Cause and Effect 2

Activating a switch to turn on another item does not, in and of itself, 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';
Some Learners may be just trying to push it away;
Some Learners may be attracted to the colour, or the shape, 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 particular Learner than we are on safer ground in assuming the Learner is making a new link. However, the more evidence we can gather to establish beyond reasonable doubt that a Learner

Absence of evidence is not evidece of absence

'Absence of evidence is not evidence of absence'. What does this mean?

Stated more simply, it asserts it cannot be assumed that a Learner's failure to respond to or perform any task (absence of evidence) does not prove an incapacity or inability to do so (evidence of absence). If Sam is asked to identify an item in a picture by choosing from one of three real life objects and fails, it does not follow that Sam is incapable of doing it, or does not comprehend the item in question. There are other possible reasons for Sam's 'failure' in the task:

Sam was not feeling well;
Sam did not like the staff member involved;
Sam was distracted by some other matter in the day;
Sam was upset about something;
Sam did not understand the instructions;
other;

While we cannot prove a Learner does not understand or is incapable of performing a specific task, it is possible to do the opposite: we can show that Sam DOES understand. That is a much more positive stance to take: rather than being negative regarding a specific Learner skill, we are able to claim a positive position. How are we able to do this? Returning to our example of Sam's choice between three items. If Sam not only responds but responds correctly and on more than one occasion then we can be more confident in stating that Sam is able to make an association between a picture and an object. Why only more confident? Why not totally confident? The reason for the hesitation is because there are other possible explanations for Sam's success:

it was by pure chance;
the 'correct response was always placed in Sam's 'preferred' position (Sam always goes for the item on the right);
staff were providing Sam with contextual cues (wittingly or unwittingly);
staff were interpreting Sam's responses and rationalizing incorrect answers;
other.

If we were to construct the test so that these alternate explanations for Sam's behaviour were eliminated then we could state with some assurance that Sam is cognisant of a symbol/picture/object relationship.

Yes but we haven't got the time to do all of that! Actually, it saves time because to assume an understanding when no such understanding really exists is extremely frustrating for both staff and Learner and leads to an eventual breakdown in progress and much loss of time. Furthermore, 'all of that' does not actually take much time: it's more about the design of the test than having to make lots of different approaches. If the test design:

overcomes the 'pure chance' element;
eliminates the possibility of staff cueing;
does not always use preferred positioning;
prevents staff rationalizations.

then, if Sam responds and is correct, we are able to say 'Sam is cognisant of a symbol/picture/object relationship'.

Proximity switch!

In establishing cause and effect, it is very important that the switch be proximal to the POLE both in time and space. That is the switch should be as near to the toy as possible and the toy should begin to operate as soon as the switch is accessed. If the toy is far away or takes a while to do anything, it makes it much more difficult for the Learner to make any connection between his/her action and the POLE.

For example, turning on a toaster with a switch (yes, I know its not a toy!) does nothing ... it takes a while for the toast to pop up. If however, it was a toy toaster which activated as soon as the switch was pressed then it would be quite appropriate for use.

Cause and Effect: The proof

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/BIGmack but ceases all further attempts when successful and the POLE is achieved;
only reactivates the switch/BIGmack when the POLE has ceased. The Learner makes no attempt to activate the POLE while the POLE is active.
goes out of his/her way to activate the switch/BIGmack in order to achieve the POLE;
locates a 'hidden' switch in order to operate a POLE;
is consistent in the above.
behaviours have no other possible explanations. These been considered and eliminated.

Teaching Object Permanence

The development of the concept of Object Permanence can be addressed through the use of toys.

Object Impermanence is a early stage of development in which a Learner 'believes' that when he can't see something it no longer exists: out of sight is literally out of mind.

Object Permanence is a subsequent stage of development in which a Learner understands that even when something is not in sight, never-the-less, it still exists.

The transition from Object Impermanence to Object Permanence is an important and necessary developmental milestone because the Learner is no longer 'trapped' in the here and now and can begin to deal with concepts that are out of sight, in the past, or in the future. Thus, the concept is another facet of the teaching of History for Learners experiencing PMLD (see also 'Reactions to toys' above).

