The Beginners Guide to Teaching Students with Moderate and Severe Disabilities
Teaching special education takes a special person with a big heart. When it comes to teaching these students, especially those with moderate to severe disabilities, there is so much variation of abilities from student to student. Although there are several different curriculum options available for use with these students, you will undoubtedly need to modify lessons and materials based on your students’ abilities. Communication is the most common deficit area among students in self-contained, special education classrooms. A student’s communication skill level often determines how students will be able to participate in lessons and activities within their day. As a special education teacher, you will need to determine what mode of communication each student will use, and modify lessons to meet this need.
With so much new technology and tools available it is hard to determine what you might need for your students to be most successful. For some students low-tech options may be best while others may flourish with the use of high tech tools such as an augmented communication device. One thing I have learned in my years of teaching is to know your resources. Talk with your school/district speech therapists and assistive technology specialists. Let them know you are not only interested in what they have to offer, but that you are willing to use the tools they give you every day in your classroom. They are much more willing to give you access to materials and technology for your students when they know it won’t sit on a shelf!
What are some limitations of students with moderate to severe disabilities?
My experience is with self- contained special education classrooms, elementary through high school. My students with moderate to severe disabilities have displayed different abilities and limitations. The most common limitation is in the area of communication. Some are mostly or completely nonverbal. Others are verbal, but lack spontaneous communication skills. Several students have motor limitations, keeping them from being able to move independently or walk. Many have fine motor limitations making it difficult to participate in writing and art activities. These challenges occur alongside many different disabilities such as autism, down syndrome, cerebral palsy, and others. While some students who are non-verbal are still quite mobile, there are others who may also have limited mobility and require a wheelchair, adaptive chair, or other equipment to transition throughout their environment. You will need to take into account your students abilities, as well as what supports they will need to overcome any limitations, when planning your instruction and activities.
Limited communication skills impact participation
When a student has difficulty communicating, they often get skipped or left out of certain aspects of classroom and small group lessons. I don’t believe this is intentional, especially for those students who are not displaying disruptive behaviors. Obviously, students who are nonverbal may display behaviors as a result of their frustration at not being able to communicate. For those students, I feel that more attempts are made to find alternate forms of communication due to the need to minimize these behaviors. We must also do the same for non-verbal students who do not display disruptive behaviors. Just because they are not appearing to be frustrated, they still have a need and a desire to communicate. We need to make sure we are giving ALL students a way to share their voice and be an active participant in all activities.
How to get started with basic teaching materials to assist in student communication?
Unfortunately, tools for communication are not one size fits all. You will need to experiment with different materials to find what works best for each student. As special education teachers we need to advocate for these tools and collaborate consistently with our school’s/district’s speech pathologists and assistive technology specialists.
Materials and Strategies to get you started:
Determining response mode
- Before deciding what tools to try with each student it is important to determine their response mode. Are they able to pick up and give you a picture? Can they touch or point to a picture? Can they push a button with their hand or do they need a different method? Do they rely on eye gaze to make choices? Do pictures need to be enlarged? Does background color affect their ability to see the items? Answering these questions will help you make the best decision in what types of tools you will need to use with your student to set them up for success.
- Actual pictures of objects and/or symbol representations can be used. This is the cheapest and most used resource. You can use anything from Clip art and your own photos, to programs such as Boardmaker or Symbolstix by Unique Learning System (ULS). These can be used for visual schedules, choice boards, and core vocabulary. You can also change sizes and colors based on your students’ needs. I highly recommend printing these materials on cardstock and laminating them.
- Having choice boards ready for various activities can be a great resource to provide your students. Our class curriculum, Unique Learning System (ULS) provides ready-made choice boards for many of their lessons. You can also make boards for other areas of your school day. For example, for circle time you can have boards ready for greetings, weather, calendar activities, etc. In your math group you can have a board with numbers to help with participation with counting. During art, you can have a board with colors and art materials to request. Choice boards can literally be helpful in all activities.
- These are battery operated devices that allow you to record a single message. Your speech therapist should be able to provide you with these. If not you can find cheaper versions online. These are great for greetings, simple messages (I need a break, I need help, etc), and for academics. I use them for vocabulary lessons, greetings, short communication phrases, and for repeated storylines during reading activities.
Tips for success in introducing communication tools to students
Now that you have some materials put together, how do you introduce them to your students? When you are introducing a new form of communication to your student, I always begin with something reinforcing and usually start with a simple requesting activity.
Find an activity or item that a student loves and print a picture or picture symbol of that item. You can use the picture by itself and require the student to touch or give you the picture in order to request the item. Another adaptation would be to attach the picture to a switch with a recording of the item. In the beginning, don’t have any distractors other than the one picture, so they can immediately have success and earn access to the reinforcer.
