Adapted Play in Early Childhood

Adapted Play in Early Childghood By Ellie Hamilton

Adapted Play in Early Childhood early childhood

Children learn through play. Young children with special needs may have difficulty participating in play activities. Par- ents and providers can use a variety of modifications and adap- tations to help a child take part in and learn from play. Children with motor, visual, hearing, cognitive, emotional social or com- municative disabilities may need support or specific interven- tions to facilitate their play. An intervention is a specific program or set of steps to help a child improve in a specific area of their developmental discrep- ancy. Each child is unique and will need individualized interven- tion based on their needs. An intervention is specific and for- malized; it lasts weeks or months and is reviewed during specific intervals. Many school districts use the Response to Intervention System (RTI) or Multi-tiered System of Supports (MTSS) to help struggling students. WHAT IS ADAPTED PLAY? Often children with disabilities do not know or understand how to play. Adapted play is modifying and adapting games, activities and toys based on an individual child’s interests and needs. This includes imaginative play. Accessing toys can be an obstacle for some children due to their disability. A child in a wheelchair may not be provided the same amount of tummy or

floor time as a typically-developing child. The lack of exposure to toys and movement may impact their access and experiences with play. A young child with a visual impairment will not have the same experiences as their typical peers. Young children with disabilities require access to toys and assistance in learning how to play. Often Individualized Education Plans (IEPs) or Individualized Family Service Plans (IFSPs) are based on goal-focused instruc- tion. If a child is delayed in the area of physical development, they may have a goal for physical therapy that is focused on walking. If a child is delayed in the area of communication their IEP or IFSP goal may focus on talking. When we have children who are medically fragile we focus on their health needs. Young children with disabilities need to have their goal focused in- struction centered around play. Young children need to have access to play and our children with disabilities will need for their play to be adapted and ac- cessible. For children in the birth to age three category, we do have some focus on play within the home visit settings. Often, preschool students have pressure to perform and work toward state common core standards. Teachers, parents and providers may focus on other areas when play should be the focus of their young child’s goals. Play provides children with their first oppor-

ELLIE HAMILTON M.A. Ed, Preschool Teacher, Special Education Consultant, Moravia, IA. Ellie is a Preschool and Early Childhood Special Education Teacher for Moravia Community Schools. She is a licensed Special Education Consultant. She served as an Assistive Technology Specialist for the Great Prairie Area Education Agency, a leading service agency in professional development with the goal of helping all students achieve and schools to continuously improve. Ellie has served on the Iowa Department of Education Preschool Specially Designed Instruction team and on the Iowa State Assistive Technology Leadership Team. She received her B.A. & M.A.Ed from the University of Northern Iowa. As well as, completing a graduate certificate in Autism Spectrum Disorders from the University of St. Thomas. Ellie is currently working toward her Iowa PK-12 Principal and Special Education Supervisor administrative endorsement. She is passionate about AT, AAC, and inclusion for children who are differently-abled. She lives in southern Iowa with her husband and two sons.

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support imaginative play for children with disabilities. The main characters are Elephant and Piggie. In the book, Piggie says he is a frog. Elephant becomes worried about Piggie acting like a frog. Piggie is in fact a pig. Piggie explains that he is “pretending.” Piggie goes on to describe that pretending is acting like some- thing you are not. Piggie asks Elephant to pretend to be a frog. Elephant decides to pretend to be a cow. The book I’m a Frog by Mo Willems can be used to introduce the concept of imagina- tive play and to support imaginative play in the classroom and at home for young children with disabilities. Children with disabilities need to have access to toys. Toys will need to be adapted to meet the needs of the individual child with a disability. The child’s interests and preferences will need to be considered. Toys can be extended or built up for a child to have a better grip on the item. Toys may need to be stabilized in one area. The area may be a table, tray, highchair, or the floor. Toys and games may need to be simplified for children with disabilities to access. Toys or other play objects will need to be kept in close range to the child to facilitate play. Areas on the toy, game, or object may need to be highlighted for the child. If the child has a color preference the color can be used to highlight the object. Toys and games need to be kept within the child’s field of vision. Parents should bring toy access considerations to the IEP or IFSP team meeting for problem-solving and goal setting specific to the child’s individual needs.

tunities for communication and, as participation increases, it au- tomatically improves the quality and quantity of opportunities (Beukelman; Mirenda, 2005).

