Families and practitioners often combine different types of embedded interventions. For example, a picture communication board might be hung on the wall to help a child express interest in playing a game; modified materials could be used to simplify the game; and other children could provide peer support and encouragement during the game.
Watch the video and look for the ways embedded interventions are combined in this example.
Video 1.14: Routine in a program – expanded block play
Austin first uses a communication board posted on the wall to decide what he wants to build. Then his therapist introduces a template to assist in the building process. Later, a peer is enlisted as a helper to create a door for his garage. In just 5 minutes, 3 different embedded interventions were used to help Austin successfully participate in this activity (running time: 3 min. 08 sec.).
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Narrator:
This video shows an occupational therapist working with a boy with autism in a preschool classroom. The child uses a communication board posted on the wall to make a choice and the therapist provides a template for building a structure. Then, a peer is enlisted to help in the building process.
Occupational Therapist:
What should we get? We’ll go with the blocks. Get some blocks and build a what? Do you want to build a barn? A house?
For this child, the team (which consisted of his teachers, and parents, and therapists) had really noticed that he was having a hard time participating in constructive building kinds of play in the classroom, and a lot of his classmates were really into that kind of thing. So, we decided that we really should do some kind of intervention for this.
Since we were already using visual supports to give him some options for activities, I thought maybe also offering him some visual supports for the actual building process would be helpful.
Boy:
What about this?
Occupational Therapist:
I think you’re exactly right. Alright, can you put them on here? Put them right on top of there. There you go.
At one of the team meetings, we actually talked through my idea of just making him some little maps that would facilitate his building. So the teacher and I had talked about this and agreed that maybe this was a good idea to try. So, I went ahead and made the map of things that he already had choices for on his visual supports for actually choosing something to build.
And I was trying to be congruent with that. So, then the next thing I wanted to do was actually go ahead and take that into the classroom and try it with him and let the teacher observe a little bit if she could just so that we could then evaluate whether this was an intervention that was really going to be helpful to him or not and if we needed to adapt it.
Now we need something for the front door. The front door. What do you think? Alright.
One of the nice things about being able to go into the classroom was that this was already an activity that a lot of the kids were doing and was one of their activity centers. So, it was a great time for him to integrate using the visual supports with making a choice about what to build and then also using the map as a visual support to actually do the building.
And the other kids were also very into this and wanted to be helpful and build with us. So, it was just a nice activity that was completely integrated into an activity that was already going on in the classroom.
You have an idea? Ok. Austin. Austin. Are you going to get your car out?
Boy:
Door.
Occupational Therapist:
Oh. Very cool. He found you a real garage door.
He did really well with this. It’s an intervention strategy that we decided was really helpful so I made some additional maps also. And they were able to continue using them in the classroom whenever this child was in this area. Right after this session where I was trying it out, I did get to talk with the teacher a little bit more and just reinforce both of our impressions that this was helpful to him. And I would just leave those maps in the classroom. And actually, I ended up…
Video 1.15: Routine at home – playing Mr. Potato Head®
Luke and a friend, Kirsten, are at home playing with a Mr. Potato Head®. Watch for embedded interventions as Luke’s mother facilitates the activity (running time: 3 min. 31 sec.).
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Narrator:
This video shows Luke, a 3-year-old boy with language delays, playing with a friend.
Christine:
Oh Luke wants to put an ear on.
Luke’s springboard:
Ear.
Christine:
Ok. Kirsten’s going to put a mouth on first. Then, you can put an ear on, Luke.
Girl:
Right here?
Christine:
Nope. Right here at the bottom. The bottom one. Ok. It’ll be your turn right now, Luke. Ok here you go. You can put the ear on. Where does the ear go? Oh. One up. It goes in at the top. Good. Uh oh! Look what Kirsten did. She gave him two mouths. He has two mouths! That’s silly. Oh. Luke took the extra mouth off.
Girl:
Eyes.
Christine:
Eyes. Oh. Luke, I think Kirsten wants to put some eyes on. Ok we need some eyes. Oh Luke’s putting the nose on first. Ok. Now it’s Kirsten’s turn to put the eyes on. Ok. Let’s give it to her.
Girl:
We’re not done yet.
Christine:
Nope. What else do we need? What else do we need? Do we need the other ear? Luke, do you want to put the other ear on?
Girl:
Right there.
Christine:
Yup. That’s right. Did you see where Kirsten pointed? Good. Alright. What else do we need? Mouth.
Girl:
We’re not done yet.
Christine:
Nope. What else do we need? Eyes? There’s eyes on there already. What goes here? What goes here? No eyes don’t go there. What goes there, Luke?
Luke:
[sound]
Christine:
Do you know? Oh you want to switch the eyes? Ok. You want different eyes. Do you want the black or the blue ones? Tell me. Black or blue? Say blue.
Luke’s springboard:
Blue
Christine:
We need some arms, right? Which ones? There’s some yellow ones or white ones, there’s a blue one. Luke wants to put the blue.
Girl:
Where are the other blue ones?
Christine:
The other blue one, I think, is out in the kitchen actually.
Girl:
I’ll go find it. Ok? I’ll be right back.
Christine:
Where did I put it? Here it is. Here it is!
Girl:
I found another one! I found another one!
Christine:
Alright! Kirsten found the other arm. It’s tough to get. They stick a little. I’ll help you. There we go. Your Mr. Potato Head is all done!
Video 1.16: Routine in a program – reading at circle time
A teacher combines several embedded interventions into circle time to support Jacob’s learning and participation (running time: 1 min. 24 sec.).
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Narrator:
Today, in Jacob’s classroom, his teacher is reading a book, that was especially made for him to fit his needs for speech articulation practice.
Narrator:
As you can see, she’s reading this book that all the kids love with the entire group. In this way, all the children provide models for Jacob for the words that have been embedded in this little story that had his target.
So, everybody says the words, everybody loves it. And Jacob, who is the little boy to the left of the screen with the blue shirt on, he gets some practice and he gets additional models.
As well as the activity being a nice integrated part of his everyday classroom routines as they have this circle time every day.
You can see they’re also using a mirror because they’re also talking a little bit about putting their lips together to make the bilabial m, b, and p sounds.
Video 1.17: Routine in a program – playing red light green light
Jack, a preschooler, plays a game of red light green light with his classmates. He starts off sitting on his teacher’s lap in the top left of screen, using a voice output switch to lead the game. Then he takes a turn scooting across the floor starting in the lower left of the screen next to the other teacher (running time: 1 min. 36 sec.).
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Narrator:
This video shows a classroom of preschoolers playing the game red light/green light. Jack, a boy with multiple disabilities is sitting on his teacher’s lap in the top left of the screen, using a voice output switch to lead the game. After the first round of play, you will see Jack next to his teacher in the lower left of the screen, scooting across the floor as he plays the game.
Class:
Vroom. Vroom. Vroom.
Device:
Red light stop.
Teacher:
Stop. Come back.
Child:
Nooooo!
Device:
Green light go.
Class:
Vroom. Vroom. Vroom.
Device:
Red light stop. Green light go.
Class:
[yelling and laughing] Yay!
Teacher:
I need one special friend to help me push the switch. Would you like to push it? Ok. Ready?
Device:
Green light go.
Class:
Vroom. Vroom. Vroom.
Teacher:
Push it again.
Device:
Red light stop. Green light go.
Teacher:
Green light go. Go. Go. Go.
Device:
Red light stop. Green light go.
Teacher:
Go. Go. Go.