Supporting Learners with Visual & Multiple Impairments
Prompting & Wait Times Within Instructional Routines
It's tempting as a teacher, parent, or para to over-prompt or reduce needed wait times for responses because we want to see the learner participating and being successful. Similarly, we may be writing routines or IEP goals with too much prompting built in without examining the active participation of the learner.
I urge us to examine our goal writing through the lens of what our learners can DO with the least amount of prompting necessary. From here, we can write routines with these achievable steps highlighted. Our collaborative teams can support and advise so we can hold true to predetermined wait times and prompting levels.
This month, we will examine prompting levels, wait times, and ways to encourage engagement to promote learner participation.
A Closer Look at Prompting
1. Collaborate with all team members to identify the accommodations that will set the learner up for success. If we minimize distractions and provide high contrast materials in the best visual field, we may reduce the need for visual prompting. If we determine that support at the elbow is needed, we may not need to provide a physical prompt to initiate the step in the routine.
2. Remember that the majority of learning happens in the mental planning and initiating of a step. Teachers and support teams can be very careful observers, noticing how and when a learner shows anticipation and initiation of a step. If a learner needs physical support to complete a step, this isn't prompting. If a learner needs full physical prompting to initiate the steps consistently, the team may need to examine if the steps or routine are appropriate for the learner's participation level.
3. Is your learner in an alert state for learning? You may find that over prompting is necessary if your learner is falling asleep, self-stemming, or disengaging. We encourage your team to assess if the routine is highly motivating enough for your learner, and perhaps consider a "warm up" routine to set the stage for learning.
4. Wait a bit longer. Sometimes we step in and provide excessive prompts because we just aren't quite patient enough. Adding in a few more seconds of quiet wait time may help reduce the need for prompting.
Hurry Up and.... Wait
1. Trial and error. In your first phase of doing the routine with the learner, be sure to video often. Team members can review the video to observe and calculate wait times. Don't be afraid to wait longer than you think feels right!
2. Write it down. Once you have a good wait time estimation, include it on the written routine. Teachers can use a stopwatch or count silently if needed.
3. Stay quiet! Sometimes we give a little verbal cue or reminder, and this can derail our learner from the mental mapping they may have been doing.
A Message from Millie
Understanding before helping
The prompting hierarchy referenced above was developed for and is used primarily with learners with mild to moderate disabilities. There are some special considerations for prompting learners with severe disabilities and visual impairments at the sensorimotor stage of development. Keep these things in mind.
1. Learners must understand what you want them to do before they can try to do it.
2. Typically developing sensorimotor stage learners are wired to watch what people around them do and try to do it too. Unless it results in something they don’t like.
3. Sensorimotor learners with severe impairments may not know what you want because they
have never seen and/or felt you do it. Sam’s teacher wants him to bite off a piece of cookie. She uses procedures taught her by the occupational therapist who works with the team to provide full physical assistance. Sam wants a piece of cookie, but he has no idea what touching his hands and face has to do with getting one.
4. Start with modeling. Sam needs to see and feel his teacher take a bite of cookie. The teacher shows Sam the cookie, puts her face in Sam’s preferred viewing area, and bites off a piece of it. She takes another bite with her face in the place where Sam can touch it easily. She shows Sam the cookie, puts her hand under his, guides his hand to her face, and lets him feel her open her mouth and take a bite.
5. After helping him understand what it is she wants, she uses hand-under-hand support to help Sam bring the cookie to his own mouth. She still uses some of the OT supports such as a little pressure at the mandibular joint to stimulate mouth opening. The procedure is more successful now because Sam understands that a cookie is waiting.
6. Full physical assistance provided with total hand-over-hand manipulation is not ever the place to start. It may be somewhat helpful later after a learner understands what you want him to do, but even then, only if he wants to do it with you. Motor participation starts with intention. Without intention, movements are not processed and stored in a way that produces skill development.
I like the AIWA procedure. Make the learner aware of what you are doing. Invite him to do it too to create intention. Wait for him to initiate a response. Assist execution of the response using hand under hand support.
Begin at 3:30 for an example of wait times and prompting in an instructional routine. The team had a written plan for wait time and the types of prompting to provide. The teacher is patient and quiet while waiting for the desired response.
Please share this new resource with families! The ECC & Me has opened an Etsy shop with monthly themed boxes, and there is one specifically for sensorimotor learners! Boxes will include a book, objects, and resources for the learning partner.
Stacey Chambers, TVI
Angela Campbell, Adapted PE Teacher
Allison Clark, PT
Wendy Pray, Active Learning Teacher
Millie Smith, Consultant for Learners with Visual and Multiple Impairments
Tristan Pierce, American Printing House for the Blind
Contact Us: TheECCandMe@gmail.com