Sensory Stories for Individuals Experiencing PMLD (Profound & Multiple Learning Difficulties)

This blog explores techniques and ideas that come from the Positive Behaviour Support Framework which you can read more about here

This article has been adapted from the original article Tony wrote for his site. Is it possible for an Individual who is Experiencing Profound and Multiple Learning Difficulties (IEPMLD) to be literate? Does the answer to the question depend on how we define literacy? In one sense, yes but the definition of a word cannot simply be twisted to suit a particular need. 

Almost by definition, an Individual Experiencing PMLD is not literate and should that person ever acquire literacy skills, they could no longer be so classified. The Question then becomes, 'Can IEPMLD experience literacy?' 

Again, this depends on how broad we will permit the brushstroke defining 'literacy' to be. However, on a conventional definition of the term, the answer would almost certainly be 'no'. What may be presently possible is for this group of people to have some level of inclusive access to 'special' presentations of stories. While any person might be integrated into (placed within) a group in a room listening to a story told by another, it cannot be claimed such a person at that time is included:

• some will be unable to hear;
• some may not speak the language of the story;
• some may speak the language but not comprehend the complexity of the semantics and or the syntax;
• some may find the speed at which the story unfolds too fast;
• some may be distracted by some other stimuli and fail to attend;
• some may be unable to sit through the entire length of the presentation (for whatever reason);
• some may have behaviours that others find challenging;
• some may fall asleep;
• some may be unable to see the actions of the narrator and or the visual props that s/he is using and thus not have the same experience as others. 

The Individual Experiencing PMLD may have variations of the majority of these issues:

"These pupils will need books interpreted for them if they are to learn from them. Their profound intellectual impairment is likely to prevent them from understanding the words, even if they are read to them, while their likely additional impairments will lead to access difficulties, such as seeing the book or hearing the words read. In summary, this group is likely to have a complex profile of needs which result in
significant barriers to acquiring literacy skills." (Fletcher-Campbell, DfEE, 2000).

Is it then possible to 'present' a story to an Individual Experiencing PMLD (or a small group) in such a way that it becomes inclusive such that each member has an opportunity to take something meaningful from the experience? An objective of this article is to explore that premise.

"When Keith Park and I embarked on Odyssey Now, we met with considerable skepticism, and sometimes wondered if we were on the right track."  (Grove 1998 page 85)

"Conventional literacy is clearly not open to children (or adults) with profound learning disabilities as they are not going to learn to read and write. However, if we conceive of literacy as ‘inclusive’, there may be ways in which even the most profoundly disabled can take part." (Lacey 2006, page 12)

What is a Sensory Story? The Definition:

"There is a range of ways of sharing stories with people with PMLD. Involving people with PMLD in story telling is usually multi-sensory and is unlikely to focus on a book, although the story may have originally come from a book. The multi-sensory experience of story telling is likely to involve objects to touch, look at and listen to; things to smell and even to taste. Suitable sentences are only usually only a few sentences long with each sentence being repeated several times to help the listeners to become familiar with them and learn to anticipate what is coming next." (Lacey 2012 , page 7)

"Telling a Sensory Stories is unlike sharing a typical story. Told in person they engage, include, fascinate and delight everyone."
 www.kickstarter.com/projects/sensorystory/sensory-stories

"Bag Books are aimed at those who cannot benefit from mainstream books. They can be enjoyed without being understood as they are told interactively through voice and emotion rather than words and pictures. They are designed for people with profound and multiple learning disabilities (a maximum developmental age of 18 months), people with severe learning disabilities (a maximum developmental age of 6 years) or people with severe autistic spectrum disorders. They are also hugely beneficial to those with visual and hearing impairments."  www.bagbooks.org

"Sensory Stories are simply sensory experiences sequenced within a narrative that can allow individuals with PMLD to participate in the world and provide a way for them to be ‘heard’."  Joanna Grace

"Multi-Sensory Story Telling (MSST) is a structured method in which caregivers read personalised stories to children with Profound Multiple Disabilities (PMD) to motivate these children to interact and explore their environment (Pamis, 2002; Multiplus, 2008). A story consists of 6 to 8 pages and every page includes 1 or 2 short sentences. Each page is supported by an object of reference, stimulating the different senses, to draw the child’s attention, invite exploration and to support meaning making." (Willems 2014 Page 5)

"Sensory Stories are a method to allow children with sensory modulation issues - sensory integration disorder, sensory integration dysfunction - to www.sensorystories.com

"A Sensory Story is a story told using a combination of words and sensory experiences. The words and the experiences are of equal value when conveying the narrative." (Grace 2014 page 13)

"Sensory storytelling – storytelling supported by the use of relevant objects chosen for their sensory qualities and appeal – has been identified as an enjoyable activity for individuals with PMLD"  Preece, D. & Zhao, Y. (2014)

While all of the above quotations hold some aspect of the nature of the Sensory Story within the words utilised, we do not think they totally capture the essence of the subject. We all grew up loving stories. We read them, listened to them, and or watched them on our screens almost every day. Story telling is one thing that has passed down from generation to generation throughout the ages. It is a quintessentially human endeavor. Therefore, involving those who, through no fault of their own, might be denied such pleasure in the process should be a part of any curriculum designed to support special educational needs:

"Sharing stories is an enriching part of life; through stories we learn who we are and who others are, we find our identities and a sense of belonging, be that in a family, a community, within a faith or a cultural group, as well as our place in history and society." ('Storytelling for young people with VI, learning difficulties and additional complex needs', RNIB Pears Centre training materials, 2014)

"It is my passionate conviction that, on the contrary, poetry and stories address the most fundamental needs of any human being, regardless of their level of disability, and that some of the best opportunities for developing the functional communication skills of students arise in these contexts." (Grove 1998)

"I believe that stories and oral story telling are a very effective way of supporting the development of children and adults with PMLD." (Dowling 2011, page 28)

A Sensory Story is an attempt by a person (or a group of people) to relate a story to a Learner (or group of Learners) in an 'inclusive' manner that will:

• bring the story to life;
• better enable the Learners to play an active role;
• be enjoyable for each Learner;
• enable enhanced Learner comprehension of each aspect of the tale as it unfolds;
• provide sensory experiences that relate directly to the narrative;
• provide sensory experiences that relate directly to the individual;
• help develop the Learner's understanding of his or her world.

As such, it may be justifiably claimed that all good storytelling is 'sensory': when parents read to their children: typically, they put on 'voices' for each character, and point to related aspects of any pictures that might accompany the text. 

The child may make a request for the parent to repeat a specific line and also ask questions about any point that they haven't quite understood. While all good story-telling has, therefore, some 'sensory' aspect, imagine that the Learner (be s/he a child or an adult) is experiencing a severe or a profound learning difficulty, does not speak, and cannot ask for clarification. 

Indeed, the Learner may have additional sensory impairments such that s/he cannot see or hear so well. These and other issues will, almost certainly, compound the Learner's ability to make sense of the tale as it unfolds such that it becomes a bewildering set of incomprehensible sensory inputs.

While the story teller may believe the Learner is sitting and understanding each aspect, this may be far from the truth especially if the Learner has no way of telling the story teller of the problem. While the Learner who is sitting still is not indicative of comprehension, the Learner who is continually moving may also indicate a lack of focus on the narrative. 

Individuals Experiencing PMLD may self stimulate (stimming). Stimming typically involves a repeated behaviour which serves some form of personal need and may also serve to create individual social detachment. Such behaviour might occur as a result of a lack of stimulation:

"Self-active engagement consists of stereotyped behaviours that develop to compensate for lack of meaningful sensory stimulation." (Pagliano 2001)

or may also result  as an individual's means of reducing sensory overload:

"In response to sensory overload sensations, many students with AS engage in behaviors referred to as "stimming." "Stims" are repetitive behaviors that seem to reduce the anxiety associated with sensory overload and enhance focus and concentration. Examples include spinning or whirling, repetitive finger flicking or fiddling with objects."  
(Boratynec  2010, page 10)

Whatever the cause, a Learner who is stimming during a Sensory Story session is unlikely to be attending fully to the narrative. Looking at this another way, the lack of such behaviour from a Learner during a Sensory Story session may also be indicative of some interest in some aspect of the narrative at that point in time.

It is our experience that the Sensory Story technique can be found in Special Education around the world from the USA to Taiwan. Sensory stories are also used with all ages and with diverse populations (see for example Aird and Heath, 1999; Pidgeon, 1999; PAMIS 2007; Boer and Wikkerman, 2008), however, there is a great variety in the manner in which it is undertaken with some staff  making use of what we might consider to be 'less than best practice'. Thus, on this page, we will not only attempt to define a Sensory Story and distinguish it from other like approaches but also set out a number of guidelines for what we would consider to be best practice. 

While others  may not agree with every point made, we hope that this page both challenges and stimulates  thinking such that you create your own ways in which to improve your establishment’s practice. 

We take a 'Sensory Story' to be the means of relating a tale to a group of Individuals Experiencing Profound and Multiple Learning Difficulties (IEPMLD) in a manner that is N.I.C.E.:

• Normal;
• Inclusive and Interactive;
• Comprehensible and Consistent
• Enjoyable and Educational.

Normal means that we should be relating stories to which our Learners can relate and have some chance of understanding. Our Learners have no experience of space or hobgoblins or epic Greek sea journeys (or probably just any sea journey) and thus such themes confound the Learners chance of comprehension. Normal in this sense, therefore, means 'everyday': things of which the Learner has some experience and to which s/he are more likely to be able to relate.

"The subject of the story applies to actual experiences from the daily live of a person, often something the listener particularly enjoys. E.g. taking a bath, having a party, going to the beach, or watch the football." (Boer & Wikkerman, 2008. page 2)

"Moreover, the story must be related to daily life activities and/or reflect aspects of the individual’s personality or interests. One of the goals of MSST is to make the Multi Disabled children familiar with certain situations in their daily life to improve coping with sensitive topics. It is found that young children learn more effectively and efficiently when instructions are contextually relevant, developmentally appropriate, and instructions capitalises on the child’s focus and interest." (Willems 2014 Page 6)

Inclusive does NOT mean the same thing as 'integrated' even though it becomes confusing because some researchers treat the terms as equivalent (see for example; Parekh 2013). Simply occupying the same space as other beings does not always mean that you are included. You might attend a lecture at Oxford University.

You would be integrated into the group, sat with the others attending that lecture, however the lecture may leave you completely baffled. You were integrated but NOT included. Inclusive also means that the Learners participate in the story and the story is delivered in such a way as to make it more accessible to each member of the group. In the best practice, Learners are enabled to take 'control' of some aspect of the story as it unfolds. 

"Inclusive literacy enables everyone, including those at OECD Level 1, to enjoy books, stories and other media in a way that has meaning
for them, even if conventional reading and writing are not achievable." (Lacey, Layton, Miller, Goldbart & Lawson 2007, page 150)

Many teachers working in special education settings may have mixed ability groups comprising one or two Learners Experiencing Profound and Multiple Learning Difficulties together with others at differing levels of ability but all having a special requirement of one form or another. For such diverse groupings good practice in the use of Sensory Stories can involve everyone at their own level of understanding with some playing pivotal roles in the story as it unfolds (the goal is control).

In this sense, also, Sensory Stories are inclusive. The Learners can all work together to benefit each other and all gain from the experience each at their own level of understanding.

Interactive means that staff spend time interacting positively with Learner throughout the story. It does not follow that staff have to operate in a regulating manner and that Learner control is lost but, rather, staff take every opportunity to interact with Learners to illuminate and illustrate the concepts involved using identical approaches (as far as is practical - it does not preclude an evolving practice based on Learner development) such that Learners can begin to show anticipation of what is to follow.

In this role, staff should be encouraged to give the Learners the lead and to note and report and record any new aspects to Learner behaviour. Interactive also means that the Learner participates; with participation comes the chance of emerging communication:

"Participation is the only prerequisite to communication. Without participation, there is no one to talk to, nothing to talk about, and no reason to communicate." (Beukelman, D. & Mirenda, P., 1992, page 177)

Comprehensible involves both the above concepts of  'Normal' and 'Inclusion'. A comprehensible narrative involves 'cognitive coat-pegs' on which the Learner can attach meaning and make some sense of the story as it unfolds. Comprehensible necessarily means multi-sensory for it is through multi-sensory stimuli that the Learner may begin to comprehend some of what is occurring:

"Multi-sensory training engages individuals with different learning styles and disabilities, because the information enters through different channels at the same time, which contributes to the apprehension of the story." (Willems 2014 page 6)

Comprehensible must include some notion of the length of the story: too long a story will make it very hard for those with limited attention spans and information processing difficulties to understand what is happening as a whole:

"Because of the short attention and concentration span, the stories must be short." (Willems 2014 page 6)

Consistent means that each time the story is 'read' it is done in the same manner such that the audience may begin to predict what happens next. Sensory stories are not just utilised once but over and over again.

This is no different to story choice by any Learner - given a choice, they will choose the same story over and over because they like the characters and, as they get to know the story, they can predict what happens next and make sense of the text to which their parent is pointing. 

Achieving consistency in a special education is sometimes difficult as there can be any number of unexpected interruptions to any session. Thus, this area is addressed further in a section below.

"Telling the story always happens in the same way and order, with a lot of intonation and at a low pace." (Boer & Wikkerman, 2008. page 2)

"All stories are told in the same order, using the same words, creating a strong repetitive component. This fixed structure makes the story more understandable and evokes a sense of having control over the environment." (Willems 2014 Page 6)

"For some individuals, having a story shared with them in a consistent manner can help them to develop their understanding, communication and expression of preferences and also relieve them of any anxieties they may feel around sharing the story and so enable them to interact with the stimuli more." (Grace 2014 page 35)

Grace (2014 Chapter Three) defines four 'tips' for consistently relating a Sensory Story; these are:

Preparation - have everything that you need checked and ready; knowing what you are going to do to illustrate the story line; 
Rate of relating - take your time and allow the Learner(s) the time to process the information being presented;
Sticking to the story line - in order for a Learner to anticipate what happens next it must be the same every time;
Understanding your audience - deliver in a manner that provides the best opportunity for learning for particular Individuals

Enjoyable means that the Learners are having fun and are not falling asleep, sitting rocking or engaging in some other self stimulatory behaviour. Thus, such things as the topic, the mode of story telling, the role of each Learner in the group, and length of the story may all have an impact on it's 'fun factor'.

Enjoyable also includes the team supporting the Learners during the story. Fun for all!

Educational means that we are relating the story for a reason. Isn't having fun sufficient a reason? Sure it is,  providing that in the rest of the session and in other aspects of the curriculum educational aspects are addressed. However, can't something be both educational and fun?!

Thus, our definition is:

A sensory Story is any set of experiences tailored to the specific needs of an individual (or individuals) that are N.I.C.E. and, when taken as a whole, relay some message, moral, myth, monologue, monograph, or matter. (Bhargava and Jones 2021)

Sensory Stories are NICE stories!

Please Note: Sensory Stories, Social Stories, Sensitive Stories, and Story Sharing are related but different approaches. Story sharing is not covered on this webpage. Social Stories are outlined in the next section but are not covered in any greater depth.

Sensory Stories and Social Stories

Sensory Stories and Social Stories are often confused. While a Sensory Story might also be a Social Story and while a Social Story might also be a Sensory Story, the two are not the same. A Sensory Story does not have to be a Social Story nor a Social Story a Sensory one. 

Even researchers sometimes get confused and use the term Sensory Story when they really mean Social Story as do many in the Bibliography section of this article  (See for example: Sherick 2004). If researchers use the terms interchangeably it is no wonder that people get confused! 

So what is the difference between a Sensory Story and Social Story? As we have already defined the nature of a Sensory Story (in the above section on this webpage), we will concentrate on providing an explanation of Social Stories such that the distinction between the two might be made explicit. 

Carol Gray, former consultant to students with autism spectrum disorders (ASD), first defined Social Stories™ in 1991. Gray defines a social story as describing:

"A situation, skill, or concept in terms of relevant social cues, perspectives, and common responses in a specifically defined style and format. The goal of a Social Story is to share accurate social information in a patient and reassuring manner that is easily understood by its audience. Half of all Social Stories developed should affirm something that an individual does well. Although the goal of a Story should never be to change the individual’s behavior, that individual’s improved understanding of events and expectations may lead to more effective responses."  (http://www.thegraycenter.org 2012)

An example of a Social Story from the Gray Center website is:

"My name is Tommy. I am an intelligent second grader at Cottonwood Elementary School. Sometimes, I have to use the bathroom. This is okay.

Bathrooms need to have a toilet or urinal, and maybe sinks. Sometimes, when people need to find a place to keep something until they need it, they might place it in the bathroom. My teacher keeps her overhead projector in the bathroom when she is not using it to make more room in the classroom. It's okay to store an overhead projector in the bathroom, but usually most bathrooms do not have overhead projectors in them.

It's okay to use our bathroom with the overhead projector in it. It's also very okay and intelligent to use our bathroom when my teacher is using the overhead projector with the class.

The custodians work very hard to keep our bathrooms clean. They use disinfectant to keep everything nice for the children. If the custodians notice bugs, like spiders, they might use bug spray. Bug spray, and other things that custodians have, are used to keep bathrooms free of spiders and things. People never use overhead projectors to keep an area free of spiders; it just would not work. If I should ever see a bug in the bathroom, it's okay to tell an adult. The adult may know how to use a tissue or toilet paper to get rid of the bug, or we may choose to use another bathroom."

As can be seen, a social story is about a real life event for a real life person. The person does not have to be autistic to benefit. A Social Story seeks to explain to the person (Learner) something about a real event in a way that they can comprehend. It has a positive focus and it is hoped that a Learner's understanding of the story will result in the Learner being better able to deal with the real life event in the future.

There are seven types of sentence that may be used in a Social Story:

1. Descriptive sentences:

Truthful and observable sentences (opinion and assumption-free) that identify the most relevant factors in  a social situation. They often answer "wh" questions.

2. Perspective sentences:

Refer to or describe the internal state of other people (their knowledge/thoughts, feelings, beliefs, opinions, motivation or physical condition) so that the individual can learn how others' perceive various events.

3. Directive sentences: 

Presents or suggests, in positive terms, a response or choice of responses to a situation or concept.

4. Affirmative sentences:

Enhances the meaning of statements and may express a commonly shared value or opinion. They can also stress the important points, refer to a law or rule to reassure the Learner.

5. Control sentences:

Identifies personal strategies the individual will use to recall and apply information. They are written by the individual after reviewing the Social Story.

6. Cooperative sentences:

Describe what others will do to assist the individual. This helps to ensure consistent responses by a variety of people.

7. Partial sentences:

Encourages the individual to make guesses regarding the next step in a situation, the response of another individual, or his/her own response. Any of the above sentences can be written as a partial sentence with a portion of the sentence being a blank space to complete.

How does that differ from a Sensory Story? A comparison of the two on a point by point basis may help to clarify the situation further:

1. While Social Stories typically address the needs of an autistic audience (although not necessarily so) Sensory Stories typically address the needs of Learners Experiencing PMLD. 

2. The focus of a Social Story, as its name would imply, is a social aspect. The focus of a Sensory Story is the sensory aspect.

3. Social Stories concern information on real life situations and the Learners role within them. Sensory Stories do not necessarily have to concern real life situations rather attempt to make the content of the story explicit through sensory methodologies for Learners experiencing PMLD.

4. A Social Story is typically designed and delivered to meet the needs of an individual Learner (though not necessarily so) while a Sensory Story is typically designed and delivered to meet the needs of a group of Learners (though not necessarily so).

5. A Social Story whilst not specifically designed to address behavioural issues (See Gray) nevertheless focuses on raising individual awareness of socially acceptable actions in specific circumstances. A Sensory Story is not typically designed to do this (although it could).

6. The goal of Social Stories is to improve an individual's understanding of events and the expectations of others in specific circumstances. A Sensory Story is not typically designed to do this (although it could) but rather focuses of the Learner's understanding of the story itself or, at least, items from within the story ( for example: basic objects {ball}, actions {go}, emotions {happy}, sizes {big}, colours {blue}, etc).

7. Social Stories are grounded firmly in reality. Some would allow Sensory Stories to be fantasies (we would differ from that point of view as is explained in a later section). Thus a Sensory Story could be a fairy story, or be about a trip into space, or attempt to bring a classic of English Literature to life (see for example 'Odyssey Now' by Grove & Park 1996)

While a Sensory Story is not the same thing as Social Story, it is nevertheless bound by a set of rules that cover its creation and delivery. While it is something of a truism that all rules were meant to be broken, we would suggest that those rules outlined in the following sections are not broken without giving it some thought! Following are a set of ten rules that we have devised as a guide to the creation or the selection of a Sensory Story. You may think that the rules are not comprehensive or are too prescriptive but they are based upon years of experience and should be considered carefully. 

The Sensory Story Rules

"Although most books were properly constructed, guidelines were barely followed during reading which may negatively influence the effectiveness." (ten Brug, van der Putten, Penne, Maes & Vlaskamp 2011 page 350)

Our experience of present practice in the use of Sensory Stories in the Special Needs Environment with Individuals Experiencing Profound and Multiple Learning Difficulties is varied: some aspects of some sessions are extremely good while others are what we would rate as 'not best practice'. So what do we (and others) consider to be best practice in this area and why? We will outline what we consider to best practice in the form of a set of rules and the 'why' we will leave to be detailed in the following sections of this article.

Case study: 

At a school somewhere on the globe, we observed a Sensory Story session which had obviously taken a lot of preparation. It was brilliantly delivered, all the staff present were actively involved and it appeared that the majority of the class were enjoying most of it. It was the sort of session that you might imagine would have obtained an outstanding grade under formal observation. However, we had serious concerns.

The story was about a school holiday that a different (and obviously more cognitively able) group of children had taken to another country. It detailed sea journeys and events of which the Learners in the class had no experience.

The teacher controlled every aspect of the story and the session. Had we not spoken the language, the session would have been bewildering although it might have been fun as we were whizzed across the room and sprayed with water.

The teacher was not reading from a script but appeared to be constructing the story as she went. The pace of the story telling was very lively. The session had many outstanding features, not the least of which was the effort of all all the staff in the preparation and the delivery but it also had several features that we would consider to be less than perfect practice.

