Adapting Play and Communication: Enhancing Interaction and Cognitive Skills in Young Children

Linda J. Burkhart

Which Children are Appropriate for Adapted Play and Multi-Modal Communication and Why?

  • Means of expressive language - for those children "locked" in their bodies.
  • Means of improving receptive language skills for those children with auditory processing difficulties
  • Improves self-concept and self esteem - which in turn, improves a child's ability to learn
  • Facilitates speech for children who would be considered pre-verbal
  • Provides motivation for those children with "Learned Helplessness"
  • Reduce frustration and behavior problems
  • Makes language visible for children on the Autism Spectrum
  • Makes language more concrete and also provides multi-sensory input for children who are developmentally delayed
  • Increases participation in daily life
  • Facilitates learning by making learning interactive
  • Means of manipulating play materials to learn cognitive concepts
  • Means of interacting with Peers

Technology is a tool for People

  • It is easy to get lost in the equipment
  • Focus should be on the interaction between child and adult or on the interaction between the child and other children
  • Success should be measured by what the child is able to do functionally

Early Cognitive Skills

Toy Exploration and Environmental Awareness

  • Visual and auditory attending
  • Tactile awareness
  • Concept of habituation and vs. curiosity and interest
  • Considerations for selecting toys
  • Integrating toys with language concepts and classroom themes and units

Cause and Effect - Understanding Contingency
  • Children learn cause and effect through experience
  • Children have a natural drive to solve problems and figure out the world.
  • Reduce prompts and design the activity so that the child can learn through Trial and Error without a lot of conflicting input
  • Use of direct activation vs. delay timers and latching
  • Delayed response - don't interrupt the thought process with too much prompting
  • Expect inconsistency - a long pause with low affect and a deep-in-thought expression on the child's face is often a sign that the child is on the verge of understanding
  • Selecting Toys to Computer Software for Cause and Effect learning
  • Cause and effect with logical sequence or outcome: using software
  • Development of skills needed for problem solving
  • Follow the child's lead to move in order to hold the child's interest and challenge their cognitive engagement

Objects in Containers Play
  • Stabilizing containers
  • Switch inside a container to provide feedback
  • Light-Tech container adaptations
  • Integrate with play activities
  • Simulation on computers

Object Permanence
  • Slow moving battery toy disappearing behind a barrier
  • Integrate with play and language concepts: pig in barn, car in tunnel, bridge, garage, etc.
  • Playboards with tunnels
  • Playboards with closed containers (tool box)
  • Shower curtain ring toy and washcloth
  • Object Permanence on the computer

Non-directed Household Play for Developing Concepts
  • Banging pots and pans (playboard)
  • Plastic whisk in strainer
  • Computer simulation

Independent play
  • A series of switch toys to choose from (first independently then with a peer)
  • Stabilizing toys: playboards with shoe strings and Velcro toys
  • Adapted board book
  • Using voice-output devices for babbling and sound play
  • Using voice-output devices for independent book exploration
  • Kid-directed computer activities

Early Communicative Skills

Joint Attention and Shared Interaction

  • For a young, shy child, avoid eye contact except for quick glance of shared delight or mischief
  • Objective is shared enjoyment
  • Use a motivating toy as focus of attention and interaction
  • Much is learned receptively at this point through modeling language and play, which only works if the child is interested and attending

Requesting Recurrence
  • Signal for "more" of a playful activity, rough house etc.
  • Add simple voice-output or sign language for "more"
  • This is a crucial step in the development of interaction and active participation

Calling and Initiating Communication:
  • Call Mom/teacher for "peek-a-boo" or "finger play" or to sing a favorite song.
  • Later, child calls mom as emotional need to touch base- "look Mommy"
  • Vary the call message using Step-by-Step to expand language and increase interest, while still keeping the same communicative function.

Providing Simple Choices and Increasing Active Participation:
  • Developing cognitive engagement, reducing passivity
  • Research shows that children learn more effectively through active participation than through passive instruction
  • Choice of actions on a toy instead of choosing the toy
  • Frequent short activities
  • Use of eye-gaze and PVC eye-gaze frame for children who face physical challenges
  • Use of eye-gaze and PVC eye-gaze frame for children who have Rett Syndrome
  • Early computer play with the child directing the actions of the computer through simple choices and observing results

Early Vocabulary:
  • Early vocabulary is first introduced receptively
  • Multi-Modal Language Stimulation - information needs to go in before it comes back out
  • Carol Goossens' - filling a cup analogy for Aided Language Stimulation
  • Language is not learned by straight imitation, it is learned through broad experiences that provide multiple repetitions of concepts, vocabulary and conventions. This provides a scaffold from which children can construct language.
  • Wide variety of communicative functions need to be represented

Developing Fine and Gross Motor Skills Through Play

Encourage Movement and Exploration of the Environment

  • Notebook switch on floor and inside obstacle courses
  • Environmentally placed messages to step on
  • Use of computer with the notebook switch and gross motor activities
  • Means ends - solving a problem to get something out of reach
  • Looking for switch toys around the room
  • Developing exploration and search strategies on a tray or table surface
  • Use of adapted riding vehicles and power wheelchairs for developing motivation and mobility
  • Tapping the child's natural drive to go after what she wants

Developing Fine Motor Control
  • Cookie sheet and bolt switch - emerging writing
  • Adapted handles for grasping: PVC pipe, hot glue sticks, shower curtain rings, dowels, Velcro, stick tac, etc.
  • Stabilizing toys: carpet squares, Velcro, shoe strings, clamps, slanted surface
  • Notebook switch for pointing skills
  • IntelliKeys overlays
  • Simulating fine motor experiences on the computer for children who face physical challenges - developing the cognitive concepts related to fine motor skills

Expanding Communication Skills Through Play

Early Interaction (sharing play/toy with an adult or other child)

  • Telephone: "Hello," "good-bye," ringing sound and later add more language - places child in control of initiating and terminating
  • Follow the leader - language master, simple scanning, voice-output, computer
  • Balloons - directing action
  • Bubbles (two step toy so there is a need to ask: "dip it in, get some more!"
  • Blocks / moving toy (need to ask "build them up.")

"Show" Stage
  • Send battery toy to adult and then request "me" to have it come back.
  • Carry something with toy (like a cookie on a plate on the bike)
  • Use language: "look at this," "hello," "good-bye," and "come here"

Turn Taking
  • Expanding contingency understanding - how my actions effect others actions
  • Play patterns and sequences
  • Two switches two kids on software that only allows one switch to work at a time
  • Play ball (penguin toy) "throw me the ball" or "get the ball"
  • Modeling with peers in a small group

Expanding Language and Concepts
  • Request actions and toys: "throw ball," "bounce ball," "bounce baby," "baby dance," " baby sleep," etc.
  • Make choices of toys and activities not visible (picture symbols or signs)
  • Choose which song or which verse
  • Combine concepts on a computer to observe results (IntelliPics)

Pretend and symbolic play
  • Model pretend play receptively before expecting it to be used independently
  • Imitation of "Mommy or Daddy things" (household tasks) Provide adapted toy and proximity to simulate whatever adult activity is going on.
  • Doll house playboard (noun/verb and noun/adjective)
  • Vehicle playboard (in, out, car noises: beep, brmmm brmmm - using voice-output)
  • Pretend cooking (battery dino eating)
  • Dollhouse play: directing action (Speaking Dynamically)
  • Adapted art activities
  • Dress up - choices and comments
  • Simulation on computers

Additional strategies for active children
  • Challenge is to find a need to communicate
  • Sabotage and place toys or needed pieces out of reach or out of sight to require child to ask a person to get an item
  • Physical play "turn me upside down"
  • Follow the leader in gross motor activities - leader wears hat or sash
  • Toys that are difficult to manipulate, but result in action "help" or "put it on"
  • Computer play (powerful motivator and multi-sensory feedback)

Emerging Mathematical Concepts
  • Patterns and sequence
  • Sequence of songs, play routines and stories - especially when related to numbers or time of events
  • Receptive: 1.....2.....3...... here it comes!, peek-a- boo, there it goes, etc.
  • Exposure to number rich environment and activities
  • Count everything as part of routines and comment on results. "Lots of kids wore tennis shoes and only one person wore sandals today."
  • Spatial and relational concepts; in, out, up, down, big, small, fast, slow,
Emerging Literacy Skills
  • Sequence of songs, play routines and stories
  • Conventions of print - left/right, lines and curves, lined up horizontally, spaces between words,
  • Exposure to print rich environment
  • Conventions of books - front, back, right side up, left/right, beginning, end
  • Exposure and play opportunities for functional use of print: lists, notes, recipes, letters, email, direction sheets, signs, labels, etc.

