Winter 2009 Table of Contents
Versión Español de este artículo (Spanish Version)

By Suzanne Becker, Teacher of the Visually Impaired and Classroom Teacher, Texas School for the Blind & Visually Impaired, Austin, TX

Abstract: A TVI and classroom teacher describes how she serves her secondary-level students who are visually and multiply impaired using Lilli Nielson’s Active Learning approach along with other strategies.

Keywords: Effective Practices, blind, deafblind, multiple disabilities, active learning, centers, Lilli Nielsen

I’ve been a TVI and classroom teacher at Texas School for the Blind and Visually Impaired (TSBVI) since the 2001 school year.  My classroom is designed for older students (13-22 years) with severe multiple impairments who are functioning below three years of age across most developmental skills (i.e.: emotional development, fine and gross motor skills, object perception, communication, etc.).  My teaching has been guided primarily by the educational approaches of Lilli Nielsen (using “Active Learning” and evaluating skills with the Functional Schemes Assessment), Barbara Miles (engaging in conversations with students based on their topics, and being extremely sensitive to the communication of our hands), and Jan van Dijk (interacting with students using meaningful calendars, resonance activities and consistency).

This type of programming existed at TSBVI for students with severe impairments of elementary school age, and I advocated expanding it to include at risk students at the secondary level.  I did so by writing a proposal to TSBVI administration in 2006, and received a grant in 2007 from the A+ Federal Credit Union to support the program.

I was led to develop this approach by a student who came to the school in 2003 at 17 years of age with many challenges to his learning.  He had a neurological disorder resulting in cortical visual impairment (CVI) and central auditory processing disorder (CAPD), which means his brain had difficulty making sense of visual and auditory information; cerebral palsy impacting mobility on his right side causing fatigue so he’d sit down often and use a wheelchair for long distances; autism; a speech impairment; and a seizure disorder monitored by high doses of medication administered during meals.  He also came with well-established behaviors, including self-abuse (dropping to the floor and head banging) and aggression (throwing, biting, head-butting and pinching).

The medical conditions this student had, and those of other students I have since taught, create a tremendous amount of confusion, pain, frustration and disruption in their lives, leaving the students in little control of their bodies and the events that happen to them.  I’ve worked hard to empower the students and let them be in control of their learning experience as much as possible. To do this, I’ve structured the classroom into distinct learning environments or centers differentiated from one another by themes, the materials stored there, the seating arrangements (tables/chairs, couches, beanbags, rugs), and the physical landmarks dividing them. This organization has helped my students make associations between the centers and the interactions, activities, materials and sensory experiences that occur in each.

The centers derive from natural occurring themes in the student’s lives.  These include:















Image 1: A calendar center that includes an area with each student’s communication system located nearest to the door, where we communicate about past, present and/or future events. 

A hygiene center with soaps and lotions of various smells and different sized containers, toothpastes and toothbrushes, hairbrushes, sponges, foot baths and hand dryers.

Kitchen Center














Image 2: a kitchen or cooking center which includes utensils such as measuring cups, stirring spoons, mixing bowls, cups, placemats, appliances such as a microwave and refrigerator,  as well as supplies such as food, spices.

A clothing center with a standing closet rack upon which clothing of various textures hang, as well as hats, jewelry, shoes and fabrics.


Image 3: sensory centers including a tactile vibration area with vibrating pillows of various sizes, and acoustic musical instruments; and an electronic visual/auditory center which contains the beloved keyboards, CDs and cassette players, light boxes and computer.

Vocational Center


















 Image 4: a vocational center that includes a can crusher, cans, trash receptacle on wheels, plastic bags, a broom, watering cans, smooth stones, planters, shovels, scoops, water hoses, paint rollers, dusters, mop heads and containers with lids.

A gross motor center with a swing, mats, scooter boards, roller skates, and rocking chair.















Image 5: a throwing center with balls of various shapes, sizes, colors and weights, plastic bottles with different materials on the inside and textures glued to the outside.

 In my earlier teaching days, I was in a smaller classroom equipped with one table where activities of very different topics took place: cooking, hygiene, vocational.  Some activities were in a one-on-one setting and some a group setting.  While each activity was differentiated by its own object symbol, the students taught me that conducting many activities in one place caused them confusion, stress and distrust, resulting in behaviors like shutting down, body or hand tension, hitting, leaving the area, or dropping to the floor.  In my attempts to be efficient in a small space, I was also controlling access to materials by keeping them in storage bins and determining when they would make an appearance based on the schedule I created.

When I moved to a larger classroom, I released control of the materials and the time frame in which to use them and gave the students more freedom to explore.  I scheduled students’ time in the various centers based on their interests, preferences, and sensory needs. I observed the actions they performed with their hands and bodies, with various materials, and with other adults, keeping a pen and paper (and at times a video camera) handy to document and make changes as needed.  I noticed students initiating more actions by reaching out and moving their bodies with greater independence, increasing their motor skills in the ways they handled objects, and increasing their social and emotional skills as the time spent in the various centers expanded.  I created a matrix for each student that outlined the IEP goals each center addressed, and hung these documents in the centers so all adults interacting with or observing the students would have a reference of what skills to target.  I also advocated for a more flexible schedule to allow the students time to continue to grow at their own pace.

Based on my observations, I purchased objects for the centers that contained properties I noticed held the students interest. One student fixated on tickling himself—using his apron strings at meals, paper towels in the bathroom, and his pillow when he woke up in the morning.  I made sure to have familiar items for tickling in all centers, and used his attraction to soft materials as a way to get him interested in the less desirable vocational center where I showed him the tickling potential in dusters, a car wash mitt, paint rollers, and a mop head.  Another student, who refused most materials, paid attention to jewelry worn by staff providing sighted guide while walking together.  He was scheduled to visit the clothing center.  We increased our jewelry collection and had interactions with him where we would put on different types of jewelry for him to notice (various beaded bracelets, a springy phone cord on my wrist, metal rings).

A different student with total blindness, a severe hearing impairment, and severe sensory integration deficits was particularly withdrawn. Touch and interaction stressed him out, causing him to drop to the floor and at times try to remove his clothing.  He primarily stood in one place twisting his upper body rapidly from side to side, or sat in a rocking chair with his legs crossed close to his body, tucking his head and arms onto his legs.  He could tolerate being in a center if it meant he had room to sway, but he was fearful of touching anything.  Presenting an object to him was too demanding, so we hung objects where he could accidentally bump into them in the process of swaying.  He felt extremely threatened by interaction, so my goal was for him to allow my presence near him.  I stood and imitated his swaying, near enough so when he chose to reach out he felt me resonating the same body movement as his. Over the entire school year, this non-demanding interaction built trust between us, and that trust helped him remain in contact with me as I invited him to follow me as I then reached out to experience objects in the centers.

When I look back at videotape from 2003, my first teaching year with the student who inspired me, I notice ways I had made learning more challenging for him than it should have been.  I limited his access to objects because I wanted to prevent his mouthing, throwing and banging them. I had an expectation about how he should manipulate objects based on their function. I placed him in group activities with multi-step sequencing and tried to have him share materials with peers.  When he attempted to leave the activity, I responded by trying to keep him in the area, but he was skilled at getting away.  When he dropped to the floor, I focused on getting him to sit back up to keep him from banging his head.

Our second school year together, I realized that group activities were too fast paced and over-stimulating to his senses, causing him to leave the area to regulate sensory input. Also, when he was on the floor, he felt stable and could bend his legs into a certain position to ease stiffness from his CP; it helped when he had stomach pain; and it also communicated that he needed to take a break. I struggled less with him when he was on the floor and instead brought materials to him. I surprised both of us by changing this conversation and it strengthened our relationship.

Our third year together, I was guided to look at Lilli Nielsen’s Functional Schemes Assessment by staff experienced in her approach from working in TSBVI’s specialized elementary level classroom. Sure enough, the assessment confirmed that my secondary level student wasn’t ready to take turns with peers nor was he at the level of multi-step sequencing.  He needed lots more time handling materials of many different properties and lots more practice having positive interactions with trusted adults who would offer him objects, imitate his actions, model object exploration, and accept him for who he was.  His competence and confidence grew!

In our fourth year together we were in the larger classroom and there was now a balance of learning centers where certain activities occurred in chairs and others occurred on the floor.  He learned to travel around the classroom and retrieve materials from consistently stored locations. His self-abuse decreased and he learned to express when he felt challenged using language and actions that we modeled. After having extended time to explore objects, he expanded his actions beyond mouthing, throwing, and banging to also include shaking, rotating, twisting, waving, scratching, and sniffing. His functional use of objects increased. He gained significantly more ability to use both hands, even the one impacted by CP, and increased his visual skills as well.

This student had a huge, positive impact on my understanding of how to teach older students with severe impairments. He taught me to listen to him and his peers with greater sensitivity, and to develop an organized environment with motivating materials, in which students can experience decreased stress and increased learning despite the many challenges of their multiple impairments.

secondary AL classroom collage