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Adapting Lessons to Support Students with Severe Disabilities


Lessons typically require that children count to complete a required task. For most children this will be a spoken response. For children who can’t use speech or other formal means of communication, you can help them perform counting tasks using one or more of the following approaches.

Counting requires that students have access to numbers or a means of tapping, clapping, vocalizing or in some way indicating that they are counting. One unaided approach to counting would involve having the student tap, clap, vocalize or otherwise make a gesture for each number while a partner says the number aloud. The student tells the partner to stop at the desired number by stopping with the clapping, tapping, vocalizing or gesturing. Sometimes it will be important for students to have access to the numbers themselves. Below a variety of ways of making numbers accessible to students with severe speech and/or physical disabilities are described.

Personal Voice Output Device:

If the student has a personal communication device, the device should be the primary means of aided communication. The teacher, teacher assistant, and/or school therapist may need to explore the vocabulary on a device or complete what is called a device walk with the student to locate the number. In completing the device walk, the communication partner locates the number on the device and shows the student how to locate it. This assists the student in accessing the number more quickly and also gives the teaching staff the opportunity to know if the number is present. If the required number is not present on the device, the staff will know to either program number into the student’s device or create a low tech alternative such as a number board.


Partner Assisted Communication Method:

A method of communication in which the communication partner identifies (by naming or pointing) the items in the selection set then waits for the student to signal (via a sound or movement) the item he/she wishes to communicate. The following is an example of how to use partner assisted communication:

Basic Partner Assisted Communication can be completed using the numbers on a communication board format.

  • The communication partner verbally and sequentially counts each number while pointing to them on the number board.
  • The verbal “cue” is number read by the communication partner.
  • When the person hears the cue representing the desired choice, he or she signals in some way using a consistent vocalization, movement, or simple voice output.
  • The partner confirms the selection “you want…”
  • Always have a way to say, “I don’t want those choices”.

Advanced Partner Assisted Communication can be completed using a group-item strategy gradually narrowing down the selection. In a counting task, this might involve grouping numbers by tens (0-9; 10-19; 20-29; 30-39; etc.).

  • The communication partner verbally and sequentially presents choices for selection first by group, once a group has been selected; each number in the group is presented one by one.
  • The verbal “cue” is meaningful for the individual using AAC, but is typically a single word or abbreviation for the selected message content (e.g., “zero-nine, ten to nineteen, twenty to twenty-nine).
  • When the person hears the cue representing desired choice he or she signals in some way using a consistent vocalization, movement, or simple voice output.
  • The partner confirms the selection “you want…”
  • Always have a way to say, “I don’t want those choices”.

These videos give examples of how to use partner assisted communication.

Handouts and links:

These websites provide information about what Partner Assisted Communication is and how to use it with students.

Use a paper or laminated version of the number board and use partner assisted scanning to provide the student with a means of selecting the desired number

Simple Voice output devices:

The student can utilize simple voice output devices to respond, answer questions, and participate in classroom discussions which include counting. The teacher can program the numbers into the simple devices and the student can activate the device at the appropriate time in the activity, to answer a question, etc. These devices can be borrowed from various resources such as North Carolina Assistive Technology Project lending libraries, school assistive technology teams, speech and/or occupational therapy departments, or purchased from vendors.

Websites for devices:

Eye Gaze:

Eye gaze communication options allow students with severe speech and/or physical disabilities the opportunity to communicate by looking systematically at a desired target. Eye-gaze eliminates difficult motor responses, but requires an attentive communication partner to observe the student’s gaze. Eye gaze is setup by the communication partner providing the student with communication options (i.e., number, words, etc.) via a translucent board of some type. The student is asked to look at the choices and then look steadily at the item they want to select, communicate, etc. This is called “holding an eye gaze”. Often times the communication partner will ask the student to look at the communication option then look back at the communication partner in order to clarify that the eye gaze observed was indeed the desired selection. Various products can be utilized to set up an eye gaze communication system. You can make an eye gaze frame from a sheet of Plexiglas or any other clear material (i.e., clear card protectors or baseball card holders). Number and/or words written on paper, index cards, or post it notes can be used to provide the communication options around the outside of the communication board. The middle of the board should be cut out and left clear in order for the communication partner to see the student’s eyes and be able to read the eye gaze.

Eye Gaze Videos/Websites:

These videos give descriptions of eye gaze and/or show different students using eye gaze in various ways to communicate.

The following website give descriptions of eye gaze boards and their use.

Light tech Options:

Light tech refers to no-computerized adaptations and supports. When devices or other computer options are not available the teacher can utilize light tech options to support communication, participation and learning. Laminated paper communication boards are one example of light tech options that can meet a student’s communication needs. The numbers, picture symbols, magazine photos, photographs, post it notes, word cards, etc. related to the science activity and/or question at hand can be arranged in tables in a word processing document, printed, and laminated for the student. Or the symbols can be cut out into individual cards and mounted on a piece of cardboard, a file folder, or foam core boards to create communication boards. Individual symbols can be attached using Velcro, clothes pins, putty, etc. so that they can be moved, presented individually or exchanged as part of the communication act. Often the teacher will show the student the symbols before asking a question, or explaining how the symbols will be used in the activity. The student can communicate by touching a desired symbol, looking at the symbol or indicating their choice through partner assisted scanning.


Light tech number board, A number page with specific numbers for the activity (i.e., up to 10, 20, etc.) written on it or made via board maker or some other symbol program.

Handouts on web: