Cody is a delightful high school student who is learning functional, daily living skills. Cody is very social, is very willing to work hard, and loves to go on trips into the community. Due to his traumatic brain injury as a young child, Cody has trouble remembering words and items unless these things are a part of his every day life. Cody has multiple disabilities, including cerebral palsy (CP) that impacts his walking; he does not have enough feeling in his one hand to read braille and the other hand has strong tremors and limited control. Cody has peripheral vision and can identify very familiar objects; he is learning to identify some pictures and familiar letters/sight words that are regularly reviewed. Cody, like many students with a brain injury and/or CVI, is more apt to remember items when the item is associated with a song, chant or motion.
With repetitive practice, Cody initially learned to visually identify the letters (all capitals) in his name. Cody identifies the “O” as a circle and the “C” as a half circle. He learned to identify the letter “B” as two circles and associates the “B” with his “Best Buddy Brian”. With a lot of concentration, he learned to finger-trace the large print letters, which helps him focus his gaze on the letter in order to identify the letter. Cody does identify simple shapes; he associates his letters with shapes. Note: It is important to listen to what Cody identifies and to build on the concepts he understands.
In the video below, Cody is initially learning to identify his first large print letters.
As part of his high school transition, Cody received O&M lessons on the high school campus. This sprawling campus has multiple buildings connected by covered sidewalks; classroom buildings have letter signs (A-E in capital letters). The Office, Media Center, Cafeteria and Gym buildings have word signs. To learn his routes, Cody needed to be able to recall the letter names of the classroom buildings; however, he was not able to distinguish the similar buildings. One day, during an O&M lesson, Cody looked up and saw the “C” on the C Building and said, “That is C Building; C for Cody!” After that, he was able to visually locate the signage and was very motivated to learn the letters A-E. Cody, who remembers complex routes using chants or songs, learned the order of the buildings by singing a modified version of “Old McDonald had a Farm”. Cody’s self-contained classrooms are in E Building; from E Building, Cody passes A building, B Building, Cafeteria and Office.
- Old McCody had a School
- E-A-E-A, B Cafeteria.
On rainy days during O&M lessons, Cody learned to identify the words, “Office”, “Cafeteria”, "Media Center” and “Gym” as sight words. He identified the first letter of the word and then the shape of the word. Initially, he did best with one large letter or one word per page in order to finger-trace the letter. (Tracing helps him bring and maintain his gaze on the letter.) However, with his limited field, he had to move his head as he traced the letter. As Cody progressed, he did best with 5” size letters. Since Cody struggles to remember the letters, he initially was successful with matching the letters or when he was given verbal letter choices to choose from. With regular practice, he did learn to consistently name the familiar letters.
Cody then moved to identifying letters on the iPad. Initially, he identified a picture of the print letters on the iPad. He loved swiping from picture to picture and calling out the letters! He also began playing basic letter apps, such as the Grasshopper apps: ABC Alphabet and Touch and Learn. (Note: Cody does not identify all the letters in the alphabet. When the game displayed a letter he did not know, Cody was given hints about the location or color of the letter, or it became “my turn” to touch the letter. ) iBooks were created with the letters that Cody could identify and new letters were added to the book a few letters at a time.
Cody was introduced to functional signage, including Men, Women and Exit. Cody successfully identified pictures (women in skirts, men in pants) more than the words “Men” and “Women”. During O&M lessons, Cody was encouraged to find the restrooms and identify the various versions of Men and Women signs.
Cody, who has always been motivated by food and restaurants, was introduced next to fast food logos. These logos were added to a photo album on the iPad. Cody would typically pick out a piece of the picture that he could relate to, such as the Bell on Taco Bell logo or the little girl on the Wendy’s logo. Once he was told which restaurant the logo stood for, he would associate the jingle with the logo. Example: Little Caesars, he always mentioned the “stick” in the picture and the jingle, “pizza-pizza” said in a rough voice. When sitting in the car, Cody began identifying the restaurants as he went past! He also started to identify types of stores, such as a gas station, school, Wal-mart, etc. Our Favorite LOGOs! iBook was created; each page had one restaurant logo. Cody provided the sentence about each logo, which helped me understand what he identified in each logo. Cody loves “reading” his Logo book! (Download “Our Favorite Logos!” iBook located at the bottom of the page.)
Next, Cody was introduced to his favorite food logos, such as the Coco-Cola symbol, Frosted Flakes (Tiger that says, GRRRR-EAT!) Picture shopping lists were created on the iPad and iPhone. When in the store, Cody would look at the picture paired with his O&M skills in order to find 2 or 3 desired items on the shopping list. Note: Cody’s O&M Adventures iBook contains a ‘chapter’ on Cody’s Trip to Food Lion which includes pictures of various cereal boxes.
Since Cody is easily distracted in community environments, learning to identify the pictures/logos at school in a controlled environment first was definitely beneficial. Repetitive activities that slowly built foundation skills improved his ability to visually identify familiar objects and to remember these objects.
Cody struggled with retelling his teachers, families and friends what he did on his O&M community trips. Now that Cody is successfully looking and identifying simple, uncluttered pictures, Cody was introduced to pictures with more details. Cody asked to go to Sheetz, a gas station and store that his family frequents. During that O&M lesson, Cody gave a tour of the store and his favorite areas in the store. I took pictures throughout the trip and put those pictures into iBooks – keeping the pictures in order as we walked the perimeter (self-familiarization O&M technique) of the store. Cody added a sentence about each picture. Cody proudly “read” his story to his teachers, family and classmates! Reviewing the story also helped Cody learn and remember the route around the store! (Download “Cody went to Sheetz iBook” at the bottom of the page.)
After creating several O&M picture books like the “Cody went to Sheetz” iBook, Cody was able to remember and retell more about his O&M community trips. Next, Cody was introduced to recording the answers to “who, what, when, where, and why questions”. Initially, Cody was prompted to answer each question – using full sentences. However, he quickly learned to chant the “w-h” questions and started answering the questions independently or with a few prompts. Using the Memo app that comes on the iPhone, Cody recorded his O&M stories and I created Cody’s O&M Adventures iBook – complete with multiple-choice comprehension questions that Cody could independently answer! (See Cody’s O&M Adventure post at the bottom of the page.)
Reviewing the iBooks before a community lesson - especially a lesson that related to a specific iBook - primed Cody to use his vision and remember details about routes while traveling in the community. These books are also great O&M activities on the days that Cody was unable to go off campus due to health issues or bad weather.
Author's Note: It took Cody about two years to progress through the activities in this post. The first visual activities using large print letters took months of repetitive practice before consistent progress was made. Once Cody made the breakthrough with identifying a few letters and that activity was paired with the “real life” need to identify signage at the high school, Cody’s progress sped up.