How can this concept be addressed through the use of toys? If we establish cause and effect and the Learner can now understand that as s/he activates the switch so the dog (indeed, any toy) begins to move along the desk top, then we can add a new dimension: behind the box! The toy is positioned so that it will move along the table top and pass behind (or through) an object (for example a box). Initially, we can ensure that some part of the toy is always visible (big toy small box) and build to a point where the toy disappears completely for a longer and longer period of time until it finally emerges at the other side. The Learner has to understand that the toy remains present and is still moving even though s/he cannot see it doing this.

Initially staff can encourages and prompt and even lift the box a little to show the Learner the toy is still there. It may be an idea to use a toy that makes a lot of noise so that the Learner can hear it even if s/he cannot see it to begin. However, eventually, the proof of the concept of Object Permanence will come when the Learner continues to operate the switch in anticipation of a (silent) toy re-emerging from out of sight at the other side of the obscuring object.

Teaching Object Constancy

Another developmental milestone is the notion of 'conservation'. There are different aspects to conservation for example the development of the conservation of mass and volume whereby a Learner understands that a liquid (for example) does not become more or less simply because it is poured into a thinner or fatter container. An earlier aspect of conservation is the notion of Object Constancy; that is, that an object is still the same object no matter from what direction or distance it is viewed. You have probably seen objects viewed from unusual angles and been asked to identify them as part of a quiz. What, for example, is the picture on the left? The answer is at the end of this piece of text!

How can we use toys to enhance Learner understanding of this concept? We can provide access to the toy in varying directions. For example the toy could move from left to right, and right to left, from distal to proximal and from proximal to distal. We can arrange things so that the Learner is viewing the toys movements from above (put toy on floor or on low table) or the side or even (although much more tricky!) from below. Thus, we should not always use the same toy in the same way; change its direction, change the way that the Learner sees it, use it on the table top and on the floor.

As you can see, from this and other areas above, the notion of ' just playing' with toys is erroneous: far more can be achieved, cognitive milestones reached and assessments made and all while having fun.

Answer to earlier teaser: It is a cup as seen from directly underneath.

Not so fast

Start slowly. Always begin by establishing a single switch and the concept of cause and effect. Do not be tempted to move to two switch selections too soon and too quickly.

Control Yourself

Where a 'toy' has to be held and manipulated to get the full effect then the control over that item must be given to the Learner. For example, a number of companies market personal massaging vibrators. Staff can hold the vibrator while it is in motion and move it gently across a Learner's arm. However, there are a number of conditions that must be filled:

the Learner must not be taken by surprise. Allow the Learner to see you and move only slowly;
talk to the Learner using very simple language and tell him what you are going to do;
move away if the Learner appears unhappy or distressed;
switch control for the vibrator must be in the hands of the Learner. If the Learner releases the switch and the vibrator ceases then staff must immediately move away. Only if the switch is reactivated should the activity continue.
If one area of the body is uncomfortable the Learner can release the switch. Staff should then try a different area.

In some cases, vibrators can be paced under or next to a Learner such that total control is in the hands of the Learner and staff are just facilitating the situation. The control could be through arm movement by attaching the Learners arm (by some wrist band) to a string switch. Thus, movement of the arm a set distance (which can be controlled) in any direction would activate the vibration. This would even work for accidental movement. However, if the Learner seems distressed by the vibration or the number of accidental activations of the device goes down rather than up, the device should be removed. While the Learner may be in control, if 'accidental switching' is in operation, s/he may not realise that s/he can stop the distressing sensory stimulation and may continue to inadvertently operate the system.

Toys and behaviour modification

While toys are not the solution to every behaviour that staff may find challenging or, indeed, for every Learner, they do present another tool for use in a battery of approaches to this issue.

“Difficult or challenging behaviour is not a part of an autistic spectrum disorder, but it is a common reaction of pupils with these disorders, faced with a confusing world and with limited abilities to communicate their frustrations or control other people.” (Jordan and Jones 1999 Meeting the Needs of Children with Autistic Spectrum Disorders. London David Fulton.)

There are certain objects, toys, and activities that may help a Learner who is feeling frustrated or angry to relax. The switch adapted pig and the switch adapted dog are two such items. Both vibrate gently and twitch and snore away. I, personally, find them very relaxing! Another popular item is the vibrating tube (see above) which Learners can wrap around their bodies. Of course, what will work for one Learner may be very different to that which will work for another. Almost anything can be utilised.

A BIGmack can be strategically positioned so that any member of the class can ask for a 'Personal Pacifier'. Staff will then know which item to provide for any specific Learner. It may be the pig for one Learner and the dog for another. Indeed, the Learner could be given a choice.