Several years of such observations later, of observing 'the Romans in Britain', 'the First World War', 'Hamlet', and other 'productions' for which the staff involved had obviously made extraordinary efforts, it became clear that there ought to be a set of 'rules' or 'guidelines' which might be considered by the staff involved before putting amazing efforts into such productions. The following section outlines what we believe to be a beginning to such 'guidelines': the Sensory Story Rules.

There are a number of rules that should be observed in the creation and telling of a Sensory Story. Of course, rules may be broken but they should be broken with care and with all staff understanding why they are being circumvented. The ten rules below are not explained here but rather each in separate sections below. While you might not agree with every rule, we would urge you to give each some thought in your future practice.

Rule 1: The Goal is Control
Rule 2: SENSE: Repetition with Consistency; 
Rule 3: Real and experiential not abstract: 'Do Tell' approach;
Rule 4: Engagement;
Rule 5: Short and Simple Sentence Structure Spoken Slowly;
Rule 6: Use your team
Rule 7: Rote Round Robin Routines R Really Ruinous
Rule 8: Content:
 - Adverse Adjectives (happy / sad, big / small, rough / smooth);
                                        Normal Nouns;
                                        Prevalent Prepositions;
                                        Various Verbs;
                                        Simple Short Sentences;
                                        Repeated Refrains are ideally everyday; (see rule 2)
                                        Proceed at a Peaceful Pace - Speak Slowly;
                                        Sensory Systems Set - Objects Organised;
                                        Passive Prompting (least to most);
                                        Engaging Everyday Experiences.
Rule 9: Choice is a Voice.
Rule 10: Age Appropriateness: Stages not Ages? No! Preference not Deference!
Rule 11: Do not include Sensory Cues or Objects of Reference within the Sensory Story that are actually in use in the school WITHOUT actually going to those places within the school: pretence / make belief (in this instance) is confusing. Both OOR and Sensory Cues require real POLE experience (otherwise the procedure will negate establishment's practice effectiveness) 

At present, there is a dearth of research studies on Sensory Stories for IEPMLD on which to base good practice. However, all those that have been published use one or more of the the above rules as part of their protocol:

"When considered together, these studies on shared reading suggest that a literacy lesson for students with severe, multiple disabilities
will include an adaptation of a storybook, opportunities for the student to make frequent responses to engage with the book and answer
questions, teacher prompting to promote use of assistive technology and other responses to show understanding, and some individualization
of the read aloud presentation based on the unique characteristics of the student."  (Browder, Lee, & Mims  2011 page 341)

The rules are outlined further below.

The Goal is Control

"Handicapped infants may begin to lose interest in a world that they do not expect to control" (Brinker & Lewis, 1982)

"Learned helplessness occurs when it is unclear to the learner that he or she is able to exert control over the environment.....For many learners, their social history has offered few opportunities to self-select desired objects, people, or activities. At meal times plates are prepared and distributed. Additional serving are provided automatically. Coats are handed out and doors opened when it is time to go. Thus, throughout the day, the caregivers do virtually everything for the learners. Initially, some learners may have attempted to self-select items of interest, but were actively encouraged not to do so." (Reichle, J. 1991 p.141)

"When children who are deafblind are young, and especially if they have additional difficulties, they may experience the world as much too large and complicated for them to exercise any control. Their experience may only be of having things done to them, not of doing things for themselves. They may have objects put in front of them to look at, but may not have any choice in the matter."  (Wyman 2000 page 82)

"By providing people with PMLD the opportunities to exert control and actively participate we help to facilitate the development of contingency awareness; the knowledge that you are able to have some effect on the environment. ... If we are to prevent individuals either from resorting to self stimulatory behaviours or from withdrawing completely from the external world then it is essential that we ensure they are able to engage with their world in an active and meaningful way." (Hogg 2009. page 20)

While undoubtedly there are a plethora of goals for standard education, and many of these may have equal relevance to those experiencing PMLD, there is one particular goal that we believe is a vital component of any curriculum designed to prepare Individuals Experiencing PMLD for a better quality of future life: that goal is 'control'.

"The provision of positive control experiences early in life will be a primary factor in helplessness immunization."  (Sweeney, L. 1993)

"A high quality of life is one in which people receive individually tailored support to become full participants in the life of the community, develop skills and independence, be given appropriate choice and control over their lives, be treated with respect in a safe and secure environment”.    (Emerson et al 1996) 

"Empowerment occurs when control, or power, is passed to an individual or group. In rehabilitation, medicine, social work, psychology, education, and many allied disciplines, it is gradually becoming recognized that the healthiest and most effective individuals have personal control and make decisions for themselves with advice and input from others. The belief here is that, for best results overall, final decisions should be made by the individuals who are most closely affected by the decisions."     (Brown and Brown  2003 page 227)

"Students become empowered by taking control of their own learning." (Sutcliffe 1990 page 13)

"Good quality support is to do with giving people power." (Virginia Moffat  1996 page 37)

Generally speaking, the more independent people are and the less external control they receive from others, the more satisfied they are (higher quality of life) (See Legault 1992).Thus, a fundamental goal of all special education should be equipping Learners to live as independent a life as possible. This has long been recognised:

"... citizens with a mental retardation have a right to receive such individual habilitation as will give each of them a realistic opportunity to lead a more useful and meaningful life and to return to society." (Bannerman, Sheldon, Sherman, & Harchik 1990)

"Even children with profound learning difficulties , given suitable conditions provided by modern technology, can make choices; in this case between sounds, voices, and rhymes provided on speakers. Moreover, they show enjoyment while so occupied and are motivated to further choice making. At the beginning of this chapter, the opinion was expressed that every step on the way to having more control over our lives is worth taking. In the case of these children, opportunity to exert control, however limited, appears to be leading to increased motivation and increasing self-regulation." (Beryl Smith 1994)(Page 5)

In order to meet this goal, staff within special education should be developing ways in which more and more control can be passed to Learners. Staff should rarely ever be doing it 'for' (there are some exceptions to this rule) and should hardly ever be doing it 'with' (again with some exceptions) but, rather, be facilitating individuals to do it for themselves. The goal of control therefore is one in which the Learner is at the centre of all that we do and the role of Significant Others is to help the Learner to take that control. This is just as true within (Sensory) Story time:

"We need to decrease our use of both verbal and non-verbal control strategies. Storytime should be a pleasurable, positive experience for the child, one in which the child is able to exert some control." (Kaderavek& Sulzby 2002)

However, while we may find a  philosophical commitment to a particular idea or an approach fairly easy, often it is much more difficult to make that approach a reality. In observing any session involving Individuals Experiencing Profound and Multiple Learning Difficulties one should be constantly asking 'who is in control?' If the answer to that question for the majority of the session is other than the Learners involved then something is amiss. In viewing videos of Sensory Story sessions available on the web (for example on YouTube) look to see who is:

telling the story;

• operating the visual accompaniment (PowerPoint for example);
• activating the switches to create sound effects;
• operating the augmentative communication technology;
• making choices;
• mostly in control!

It is not the Staff's role to do these things for the Learners, it is the Staff's role to facilitate the Learners in doing it for themselves.

Is it possible for the Learners themselves to relate a story and to control all the sensory aspects as it unfolds? Yes it is! With modern technology that is readily available and not too expensive this is not only a possibility but it should be the aim of every specialist establishment to ensure that such equipment is made available to each staff member who is envisaging making use of Sensory Stories during the session. To this end, we have included a complete section on 'necessary equipment' later in this article.

Take Twice Daily Until Better: Repetition. In order for an Individual Experiencing PMLD to comprehend the world out there it must make SENSE:

Structure (scaffolding);
Experience: reality not fantasy;
Numerous times; repetition;
Same every time: consistency; 
Engagement  (with interest).

The world as presented to an Individual Experiencing PMLD will need to be 'structured': that is, another will have to present the part of it they wish  the individual to comprehend in such a manner that Learner understanding is feasible (The work of Lev Semyonovich Vygotsky on the 'zone of proximal development' is relevant here as well as that of Jerome Bruner on what he termed 'scaffolding'). This typically means breaking it down into much smaller bite sized chunks before presentation.

"A handicapped child represents a qualitatively different, unique type of development... If a blind or deaf child achieves the same level of development as a normal child, then the child with a defect achieves this in another way, by another course, by other means; and, for the pedagogue, it is particularly important to know the uniqueness of the course along which he must lead the child. This uniqueness transforms the minus of the handicap into the plus of compensation." (Vygotsky, L.S. 1993)

"One of Vygotsky's main contributions to educational theory is a concept termed the 'zone of proximal development'. This he used to refer to the 'gap' that exists for an individual between what he is able to do alone and what he can achieve with help from one more knowledgeable or skilled than himself." (Wood, D. 1988)

"The mother must always be a step ahead, in what Vygotsky  calls the 'zone of proximal development'; the infant cannot move into, or conceive of, the next stage ahead except through its being occupied and communicated to him by his mother." (Sacks, O. 1989)

Experience relates to learning that is part of the real world of the individual and not something that they have never known and never will know. Experience of the world is covered in the next section 'Real Lives' and is therefore not detailed here any further.

Numerous means that the process need repeating over and over such that the individual has more than one chance to grasp it. For those Experiencing PMLD this might mean daily encounters with 'scaffolded' material. 

Therefore, any Sensory Story must not simply be told just the once but, rather, many times and each time the telling must be the same: it has to be consistent such that the individual has a chance to build on previous encounters and to anticipate forthcoming events.

Finally, in this section, any Learner who is not attending (for whatever reason) is unlikely to comprehend that which is being taught. Thus, both the material and the manner in  which the material is presented must engage the Learner. This too is covered in another section of this article  and therefore will not be detailed further here.

This section of the article deals with repetition and consistency both of which are vital ingredients of the mix that go to produce a successful Sensory Story. With repetition comes some chance of comprehension:

"Students may need many repetitions with a book to understand the story and be able to produce comprehension responses." (Mims, Browder, Baker, Lee, & Spooner. 2009 page 411)

The word 'repetition' as used within this section of this webpage  has two meanings: 

Repetition of the presentation as well as ... Repetition of some of the items within the presentation (repeated story lines for example or the same sensory experience repeated more than once). A repeated story line should ideally be a short sentence that is in everyday use and not something that the Learners are unlikely to hear at any other time. The reason for this should be fairly obvious; in using an everyday sentence consistently staff are helping each Learner better to understand their world. As such, careful consideration should be given to the repeated parts of any Sensory Story. Thus, ideally, when creating Sensory Stories, a repeated story line should be tailored (as far as is practical and possible) to be of use to the Learners understanding of their world at other times beyond the story itself.

"Constant repetition and a great deal of support will be needed to generalise learning into new situations." (MENCAP, 2008, Page 4)

"Repetition provides rehearsal and consolidation of known games and activities, and a continuous secure base and reference points. Through repetition variations occur, leading to new games and activities." (Quest For Learning, 2009, page 41)

"In order to meet their specific learning needs, a curriculum designed for pupils with MSI must provide frequent repetition and redundancy of information" (Murdoch et al, 2009, page 12)

"Remember that short, daily repetition is more valuable than longer, weekly sessions"  (Association of Teachers and Lecturers, 2013, page 4)

"Focused on repeating sequences of sensory storytelling with the same three stories told every week for six weeks and then another three stories. The would allow for,the development of a pattern of sensory experiences using voice and body, and words and multi sensory objects."  (Dowling, 2011, page 29)

Repetition of the presentation should be at the very minimum once per week although, ideally, it ought to be daily or every other day. This should continue for an entire term before any new Sensory Story is introduced and, thus, a maximum of three Sensory Stories per year is recommended.