Next, slowly introduce pictures of uninteresting items as distractors to make sure they are making a purposeful choice, using the correct picture to make their request. ALWAYS give access to the reinforcer immediately after they appropriately make their request. This is so important to making communication meaningful to them!
Finally, as they learn more than one picture, you can increase the number of choices of reinforcing items they have to choose from as they master what each picture means. For example, if you are using food items, you can work toward giving them a choice board of 3-4 snacks they like during snack time and they can appropriately choose what they would like to have.
When you are ready to move on to activities other than requesting reinforcers, I suggest providing opportunities within context. For example, if you notice they need help opening a drink, prompt them to ask for help using a picture or a switch. Slowly introduce new words and phrases as they get used to their mode of communication and begin expanding throughout different activities.
Common Questions/FAQ on increasing participation of students with limited communication skills
How do I write academic IEP goals for nonverbal students?
- Although there are many different areas to write goals for (i.e. reading, math, life skills, etc.), key factors to consider participation and independence. Some great questions to ask as you examine a goal area are: How will my student participate? In what ways is my student participating currently? What limitations does this mode of communication present? How else can my student access the lesson/activity? Do I find myself skipping steps of lessons/activities because they are nonverbal? What ways could I provide opportunities to avoid this? Once you answer these questions you can build a goal around how independently a student can participate in that area. Be sure to include any conditions in the goal (i.e. given verbal and gestural prompts….., given a communication board….., etc.).
How can I establish a routine using visuals and pictures in my classroom?
- Visuals are a key component to establishing routines in any special education classroom. We use a large classroom visual schedule, listing the order of the day’s activities. Students also each have individual schedules they use throughout the day to transition through their activities. Additionally, we have visuals to show daily class jobs, daily circle time jobs, and class rules. Don’t forget staff need visuals too! Throughout the day there are Powerpoint slides for each activity on the Smart Board for us to refer to, showing reminders of what each staff person is responsible for. There is so much happening at once sometimes in our class, and it is important to remember all the little things that help the day go smoothly.
What activities can I add to my daily classroom schedule to address participation goals?
- Participation is essential in all activities throughout your classroom schedule. There are several great activities you add to your schedule that will give more opportunities for participation skills. As you do this, you will discover ways to incorporate new methods and strategies into your academic times. Circle time or Morning Meeting activities are great ways to include opportunities to learn vocabulary through pictures and communication devices. This also provides practice with interacting with other students in the class. Providing opportunities for games offers a chance to practice turn taking skills and good sportsmanship. Scheduling a time for play skills gives opportunities to learn to communicate with peers. Any participation with general education students such as during lunch, recess, and/or specials provides great models of communication and practice in social skills. Arts and crafts also can provide opportunities to explore fine motor abilities and adaptations as well as communication of art tools, colors, and shapes. Often, students and staff will discover a strategy during one of these fun activities that can then carry over into small group work and lessons!
How can students with very limited mobility participate in classroom lessons?
- I highly recommend consulting with your school/district’s Physical Therapist to determine if there is any equipment available to help your students with limited mobility. I have often seen students who are in wheelchairs are left to sit off to the side, not really completely part of the group. There are various activity chairs and adaptive chairs that these students may be able to use to sit at a table or desk with their peers so they can work next to them. Also, your Occupational Therapist may have access to materials and tools to help with table top activities such as writing, cutting, and art activities. We even have switch-activated scissors for one of our students!
How can students get an augmented communication device?
- Communication devices can be covered by Medicaid and your school district should have a process in place for acquiring a device for a student if it is appropriate. Talk to your Speech Therapist. Usually two or more devices are trialed with the student to see which one would be most appropriate. It can be a lengthy process but worth it! Once the student receives the device he/she can use it at school and at home. If for some reason getting a device is not an option for that student there are some great apps (some are free!) that can be used for communication as well.
The Last Thing You Need to Know about providing a classroom environment where all students can participate
When planning for any lessons or activities that will include all students, always determine what your goal for each student is within the activity. The end goal may be very different for each student. Is the goal to learn content? Attend a certain number of minutes without protesting? Sit upright during a group activity on the floor? Make a purposeful choice between 2 pictures? All of these goals can be adapted to almost any activity or lesson throughout any school day, making each activity purposeful for all students. In the end, all their goals should be designed to lead them towards independence.
If you have found this post helpful, please share and comment below. Also, I would love to hear how you are finding success with including students with limited communication skills in all your classroom activities! We can be such a help to each other as a community of special educators.