The establishment has to create a policy regarding the provision and use of Personal Pacifiers.such that all staff are aware of how the should be deployed and Learners know the limits of their use. Together with a time out area and other strategies, they can help to reduce behaviours that staff may find challenging.

It is important to make planned provision for the avoidance of Learner dependency on Personal Pacifiers. To this end the policy document should reflect a plan that reduces there use with any Learner over a period of time.

Personal Pacifiers also act as distracters, drawing the Learners attention away from the thing that was bothering them. After a short period, they may be able to rejoin the class and carry on with their work.

Ideas for using toys

The sections below detail a number of ideas that I have used or others have suggested for working with different toys. Please feel free to adopt, adapt or reject any as you consider appropriate. If you have other suggestions then please contact TalkSense and let me know so that I can add them to the site for the benefit of all. Some of the ideas presented require the use of specific toys some will work with almost any toy. Have fun!

Some of the ideas relate to work in specific areas of the curriculum and detail how toys may be used to teach maths, literacy, history, geography ... Again, if you have further ideas, please send them in. I'll add them and credit you and your place of work.

Assessment with toys

As toys are very motivational, a Learner’s interaction with a toy or toys can provide us with much information about their present abilities. If a Learner fails to perform that is not indicative that they cannot perform: they simply may not be motivated to do so.

Assessment should not be through toys alone, other methodologies must always accompany the use of toys for this purpose.

A number of questions can be asked – does the Learner:

respond, in any way, to the toy;
attend to the toy;
track they toy visually while it is moving;
anticipate the movement of the toy / learn to anticipate the movement of the toy;
work with a switch to operate a toy purposefully;
habituate to the toy (become bored with it;)
respond to one toy but not another – why?
choose the toy;
realise when the toy is going to stop;
control the toy spatially;
make a sound when activating the toy (Respond to this sound as though it were purposeful – see Jean Ware’s work on ‘Creating a Responsive Environment’)

How did the Learner interact with the toy? For what period of time? What movements did the Learner exhibit during interaction with the toy? What noises did the Learner make? Which toy was most motivating? Why? …

Multi-tasking Toys

While it is likely that you will begin with the switch activating a toy that performs its routine this is not likely to captivate the Learner for very long. How long does that yapping dog hold its interest? 5 minutes? 10 minutes? 1 hour? It depends on the toy and the individual. The same toy can be made more interesting by getting it to do something – for example, the yapping dog, as it moves forward, can carry something, or knock something over, or push something like a ball, or cause something else to happen. Equally the dog’s orientation to the user can be adjusted – sometimes moving right to left then left to right, sometimes moving towards the Learner.

I have seen toys that feed fish! The toy is positioned on top of the fish tank such that when it moves forward it knocks over a hinged receptacle that contains just the right amount of fish food for the fish in the tank and, thus, the fish are fed. The Learner is made responsible for feeding the fish each day. No-one reminds the Learner of his/her duty but a vigilant staff member always checks and then reprimands the Learner if the chore has not been undertaken by a certain time. The Learner is made responsible. The level of responsibility can vary from Learner to Learner but each but be held responsible. It is in part through responsibility that Learner Passivity is diminished.

Expensive? Rubbish!

Learner Toy environments need not be expensive: an old cardboard box, some old tin cans, and a ball, together with a switch and a toy can provide many hours of exploration and learning. The toy can be used to push a ball into the box or knock down the pile of tins, for example. In the symbol to the left the pony is being sent into the stack of tin cans: what fun will the Learner have if you build up the stack and keep saying "now you won't knock it down, will you?" and, of course, that is exactly what you want the Learner to do! Each time s/he knocks it down, you build the stack once again. I know who'll tire of the game first!

Tin cans can also be used to provide obstacles around which a toy car to manoeuvre. There is no end to the fun you can have with things you might otherwise throw away!

Literacy

"If you don’t teach a child to read, the child will never learn to read" (Koppenhaver D., 1999)

How can switch adapted toys be used to help with literacy? They can be used to illustrate some part of a story and bring the story to life. When coupled with a BIGmack (see the BIGmack page for ideas), the Learner can speak out a repeated line from a story and then cause a scene from the story to happen on the desk top! For example, in the Billy Goats Gruff story a goat can be made to knock down a bridge with the Troll on it. The bridge can be constructed out of pieces of foam or wooden blocks or empty cardboard boxes and, if you don't have a walking toy goat attach a picture of a goat to a toy car. What you don't have a picture of a goat?! Contact me on the form at the bottom of this page and I will send you one!

