Dbi review issue Number 45 • January – June 2010

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Colombian communication ministry

Supports its access for people who are deafblind

In 2007, SURCOE the National Association of Deafblind people in Colombia, based on National and International laws for disabled people, such as access to information and communication, proposed a project called “CONNECTING SENSES WITH DEAFBLINDNESS” to the Colombian Information Technology and Communication Ministry. The proposal requested the creation of Information Technology (IT) rooms, paid for by the government, for people who are deafblind and people with multiple disabilities, to access the latest technology.

The way this works is that SURCOE selects a city where they know people with deafblindness live; they arrange a visit to present the plan to the authorities to set up the accessible IT room. They arrange for a meeting with government and non government organizations’ representatives. The organizations are invited to be part of the Project, encouraged to include this project as part of their own organizations’ action plans, as a way of guaranteeing their long term sustainability. From the participants attending these meetings, a local organizing committee is formed to guarantee availability of the following equipment and services:

– Accessible space and internet access for the people with disabilities

– Furniture and equipment (including insurance)

– A co-ordinator responsible for the service.

Once this is all in place, SURCOE signs an agreement with the organization(s) and offers training in deafblindness and IT to the coordinator, the users and the community leaders, who can themselves serve as future trainers to other people with disabilities in that city.

The next important step is to develop public awareness of the project. This is done with all the organizations that participated in the initial meeting, through arranging media events in the community and visits to the various institutions serving people with disabilities.

The final part is the monitoring and evaluation of the project to determine its impact after the first year of operation. During this period, SURCOE offers advisory support to the coordinator and the users as the need arises.

Through this project, SURCOE is ensuring that there is the funding for more people who are deafblind and isolated in different cities in the country, to access the technology, read a book, use the internet, hear music or chat with friends. As of May 2010, this program serves 1703 people with multiple disabilities including deafblindness in 12 cities throughout Colombia. There are plans to establish this service in four more cities during the second half of this year.

For contacts or information, please contact sordociegoscolombia@gmail.com

Supporting the development of literacy in deafblind children

through interactive dedicated software: a pilot project

Ben A.G. Elsendoorn1, Peter Brouwers2 and Hans Luiken1,2


Aim of the project was to investigate whether the introduction of computer-controlled interactive activities and exercises could contribute to the development of literacy in a deafblind student with additional spasmodic motor problems. Special exercises were developed using dedicated software. Functional specifications were drawn up by the teachers who also supplied the linguistic content of the exercises. The types of exercises were conform to what was described in the child’s personal development plan. All exercises were gradually introduced to the child who learned to work independently. In the end the exercises also turned out to be valuable additions to the curriculum of other deafblind children.


It is essential that the development of literacy in children with disabilities should be supported as much as possible by creating optimal circumstances in the classroom (Justice and Pullen, 2003). However, it has been noted that there is an unfortunate lack of research that aims at investigating how children with visual and multiple impairments, such as deafblindness, can best be supported (McKenzie, 2009). There still is a vast, uncultivated area of strategies that can be employed to support literacy development. This article will present an example of educational software and exercises which was designed for one specific deafblind child with spasmodic motor problems (who will be named M, hereafter), but which can also be used for other deafblind children without this additional constraint. The children are all students at the Royal Dutch Kentalis Rafael School for deafblind children. They vary in age between 5 and 18 years.

M is a nine-year-old, male child with very restricted visual capacities and limited residual hearing. In addition his motor skills are severely hampered by spasms, which prevent him from working with a computer using standard keyboard and mouse controls. M sits in a wheelchair which has a mounted restraint with a button that can be operated by the child’s head to register his reactions in the computer system. Teachers expected that M’s autonomy would increase as a result of the exercises: M would be able to select the exercise he wants to do and to autonomously finish a particular exercise. This could have a favourable effect on his well-being.

According to his teachers, the language development of this deafblind child with spasmodic limitations was judged to lag compared to his cognitive capacities. By means of extra exercises it was thought to be possible to increase his linguistic competence. However, adequate computer programs which would allow independent training were unavailable in Dutch. It was decided to develop a framework with a number of different types of exercises which could be filled with different linguistic content in order that they could be used repeatedly for different end-users with dissimilar levels of linguistic competence.

Educational pathways are established for all students at the school in their Personal Development Plans. The goals for M were the following:

• Controlled education to learn clicking by means of a one-button switch.

• Expanding his vocabulary.

• Recognition of words on the basis of their shape and contours.

• Development of his capacity to analyze and synthesize words with a maximum of three syllables.

• Stimulation of auditory processing of information.

• Understanding of a short story (presented auditory and visually).

• Relaxation through repetition and predictability.

• Coupling amounts to numbers.

• Managing educational exercises (puzzles and matching exercises).

• Developing a feeling of competence.

To this end various types of exercises were developed according to a specified framework, which could be filled with a diversity of linguistic content depending on the various targets accomplished at a certain point in time. Evidently the exercises that are presented have been previously selected by M’s teacher to fit in with the Personal Development Plan. A variety of exercises have been developed and include action-reaction, matching, associating, sequences, reasons and results, relation between phonemes and graphemes, vocabulary, picture books and development of numeracy.

Exercises were developed using the Classroom Suite authoring tool by Intellitools. Research showed that using Classroom Suites versatility provided significant improvement of reading performance for first grade students with disabilities or reading problems (Howell, Stanger, Erickson & Wheaton, 2000). Off-the-shelf software hardly ever does justice to a student’s individual capacities, but with this system it is possible to develop exercises that focus on a student’s competence in a specific modality. The authoring tool takes learning which is based on anchor stories as a starting point and can also be used in addition to an existing curriculum. Nearly all representations of language, such as written text, (synthetic) speech, sign language movies, and pictograms can be used in combination with video and images. By carefully noticing what the student needs the exercises can link up to his residual functions and his perception.

Functional specifications of the computer system and application

Teachers of the school for deafblind children were asked to supply functional specifications for the application. Computer-control by M is carried out by means of a one-button switch, which he operates with his head. Since M cannot select from multiple options by a simple mouse click the possibility of making a choice has to be indicated in a different way. Exercises had to be developed in such a way that all possible choices were presented simultaneously on the screen. Each option could be activated in turn for a limited period of time. The active option is indicated by means of a blinking cursor underneath or, in the case of images, by highlighting the selectable picture. By pressing against the head switch, which then will function as the left mouse button, M can make his choice.

Because of his decreased visual capacities colour and contrast have been adapted for M; images, buttons can be enlarged and characters can be presented in different sizes against a contrastive background. M prefers character type Comic Sans in size 72 pts. They are presented in black on a yellow background, as this is M’s preferred contrast and colour combination. The program uses a 22-inch lcd full-colour monitor.

Exercises are presented in a scanning mode, which means that all choices are simultaneously presented but remain clickable in turn for a certain period of time. This duration of this period can be determined by M and it allows him to select his own exercise. Because of his deficiencies M will have variations in processing durations. Being able to determine by himself the moment he makes a choice or gives an answer not only decreases the number of incorrect answers, but also gives him a feeling of autonomy. Of course a maximum time slot has been set in which M is considered to be able to give a reaction. By means of trial and error this time slot has been adjusted such that he is allowed to give a response without getting frustrated. At the end of each exercise, and sometimes even after each given response, M will be rewarded by means of a sound-supported, moving animation sequence.

It is known that working with a computer can be very demanding for M due to his multiple sensory and motor impairment. The activities will therefore never exceed a thirty-minute duration. In addition, M’s mood can be frequently subject to changes owing to his spasms. The degree in which spasms may occur are also influenced by external factors: loud sounds have a negative effect on M’s well-being and may cause an increase in spasms. It is also known that his spasms will increase with age.

M regularly needs help because of his uncontrolled movements. His computer configuration is such that he can work as independently as possible. The one-button switch has been mounted and fixed to his wheelchair such that it is not affected by M’s spasmodic movements.

Developing activities and exercises

M’s personal development plan indicated that introducing new words or concepts could best be supported by images. These should represent objects that are familiar to him. (For another student it is obligatory to use her teacher’s own voice, because she cannot handle other voices in an instruction situation).

Exercises have been put together in cooperation with and on the advice of various personal coaches. If necessary, the initial versions of these activities could be adapted in a second development round. Observing M doing these activities in the classroom and through conversations with his teacher we started to comprehend the effectiveness of the activity. In some cases this understanding resulted in either the activity getting adapted or in changing the way in which M was instructed in how to carry out the exercise.

To increase M’s feeling of autonomy it was decided to present him with the possibility of selecting one of a number of different exercises. To facilitate his choice the exercises were printed on a sheet with stickers. M would choose one exercise, whereupon the teacher would remove the sticker from the sheet and stick it in M’s personal calendar book. Next M would carry out the specific exercise on his computer.

It appeared that concentration played a very important role in changing or selecting an exercise. Therefore the teacher disabled the one-button switch during the instruction stage. This made it possible for the teacher to discuss the choice of the next exercise and for M to better focus on the conversation.

Repetition is of utmost importance to have knowledge rooted in students with such limitations. Hence in some activities, such as the picture book in which the story is read aloud, the student has the possibility to use the function “previous page”. By clicking this the same part can be listened to once more. When the student has autonomously listened to the picture book several times, the teacher may decide to disable this option.


Hitherto a total number of 85 different exercises have been developed for deafblind students at the Rafael School, of which 50 have been especially designed for M. A few of them will be described in more detail here. The simplest one is a detection and action-reaction activity: two images are presented and M can select either one of them. When he does, the selected word will be pronounced. At a later stage, two images were presented. The corresponding word of one of them would be read aloud and M would be requested to indicate which of the two was pronounced. At a more advanced level M would be shown pictures of people known to him and be asked to match the written name of one of them with the corresponding picture. At first these names would be pronounced, but at a later stage only the written name would be given. One of the picture books developed for M dealt with his holiday period with his grandparents. M would be able to go through this picture book at his own pace. Other exercises have been developed to train M’s visual memory, e.g. when the task was to tell the hiding place of a particular object or to perform a memory task in a 3 x 2 field.

For a few older students exercises were made with content in English. One particular task was to match the written denomination for a specific colour to the corresponding patch. In other tasks they were asked to match the written number to the corresponding symbol or carry out a memory game with numbers in English.

The main focus of the project described here has been on the development of a framework consisting of a range of exercises according to a particular outline or template. Linguistic content could be provided at various levels, depending on whom these exercises were intended for. For the students that have used these exercises in this experimental stage of the project no baseline has been established which would give a measure of their linguistic proficiency level at the start of the project. It has never been the scope of this project to investigate whether they would learn more quickly with these exercises than without them. What we did find beyond any doubt, is that the activities and exercises contributed positively to the expansion of their vocabulary and their linguistic proficiency, regardless of the fact that in most cases it still remained at a very basic level.

The activities definitely contributed to the feeling of autonomy with M. He reacted very enthusiastically to the fact that he was able to pick an exercise all by himself. His reaction was so vehement at times, that he would be seized by another spasm attack. Consequently, the teacher had to be present to help at the initial stages of a new exercise. It appeared that M could work increasingly autonomously when he became more acquainted with the (type of) exercise. M would give more and more verbal reactions because he was aware of the next step in the exercise.

At the start of the project it was decided that the Rafael teacher responsible for the school’s information and communication technology would participate in the project. He was trained to work with the Classroom Suite authoring tool and would ultimately design his own exercises and exercise templates. It was hoped that by doing this, knowledge on how to work with the authoring tool would be secured in the school itself and knowledge could be transferred to other teachers at the school.

As the number of exercises and activities increased, so did the database with material consisting of images (photographs, pictograms, drawings), audio (spoken words, sentences, texts and songs), video (movies and sign language movies), which were classified according to topics and themes. Teachers working with this database will ultimately adapt it to their own situation, which will make the database increase in size.

At present both the project and the software are being implemented in School Rafael. The system has been extensively presented to the school’s teachers. They were given an overview of the programs possibilities. Workshops will be organized for them where they will be taught how to work with the authoring software so that they may start developing new exercises themselves. Since teachers have witnessed the results obtained with M, many of them now want to implement the software and the accessory exercises in their own educational practice. The choice to predominantly carry out this project in the school has resulted in a large acceptance with other teachers. For the moment, exercises and activities have been made available in the form of templates, which can be filled with linguistic materials by every teacher. As a result the project has turned out to be very flexible and employable for nearly all students.

1 Royal Dutch Kentalis, PonTeM – Department for Research & Development, Sint-Michielsgestel, the Netherlands

2 Royal Dutch Kentalis, Rafael School for Deafblind Children, Sint-Michielsgestel, the Netherlands


Howell, R.D., Stanger, C., Erickson, K. and Wheaton, J.E. (2000) Evaluation of a computer-based program on the reading performance of first grade students with potential for reading failure. Journal of Special Education Technology 15 (4), 5-14.
Justice, L. M., & Pullen, P. C. (2003). Promising interventions for promoting emergent literacy skills: Three evidenced-based approaches. Topics in Early Childhood Special Education, 23, 99–113.

McKenzie, A.R. (2009) Emergent literacy supports for students who are deafblind

or have visual and multiple impairments: A multiple-case study. Journal of Visual Impairment and Blindness, 103(5), 291-302.


This research project was financially supported (in part) by grants of the Johanna Kinderfonds, the Revalidatiefonds and the Skanfonds.

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