Of course, if the group has made significant progress and really needs to move on then more than one Sensory Story per term can be attempted. However, movement to another Sensory Story should never be consider to alleviate staff boredom! Progression to a further Sensory Story should depend upon an assessment of the group's ability to comprehend the narrative or, at the very least, specific and targeted aspects of the narrative. Thus staff would be looking for particular behaviours from each member of the group which clearly demonstrate understanding. This is aspect is covered in greater detail further down this article . 

While "short, daily repetition" (see above quote from ATL) would seem to be a good guide in this matter, we can hear people asking, 'How short is short?'. It is not the same as asking 'how long is a piece of string?' because we do have some boundaries. 

Obviously, a single Sensory Story must be able to be 'told' within a single session and therefore the length of any of your sessions forms an upper boundary. However, other factors too will have a limiting factor (including but not necessarily a complete listing):

• the attention span of the Learners for such an approach;
• other curricular (or practical) requirements that must be completed within any session;
• the size of the group;
• the speed at which the Story is presented.

With all this in mind, the best advise that we can currently give is that approximately 20 to 30 minutes per story on average would be a good target. 

While a single Sensory Story repeated frequently throughout a term (assuming a three term year) is recommended, it may be that targets have not been met and the story is continued into the following term. Also, staff may wish to return to a prior Sensory Story after a period of time to evaluate what, if any, aspects of the story the Learners have retained as a part of Learner assessment.

Real Lives

"The whole point of storytelling the world over is that there should be delight in the telling and the sharing. Nothing else really matters."  (Mencap 1999 page 103)

"Fiction, literary works invented by the imagination, tales that are probably totally irrelevant to their everyday lives - what a refreshing concept for people with Profound and Multiple Learning Difficulties." (Fuller 1999)

No, it's not refreshing! If it's 'totally irrelevant' it is also probably meaningless. Is it true that 'Nothing else really matters'? Come on Mencap! Surely some form of understanding is important.  If we are prompted to begin with Objects Of Reference that are meaningful to those who will make use of them (see Park 1999) then why should we call the use of something that is 'probably totally irrelevant' refreshing?! It opens the floodgates to the use of almost anything:

"In answer to the 'what?' question, we have established that in this context 'anything goes'; any text, that is, which excites you enough to want to share it" (Grove 1998 page 19)

We  also doubt that 'anything goes' can ever have a positive slant for those experiencing PMLD. This is not to say that the work of Ms Fuller and Ms Grove is all wrong, it most certainly isn't: we are truly motivated by it, it is simply that we question this particular aspect of it. It is probable that some Learners Experiencing PMLD may even have difficulty in understanding some concepts that we might consider to be commonplace:

"These students may also need to build language concepts concurrently with literacy exposure and knowledge. For example,students may not understand even literal concepts presented in the book like 'tree' or 'box'."  (Mims, Browder, Baker, Lee, & Spooner. 2009 page 411)

Therefore, we would want carefully to select stories whose content has some chance of being comprehended by those for whom the story is intended; that is real life situations that we know the group has experienced or will experience:

"Use strategies that combine learning in real-life situations with learning in controlled or simulated environments"   (Dee, Devecchi, Florian, & Cochrane 2014)

"The value of having stories that relate to the real life experience of students was highlighted again and again. In some cases these relate to real life events or activities that may occur infrequently." (Preece, D. and Zhao, Y. 2014 page 9)

"The subject of the story applies to actual experiences from the daily live of a person, often something the listener particularly enjoys. E.g. taking a bath, having a party, going to the beach, or watch the football." (Boer & Wikkerman, 2008. page 2)

"Moreover, the story must be related to daily life activities and/or reflect aspects of the individual’s personality or interests. One of the goals of Multi-Sensory Story Telling  is to make the Multi Disabled children familiar with certain situations in their daily life to improve coping with sensitive topics. It is found that young children learn more effectively and efficiently when instructions are contextually relevant, developmentally appropriate, and instructions capitalises on the child’s focus and interest." (Willems 2014 Page 6)

"These stories are related to daily life activities and/or reflect aspects of the individual’s personality or interests. Each page of the story is supported by an object of reference stimulating the different senses to promote a more effective way of learning, because the information enters through different channels" (Willems 2014 Page 12)

"Many teachers are concerned that sensory experiences alone are not enough because they do not necessarily have any meaning for the pupil. It is only when they have intrinsic meaning of their own, or are part of an experience which itself has meaning, that they will provide the opportunity for meaningful involvement in the learning process and the development of concepts leading to more subject-specific understanding." (Ouvry and Saunders 1996 page 206)

"The difficulty here is that the sensory experiences may seem quite random and meaningless to the pupil with PMLD when provided through a subject whose meaning is outside the understanding of the pupil."  (Ouvry and Saunders 1996 page 207)

"The ‘sensory approach’ to providing experiences to individuals with PMLD often simply provides experiences that are, as Ouvrey & Saunders (1996) point out, bereft of meaning for the individuals receiving them. They argue that 'Activities using this type of equipment are often carried out in situations which do not provide a meaningful context'. " (Barber & Goldbart 1998 page 15)

Stories about space, aliens, monsters, ancient epic sea journeys all seem like harmless fun. Indeed, they appear to be motivating for reader and listener alike. Very inspirational people have poured their heart and soul into showing us how to make them accessible (see the works of Chris Fuller, and Nicola Grove, and Keith Park for example) but what do Individuals Experiencing Profound and Multiple Learning Difficulties know of such things?

While we would all support the notion that great literature should be accessible to everyone and therefore should be a right, we would certainly wish to be able to explore said literature at a point in time when it would have some chance of being meaningful. We are not of the opinion that by making certain sections of the prose accessible at an experiential sensory level the Learner can somehow 'apprehend' (rather than comprehend) the narrative as a whole. 

"Apprehending means more than comprehending. Students who cannot decode meaning may be able to apprehend meaning through repeated associations and inference" (Grove 1998 page 20)

This is not to say that we should deny access to stories; we most certainly should not, nor is it to say that those who have proposed such things are completely wrong in all that they suggest; far from it - they are truly inspirational in every sense of the word.

However, this is to say that we should begin by selecting (creating?) stories whose content already has meaning and relevance for the audience. The stories should be just as exciting, just as much fun, just as accessible but, ones for which the Learners may already have some basic cognitive coat-pegs on which to hang them and by which to make sense of them.

We might ask ourselves here, where is the research evidence that supports 'apprehension of meaning' in Learners Experiencing PMLD? While we concede that specific sensory experiences provided in the course of a narrative create responses that are indicative of Learner cognition at some level, it does not follow that the same Learner will combine a number of these into a whole and somehow 'apprehend' the text. Indeed, Grove goes on to say that (1998 page 20):

"A work of literature only comes alive in the mind of its audience, whose understanding of its meaning is filtered through the life experiences of each individual."

"Comparative research from the USA demonstrates the serious consequences when there is too much of a mismatch between the expectations of teachers and the experiences of pupils" (Grove 2013 page 6)

If you have never been to sea and have no knowledge of pirates (You have never watched Captain Jack Sparrow) how does a set of sensory experiences in the Multi-Sensory Room around a story of swashbuckling adventure come to form a meaningful whole if you are profoundly cognitively handicapped with additional sensory impairments? Sure, it might arouse passion in the staff and be a whole load of fun (both of which are good things) but can we really claim that the Learners somehow 'apprehend' the whole through a process akin to osmosis?

"It does not matter whether they can cognitively follow the narrative line, there is always a sensory narrative that the listener can follow" 
(Dowling, 2011, page 28)

Sensory narrative? Dowling does not really expand on this concept but does go on to state that:

"If he was not able to understand the story, he would at least have the patterns of familiar sensory experiences from the props , the way I used my voice and tone, and the patterning of the words." (Dowling, 2011, page 29)

While we might question whether it matters 'whether they can cognitively follow the narrative line" we would agree with 'patterns of familiar sensory experiences'.  If we are telling tales of exotic and esoteric experiences with which Learners have no prior experience and connection then it is very unlikely that they will be able to follow the narrative cognitively. Selecting or creating stories that are based in the Learners prior experience provides at least some chance that they will be able to follow the story especially if the supplied sequential sensory stimulation supports that cognition.

Sure, some stories seem to be fun but isn't it possible to locate or create stories and poems for our Learners whose content is both exciting and fun but. at one and the same time, has at the very least some possibility of being understood as whole when delivered at at a sensory level?

"Who is knocking at my door in the candle light?  (explore light & dark)
What is knocking at my door and causing me to fright?  (what is scary and what is not)  I ask, 'Who is it?' and silence my head does cut, (silent vs noisy) Should I open the door or should I keep that door shut?"  (choice: open vs closed)."

The last line of this verse offers a choice: open the door or leave it closed? The choice can offered to the group with specific consequences to choices made. What is outside the door can be amusing or scary or unusual or normal or ... take it wherever you will but look to the needs of the Learners.

We are sure that you can create a whole range of fun and exciting possibilities for a sensory experience or, if you do not feel the creative urge welling up inside, spend a little time looking through children's books and poetry to find a suitable narrative. A short search on YouTube yielded some really interesting possibilities: for example, the late great Shel Silverstein's work which can be read as a poem, told as a story, and he even sang as a song if you search hard enough ... Here's a poem about being sick ...

Sick by Shel Silverstein  (https://www.youtube.com/watch?v=7VE8U3Z_av8)

Fun? Sure! Can we make it a sensory experience? Sure! Is some of the language a little too complex and might we simplify it a little without changing the structure or the nature of the poem? Sure! Is it too long for a session and could we shorten it somewhat? Sure! Does it contain references to which the Learners may already have some experience? Sure! You don't like it? Well, go choose another!

The point is that we didn't have to look too long or work too hard to create or locate a suitable narrative. The hard work actually follows the selection of the prose in making it accessible to the Learner(s).

Amother is working with her young son using commercially available books. Her first approach isn't very successful however the second with the ‘5 little ducks’ book yields more positive results. She is singing and using other cues to focus her son on the narrative.How could she improve her practice further?

Mum should ensure that the counting correlates with her son's tactile experience;
If Mum is using hand over hand prompting. It would be better to use hand under hand prompting as the child can then see his hand pointing to and interacting with the book rather than his mother's hand;
Mum is in control, the experience might be improved if the boy were to have control some of the time: for example, he might use a BIGmack to sing 'over the hills and far away' in response to Mum singing  '...ducks went swimming one day"
Rubber ducks are cheaply and easily purchased. It would be relatively easy therefore to illustrate the story with five little ducks!
Other? You have probably thought of other ways of adding sensory experiences and improving learning while using this everyday story.