In today's commercial world, many films for children are accompanied by the marketing of books and toys. This provides a source of both toy and story (and eventually the video!) to use in such an approach.

TalkSense is very grateful to Mary Sagstetter of AbleNet for assistance with ideas and photographs on this literacy section of this page.

There is a complete page on this website devoted to literacy. Click on this LINK to go there.

The BookWorm

The BookWorm (from AbleNet) can be operated via a switch. The BookWorm can read out a story recorded, line by line and, as such, learners can interact with print for maybe the first time in their life. However, it isn't enough just to read out a pre-recorded story, the Learner must be immersed in text. It doesn't matter whether the Learner recognizes letters or word form – unless the learner is exposed to such experiences s/he will never begin to develop such skills. The Learner will never understand that words are made of letters and that words attach to real things in the real world. Using the BookWorm in conjunction with toys can be a way to open up the world of literacy to those with significant learning difficulties. The bookworm could be used to read a line from a story and the toy could act out that line. Of course, that means matching stories with toys or thinking creatively as in the ‘Three Billy Goats Gruff’ above but, as there are a whole range of switch adapted toys and even more toys that you can switch adapt if desired, it should be possible to illustrate at least part of any story.

The objective is not to get Jane or John reading independently (at least not straight away!) but to involve them in the world of literacy. Sensory stories and the bag book approach may not necessarily be a literacy based approach – however, it would not take much to include some aspects of literacy in such work.

Sensory Stories

Sensory Stories are stories that have other dimensions: that is they are not simply read out loud but, rather, the audience is immersed in the story as it is brought to life through the use of additional sensory materials. Click on Pete Wells logo to open Pete's web page (recommended) that contains a number of such stories There are also other commercial and non-commercial sites including:

          -     BagBooks
          -     Flo Longhorn and Richard Hirstwood
          -     Moorcroft School
          -   Pamis

When experiencing a sensory story the Learner is immersed in a world of sensory experiences that are linked to text. Toys are one means of providing some of those sensory experiences; those that vibrate and move and sing all can help to bring a story to life.

Numeracy

As with literacy, unless Learners are exposed to aspects of numeracy they will not begin to develop numerical awareness. It becomes a self fulfilling prophecy: for example, because we feel that certain Learners will never be able to manage money we do not involve them in that aspect of their lives. They do not handle money, collect their change from the cashier, and do not even receive pocket money (an allowance) from parents – ‘Oh, if he needs anything, I just get it for him.’ While it may be a truism that some Learners will never be able to master the addition of two abstract digits written on a piece of paper, it does not follow that those individuals will not benefit from exposure to aspects of numeracy. Numeracy is NOT simply about counting or addition. It is concerned with many other things: size and shape, distance, spatial awareness, and relationships to name but a few. As with literacy, it is possible to add some feature of numeracy to all sessions such that we are able to create rich and diverse learning environments filled with exposure to both literacy and numeracy without these items necessarily being the focus.

There are so many numeracy applications of the use of toys that this page of the site could become very large! I will suggest several to start the process and add more later and as they are suggested by others. Numeracy is an umbrella term covering many areas of study: conservation of number, categorisation, space and time, shape and size, area and volume, addition, subtraction, to name but a few. It requires but a little lateral thinking to understand how toys can be used to illustrate these concepts and bring them to life for individuals experiencing learning difficulties. Space and time are covered separately under the headings of geography and history so they will not be duplicated here.

Counting with toys

Counting with toys can be achieved in a number of ways:

There are toys that have moving parts that can be counted as they perform their actions, for example the Dalmatian Chase has toy dogs that chase each other down the slide; similarly with the Penguin Roller Coaster. The Learner can be tasked to stop the toy after a certain number of animals have performed their function.

Moving toys can be made to move in a straight line past numbered posts with equidistant spacing. Can the learner stop the toy at a certain point?

On certain toys the number of specific actions can be counted within a certain time frame. For example: how many flies does the frog catch in one minute?

A train can be made to do a certain number of circuits.

A Wobble Switch can be mounted securely on a Sensitrac Angle Arm. The Wobble switch can be attached to a BIGstep (or equivalent). The BIGstep can be made to count out load … one … two … three … The toy itself can then be made to activate the wobble switch every time it passes! No wobble or leaf switch? OK, get the Learner to run the toy directly into the BIGstep at the end of each circuit ... it will count the number achieved in a specific time frame.

