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
Technology is a tool for People
- 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
- Provides motivation for those children with "Learned
- 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
- Means of interacting with Peers
- 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
Early Cognitive Skills
Toy Exploration and Environmental Awareness
Cause and Effect - Understanding Contingency
- 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
Objects in Containers Play
- 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
- Cause and effect with logical sequence or outcome: using
- 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
- Stabilizing containers
- Switch inside a container to provide feedback
- Light-Tech container adaptations
- Integrate with play activities
- Simulation on computers
Non-directed Household Play for Developing Concepts
- 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
- Banging pots and pans (playboard)
- Plastic whisk in strainer
- Computer simulation
- A series of switch toys to choose from (first independently
then with a peer)
- Stabilizing toys: playboards with shoe strings and Velcro
- 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
Calling and Initiating Communication:
- Signal for "more" of a playful activity, rough
- Add simple voice-output or sign language for "more"
- This is a crucial step in the development of interaction
and active participation
Providing Simple Choices and Increasing Active Participation:
- 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-
- Vary the call message using Step-by-Step to expand language
and increase interest, while still keeping the same communicative function.
- 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 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
- 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
Encourage Movement and Exploration of the Environment
Developing Fine Motor Control
- Notebook switch on floor and inside obstacle courses
- Environmentally placed messages to step on
- Use of computer with the notebook switch and gross motor
- Means ends - solving a problem to get something out of
- 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
- 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
- Telephone: "Hello," "good-bye," ringing
sound and later add more language - places child in control of initiating
- Follow the leader - language master, simple scanning,
- 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.")
- 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
- Use language: "look at this," "hello,"
"good-bye," and "come here"
Expanding Language and Concepts
- Expanding contingency understanding - how my actions effect
- 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
Pretend and symbolic play
- 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)
Additional strategies for active children
- 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
Emerging Mathematical Concepts
- 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 Literacy Skills
- 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
- Spatial and relational concepts; in, out, up, down, big,
small, fast, slow,
- 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,
- Exposure and play opportunities for functional use of
print: lists, notes, recipes, letters, email, direction sheets, signs,
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
Control and Connection may be reflected in:
- activity selection (making soup or making mud pies)
- setting up communication opportunities within an activity
- natural prompts
- select beginning vocabulary that facilitates control and
(uh oh, yeah!, more, all done, that's silly!)
Where do you begin?
- action oriented play (turn me upside down, bounce on the
- variety of communicative functions
- social "chit chat"
- relating and sharing experiences (news)
- expression of a whole range of feelings, emotions
- choice making (engineer choices into each activity)
- directing action (follow the leader)
- expression of needs
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
- Move from requesting one activity to choosing between
two or more.
What is developmentally appropriate for young children?
Integrate communication with play or functional activity
- 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.
Follow the child's direction or lead: empowering the child and giving
him or her the control.
- 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
- 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
Keep questions and extraneous language to a minimum
- Child directed activities keep the child's interest and
- 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,
Expect delayed processing time
- 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
Reduce motor demands
- 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.
Minimize random activations
- Use eye-gaze frame and vest.
- Try a light pointer.
- Experiment with a flip chart.
Recognize the child's sensory needs and issues
- 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
- Ask for confirmation with eye gaze strategies.
- Successively eliminate choices. (verses in a song, building
Allow the child to withdraw and center and then continue at his own
pace, kids learn in short spurts
- Provide opportunities for the child to request and control
- Work with occupational therapists to evaluate sensory
processing and develop appropriate interventions
Self directed repetition (difference between getting bored with something
and assimilating something)
- Go with distraction and then entice the child back.
- Provide the child with a means to communicate about distractions.
Provide child with natural multiple opportunities
- 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)
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
Linda J. Burkhart
6201 Candle Ct.
Eldersburg, MD 21784