Developmental Doman

Example Play Activity

Adaptive Behavior

Ask for help social story in the dramatic play center Turn-taking games with family or peers

Communication

Fine motor

Draw with peers at the Art center

Gross Motor

Join peers, touch toys, access a switch toy, and take turns with peers Use a feeling card during play to ex- press feelings

Social-Emotional

Play is crucial for child development. Games give children pleasure and encourage them to go further, repeat, try and learn from their experiences (Ferland, 2006). Unfortunately, in the hustle and bustle of working toward core standards gameplay can be minimal or nonexistent. Peer-mediated Intervention is an evidence-based strategy for young children with disabilities that can be implemented to sup- port play. Typically developing peers are selected and taught to recognize and appreciate differences. The peers are taught the target behavior that will be used to facilitate the intervention. The adult leading the intervention plan should first model the use of a strategy. After the adult has modeled the intervention plan the peers can role play with one another to practice the skill or strategy. It is recommended that the assigned peer interacts with the child with a disability for 15 minutes daily. Imaginative play is essential for child development. Our cur- rent reality of regular screen time can limit opportunities for imaginative play. Children who have access to regular screen time may imitate the play or scenarios they have viewed on the screen instead of creating their own imaginative play scenario. Developmental psychologist Thalia Goldstein, Ph.D., studied 97 five-year-olds enrolled in Head Start programs. The kids were split into three activity groups. One group pretended to be ani- mals or other people; one group was read to, and a third group built with blocks. What was discovered was that the children who were in the dramatic pretend-play group increased their emotional control over the course of eight weeks during the study. Kids are learning what their emotions feel like in their bodies, what their emotions feel like in themselves and how they can begin to modulate and control those emotions. My challenge to providers, therapists and parents is to pro- vide access to play instead of pulling children out of play. IEP and IFSP goals should focus on play for all children under the age of six. The foundation of learning for children in the early childhood years is play. Our children with disabilities need to have play incorporated into their specially designed instruction. The children’s book I’m a Frog by Mo Willems can be used to

There are six stages of play • Unoccupied Play (birth-three months) • Solitary Play (birth-2 years) • Spectator/onlooker behavior (2 years) • Parallel Play (2+ years)

• Associate Play (3-4 years) • Cooperative play (4+years)

Often children with disabilities can get stuck in one stage of play. If providers focus on teaching a child how to build a tower and never move on to how to create a shared structure the child may become stuck in one stage of play. If a child has had limited access to play, they may be in an early stage of play and need in- tervention to move toward a more developmentally appropriate stage of play. As a child has access to experiences they will move through the stages of play. Children who are medically-fragile may have very limited exposure to play which impacts their overall development and stage of play. DIY (do it yourself) or Upcycling (whatever you want to call it) is one way to incorporate play for young children with dis- abilities. Providers that enter the home for children with IFSPs or those who are at home due to the child being medically fragile can bring in a simple empty paper towel or tin foil roll and ask the families to save them instead of throwing them out. Play- ing with a paper towel roll can be associated with fine motor standards for gripping, picking up, and hitting the objects to-

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Minute Filler document includes core words and examples of how to use the words for needs and wants, getting and giving information, and social interaction. The Mr. Potato Head Five Minute Filler document could easily be sent home for a student to practice using their core words in an adapted play setting. The family and providers would have access to the same document and could highlight words that are used for quick and efficient data collection. Dr. Lilli Nelson’s Theory of active learning states that active learning is based on the belief that ALL children can learn. Chil- dren need environments created that encourage active explo- ration. Parents and caregivers should not interfere with play, meaning we are not guiding the child’s hands or telling the child what they should do. Dr. Lilli Nelson recommends encouraging the child to be an active participant in their own learning by cre- ating spaces and presenting materials that are interesting and safe to explore. The play environment should be responsive, something should happen when a child moves or hits some- thing. The Activity Gym by Enabling Devices incorporates lights and sounds. Providers can change the toys and placement of items. DIY water or sensory walls can be created with household items to encourage active learning exploration.