How many skittles (tin cans) can you knock down with a moving toy?

Knocking down skittles can be used as a form of subtraction. Five skittles out. Knock down three. How many left? Two. Five – three = 2

Blow a specific number of bubbles with a bubble blowing machine.

Play dice games with giant dice and count the spots. Put the dice at the top of a slope. Now get a moving switch adapted toy to push it down the slope providing a random number generator!

Play card games with giant cards and count the spots.

The above list is not intended to be exhaustive but, rather, to provide a range of ideas to illustrate the concept of counting with toys.

Remote controlled numeracy

There are a number of toy wheeled vehicles on the market that can be remotely controlled (no wires) to move forward and backward or turn left and right through either a joystick or four switches. These can be used in any number of exciting ways to develop numerical concepts:

Using just one switch to move forward only, the vehicle can me made to knock over a group of objects (skittles? old tin cans?) and varying distances from the Learner. The spacing between the objects can reflect the concept of distance. Talking Bowling pins can provide a voiced feedback when all the pins have been knocked down!

Using just one switch to move forward only, a string can be attached to the rear of the vehicle (with numbers one through ten at equal distances). As the vehicle moves forward on activation of the switch so it pulls the string out from a container (box) revealing the numbers as it goes – thus measuring any item placed alongside the vehicle. The learner is empowered to measure with minimal assistance.

Using just one switch to move forward only and a BIGstep, the vehicle is driven forward into the BIGstep (mounted vertically on a Sensitrac angle arm so that it doesn't move) causing it to activate. On activation the BIGstep counts forward (one) message and fires off another system (BIGmack) linked to it which makes some rewarding sound and than asks for the vehicle to be replaced! The process can begin again. The second time the vehicle hits the BIGstep it will say two, the rewarding sound will repeat and the message will instruct the vehicle to be replaced …

Using just one switch to move forward only, the learner has to aim to get a high score by stopping the vehicle on a floor mat marked with shapes (circles?) of increasing difficulty and various scores: a form of horizontal archery with the vehicle as the arrow! Others can also participate using the vehicle of by throwing boccia balls onto the target area. Indeed, a boccia ball could be attached to the vehicle for the learner to participate in a game of boccia.

Using all four directions from either a joystick or four switches, the learner has to navigate an obstacle course (see geography - spatial awareness)

The Learner has to drive a vehicle into a box that is labelled with a shape to receive a reward. For example, there are three empty boxes on their side: one has a triangle label, another a square and the final box a circle. Give the learner a circle shape. Now ask the learner to navigate the car to the circle garage… This idea can be developed as a way to promote the development of categorisation skills. Label the box garages with three categories (for example: animals, buildings, and clothes) then add an item from one of the categories (or a picture thereof) to the car. The Learner has to drive it into the correct garage. If the Learner is only able to operate a single switch then change the idea slightly so that the vehicle can drive in a straight line past all the boxes and stop in front of the chosen category.

I've got it pegged!

An idea is to build a simple ramp from a board that is hinged at its base to provide an adjustable angle. We now have a platform from which to launch a toy vehicle (any toy vehicle - it should not be switch adapted) or other moving object (for example: a ball). As an alternative to a board, a piece of PVC guttering (C or square section) will also perform as well. If the board/PVC guttering at the base, it can now be adjusted to almost any angle between 0 and 90 degrees. A pole with an adjustable peg can provide for varying angle adjustments (see diagram). A toy vehicle or ball can be placed on the slope and released.

How far does it go? A simple measuring system will suffice.
What happens if the angle is changed?
What happens if the toy is released further up or down the slope?
What happens if the ground is sticky or wet or is sandy?

There is scope for a lot of experience and learning of mathematical concepts within the use of this system.

How does a severely disabled Learner release a toy car (or ball or anything that will move or roll) if the Learner cannot manage it independently? The usual response is to provide staff assistance to help them to do it (hand under hand) or to do it for them by following their instructions/directions – while, indeed, some assistance will be required from another to position and orientate the system and load the ramp with the toy or ball, it would be better practice if the Learner could be in control of as much as the process as possible (the Goal is Control!).

One solution is to use a string attached to a switch adapted toy that moves forward and is able to pull out a peg to release the toy/ball and enable it to run down the slope. The Learner has to decide on the:

positioning/orientation of the device;
angle of the slope;
position on the slope of the peg stopper;

and then activate the toy to pull out the peg and release the ball to roll to the target!

In the illustration, the switch activated bulldozer pulls on the chain which, in turn, pulls out the orange peg from the side of the ramp allowing the ball to roll down the slope. The ramps angle is set by putting a peg into one of the holes on the blue vertical bar. The ramp is hinged and rests on the the peg at the angle selected.

Bee-Bots

Bee-Bots are programmable floor robots. The Bee-Bot's simple, friendly layout is a perfect starting point for teaching control, directional language and programming.

A range of floor mats are available to provide a variety of activities that can be used in a range of curricular areas. There are a number that can be used mathematically including mazes, games, numbers and money.

The issue with the Bee-Bot is that it is not switch adapted and therefore cannot be controlled directly by a Learner. However, the Learner could instruct another (using a communication board or BIGmacks or BIGsteps or any simple VOCA) with regard to the simple programming required. The mats, of course, can be used with any remote controlled vehicle and as a resource in their own right.

Bee-Bots and mats can be purchased from TTS (www.tts-group.co.uk).

Books and such

Readers may want to take a look at Flo Longhorn’s excellent book "Numeracy for very special people" (2000). Other resources include:

"Implementing the National Numeracy Strategy for Pupils with Learning Difficulties: Access to the Daily Mathematics Lesson" (2000) Ann Berger, Denise Morris, Jane Portman. Publishers - David Fulton

"Numeracy and Learning Difficulties: Approaches to Teaching and Assessment" (2004) Peter Westwood Publishers - David Fulton

"Mathematics for Children With Severe and Profound Learning Difficulties" (2001) Les Staves. Publishers - David Fulton

"Teaching Mathematics to Students with Learning Disabilities", (Fourth Edition) (2001) Nancy S. Bley and Carol A. Thornton. Publishers- Pro-Ed

"Teaching Mathematics to Middle School Students with Learning Difficulties" (2006) Marjorie Montague and Asha Jitendra Publishers- Guilford Press

"Stimulating Early Numeracy: The effects of remedial intervention on the early numeracy achievements in young children with special educational needs" (1998) Esther A.M. Schopman Publishers- Graviant

Also check out the Very-Special-Maths website TalkSense recommends it!

History

Please note: there is a webpage on this site devoted to the concept of history for those experiencing PMLD. To reach it please click on the history book left.

I have nothing but admiration for those staff that are tasked with the role of teaching an historical agenda to individuals experiencing Profound and Multiple Learning Difficulties. I have oft thought that teaching history to such Learners was akin to trying to teaching me the mathematics of black holes, I am just not ready for it – of course, I have the right to study that particular area if I choose but I would want to do quite a bit of preliminary study first, maybe years. Using black holes as a vehicle to teach me ‘other things’ (for example, communication or sensory awareness) seems a little unrealistic and the effort spent in creating scenarios for black holes which would support ‘communication’ would go much further (and probably be better spent) in directly addressing that particular need. As already stated, I have great admiration for those that use this ‘vehicular’ model approach to the curriculum. However, isn't it like saying that we know what people really need but we have to teach this subject and so we’ll approach what is really needed sideways? If you are not actually teaching history but something else entirely hidden within, what’s the point? Why not attack the ‘hidden’ directly, everyday, in a coordinated approach?

Of course, there is nothing wrong with such an approach: creating scarab beetles, or dressing as a roman, of face painting as a Native American, or cooking and sampling medieval fare ... the communicative and sensory experiences of such activities are valuable in their own right and do address aspects of the National Curriculum but, are the individuals really Learning history: Are historical concepts really being addressed or merely side-stepped?

I don’t want to devalue those who fought hard for the right of learners experiencing PMLD to have access to the National Curriculum but, having a right to do something does not necessarily mean that you have to do it. I have the right to study the mathematics of black holes but I assume Cambridge University would not admit me unless I could show I was prepared for work at that level. The philosopher Wittgenstein once asked his students ‘What if a lion could talk?’ His reason for asking this question was to make the point that, even if a lion could speak English, we may yet have a long way to go to understand its words, as our experience of life is far removed from that of the lion. We would have to approach the lion within its own frame of reference for meaning to be explicit. I would suggest that our experience of the world is equally far removed from that of Learners and they may be best served by our approaching from their frame of reference or as near to it as it is possible to achieve.

Thus, language should be kept to a minimum and we should use sensory approaches were possible. The sensory approach is the vehicle and the content is ‘history’ …

The concept of time

So why not actually teach history? It is my opinion that, a Learner cannot appreciate history without having certain fundamental concepts. Some of these concepts are covered below. However, the most important of these is a concept of time. The concept of time is where I would begin to teach history to individuals experiencing such levels of difficulty with understanding. Does the individual understand that there is a past and that there is a future or is s/he fixed in the here and now? It seems to me that, no matter how many times you wrap an individual in a toga and claim some form of sensory learning, it is all so far removed from real life and real needs as to be (with great respect) irrelevant. The Learner needs to grasp the fundamental concept of time and we have a responsibility to help him/her take that step.

I have a fish pond at home containing over 100 goldfish. Initially the goldfish were very timid and dived to the depth when I peered in. However, I feed them daily during the summer: now, when I approach to feed them, their behaviour has changed, they group near the surface, swimming in shorts lengths, then turning and swimming back in a confined area proximal to me at a higher speed. The only reasonable explanation of this (unless you can supply a logical alternative) is they are aware I am going to feed them and they are anticipating this (I do not think they are merely excited by my physical presence – I am not that vain!). Goldfish do not have memories of less than three minutes, that is an urban myth. They can at least remember from one day to the next and, I am speculating, if I missed feeding them for a day, they would remember for two days. I observed a change in behaviour which leads me to deduce that my goldfish have a recollection of the past because they anticipate the future. I don’t know how many neurons a goldfish possesses although the average human brain is about 13,500 times as large by weight but, I am as certain as I can be that, they are not smarter than the Learners with whom we all work. If goldfish can demonstrate a sense of past then so can Learners. We just have to help them to demonstrate this skill.

How can toys help teach history? Not by dressing dolls in period costume or using toy soldiers to enact battles on the Normandy beaches (with great respect to those that may have attempted such a feat) but rather by addressing the concept of future and past. The Learner needs to appreciate that s/he has a past and be able to recall events from that past and apply these recollections to the future (anticipation). This is the basis for any Objects Of Reference (OOR) scheme: a link is forged between an object and a POLE (Person, Object, Location, Event) via the presentation of the object prior to movement to the POLE on each and every occasion. It is hoped (anticipated!) that the Learner will come to understand the object symbolises the POLE and anticipate what is about to unfold.

A Switch Adapted toy’s untiring and unchanging repetition of the same action over and over is a basis for teaching the Learner to anticipate (contingency awareness). Removal of a toy that causes a startle reflex (for example) is not always the best course of action: providing the toy is not causing undue distress or is not likely to cause a seizure or any other negative outcome, the Learner might be better served if we watch and wait to see if s/he becomes accustomed to the toy and relaxes while it performs its actions, even enjoying what originally caused the startle reflex. If the Learner’s startle reflex fades and disappears, what can we say about the nature of the Learner’s experience? Can we believe other than the Learner has come to expect the action of the toy? How long did this take? Often, we remove any source of ‘upset’ from an individual before they have chance to learn from the experience – they never learn to cope with the world and always remain vulnerable. No one is suggesting that we deliberately startle any Learner, just that we make the most of opportunities as they naturally arise.

If a Learner comes to expect a certain outcome then s/he must be recalling that knowledge from past experience. This provides evidence that the Learner is using memory. However, as observers, how do we read internal states of mind of any Learner, especially a Learner who cannot report on those states of mind? The short answer is that it is incredibly difficult and it may be a complete assumption on our part unless we have further observable evidence (such as the reduction in the startle effect) to collaborate our deductions. Therefore, from time to time, it is necessary to step back and make an objective assessment of the Learner’s abilities. We should not just move forward assuming that everything we have tried with the Learner, every lesson taught, has been learnt and understood, especially if we have minimal or circumstantial evidence. How can we tell if a Learner is recalling past events and applying them? Simply activating a switch to operate a toy may be suggestive of this. However, how do we know that the Learner is not motivated anew by the switch alone, each time it is accessed? Rapid and repeated activation of the switch suggests that the switch itself is the motivator and there is a memory of the motivational aspect of the switch (the click, the feel?) which warrants repeated activations. Analysing the Learner’s behaviours in this way may help us reach conclusions about his/her internal state of mind. It is necessary to ensure that the interpretation of the behaviour is the only plausible one given the circumstances or else we merely delude ourselves and fail to assist the Learner to make further progress.