The main point here is that it is possible to find commercially available material that concerns events that a Learner is capable of comprehending and to use such material to really good effect. There are many children's books about real life everyday events with repeated story lines and fabulous graphics. Avoid those books that contain abstract concepts and all things alien to the Learner's experience. Keep your eyes peeled the next time you are in a book store!

While the focus is on the everyday, it does not preclude the use of a Sensory Story in tackling 'sensitive areas' (See Taylor 2006 and the work of PAMIS). For example:

Where has my dog gone?
Where has my dog gone? Why did mother cry?
He's not around the house. Mum said that all must die.

Where has my dog gone? I have looked among the trees.
I loved it when he came, and slept upon my knees.

Where has my dog gone? Mum say's he's gone away.
I think that he'll come back, to me another day.

Where has my dog gone? I miss him more each day.
It makes me feel so sad, Why did he go away?

Where has my dog gone? I don't understand it all.                                                      

Why would he go away, and leave behind his ball?

Yes but you have already said that we should be selecting stories about which our Learners have some chance of understanding. Surely, the idea of 'death' is beyond their comprehension?

You may be right but it is not beyond their experience. As they grow older it is inevitable that something or someone to whom they are close will be lost or will die. While they may not understand the concept they will be aware that someone they knew and loved is no longer around and not understand why. 

We tend not to talk directly about death and couch it in abstract language such as 'gone away' but why would someone you have known all your life just go away? No matter how profoundly cognitively impaired the Learner, wouldn't they feel a sense of loss at this suddenly missing part of their life? Isn't it better to make some attempt to explain death in a manner that they have even a small chance of understanding?

In ensuring that we provide narratives that have the greatest possible chance of being comprehended by the Learners an idea is to utilise the 'Do Tell' strategy.

The 'Do Tell' strategy is a relatively simple idea; put simply, it means first you do it and then you talk about it. For example: you might go on a field trip to a nearby wood with the group with specific objectives (tasks for the group to do there) in mind. 

You may do this more than once. Then you might create a story about a person or a group going to some woods and the things they do there. No doubt, if you have been to the woods several times there will be particular memorable moments that you could incorporate into a story.

The beauty of this is that you know you are relating a story of which its concepts the Learners already have experience. 

It doesn't follow that they will comprehend the story. No, that is correct. However, if they cannot comprehend a story of which they have had experience of all the concepts then what chance have they of understanding a story about aliens?
 
But why Shouldn't Learners Experiencing PMLD be able to learn about Aliens?

Why? What is more important: to learn about Aliens or to learn about everyday events and the things in them. What experience have Learners Experiencing PMLD with space? Do they even remotely understand the concept? Even if we show them pictures of planets and stars and rockets is this something that they can comprehend? We would suggest it is unlikely.

es, but the story is a vehicle for the sensory learning of concepts and, as such, isn't any story is as good?
If the story is the vehicle for learning such concept then why not put those concepts into a story line that the Learners have some chance of comprehending - that is, something they have actually experienced or have the possibility to experience.

Aren't you denying inclusive access to the National Curriculum? 
Having the right to access something is not the same as having to do it. Everyone should have the right to study the mathematics of astrophysics but that doesn't mean that everyone should do so! Surely, such a person should have reached a certain level of understanding before embarking on this particular course? Isn't that why universities demand particular grades at advanced study levels before allowing admission? We have a 'right' to study this area and no one would deny that but we also have to have the ability to cope with the demands of the topic; that is, there are some prerequisites that we must fulfill in order so to do. Let's start with fulfilling those prerequisites (such as understanding the concept of number)  before leapfrogging ahead.  

Aren't stories about space more exciting than stories about going to the woods or the supermarket?
We can think of ways of making a walk in the woods just as exciting as a trip into space. Excitement comes through:

• the way the story is told;
• the way the story unfolds;
• the atmosphere created in the session by the staff;
• the element of suspense and surprise;
• the fun aspect.

As such, any story line can be exciting and any story line can be boring.

Don't Learners have experience of space through watching TV programmes such as 'Dr. Who'?
Can we guarantee that all the Learners in the group have watched Dr Who? Even if this were true, could we state that they understood the plot and had experience of space and time? How we we establish this as fact? In a sense, isn't Dr Who a story about space told through film and doesn't that leave us with the same issue: How can a Learner experiencing PMLD comprehend a story about space when s/he has no experience of it?

But he enjoys Dr Who!
That's great but does he understand it? It is possible to provide lots of things that an individual might really enjoy but, in schools and colleges at least, we need to question the educational benefit. If it can be established that there is continuing educational benefit then the prescription is a dose of the Doctor daily! However, we would doubt that can be established. 

Why can't these stories be just for fun?
We are actually saying that they should be fun; not just for the Learners but for all involved. 

"Most important of all is the enjoyment of the storytelling activity. We have adapted stories in order to enjoy them and not to pay homage to them. The staff have enjoyed the stories and this enthusiasm has transmitted itself to the children." (Birch, Cross, Dumble, & Park 2000)

However, we would want to ask, 'Is it not possible for a session to be both fun and educational at the same time? Furthermore, what is the primary purpose of school (or college or other 'educational establishment') if not education?

What about fairy tales about frogs turning into princes?
Frogs do not turn into princes! What knowledge do Individuals Experiencing PMLD have of frogs? Very little we expect. Of course, if you were to get some frog spawn and put it into a clear container you can use an old overhead projector to project it onto a screen.  In such a way you can follow the development of the frog through it's life cycle before releasing the frog back into the wild.  Thus, a story about frogs is fine providing you have prepared the path to understanding by providing experiences of frogs. However, Individuals Experiencing PMLD have no knowledge of animals metamorphosing into humans or visa-versa so why confuse them by such tales? Why can't the story simply be about a frog wanting to cross a road, or wanting to find a new home, or sitting on a speckled log? These things can be just as much fun and just as sensory and, at one and the same time, be educational.

Let's give the last word, in this section, to Steinberg:
be related to objects, events and situations in the
"It is further necessary that the speech to which children are exposed environment and to experiences in their minds." (Steinberg, D., 1993, page 17)

Engagement

• Comprehension and Consistency
• Active: responsive environment  
• Peaceful: distraction free  
• Time: Tempered Telling of Tale  
• Interesting  
• Verify: basic needs met    
• Attenuate: waiting & distractions  
• Time: Regular and Repetitive
• Education and Enjoyment 

"Sustainable learning can occur only when there is meaningful engagement. The process of engagement is a journey which connects a child and their environment (including people, ideas, materials and concepts) to enable learning and achievement." (Carpenter et al., 2011)

It will be obvious to all who are reading this text that the cognitive engagement of the Learner(s) during the narrative is an important factor in the comprehension of the story overall. A number of components contribute to Learner engagement with the narrative which are covered by the acronym 'Captivate' (see outline above). Each of these components is detailed below. The young lady in the illustration is obviously not captivated by the Sensory Story and has fallen asleep! 

Comprehension and Consistency

The importance of Learner comprehension has already been featured several times in this article . It should be a feature of all that we attempt to do with IEPMLD. How can we try to provide the best possible atmosphere for Learner comprehension? There are a number of things that we suggest,  many of which have been covered in the sections above or are covered in the sections below. Among these is a need for a consistency of approach  over each session even (especially?) if the Sensory Story is being narrated by another member of staff. It is really important that the chosen story is delivered in the same way using the same props on each telling:

"Telling the story always happens in the same way and order, with a lot of intonation and at a low pace." (Boer & Wikkerman, 2008. page 2)

"All stories are told in the same order, using the same words, creating a strong repetitive component. This fixed structure makes the story more understandable and evokes a sense of having control over the environment." (Willems 2014 Page 6)

"For some individuals, having a story shared with them in a consistent manner can help them to develop their understanding, communication and expression of preferences and also relieve them of any anxieties they may feel around sharing the story and so enable them to interact with the stimuli more." (Grace 2014 page 35)

The first quote (Boer & Wikkerman, 2008) also highlights the importance of 'pace' in the telling of the narrative: too fast a pace and the narrator will almost certainly lose his/her audience's grasp of parts of the story and very probably of the story as a whole.

Consistency also supports Learner anticipation: the Learner is able to anticipate what happens next and may show that awareness by behaving in an indicative manner; perhaps moving an arm or leg to facilitate an expected action from another. Such behaviours are a means by which staff can assess Learner comprehension and progression as well as the quality of the teaching methodology employed.

"Early intervention is likely to be of the most benefit, with research suggesting that consistency among professionals – and/or input from the same individual(s) where possible – is seen to be the optimal approach​." (Carnaby, 2004, page 19)

"A consistent approach is vital so that the individual knows what to expect and when." (Lacey & Ouvry, 2013, page 45)

"The programme is designed to be carried out the same way with the same tactile objects and music introduced in the same order. That is to say, it is a structured, repetitive, consistent and predictable play activity that enhances a child’s sense of anticipation. This is an important first step for the child in making cognitive links such as cause and effect and rudimentary choice making skills. Children with severe learning and sensory impairments need this type of predictable, structured programme in order to develop reciprocal interactions and intentional communication." (Murray, Ells, & Wainer, 2007, page 2)

"With regard to the application of the MSST book, it should be read in the same way each time in terms of word use and setting. By repeating the story, the listener may learn to recognize the story by association and enables the person with PIMD to get to know their personal story and the stimuli used in that story." (Ten Brug et al, 2012, page 21).

"With the objects being presented in the same sequence each time, and with each child being presented with the tactile objects in turn – means that the stories were identified as being extremely helpful in the development of turn taking and anticipation, as well as with regard to remembering." (Preece and Zhao, 2014, Page 15)

While it might be assumed that storytelling sessions naturally tend to be delivered in a consistent manner, our observations tell us that this is not necessarily the case. Indeed, there is research evidence that supports this contention:

"... few of the storytelling sessions that we observed adhered strictly to the guidelines suggested in the training notes. Though these state, for example, that storytellers should not seek to embellish the storyline we witnessed a lot of variation in how stories were interpreted and individualised and how the materials were used."  (Preece and Zhao, 2014, Page 30)(See all ten Brug et al 2012).

Active and Coactive

"... the stimulus is offered to the listener in an active way to maximally engage the person with PIMD"  (Ten Brug et al, 2012, page 20).

​Active suggests that the Learners must not just be sat listening during any Sensory Story session: they must play an 'active' part. Indeed, as has already been suggested, where possible the Learners themselves should control as much of the narrative and the action consequent on the narrative as possible. Learners should not be sat for long periods of time with nothing to do but listen and therefore all sensory stories should have both a repetitive story line which is consistently followed by a repetitive action that all in the group are encouraged (and assisted where necessary) to perform.

This could be something as simple as clapping their hands or stomping their feet so long as it ensures that no group member is idle for longer than two minutes (max) simply listening to a narrative. There is a tendency for 'idle' bodies to self stimulate and this should not occur if the Learners are actively engaged with the narrative and the action. Indeed, 'stimming' (self stimulatory behaviour) may be indicative of the cognitive disengagement of a specific member of the group.

