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Using sound to understand the environment and to be able to handle the surroundings for a person with severe visual impairment and autism.

Focus: School years

Topic: MDVI

MajBritt Edlund

Special-education teacher,

Gerd Tobiason Jackson

Special-education teacher,

Gunnar Lönngren


Swedish Institute for Special Needs Education

Resource centre vision

Box 9024

SE-700 09 Örebro


Tel. +46 19 6762100/exchange: connection 158


A case study within the Nordic project about “Persons with visual impairment and autism related difficulties”. The project time period is 2000-08-01 to 2002-08-01.

In our profession we meet children and juveniles with severe visual impairment or blindness who spontaneously use sound and react to it in a functional way.
When it comes to children and juveniles with autism, sound may be disturbing to them, according to literature. Today the collected knowledge is very limited about how to meet children and juveniles with severe visual impairment or blindness in combination with autism.

The children/juveniles with severe visual impairment/blindness create their own sounds with objects, they create their own mobility sounds and they react to sound or they don’t react to sound. Children and juveniles with autism related difficulties have a different way of understanding and interpreting their sensations, especially when it comes to perception of touch and sound. Some show no reaction to strong sounds but react to very weak sounds.

Today we know quite a lot about pedagogy for people with autism as well as pedagogy for people with severe visual impairment/blindness.
A lot of the pedagogy for these two functional disabilities is/can be contradictory. The pedagogy for people with autism is mainly based on visual  information. The pedagogy for people with severe  visual impairment/blindness is mainly based on tactile and auditory information.
We have chosen to focus on the auditory information in order to better understand “What is happening in what appears to be happening” since we meet children/juveniles with different visual impairments who live in a ”world of sound”[1].

Our study is trying to answer the following questions:

What meaning does sound have to people with both of the functional disabilities, severe visual impairment/blindness and the diagnose autism?
How can we make sure that their strongest senses are employed when carrying through activities?

We have documented everyday situations in our school environment through 28 video recordings, carried out during a few days. These recordings have been analysed.
Our object of study is a 14-year-old girl who came to Sweden in 1991, and she is diagnosed to have autism and ROP (Retinopathy of Prematurity).

In this material we can gather that our object of study most commonly reacts by doing a [2]sound object identification” after the introduction of the focus sound. We can also see that her sound object identification is tactile in most cases. We see that she identifies sounds much more often than she identifies people and objects.
We also see that she prepares for sound object identification a number of times. The most obvious example would be when she shifts her cane from one hand to the other to be ready for sound object identification.
We see her “sound response”. Every sound response observation note indicates her showing a physical and emotional sound response.
We can also see that she carries out simultaneous behaviours. She carries out tactile behaviour along with verbal behaviour, tactile behaviour along with other tactile behaviour and gross body movements along with fine motor skills.
Finally, in this material we see that occasionally she performs initiation, the conclusion of an activity and the shift of focus (from an activity of her own to a parallel activity carried out by another pupil).

We have also tried to look at whether our object of study can do a sound object identification regardless of other competing sounds, presented at the same time as the focus sound. Five times out of eighteen she managed to identify objects in spite of the competition from other sounds. On all these five times the competing sounds were adults talking.

Furthermore we have tried to describe how our object of study examines objects when a focus sound has been presented. We have studied seven video sequences in which our pupil is the transmitter of focus sounds and where she handles objects. We notice that the most common pattern is that she touches the object once or twice when she examines it. On most occasions she uses just one hand, the right one, to examine objects. However, on four occasions out of eighteen she also examines objects with her left hand or left half of her body. In two of the seven video sequences we notice that she shifts from one hand to the other/crosses her body centre line when she examines objects.
In these sequences we have also noticed that our pupil is performing her own initiated conclusion of an activity. On five occasions this takes place through her verbal sound object identification and on  four occasions through her motor movements. During two of these sequences mentioned she finishes the activity by using both ways of expression.

As we study the adults present and their way of working together with our object of study, after the presentation of focus sounds, we can gather that in most cases they confirm our pupil. Moreover the adults explain, teach and illustrate. They also urge and encourage, and they wait. This means that the adults in our material to a large extent support, help and encourage our object of study in situations where sounds are presented. But we can also notice that the adults act in a controlling and predicting way. This means that there should be more to learn about the ways to behave and act in view of the pupil’s reactions to sound presentation.
If we study the category control we discover that on every occasion where adults have acted controlling towards our object of study after a sound presentation, the control is aiming towards developing a tactile behaviour or tactile experience for our object of study.
The category prediction shows that the adults have anticipated the sound reaction of our object of study.

We also see that the adults confirm about half of the sound object identifications performed by our object of study. In this material adults clearly confirm verbal sound object identifications more often than tactile ones.

We have also tried to study the interaction that grows/never shows between present adults and our pupil. Interaction, by our definition in this case, is that our object of study and the adult in question show a mutual direction of attention.
The category no interaction constitutes 29% of our interaction notes. This means that on these occasions there is no interaction taking place according to our definition after the presentation of a focus sound. This means, on the other hand, that 71% of our notes show some kind of interaction between our pupil and the adult/adults.
Still, we say that the interaction doesn’t get really interesting until it involves four steps. Not until then we can see that our pupil and the adults are participating actively (active=minimum two contributions to the interaction). This interaction constitutes about 21% of our interaction notes. So, we see that our pupil and the adults are interacting in a way that is interesting to us.

Do we mean that the behaviour of our object of study when handling objects, from the study results presented, is a repetitive and ritualistic process or do we suggest that it is functional?

The results show that she touches the objects she handles just once or twice. Our object of study shifts hands and crosses her body centre line in only two out of seven sequences.
She performs her own initiated conclusion of an activity in five out of seven sequences.
We suggest that this material indicates that her way of handling objects after the presentation of a focus sound is not repetitive or ritualistic, but rather functional.

In the light of the abovementioned reason, we ask ourselves the following:

Is it easier for adults to pay attention to and confirm verbal expressions compared to tactile expressions, in interaction with the target group?

Is it a general adult notion to regard the use of sound as an expression of lower intellectual function?

Definitions of words used in our paper

cross body centre line – where a movement goes from left to right or the other way around

focus sound – the sound after which we observe the pupil´s reactions

mobility – moves and movement

prediction – the adult reacts before the pupil does

sound object identification - means to identify a sound or where the sound came from – tactilely or

verbally, i.e. to name it or touch it, to express the origin of a specific sound

sound response – shows a reaction to have heard something and responds

world of sound - the world of sound includes the immediate environment and the surroundings of the pupil

[1] The world of sound includes the immediate environment and the surroundings.

[2] Sound object identification means to identify a sound or where the sound came from – tactilely or verbally, i.e. to name it or touch it, to express the origin of a specific sound.

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