Please Note: There is a whole page on the teaching of historical awareness in Learners Experiencing PMLD on this website; go here.

The passage of time

In order to assist Learners understand the passage of time, we can ensure that the day and the sessions follow a familiar structure. Familiar structure can help an individual come to understand the passage of time – certain things happen at certain times on certain days. Not just the daily timetable but a timetable within the session itself. A time for toys perhaps. A time when the learner is assisted to ask for the toys – perhaps through a BIGmack (like device) with a toy symbol clearly attached.

Thus, varying the time-table too much can be counterproductive. A structure that is familiar will assist Learners to make sense of their world. This process is further supported by the use of tangible symbol forms, including OOR and Sensory cueing.

We can also assist by telling the Learner ‘It’s time to/for …’ and signing (Makaton/Signalong/Other) accompanied by the correct use of Objects Of Reference (where relevant). Signalling ‘Time for’ by pointing to ‘watch’ and signing, saying and presenting OOR consistently, time after time, over a period of (perhaps) months, will assist the Learner to make a connection between a sign or OOR and a POLE.

Some establishments have certain musical beginnings to specific days to help individuals to understand that, for example, 'today is a Wednesday’. For some, the notion of a 'Wednesday' is just as abstract as the notion of the mathematics of black holes. That is not to devalue it as, for others (and perhaps for many), it may well be relevant. However, there needs to be more fundamental structures in place for those not yet ready to grasp the concept of ‘day’. Even working on the structure of the day may be too advanced for some: we may need to work more fundamentally on the structure of the session. Not ‘what is happening this afternoon’ (that’s too far away for some) but ‘what is happening now’.

Memory Books

A Memory Book is a form of diary that can assist the Learner with the concept of time. If an item is pasted into the Memory Book to represent each session, then it becomes possible to look back at what happened this morning or yesterday. The ‘item’ should be some meaningful thing from the session (a piece of the artwork produced, a ticket from a bus or a train journey, the logo from a bag of the shop visited, a digital image of the Learner engaged in the activity, a small flat piece of dried food that was used in cooking, …) and not a written report on how much ‘Jenny enjoyed this session’ (note: Learners with limited visual acuity will need 3 dimensional cues in their Memory Books). Furthermore, the Learner must be actively involved in the completion of the Memory Book, perhaps using switch adapted electric scissors to cut out, assisting with the application of paste, and helping to position the item on the page. Schools and parents can collaborate on this process to produce a Learner accessible historic record of the events that have occurred in the Learner’s day, the Learner's week and, over time, the learner's life. As ‘Memory Book Time’ should be fixed to the last few minutes (10 minutes?) of a session it also acts as a ‘sensory cue’ about the timeline indicating that the session is about to end.

Parents can explore the Memory Book's recorded events of the day with the Learner each evening. The items contained on the pages should be a rich source of sensory stimulation for the Learner and promote a theme for communication between parents and their children. Of course, the Memory Book is not a one way system (school to home), it can also be used for parents to record evening and weekend activities and, thus, it becomes a sensory record of of a Learner's day, week, and life.

Memory Books can also be used to prepare a Learner for a forthcoming event by placing a cue to that event on the appropriate page in the Memory Book and then counting down to it by showing the reducing number of empty pages as time progresses. Not all Learners will understand the concept but, unless we attempt such things, they never will.

There are certain rules to the creation and use of Memory Books such that they do not become something else such as a home school diary which are different things entirely.

- Entries should be relevant to the Learner and the session;
- Entries should be made in the last ten minutes of any session or period;
- Entries should NOT be the symbol for the session otherwise the Memory book becomes a copy of the
timetable;
- The Learner should be immersed in the entry. Not an observer but actually involved.
- Staff must not write in the Memory Book other than a brief explanation of the attached entry/item if not
self evident;
- The Memory Book itself should become familiar to the Learner ... a sensory experience.
- The Memory Book is the property of the Learner but the Learner may be assisted by any
Significant Other (Staff, Parent, carer ...) to complete entries day, evening and weekend.
- Memory Books must be used, reviewed, talked about etc where appropriate by Significant Others
and not simply put in a bag and forgotten.

More on the use of Memory Books can be found on the Memory Book page of the website.

Bibliography and References

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