"Even children with profound learning difficulties , given suitable conditions provided by modern technology, can make choices; in this case between sounds, voices, and rhymes provided on speakers. Moreover, they show enjoyment while so occupied and are motivated to further choice making. At the beginning of this chapter, the opinion was expressed that every step on the way to having more control over our lives is worth taking. In the case of these children, opportunity to exert control, however limited, appears to be leading to increased motivation and increasing self-regulation." (Beryl Smith, 1994, Page 5) ​

Coactive suggest that Learners and staff interact physically during any Sensory Story session. Coactive interaction can take at least two forms: planned and responsive.

Planned coactive interaction takes the form of Learner and either a staff member (or even members) or another Learner (or Learners) from the group working together. There are numerous example of coactive interaction that could possibly take place during a Sensory Story session; for example: working as a team with a 'parachute', playing pat-a-cake with another person, throwing and catching bean bags, sitting and rocking together to music.

It should not be assumed that a staff member performing some action while a Learner observes is coactive: the Learner is playing a passive role here. Responsive coactive interaction brings in the work of Jean Ware in 'creating a responsive environment' (1996) in which staff actively respond to cues from Learners in specific ways that lead to greater Learner control and communication skills. 

While Sensory Stories necessarily require as much consistency as is possible, responsive coactive interaction suggests that staff 'respond' to 'cues' from Learners in specific ways even if that action is not a feature of the story line at that point in time!

To accommodate this the storyline might include a 'non-temporal action' that can be performed at any time during the story on request of any Learner giving a clear signal to the group. For example, the story line might include some aspect of swapping positions which can be performed at any point in the narrative. 

Each Learner is given a physical or verbal prompt cue which will trigger this action. Such cues are assigned to each individual on the basis of their ability to perform such an action. It would be no use in assigning John an arm raising cue if he cannot raise his arm for example. Staff should be wary of assigning cues that a user naturally uses very frequently otherwise the whole session will be one in which the group is swapping positions! 

Cues that are already being utilised for  other aspects of the curriculum should be avoided also. It would be extremely confusing for a Learner if a cue used in another session to mean one thing is now used within a Sensory Story to mean something quite different. Swapping positions might be accompanied by a cry of 'all change' at which point staff assist the Learners to change either their positions within the group or their orientation within the room or even the room in which the story is unfolding (although this might be somewhat impractical!).

The point is that ultimate control is given to each Learner to halt the process for a few moments (all these aspects should not last for more than a minute or so). What if each of the Learners signals for a responsive coactive interaction more than once during a session?

In that case, you will spend a lot of time doing whatever it is you planned on doing in response to the signal! If it takes the whole session that should not be seen by anyone as anything other than positive: the Learners were in control and they were repeatedly 'asking' for this response - isn't that a huge step in the right direction?

What if it happens every Sensory Story session for the rest of the term? Yes! You have made a real difference! So what if you never get to tell the full story, you now know that the Learners 'understand' that they can control their environment through their actions and that is a milestone worth reinforcing. 

However, on the next Sensory Story session in the following term where a new Story is introduced, such responsive coactive cues can be changed and also made more difficult such that the Learners are tasked to work even harder to take control! 

Peaceful

Peaceful does not mean boring. Peaceful does not mean a lack of action. Peaceful does not mean that Learners can fall asleep! Here, one aspect of peaceful means that the Sensory Story Session is not interrupted by outside agencies. If you have a do-not-disturb sign place it on the door to the classroom: "Do not disturb. Sensory Story in session".

Ensure that everyone in the establishment understands that 'do not disturb' means just that. An interruption to any session might easily break the cognitive engagement of any Learner that has been hard won by the staff working on the narrative. You are being observed and it happens to be during a Sensory Story session? Then let the observers know the 'rules' about the session and ask that they are either in the room before the session begins or that they enter quietly and do not disturb the story flow.

Peaceful also means that the narrative presentation and pacing should be inclusive for every member of the group and thus it is 'peaceful' as opposed to 'stressful' and/or 'confusing'. Pace is covered in the following section on time.

Time

(Speed at which the tale is told)

"For some children, it seems to be important to have time to explore objects independently, and it is crucial that they are not rushed with this exploration" (Nunez 2014 Page 19) 

A Sensory Story session will be around 20 to 30 minutes long on average although it might take up an entire session if the Learners attention can be held for that amount of time by the process; it will depend on the nature and dynamics of the group in question and, as each will be different, there is no hard and fast rule on this matter written in stone. 

It is important that any Sensory Story is narrated at a pace at which the Learners have the time to comprehend the aspects of the tale as it unfolds and,thus, it should not be too fast.

"This activity seemed much more attuned to the adults’ natural interactive style, was much slower-paced, and the students were quickly
and fully immersed in the activity." (Preece and Zhao, 2014, Page 30)

However, neither should it be too slow for any Learner as this might lead to cognitive disengagement resulting in some form of stimming. This suggests that resources need to be prepared in advance carefully such that there is enough for each member of the group and they do not have to sit and await their 'turn'. Awaiting your turn almost certainly means sitting idle while staff are focused on some other person or process. A possible outcome of this is a lack of Learner stimulation leading to cognitive disengagement.

"Many teachers spoke of how useful it would be to have extra resources that match the objects mounted on the boards, which would facilitate storytelling to groups of children. This would be felt to be particularly where there are children with very delayed processing, as this would allow more than one child to explore the object at a time." (Preece and Zhao, 2014, Page 24)

Interesting

“This one story…it just didn’t make sense. It didn’t make sense to me at all, and it was like, “Well, actually I’m not enthused by this…how am I going to make it interesting?” It stumped me.” (Preece and Zhao, 2014, Page 20)

As any story must be interesting to engage its audience, staff need to think about ways in which they are going to make their Sensory Story as interesting as possible to their particular group. There are several aspects to this; the first covers the way the story is told:

"The least successful storytelling session that we observed adhered tightly to the script, but was told in a stilted manner, with little enthusiasm – and failed to really engage with the students." (Preece and Zhao, 2014, Page 30)

If the narrator cannot convey excitement and enthusiasm in his/her voice then it cannot be expected that the audience will reciprocate. 

A further aspect of Learner engagement with any story is making it as interesting as possible by incorporating elements that are known to be motivating for an individual:

"In order to make contact with Joyce, one needs to know her well. Joyce reacts mainly to sensory stimulations like sound, bright colours and touch. Without them she closes up." (Boer & Wikkerman, 2008. page 2)

Each Learner in a group will have a BEST (Best Ever Stimulating Thing): a Person, Object, Location, or Event (POLE) that motivate and excites them more than anything else.

If such BESTs are incorporated into the story in some way then the story line is almost guaranteed to be of interest to the Learners. We are aware that it is more difficult to establish a BEST for some Learners than for others but every person has one, you just need to continue to work to try and discover what it is. 

Significant Others (Parents, carers, etc) may be a great help in this mater. As each Learner will be likely to respond more to one or more forms of sensory stimulation than others, planning for the story should involve interactions that reflect these known behaviours. That is not to say that you should avoid all other forms of stimulation although, obviously, visual cues are unhelpful to the Learner who has no sight.

Interesting also implies involvement. A Learner needs to be actively involved and engaged for the majority of the story; do not leave any single Learner with large periods of time in which they are not mentally or physically challenged as this will likely lead to cognitive disengagement.

Interesting also implies fun although while all fun things must be interesting it does not follow that all interesting things are fun! However, if we can build a large portion of fun into any Sensory Story session it will help to motivate both the Learners and the staff. Staff attitude to any session is hugely important to its outcome and, as such, we need to ensure that they understand what we are doing and why and are also actively involved throughout the session.

Verify

Staff need to verify that the members of their group are in a good position both physically and mentally to benefit from the Sensory Story session. It is important to verify that the needs of the individuals in the group have been met: if a Learner is in pain, or wet, or hungry, or angry, or upset, or simply tired after prior physical exertion, then it is unlikely that s/he will be able to engage with any teaching session including a Sensory Story. 

This has been recognised for over 50 years (see, for example, the work of Abraham Maslow). Removing a Learner from a group mid story session is not only problematic for the specific Learner but also interrupts the flow of the story for the rest of the group and may involve a reduction in the staff to pupil ratio within the classroom to provide support for the narrative. 

Thus, for example, rather than attempting to awaken a sleeping Learner which would interrupt the flow of a story line for the other Learners in the group it may be better to let the Learner sleep as the Learner will get many other chances to be a part of the Sensory Story. In this way, the Learner can recover from his/her tiredness and benefit from any further classes during the day.
However, if this particular Learner is always falling asleep during the Sensory Story session then this requires further investigation and a method of remediation.

A further aspect of verification is a check on the quality of your teaching and, as such, the progress of the Learners within the group. As this is covered in a later section on assessment it will not be expanded further here.

Attenuate

Specific 'aspects' that can creep into any session have the ability to affect desirable outcomes. There may be several such 'aspects' but, here, we will deal with just two: waiting and distractions.  The issue of 'waiting' is further addressed in the section on 'round robin' approaches to follow. It should be noted that it is common to find occurrences of self stimulatory behaviour amongst the population of Individuals Experiencing Profound and Multiple Learning Difficulties. 

The aetiology of such behaviours is complex but one causal factor is a lack of extrinsic stimulation. As such, Individuals who are sitting idle and spending periods waiting will tend to self stimulate.

Others may fall asleep and some may even resort to behaviours that others may find challenging perhaps in an attempt to gain attention. None of these are desirable and thus periods of idle waiting need to be reduced (attenuated) to a minimum. 

Behaviours that others may find challenging may also act as a distraction from the goals of any particular story segment. If Learners are focused elsewhere they are unlikely to be attending to the story or to a specific aspect of the story. As such staff should plan to try to reduce (attenuate) all external distractions: for example, you might put a 'do not disturb' sign on the door handle outside the room to notify others that, unless it is an emergency, they should not enter.

As the story is illustrated through the differing senses, all competing sensory input from other sources needs to be attenuated: you will want a quiet place to work in which you can control the ambiance as much as is possible: can you control the light, the sound, and the smells? It might be unwise therefore to consider delivering a Sensory Story in the classroom next to the dining hall in the period before lunch when the kitchen noises and smells are still pervasive even with a closed door.

Time 
(Regular and Repetitive)

"Routines are activities which the child comes to know and expect in certain situations. We strengthen desirable behaviours by eliciting them in the context of routines. These should be carried out in the home , at school and in the therapy room. The care giver can establish routines during bathing, feeding or storytelling. Classroom routines include snack time, music time, and lunch hour. As professionals we can develop activities that create expectations and motivate the child." (Katz Mendoza, A., 1990, page 105)

"Daily living routines can provide many opportunities for communication, if they are structured with this purpose in mind. In most homes and classrooms, routines such as dressing, bathing, toileting, eating, and changing the motorically involved child's position occur at regular times and intervals throughout the day. If this is not the case, these routines should be regularized as much as possible so that the child can begin to anticipate their occurrence. In addition, routines should be conducted in the same sequence each time, again so that the child can begin to anticipate what happens next. Finally, whenever possible, sufficient time should be included in the routine so that contextual communication instruction can be conducted concurrently with the activity." (Beukelman, D., & Mirenda, P., 1992,  page 176)

"Repeated occurrences of the same sequence of events, created by regular scheduling of the same activities at the same time, may help the development of anticipation, which is an important step in learning to communicate. It may also help the development of a sense of the passage of time. Additionally, one study found that children spend more time on task when consistency is maintained. A timetable in which there is little consistency from day to day is therefore unlikely to be  the most appropriate for pupils with PMLDs." (Ware 1994, Page 115)

A weekly Sensory Story Session in which a new story is introduced in each session is unlikely to produce positive educational results. While staff may put in a great deal of effort to such sessions, both the time frame and the lack of repeated encounters with materials will serve to reduce the efficacy of such efforts and may even render them redundant. It may be that the Learners appear to be enjoying such sessions but, if enjoyment is the only consideration, why are we bothering with school? Whilst 'Enjoyment' is one of the components of 'captivate' so is 'Education'. Thus, any Sensory Story must be delivered:

• consistently;
• regularly;
• repetitively.

