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Adapting Lessons to Support Students with Severe Disabilities


Lessons typically require that children are able to recognize and demonstrate recognition of items in some way. For most children this will be accomplished through a spoken or physical interaction. For children who can’t use speech or other formal means of communication and have significant physical difficulties, you can help them recognize items and demonstrate their recognition of those items by using one or more of the following approaches.

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., photographs, picture symbols, 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). Picture symbols, photographs 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.

Items can be held up one at a time and the student can signal when they see the one they are supposed to be recognizing.

Yes/No Board:

Many students with severe speech and/or physical disabilities are able to indicate a reliable yes/no response via eye gaze to yes/no symbol or words. Others have specific movements that represent yes and no for them (i.e., look up for “yes” and over to the left for “no” or use head nods, etc.). A simple yes/no board can be made out of poster board, ethofoam or other material according to the student’s needs and whether the student will look at or touch the target yes/no items. A yes/no board can be used via eye gaze, partner assisted scanning or direct selection(touching) to indicate the desired response to questions or express other needs within activities.


Simple Voice output devices:

The student can utilize simple voice output devices to respond, answer questions, and participate in classroom discussions. The teacher can program messages 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: