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Developing Communication and Access Skills: Children Who Face Severe Physical and Multiple Challenges

This event is open to the public


The HSC Pediatric Center
1731 Bunker Hill Road NE, Washington, D.C. 20017
Conference Rooms A, B, & C

Are you working with children who face severe physical and multiple challenges in addition to complex communication needs, such as Cerebral Palsy, Rett Syndrome or Traumatic Brain Injury?  Do you find them struggling to juggle the challenges of motor coordination, sensory processing, communication, language, vision and cognition needed to effectively communicate what they are thinking?  For many of these children, direct access using their hands to operate a communication device or access a computer is not an effective strategy.  In addition, for some of these children, cortical visual impairment complicates this process even farther.  

Where do you start? How do you motivate children to engage their brains in an active learning process? How do you tap into the child’s communicative intent?  How will the child make choices and experience the flow of conversation?  How do you develop language skills so that children can begin to communicate what they are thinking?  How do you teach motor skills for accessing communication devices and computers? How do you provide a comprehensive adapted communication learning environment for children who face such significant challenges? This two-day course will cover a range of strategies to answer these questions.  

Characteristics of Cortical Visual Impairment (delineated by Dr. Christine Roman-Lantzy) will be presented in terms of strategies to develop vision, communication and access skills.  The use “Light Tech” partner-assisted communication books and strategies will be demonstrated.  Organization of vocabulary by pragmatic intent (PODD), based upon the work of Gayle Porter (Melbourne, Australia), will be introduced.  (Please note that this is not an official PODD course)  Strategies for moving beyond cause and effect to two switch step scanning will be detailed within a systematic framework of stepping stones (Burkhart). Come and explore creative and practical strategies to overcome these complex barriers to language and learning.

At the end of this 2-day course, participants will be able to:

  • Describe the challenges faced by teachers, therapists and parents working with children who present significant multiple challenges and who are often not “testable” by traditional means of assessment. 
  • Discuss how the brain develops and describe implications for teaching and learning for those students who are developing differently
  • Give practical examples and strategies to increase motivation, active engagement, and participation, based upon how the brain develops and processes information
  • Discuss the characteristics of children who have cortical vision impairment and describe effective strategies for helping these children develop vision and communication skills. 
  • Describe AAC strategies currently used with children who have severe multiple challenges and explain what is typically missing in this approach
  • Discuss the importance of receptive language input and describe the process for creating an aided language learning environment 
  • Briefly discuss the concept of pragmatic organization of vocabulary (PODD) for beginning communicators, and give examples of how this is used with multi-modal partner-assisted communication strategies. 
  • Discuss the difference between autonomous and independent communication and explain the importance of autonomous communication for the beginning communicator.
  • Describe strategies for teaching a yes/no response for the specific purpose of partner-assisted scanning.
  • Describe the motor-cognitive learning process for developing automaticity of motor skills
  • Describe the juggling act for children who have severe multiple challenges, and explain the importance of parallel programming in learning access skills including switch access and eye-gaze
  • Describe the ‘Stepping Stone to Switch Access’ (Burkhart) progression for learning to use a single switch for multiple purposes and locations,  using two switches for two functions for discrimination and problem solving, and then steps to learning to scan
  • Discuss creative strategies and software setups to motivate and teach skills in the areas of play, communication, emergent literacy, and communication utilizing two-switch step scanning.



Linda J. Burkhart Background

Linda Burkhart is an internationally known leader in the field of assistive technology for children who face severe challenges.  She has developed numerous adapted devices, activities, and innovative implementation strategies.  She is the author of a number of books and software titles on topics of adapted play, assistive technology and augmentative communication. 

Linda was a classroom teacher for fifteen years. Then for eight years, she worked as an Augmentative Communication and Assistive Technology Specialist for the Center for Technology in Education - a joint project between the Johns Hopkins University and the Maryland State Department of Education. Currently, Linda works as an assistive technology and communication integration specialist, trainer, and private consultant.


Dates: August 15, 2019 - August 16, 2019

Price: $275 (limit 30 participants)

CEU: 13 Hours

A cafeteria is available on-site 

Register for the course 

If you have any questions, please contact Jessica Fisher at