"With regard to the application of the MSST book, it should be read in the same way each time in terms of word use and setting. By repeating the story, the listener may learn to recognize the story by association and enables the person with PIMD to get to know their personal story and the stimuli used in that story. This sense of having control over the environment, the feeling of ‘knowing that something is coming’, and the opportunity to anticipate is expected to positively influence the person’s sense of involvement and well being." (Ten Brug, Van der Putten, Penne, Maes, & Vlaskamp 2012 page 21)

"As the story is being told more often, it is clear that Joyce responds sooner to what happens in the book. She smiles more often, moves into a listening position, turns her face into the direction of the stimuli and is more relaxed. MSST proves to benefit Joyce a lot." (Boer & Wikkerman, 2008. page 2)

The word 'regularly' implies that there is a consistent presentation of the Sensory Story every Tuesday and Thursday (for example). How regular is regular will depend on a number of limiting factors imposed by the makeup of your establishment and its curriculum.

While a daily presentation has been suggested earlier in this article it may be that is not possible because of other demands however, the minimum number of presentations in any one week should be two. 

Remember, providing the story is presented consistently it does not matter if the same staff member acts as narrator although this is obviously preferable. The best possible presentation may however not be from a staff member at all but rather be placed under the control of the Learners themselves with the staff acting as facilitators to the narrative.

Repetitively implies that staff continue to deliver the same Sensory Story in the same manner over and over, acting to support the Learners and facilitating the narrative:

"Constant repetition and a great deal of support will be needed to generalise learning into new situations." (MENCAP, 2008, Page 4)

"Repetition provides rehearsal and consolidation of known games and activities, and a continuous secure base and reference points. Through repetition variations occur, leading to new games and activities." (Quest For Learning, 2009, page 41)

"In order to meet their specific learning needs, a curriculum designed for pupils with MSI must provide frequent repetition and redundancy of information" (Murdoch et al, 2009, page 12)

"Remember that short, daily repetition is more valuable than longer, weekly sessions"  (Association of Teachers and Lecturers, 2013, page 4)

"No, I am not kidding. Most of us do not learn anything without trying it 1,000 times, or 10,000 times, so I am asking for only 100. 10 is not enough."(Kangas K. 1990 page 65)

Ideally a single Sensory Story will continue throughout an entire term before any new Sensory Story is introduced and, thus, a maximum of three Sensory Stories per year is recommended. Of course, if the group has made significant progress and really needs to move on then more than one Sensory Story per term can be attempted. 

The Murdoch et al quote (2009) above notes that a Sensory Story should contain 'redundancy'. Redundancy implies that the story should contain restatements of bits of  information in slightly varying form so that each statement builds slowly on the preceding one (The orange needs to be cut; a knife is good for cutting an orange; let's get a knife to cut the orange; cut the orange with the knife)(see Blank and Marquis 1987).

This leads to a re-formulation of the  point  made earlier in this article  recommending the use of short sentences: it now becomes 'use short sentences but build in considerable redundancy such that each sentence builds into the next and helps to ease Learner comprehension':

"The alteration in the teacher's pattern of language has definite advantages for language disabled children. As noted above, the expanded verbalization is largely redundant. As a result, if children attend, they have the opportunity to have the information reinforced. By contrast, if their attention wavers, they still have the opportunity to hear the message that might have been missed. In addition, the expanded messages provide children with more time between questions, thereby meeting their needs to have longer periods in which to process information. Finally, in making the implicit explicit, the demands for inferential reasoning on the children's part are reduced, thereby bringing the conversation within manageable proportions." (Blank and Marquis. 1987)

Redundancy aids interaction between the Staff and the Learner. It eases the mental effort required by the Learner to comprehend the narrative. Consider the following two texts:

'I have put lots of things on the table today. They are all sorts of fruit. As we have not done it before, that is what we are going to work with today.'
'Look at the table. I have put lots of things on the table today. The things on the table are all sorts of fruit. We have not had a story about fruit before. We are going to have a story about fruit today.'

The second text example holds considerable  redundancy but only increases the text by about 10 words. No assumption is made of  'carry-over' and intra-phrasal comprehension. The concepts are  made explicit in each phrase. Each phrase builds on the next. By building redundancy into communication interactions with Learners in any Sensory Story presentation, staff assist their comprehension, which should never be taken for granted.

Education and Enjoyment

The educational aspects of any Sensory Story are diverse. As such, any Sensory Story well delivered will address some of the personal objectives, goals and targets of each member of the group. 

While it is also possible to include specific target behaviours for certain Individuals this may therefore not be necessary. However, providing they do not detract from Learner comprehension of the narrative, there is no reason why specific objectives cannot be addressed during the session to targeted Individuals. Of course, if the Sensory Story is being delivered to a single Learner then it should be formulated so as to address his/her personal objectives and goals.

Sensory stories can assist with the development (PROGRESSION) of:

• Personal Objectives and Goals;
• Realization: Anticipatory awareness - Contingency awareness (cause and effect);
• Object Permanence;
• Group dynamics (interaction with peers);
• Response to choice;
• Emergent Communication Skills;
• Secernment: Discriminate and distinguish;
• Sensory awareness and tolerance of external stimuli;
• Interpersonal Interaction: Joint attention skills (dyadic and triadic behaviours)(See Nunez 2014);
• Object recognition; Observation skills (awareness of their world);
• Numeracy and literacy

While some might wish to include 'waiting' and 'turn taking' to the above list, we would wish to treat these with some caution. Waiting and turn taking are addressed below in the section on Round Robin approaches. 

In addition to the above areas of development, Sensory Stories can also cover every aspect of the curriculum from art through geography and history to mathematics and technology. However, it should not be assumed that 'history' is addressed by relating a story about 'the Romans in Britain'!

We would urge you not to do this. History for those Individuals Experiencing PMLD should look and feel quite distinct from the history that we experienced while at school. As such, history is given a quite different take and will be covered in a future article (watch this space!)

If neither the Learners nor the Staff are enjoying the Sensory Story process the outcome is very likely to be negative. The process should be both educational and fun: there is no reason why this cannot be so. 
 
Memory Storage = Memory Story-age!

"Lochi is a 'peg system' that uses a structure you know to arrange what you want to remember. You can use the rooms of your home, your body, the streets between your home and office, any series of objects that is firmly fixed in your head." (Minninger,1984)

Pick up any book on improving your memory or search on line for such a technique and you are very likely to encounter a variation of the peg system in the quote from Minninger above. Basically the peg system takes a well known story line and uses its components as 'pegs' on which to hang the information to be remembered.

Thus, by replaying the story line, as you reach a component part you encounter a piece of information to be recalled. The technique works well and some of the people who have won awards for their ability to memorise use a variation on this theme. As stories proceed in a logical way (the Princess has to meet the Prince before she can decide whether she wants to marry him) they are easier to remember than any set of random data.

If the story is told over and over then this will aid memory even more. Should the story contain not just fictional fancies but also some indisputable information then that information is as likely to be recalled. 

How does this relate to Sensory Stories? Our stories can be about real life events that have some chance of making sense Learners and the stories can contain specific sensory substance that we are hoping to teach. Such as? That depends on what you are trying to teach. For example, you might want Learners to learn specific symbols. The symbols can be a part of the story representing real objects or actions which should also be shown and experienced. 

The point is that a Sensory Story can be a teaching tool that assists Learners to comprehend and remember new things that are or will be part of their world.

Preference not Deference

"While age-appropriateness and developmental appropriateness are both important concerns, maybe we should concentrate more on what is ‘person-appropriate’"    (Smith, 1996, page 79).

" ... stating that of course the chronological age of a person is one of the aspects of the person to be addressed in our education and care. However, we must not allow this issue to become paramount over the need to give regard to where the person is ‘at’ developmentally, psychologically, emotionally and communicatively. Additionally, people of whatever age can want or need physical stimulation and support." (Hewett, 2007, page 121)

"The storytelling has generated much discussion on what is age-appropriate material - for example, at what age, if any, do fairy tales become inappropriate?" (Birch et al., 2000, page 4)

"A principle operating in services throughout  Australia, the UK, and the USA is that of age-appropriateness. The principle of age-appropriateness is widespread throughout government policy and non-government practice guidelines, but the exact meaning of the term is rarely defined. It is commonly assumed to mean activities and approaches commensurate with an individual’s chronological age. Dress, furnishing, object  selection, and the style of interactions, are all supposed to be age-appropriate, according to many policies. However, when this principle is applied to people with profound intellectual and multiple disabilities, I argue that instead of promoting a good life, the principle contributes to practices that compromise individuals’ health, well-being, quality of life, and their human rights." (Forster, 2010, page 129)

Our guess is that everyone reading this webpage has something that they like which is not particularly age appropriate. For example, Tony  admits to both watching and enjoying  'Sponge Bob Square Pants' from time to time.

Dolly admits to  taking a pink rabbit with her to bed. The issue is that we chose to like these things, they are our preferences. We did not defer to some other person's choice on our behalf (deference). Had I been taught Mandarin by using Sponge Bob when I had never seen him before or had Dolly been lectured on the curriculum in special education by use of a pink rabbit then we might have questioned the (age) appropriateness.

Actually, while working in Taiwan and trying to learn some Mandarin, Tony did watch children's cartoons because he thought that the language might be simpler for me to understand. However, again, it was by his choice and preference. 

There have been several studies and many papers concerning the use of dolls as therapy with older people with dementia that highlight the positive outcomes of such an approach and which reflect and reinforce the notions made in the quote by Forster above (for a review of doll therapy see Turner and Shepherd 2014). However, the dolls are not imposed on the individuals.

Indeed, Ellingford et al. (2007) argue that dolls should be introduced indirectly by leaving dolls in communal areas and on chairs, to allow for freedom of choice and free interaction.

In relation to Sensory Story practice therefore, the story line should relate to Learner preference and Learners should not have to defer to another's choice that is not age appropriate. Thus, a Sensory Story told to a young adult might involve a doll (as in the cartoon) if that person has a preference for dolls. 

As dolls are this particular Learner's B.E.S.T. (Best Ever Stimulating Thing) their use in the Sensory Story might help to captivate and engage the Learner in the process. B.E.S.T. practice, by definition, is highly motivating and may therefore be used to illustrate a story (see section below) without fear of accusations of age inappropriateness (although some unenlightened individuals might claim otherwise!).