Facilitating Interactive Communication

General principles: some of these may seem to be subtle, but often they make a significant difference in terms of success

All children have a basic need for Control (contingency) and Connection - If we can use these basic needs as motivation we can facilitate communication.

Control and Connection may be reflected in:

  • activity selection (making soup or making mud pies)
  • setting up communication opportunities within an activity (sabotage)
  • natural prompts
  • select beginning vocabulary that facilitates control and connection.
(uh oh, yeah!, more, all done, that's silly!)
  • action oriented play (turn me upside down, bounce on the ball)
  • variety of communicative functions
    • social "chit chat"
    • relating and sharing experiences (news)
    • humor
    • expression of a whole range of feelings, emotions and opinions
    • choice making (engineer choices into each activity)
    • directing action (follow the leader)
    • expression of needs

Where do you begin? Figure out what the child really likes or would most likely want to do and start with that activity (ex; tickle, bounce, juice, swing, bubbles, Mommy's song, silly noises, etc.)
  • Balance novel with known to create a feeling of familiarity and comfort with curiosity and intrigue.
  • Try requesting actions on a toy instead of just requesting a toy.
  • Move from requesting one activity to choosing between two or more.

What is developmentally appropriate for young children?
  • On the go - not a sit down directed lesson
  • Short attention span is normal
  • Entice the child back into an activity with surprise, peeking, hiding, etc.

Integrate communication with play or functional activity
  • Use battery toys to cause something to happen that gives the child control and provides topic of communication. (roll a ball, knock over blocks)
  • Adapt battery toys to fit pretend play. (puppet on bump'n go toy)
  • Stabilize toys for more independent play. (Velcro® playboards with indoor/outdoor carpet)
  • Use adapted spinners and generic game boards to play games.
  • Use toys that require assistance to operate. (helicopter)
  • Use multi-modality aided language stimulation to model appropriate use of language
  • Provide child with multi-modality means for participation in the conversation

Follow the child's direction or lead: empowering the child and giving him or her the control.
  • Child directed activities keep the child's interest and receptivity high.
  • Don't get into a battle of wills (example of snack - teacher directed: show me cookie vs. what do you want?)
  • Set up scenarios that encourage initiation. (phone play, bubbles, songs)

Keep questions and extraneous language to a minimum
  • This may feel unnatural.
  • Put verbal patter in your head.
  • Avoid using What is this? and yes/no questions
  • Use natural prompts, facial expressions, look of interest, attend to another child (doll or puppet), feigned disinterest, or pauses to encourage initiation

Expect delayed processing time
  • Use anticipatory pauses.
  • Don't distract the child from his thought processes.
  • Use environmental prompts instead of physical prompts.
  • Allow the child to control the sensory experience.

Reduce motor demands
  • Use eye-gaze frame and vest.
  • Try a light pointer.
  • Experiment with a flip chart.

Minimize random activations
  • Reduce activation size to require closer attention.
  • Increase distance between selections at first. (Radio Shack picture frames)
  • Have child move to selection in his environment.
  • Try picture exchange.
  • Wait for child to focus on selection before moving it within reach.
  • Ask for confirmation with eye gaze strategies.
  • Successively eliminate choices. (verses in a song, building parts)

Recognize the child's sensory needs and issues
  • Provide opportunities for the child to request and control sensory input
  • Work with occupational therapists to evaluate sensory processing and develop appropriate interventions

Allow the child to withdraw and center and then continue at his own pace, kids learn in short spurts.
  • Go with distraction and then entice the child back.
  • Provide the child with a means to communicate about distractions.

Self directed repetition (difference between getting bored with something and assimilating something)
  • Adult directed: habituation, boredom, anger,frustration, feeling of powerlessness.
  • Child directed: as needed to assimilate concepts, to practice new skills, to feel a sense of "I can do it" and show someone else their accomplishments (share the joy)

Provide child with natural multiple opportunities by responding with small amounts of what was requested or actions of short duration.
  • Offer small bites at snack.
  • Try actions on toys.
  • Communicate within the activity instead of just choosing the activity.

Linda J. Burkhart
6201 Candle Ct.
Eldersburg, MD 21784

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