gether. Using the paper towel roll to whisper words to each oth- er is linked to communication listening and speaking common core standards. Having a child experiment with different sizes of towel rolls and place them inside of each other aligns with math common core standards for sizes and quantities. Providers can use upcycled items and create play experience aligned with the child’s goals. Screen media is often provided to children in place of mean- ingful play. Children with disabilities will require technology to communicate and access toys and games during play. The American Academy of Pediatrics (AAP) discourages all screen media for children less than eighteen months of age, except video chatting with the assistance of a caring adult. For chil- dren ages eighteen to twenty-four months, it is recommended that caregivers use high quality, educational media and use that technology to interact with the child. Further, children two to five years of age should be limited to one hour per day of high-quality screen time, alongside a caring adult who can help them understand what they view and how to apply it to the world around them (AAP,2016). For children who need to access screens, Mount N Mover by Blue Sky Designs can be used to cre- ate an accessible environment for children in multiple settings including a hospital or home care setting. Adapted play includes songs and fingerplays. It is very com- mon for children to passively view videos that include “edu- cational” content and songs. For children to learn and create concepts and connections they need to be actively engaged. Youtube has a place in education and can be very engaging for learners. Songs and fingerplays with actions and imaginative play with music encourage developmentally appropriate play and can be adapted for all learners. Five little pumpkins sitting on a gate is much more interactive with laminated numbers and pumpkins. The child can watch the teacher model the adapted finger play, participate as a group, and retell the finger play inde- pendently after multiple exposures. A child can match the num- bers or objects instead of retelling if that is the stage they are in. The song Looking For Dracula teaches the concepts over, under, around and more. Raffi’s song Apples and Bananas can be paired with pictures or real items to teach vocabulary. The song Going on a Bear Hunt can be used to teach imaginative actions and for students to have access to a peer model’s imaginative ideas and thinking in a group setting. The Core Word Classroom by Assisiveware has free templates and examples for how to incorporate Core Words into play. Core words are the 50 to 500 words that make up most of what we say in typical conversation and writing. The Core Word Modeling Guide provided by Assistiveware includes one-page guides to support the team to model core words to match the language levels of Augmentative and Alternative Communication (AAC) learners. The Core Word Five Minute Fillers are one-page quick reference sheets to help you make the most of every opportu- nity and model core words on the fly. The Mr. Potato Head Five

Water Walls DIY Toddler and Baby Sensory Walls

TIPS AND CONSIDERATIONS FOR SUPPORTING PLAY To support boundaries for a child with special needs colored tape can be used to create play boundaries or define the rules of a game. A child’s preferences or restricted interests can be used to expand their play. For a child who likes dinosaurs and is tactilely defensive, have the child hold the dinosaurs and make dinosaur prints instead of touching the play-doh. This can be replicated with shaving cream, water and sand using the child’s preferred toy. The child can have a similar experience to their peers that is adapted for them based on their interests and

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needs. One child may be practicing pointing their finger and not yet ready to hold a writing utensil. A child who may not yet be ready to hold a pencil or crayon can write or draw using shaving cream or sand on a cookie sheet using their finger. A stylus can be used or pencil if the child does not want to touch the shaving cream or sand.

Communication Placemats

the child likes one zoo animal you can create communication placemats with the preferred animal and other animals. Peers can join the table with the placemats and toys. The provider can model and introduce new animals and ways to imaginatively play. The placemats can also include other prompts, sign lan- guage cues or visuals specific to the child’s needs during play. The 5 point feeling scale created by Kari Dunn-Buron can be used to assist with transitions during play. Young children have strong feelings and often need assistance identifying their feel- ings and expressing them especially when the child has com- munication or other delays. The five point feeling scale can be laminated and placed on yarn to create a necklace. When the child is upset the teacher or a peer can point to the feeling scale and talk through the problem. It can be posted around the class- room to support all children. The Second Step Curriculum is a tool that can be used to support young children with disabilities to navigate strong feelings. The curriculum includes visuals and posters that describe feelings. The curriculum teaches children strategies for calming down and solving problems during play. A child that is in a wheelchair will need their play space to be created. First, the classroom will need to have enough room for the child to navigate their chair to each play area. One option to create a play space on the chair would be on a tray for a stander or wheelchair. A two-inch suction cup dent puller can be used to create a boundary when a child is rolling toys on their tray. A pool noodle can also be cut in half and taped or velcroed to create a play space boundary. While it is important for children to learn that items can be dropped, it is essential that they have access to their toys. The placement of the toys and the boundaries are

