Ask his family or others who know him best what he does at home. Try introducing – at his pace – a variety of actions, people, and objects. Here are some suggestions:• Consider the size, temperature, texture, function, sound, sight, taste, smell, and movement in the activities, actions, or items you offer.• Observe how the student uses his senses. Which sensory channel(s) does he rely on the most: vision, hearing, touch, smell, taste, or movement such as spinning, swinging, tapping a hand.

• When observing the student, watch for behavior that may show a LIKE or DISLIKE of the object, action, or activity introduced to him:

  • Change in breathing
  • Slight body movements
  • Muscle tension changes
  • More or louder vocalizations
  • Mouth opening or closing

  • Can he move his head, lips, a finger or a toe?
  • If the student constantly whines or frowns to show displeasure or discomfort, does that stop when presented with something novel, for example, a warm neck wrap? a resonant drum?
  • Start a list. Keep data on how often you’ve presented the activity, action, or item, and the student’s responses to each. Watch for very subtle responses (such as those listed in FAQ #1).

For a variety of reasons, children with significant disabilities sometimes recoil from touch or dislike exploring through touch. They may have experienced frequent hospital visits and have come to connect new people with painful procedures. It takes time to build trust. Here are some approaches that may help establish trust with a child with significant disabilities. The result will be a student who is more willing to accept touch and use touch for exploring:• Tap the student on the shoulder and say hello before trying to move the student’s hands, feet, or body.• Provide consistent opportunities rather than forcing participation.

• Use a Hand Under Hand approach (your hands under his) to introduce new things.

• What about temperature? Does he prefer warmth? If so, try warming a washcloth, neck pack, or other object in the microwave and see if that makes it less aversive.

• Ask the person who has the most positive interactions with this student how they help the student accept objects or actions. With permission, videotape these positive interactions and observe carefully.

• Set up a schedule and follow it consistently so that the student can anticipate what will happen next.

Some students have been moved through the day with little meaningful interaction or decision-making power. What may work for nursing care does not work for learning and can create what’s called “learned helplessness.” If this has happened with your student, your job is to be consistent, persistent, and kind as you offer continued opportunities for meaningful learning. These “opportunities” may include things like “wait time,” or use of a Resonance Board or adapted Little Room. Here are some suggestions and things to keep in mind:• Have you tried Hand Under Hand to develop a shared focus of attention?• Watch for subtle changes in the student: body tension, breathing rate, or turning her head from the item or action. (See FAQ #1 and #2.)

• Know the student’s temperament. Some people are easy going and “go with the flow.” Some are “feisty” and protest often. Others may be less outwardly expressive, yet actually are enjoying an activity, action or object.

• A combination of strategies can allow a student to move from passive to active, from protesting to tolerating, and eventually to active participation. This process may take weeks, months or years, so keep data on each small success.

Always continue to search for more experiences and objects that will broaden a student’s interests and become “likes.” Keep in mind:• What qualities does the electric toothbrush have that might lead to other LIKES? For example, make a smoothie with a blender and let him feel the vibrations of the motor. Try a small electric fan, one that is safe for exploring fingers. Or try a battery-operated pillow.• Allow the electric toothbrush to be used as part of concept building. For example, make a box of related things – other toothbrushes, toothpaste – plus one thing that doesn’t belong. As the student does this activity, allow a certain amount of time for him to play with the favorite toothbrush. (Set a timer.)

• Allow time for him to use the toothbrush when it is appropriate – for example, after lunch for toothbrushing.