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Adapting Lessons to Support Students with Severe Disabilities


Lessons typically require that children write in journals, etc. to document results in some way. For most children this will be a written response. For children who can’t use their upper extremities to write or type, you can help them write or perform written communication by using one or more of the following approaches.

Simple Voice Output:

The student can utilize simple voice output devices to respond, answer questions, and participate in classroom discussions. The teacher, assistant or student partner 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.


Record what needs to be written on simple voice output device, let student activate the device and someone else writes it down for student.

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., 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.

Alternate Pencil:

Students with significant physical disabilities often cannot use their hands for writing. They must learn to utilize an alternate way to perform writing task. The Center for Literacy and Disability Studies at the University of North Carolina at Chapel Hill has developed alternate pencils that students can use via partner assisted scanning or eye gaze communication. This website explains what alternative pencils are and the various types available:

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 desired vocabulary. In completing the device walk, the communication partner locates the desired vocabulary items on the device and shows the student how to locate them. This assists the student in accessing the vocabulary more quickly and also gives the teaching staff the opportunity to know if the vocabulary is present. If the needed vocabulary is not present on the device, the staff will then have to decide to either program the target vocabulary onto the student’s device or locate words that could be used to describe the target vocabulary (i.e., if student doesn’t have the word volcano they could use the words hot mountain) so that the student can successfully communicate during the activity.


Use student’s device with symbols, spell page or a combination of both, this can be hooked up to the computer to print out work or someone can copy what is written on the message window of the device.



If their speech is intelligible, students can dictate to communication partners who in turn write down the information for the students.


Various types of software options are available to assist with writing. Onscreen keyboards can be utilized to provide keyboard access. These software programs place a keyboard onto the computer screen and the student then accesses the onscreen keyboard via their determined access method (i.e., mouse use, scanning, etc.). Another type of software that can be utilized is voice recognition software. This software requires that the student has good speech ability. This software will type out into word processing software what the student verbalizes.

Adapted Keyboards/Equipment:

There are various types of equipment that allow individuals with motor difficulties to access the computer for writing. There are a variety of alternative keyboards, trackball, etc. which the student can access via various means. Some of these options are described in more detail at the following sites:

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 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. Handouts on web:,%2...