Often fluorescent lighting can be distracting and for some children painful. Play areas can be dimly lit or fluorescent light fixtures can be covered with blue coverings to dim the light. A child may need tinted glasses or a hat to dim the lighting in some areas of the school or center. For a child that is transition- ing from the home setting to a school or daycare setting and is sensitive to loud sounds, you can record the sounds of a busy classroom and introduce the child to them at home. As the child is introduced to the sounds noise-cancelling headphones can be offered to support lessening the loud sound experience. The lunchroom and playtime (or center time) are often very noisy times of the day in early childhood settings. For a child to be suc- cessful during playtime they will need to be prepared for loud noises. A child who is not able to adjust to the loud sounds may need headphones for certain loud play activities such as blocks. Children with special needs may have difficulty entering a playgroup. Some children may need something to keep their hands busy as they navigate entering a playgroup. Spiral hair ties, spiral key rings, and spinner toys all work well. They are small and can be placed in a pocket or placed on yarn for a neck- lace to be easily accessible when needed. Young children who have a tendency to hit their peers during classroom transitions may also benefit from holding a soft spiral hair tie or key ring to keep their hands occupied. A social narrative should be used as an intervention to support a child to enter a play area calmly and successfully navigate play transitions. A child who has restricted interests or preferences can be in- troduced to new concepts using communication placemats. If

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Gesture

What it means

What you should do

of children may watch the video once. A child with Autism Spec- trum Disorder may watch the video a second time before joining peers in play at the block center. The Clips App can be used to create short modeling videos on an Apple device. Book Creator can be used to create books with video links for video modeling. Power Cards and Social Narratives can be used to support children with special needs during play. Both interventions de- scribe social situations for learners by providing relevant cues, explanation of specific feelings and thoughts of others in a social situation and descriptions of appropriate behavior expectations. Social narratives and Power Cards are individualized based upon the needs of the learner, short and written from the perspective of the learner. The Power Card strategy consists of a brief scenario and a visual cue. Social Narratives have a more detailed story format.

Waves hands back and forth near chest

I’m done! Or I need a break

Model you are done playing! Allow re- quest if possible

Example Gesture Dictionary

important for the child to experience the toy and manipulate it. For a young child that is not yet communicating verbally a communication gesture dictionary should be created and shared between home and school. The gesture dictionary should be continually updated as the child gains more gestures. The communication gesture dictionary includes a gesture the child makes, what it means and what you should do. This infor- mation should be shared between the family and all providers. Peers should be taught what to do as well so they can com- municate in a play setting. The intervention Stay, Play,Talk is a peer-mediated intervention used to increase the social interac- tions of preschool children. Typical peers are taught three skills: stay near their partner, engage with their partner and talk with their partner by commenting on play activities and responding to their partner’s communicative efforts. The sessions take place during daily activities that involve play. Stay, Play, Talk has been found to produce lasting improvements in children’s social in- teractions.

Video Example Imaginative Play with the Doctor’s Kit https://www.youtube.com/watch?time_ continue=3&v=Kip5KMDfQNA

Video modeling can be used to teach children how to play with toys, join playgroups and other important play skills. Vid- eo modeling is an intervention that uses technology to provide visual modeling of a targeted behavior or skill. Video modeling can be utilized with the whole group of children or as an individ- ualized intervention. All children can benefit from seeing what to do in the block center using video modeling. An entire group

Image credit Resource Galllery of Interventions Ocali.org

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may need to model how to use the holding box for a child with a disability. The typically-developing peer can place an object in the box to demonstrate for the child with a disability. Social narratives or real photos can also be used to support how to use the holding box. A timer can be used for a child to practice us- ing the holding box. The child can place their special toy in the box and when the timer goes off, they can go back and get their special toy. The goal is over time the child will be comfortable to separate from their toy and join peers in play. For a provider who is doing home visits for a child with special needs, the provider will be focusing on the child’s individualized goals. I would challenge providers to ensure they are including play in all aspects of their data collection. As an example, a child’s goal may be for the child to stack blocks and focus on a task by following directions. Providers can consider the stages of block play and encourage the child to expand their block play as well as direction following within a play setting. The fine motor goal of stacking blocks can be accomplished simply by modeling and stacking blocks or the provider can consider the stages of block play and work toward a higher level of play. For a child who has difficulty with change, providers can make small changes and support the child through the problem-solving process. Adap- tive textured blocks can be added with soft or wooden blocks. The child may refuse to use the new blocks or could have a melt- down. The provider can model how to use the different types of blocks and assist the child in using calming strategies. Young children can get “stuck” in a stage of block play and will need di- rect modeling and support to move on to the next stage. What stage is your child in?

Mayer Johnson Boardmaker symbols https://goboardmaker.com/

Young children often need support and practice when taking turns. A taking turns necklace can be created with yarn and May- er Johnson Symbols from Boardmaker online. The symbols “my turn” and “your turn” can be color-coded green for “my turn” and red for “your turn.” If the child has an understanding that green means go and red means stop the color coding can support the visual necklace. If the child does not yet have an understanding of red means stop and green means go, the providers can teach the skill with games and visual supports. Visuals can be creat- ed to support the intervention theme of red meaning stop and green meaning go. The children can exchange the necklaces when the favorite toy or game is exchanged. The children will need adult support and as the children begin to understand the turn taking necklace then peer models can begin to assist the child with special needs instead of the adults. Providers need to share ideas and stay up-to-date on current Early Childhood As- sistive Technology. The Early Childhood Special Ed and AT Blog includes app reviews, switch ideas, specific disability informa- tion and more. Subscribe to get updated information sent di- rectly to you. A holding box for preferred toys can be used to support play for children who have a difficult time separating from a special toy or object. The box can be as simple as a shoebox or a plas- tic crate. The holding box will need to be individualized for the student’s needs. A plastic crate will work well for a child who is attached to an object like a blanket and needs to be able to see that it is safe. Some children have difficulty separating from a small toy or figurine and just need to place it somewhere before they can begin to play with other toys. The idea is that the toy or object is safe and the child will get it back. The holding box is not used to take away toys for punishment. The holding box can be used by any child in the class. A typically-developing peer

Stages of Block Play

Stage 1 (2-3 Years) Non-Construction • Carrying and Dumping Blocks • Learning about block properties • Developing muscle tone and coordination

• Children explore the properties of blocks by moving, touching, holding and feeling as opposed to building.

Stage 2 (age 3) Repetitive

• First structures appear • Puts blocks side by side • Experimentation and problem-solving • Encourages cooperative play • Stacking blocks vertically in repetitive patterns

Stage 3 (age 3-4) Bridging • Creating bridges

Stage 4 (age 4) Enclosures • Create a space and enclose an object or area • First with blocks lying flat, then vertical enclosures

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DO IT YOURSELF-- DIY

Stage 5 (ages 5-6) Structural • Creating structures

Young children need to play in order to learn and reach their goals! Providers need to think beyond switch toys. If we focus simply on switch toys, they will miss out on other play opportu- nities throughout the day. Adding a laundry basket in a wagon to the outdoor play area with accessible toys for a child to access allows the child to play with peers in the least restrictive environ- ment. Parents and providers must consider what typical peers are using during play and how the TEAM can make it accessi- ble for our young children with disabilities. Twelve categories are listed below with assistive technology items and resources to support play for children with disabilities in early childhood settings.

RECOMMENDED ADAPTED PLAY PRODUCTS

ART AND FINE MOTOR Zot Artz Adaptive Art Tools For Children with Disablities

Raised Line Coloring Book Raised Line Coloring Book Raised Line Braille Color and Paint Loop Scissors Melissa and Doug Water Wow Melissa and Doug Zip Button Bear Desktop Slant Board Industrial Strength Twist Ties

Use an empty veggie tray to adapt games

COMMUNICATION The Core Word Classroom Assistiveware Matt & Molly Kits Blue Bee Pals

Wristband Board Stay Play and Talk Tobii Dynavox Facebook Share Snap Plus Core App (picture below)

Accessible Playground

Quiet Spray Visual Support

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• Use pillows to prop up a student to be positioned to draw on a cardboard box. • Tape paper under the table and have students cross the midline to draw under the table. • Freeze small figurines in an ice tray and use them to sup- port and encourage play. • DIY Music Kit Includes one regular guitar and one switch adapted as well as Music Kit • DIY Assistive Technology Devices to Make @ home • Pool noodles can be used to create play and safety bound- aries. Preferred colors can be used to motivate the child. • A laundry basket can be used to position a young child for play indoors or in a wagon for joining peers outdoors. • Create a water wall for children to access water play. • Sensory walls and boards.

Daniel Tiger for Parents IOS App

SEATING AND POSITIONING • Bilibo Seat • Bumbo Seat • Scoot 4-in-1 Mobility Rider

Visual Support for an outdoor scavenger hunt

BOOKLETS & RESOURCE GUIDES • PACER Center’s EZ AT Booklet

• EZ AT Activities for Children Ages 3-8 with Disabilities • Toys: Universal Tools for Learning, Communication and Inclusion for Children with Disabilities • Able Play Toy Guide by Lekotek • Easter Seals Resources for Play • Toys and Play for Children with Disabilities Resource List • Tactile Books Pathways to Literacy

APPS

• PBS Kids • Social Story Creator & Library • First Then Schedule

Zip Zach Youtube - https://www.youtube.com/watch?time_ continue=1&v=n-nIok-OziY

• First Then Schedule HD • Visual Schedule Planner • Choice Works • Scene Peak • Daniel Tiger for Parents IOS App (images right top side)

• Cube Chair • Cube Chair Desk • Wedge • Adapted Trike

• A laundry basket can be used to position a young child for play indoors or in a wagon for joining peers outdoors. Rolled up towels can be used to improve positioning.

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TOYS & GAMES

• Frankie the Bubble Fish • Little Tikes Shopping Cart (add weights to improve sta- bility) • Tactile Step N Stones • Skoog Music • 25 Braille Toys for Kids who are Blind • Hi Ho Cherry Oh • Activity Gym • LED Color Changing Balls • Big Water Toy by Enabling Devices

• Starfall • ABCYA • Tarheel Reader • Help Kidz Learn Switch Games • Tar Heel Gameplay

ACCESS • Mount N Mover by Blue Sky Designs • Elevated Sand Table • Pinterest Link

Meet Thotso Book by Rachel Robb Avery, Phd

• Hitch Switch Interface • Switch Accessible Apps • Melody Bells • Glenda’s AT Info and More’s Switch Activities • Dent Puller (create play boundaries)

• Center on the Social and Emotional Foundations for Early Learning (CSEFEL) • 5 point feeling scale • Carol Gray Sample Social Stories • Book Creator One • Power Cards • Colored Tape (to create visual boundaries) • Headphones TIMER OPTIONS TO SUPPORT PLAY • Children’s Countdown Timer • Free online timer • One Click Timer (only on Chrome Browser) • Time timer IOS App • Time Timer Visual Timer • Clock App on Ipad & Iphone -Stop playing feature BOOKS & KITS • I’m a Frog by Mo Willems (children’s book) • Loose Parts Inspiring Play in Young Children • Assistive Technology Solutions in Minutes • Early Childhood Special Ed and AT Blog • PEAT’s Suite • Cara’s Kit Preschool • Cara’s Kit Toddler • Do Watch Listen Say

• Ablenet PowerLink • All-turn-it Spinner • Big Red Switch • Letsparticipate.org • Industrial Strength Twist Ties • Pouring Cup

CHALLENGING BEHAVIOR SUPPORT

Sunshine glasses (from Meet Thotso) worn by Carter Hamilton

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PLAY RESOURCES

pbskids.org Play Modifications for Children with Disabilities Article rachelrobbaveryphd.com Schoolspecialty.com secondstep.org skoogmusic.com/specialeducation/

Becoming Young Thinkers Developmentally Appropriate Pratice in Early Childhood Pro- grams From Play to Practice Lisa Murphy on Being Child Centered Play the Foundation for Children’s Learning Saving Play The Project Apprach for ALL Learners The Project Approach

Socialthinking.com Superduperinc.com Tarheelgameplay.org tarheelreader.org Tobiidynavox.com

REFERENCES

understood.org Vanderbilt.edu Zerotothree.org Zotartz.com

aap.org Abledata.acl.gov Ablenetinc.com Afirm.fpg.unc.edu amazon.com/Wiggle-Seat-Inflatable-Sensory-Certified amtrykestore.org Asatonline.org autism-products.com belson.com/Handicap-Accessible-ADA-Sand-Differ-Play- ground-Component Bluebeepals.com brazeltontouchpoints.org bumbo.com Carolgraysocialstories.com Craftulate.com cidd.unc.edu Csefel.vanderbilt.edu CTDinstitute.org Easterseals.com Eclre.org Enablingdevices.com ebip.vkcsites.org especialneeds.com/shop/special-needs-seating-positioning/ positioning-aids Goboardmaker.com Iowaaeyc.com Learningtools.donjohnston.com lekotek.org Letspartcipate.org moluk.com/bilibo.php Mountnmover.com naeyc.org Nea.org n2y.com/symbolstix-prime/ Nwaccessfund.org

Ocali.org Pacer.org Pathstoliteracy.org Pathways.org

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