Story Illustrations

Story Narratives can be illustrated using all of the senses and will vary according to the specific needs of the Learner or Learners in question. Illustration will thus involve any number of Managed Sensory Perceptions tailored to the requirements of the narrative and the needs of the Learners.  Sensory Experiences may involve a combination of the use of the following aspects:

Sensory Objects

A Sensory Object is thus any item that offers a sensory representation (through sight, sound, touch, smell, or taste) of any part of a story. This could be a single word (for example 'ball' or 'muddy') or combinations of words ('big ball', 'small square brick') or a complete sentence ('The big ball was covered in mud') although the latter might involve Sensory Actions.

It should be noted that there is a difference between Sensory Objects (objects that are used to illustrate a narrative) and Objects Of Reference (Objects that are used to indicate a change in POLE: Person, Object, Location, Event). A sensory Object is NOT therefore an Object Of Reference and should not be confused with such. While Sensory Objects might be used to illustrate a story line Objects Of Reference should never be used for this purpose. However, as even published papers can mix up the terms it is understandable that people can become confused (see for example: Bolt 1999).

Sensory Actions

A Sensory Action is, as its name implies, any action performed by or with a Learner or Learners that involves movement of a body part or the whole body (or person in wheelchair) used to illustrate a part of the story line:

"John moved slowly to the other side of the room" (the group all move or moved slowly to the other side of the room);
"Sasha went under the branch" ( a branch is positioned such that each group member can go under it);
"It went around the table and everyone followed" (the group go around the table); 
"Sajid began to rock forwards and backwards" (Learners work with supporting staff co-actively to rock).

As such it might be that some form of Intensive Interaction (See Hewett & Nind 1993) could be incorporated into the session plan for the Sensory Story as a Sensory Action. Indeed, one to one interaction might be a most basic requirement for the individual:

"There is an indication that 1-on-1 play precedes play with objects, in that some children in the sample are more able to play 1-on-1 than with objects, and even those children who play with objects have developmentally preferred 1-on-1 play before progressing to objects, or revert to 1-on-1 play once they are bored."  (Nunez 2014 page 17)

With the exception perhaps of most individuals with autism: 

"The exception to this are children with autistic-like behaviours who prefer completely solitary play or mouthing objects." (Nunez 2014)

However, this is NOT to say that Individuals with autistic behaviours will not benefit from Intensive Interaction techniques.

Sensory Experiences

A Sensory Experience is an event that involves others performing some action that can be discerned by the Learner that is not strictly a Sensory Object or a Sensory Action. Typically, a Sensory Experience is controlled by a Significant Other (Staff member, Parent, Carer, ...)

"It was night and darkness was all around" (Staff shut the blinds and turn off the lights)
"The sky above was blue and cloudless" (Staff hold a blue sheet above the heads of the Learners)

The controlling aspect of Sensory Experiences is typically in the hands of others. However, as the goal is (Learner) control best practice dictates that such experiences should be under the control of one or more Learners forming the group where possible:

"It was night and darkness was all around" (The room is dark but the lights are on. However, the lights can be turned off by a Learner via a single switch)
"The sky above was blue and cloudless" (PowerPoint controlled be a single remote switch depicts a blue and cloudless sky)

However, not all Sensory Experiences need to be controlled by the Learners. It is not poor practice for Significant Others to provide some of such events to illustrate a story line.

Thus, Managed Sensory Perceptions (MSP) serve to illustrate the story line in an attempt to enable Learners both to engage with and comprehend it. MSPs can be broken down into The best utilization of Sensory Objects (SO), Sensory Actions (SA), and Sensory Experiences (SE) brings a story to life for the Learners. MSPs are necessarily 'managed'  because they are carefully selected by Significant Others to have IMPACT:

Illustrate an aspect of the story line;
Meet the requirements of the Learner(s);
Permit increased comprehension of the narrative;
Allow Learners to have control whenever possible;
Captivate and engage the Learner(s);
Teach and Test a Learner's comprehension.

The narrative itself is a Sensory Experience as the Learners are hearing the sounds as they are spoken (unless they have a significant hearing impairment). Of course, hearing sounds does not equate to being able to make sense of any one of them, much less combine them together into a meaningful whole. However, when taken together with a range of other MSPs, it is envisaged that  Learners may be able to comprehend more of a story than would otherwise have been the case.

It is our belief (hope?) that a selection of MSPs can combine together to form an ESP of the story as a whole. Where ESP does not stand for 'Extrasensory Perception' but rather 'Emergent Sensory Perception' of the whole: what Nicola grove might call 'apprehension':

"Apprehending means more than comprehending. Students who cannot decode meaning may be able to apprehend meaning through repeated associations and inference" (Grove 1998 page 20)

As Extrasensory Perception is said to go beyond the the standard perception of the world so Emergent Sensory Perception goes beyond a mere understanding of individual MSPs to a grasp of a story as a whole:

"The whole is greater than the sum of the parts" (Aristotle)

Perhaps this should more correctly read 'the whole is other than the sum of its parts' if a Learner is able to apprehend the meaning of the narrative as is ultimately intended. ESP is 'Emergent' because it just not simply arise fully formed but, rather, has the possibility to develop over time with consistent presentation and application of the techniques outlined in this article. 

Benefits of Sensory Stories

Why should Sensory Stories play any part in the curriculum for those experiencing PMLD? Should Sensory Stories be used at home by parents with their children? Are there any benefits?

"Research has identified that multisensory storytelling can help individuals with PMLD cope with sensitive issues, such as living with epilepsy, dental treatment or sexual behaviour (Lambe and Hogg, 2013; Young et al. 2011). Such stories can help with the development of literacy skills (Fornefeld, 2013; Watson, 2002) and can support interaction and enjoyment (Park, 2013)". (Preece & Zhao 2014)

"Positive changes in engagement with the story were shown for seven of the eight participants. For six of the seven, a parent and a professional agreed that the outcome of the experience positively enabled the participant to cope better with the sensitive topic." (Young, Fenwick, Lambe & Hogg, 2010)

Within the context of good practice in the construction and relating of Sensory Stories there are a number of potential benefits. These may include:

• Builds Bonds: contingency awareness skills;
• Enhances Engagement through Enjoyment;
• Normalizes Nervous Notions;
• Enriches Emergent Communication Skills;
• Forum to provide choice and control;Improves Intrepidity;
• Teach and Test Comprehension as well as to Teach Toleration of situations;
• ​Supports Subsumption.

Builds Bonds

Contingency awareness is the building of a bond between two events, the knowledge that one thing follows another. By exactly following the same story line in each delivery of the narrative Learners can begin to learn to build bonds and anticipate what will happen. Builds Bonds also speaks to the notion of creating an environment that provides greater social interaction between staff and students. Sensory Stories also provide a framework within which Significant Others are assisted to broach 'sensitive areas' (See the work of PAMIS: Young et al 2010) that they might find more challenging without such a structure

Enjoyment brings Engagement

We all tend to engage with the things that we enjoy and 'tune-out' with events that are boring or which we don't like. If Sensory stories have been i) designed to be enjoyable and are ii) delivered in an exciting manner, they are more likely to engage Learners. (See Ten Brug et al 2014, 2015)

Normalisation of Nervous Notions 

Refers to the propensity for specially created stories to provide a safe environment for a Learner to explore a world that s/he finds frightening (or otherwise troublesome) for whatever reason. A Learner who doesn't like noisy environments or large crowds may be able to explore coping strategies for such issues within a story line in the safety of the classroom. Pamis' Sensitive Stories are a variation on this theme the Pamis literature states, 'Sensitive Stories aim to explore difficult issues with people with PMLD. Through the use of objects that engage the senses, we can begin to explore and educate issues.' 

Emergent communication skills

Emergent communication skills may be enriched through Sensory Stories: Communication skills, by definition, develop in the cause of interaction between two or more people. Good quality Sensory Stories are necessarily interactive and, as such, can benefit the development of very early emergent communication skills in Learners.

Forum for choice and control

Sensory Stories, correctly constructed, should provided by a forum for Learner control as well as for choice. Learners are able to practice both control over the events in a story line and as well as making choices within the security of the classroom. In terms of choice, Learners can demonstrate their likes and dislike through their reactions to specific parts of the narrative. Staff may use knowledge gleaned from Learners during such times to help them improve the Learner's experiences: 'Johnny doesn't seem to relate well to things that are dark in colour, let's try and ensure the things in his room are quite light and bright.'

Improves Intrepidity

Learners feel more increased confidence when repeatedly meeting stimuli within  the same safe story line each day. There is security in familiarity for most people. Learners are more likely to investigate and take chances in safe and familiar surroundings. The repetitive nature of Sensory Stories provides such an environment.

Teach and Test

Sensory Stories can be used to teach greater comprehension of particular POLEs (Persons Objects Locations or Events), that is, of targeted concepts (see Watson, Lambe & Hogg 2002). For example, a story line about a teddy bear might use several cardboard sheets/cards to which sensory surfaces have been added. Only one of the cards however is covered with teddy bear fur (the others have very distinct surface textures). During the story line the teddy bear card is used to illustrate the feel of the bear (which for example, in the story, may have gone missing). At various points in the narrative, the Learner might be asked to discriminate between the bear card and another card (or cards) that has a very different texture. Does the Learner show any recognition of the bear card? While it would be great if the Learner can pick out the exact card, it doesn't matter if s/he does not, as the experience of the card is repeatedly built into the story and, as such, the Learner is being taught that this tactile sensation is to be associated with this particular item. What if a Learner is tactile defensive and does not like to touch the cards? Tolerance of disliked situations may be improved within Sensory Stories: By practicing experiencing Sensory Story situations, which model the real life events, Learners can improve their ability to tolerate those they find difficult. Furthermore, it is possible to build tolerance by starting with a less threatening substance and gradually moving to the one the Learner finds more difficult. For example, if a learner has a problem with viscous materials, the story could perhaps begin by having the Learner put his/her hands in water but gradually (by adding paste each day?) make the water become more sticky such that the Learner grows in confidence and ability over time.

Supports Subsumption

Subsumption is another word for inclusion. Sensory Stories are a means of including all children in literacy based activities at their own level of ability: This can be at any age be it at home, in school, in college, or in the world beyond. It has been shown, for example, that children with very significant cognitive and physical difficulties tend not to be included as readily in family activities when compared to typically able siblings or peers (see Axelsson 2014); 

"It was found that children with PIMD participated less often, compared to children with typical development, in a large number of family activities .... Children with PIMD also participated in a less diverse set of activities. Additionally, they overall had a lower level of engagement in the activities; however, both groups of children showed higher engagement in enjoyable, child-driven activities and lower engagement in routine activities."  (Axelsson, 2014, page 5)

"His interest in the materials, storyline and interaction with the stimuli increased over time (Fraser’s mother). His resistance to touch and explore the latex items in earlier readings changed dramatically in the final reading. He used purposeful and exploratory actions towards the items (Fraser’s teacher)." (Young et al, 2010)

It is not claimed that the above listing is fully comprehensive; there may well be many other benefits (perhaps some that are specific to certain individual Learners) that you discover in your experience with developing and using Sensory Stories. If you know of such a benefit why not share it with us by using the form at the bottom of this page such that we might add it to the list and share it with others.

Sensory Linguistics

"If we were to attempt to say what any utterance in a conversation meant and, in doing so ignored its context of use, we would be forced to conclude that its meaning would be vague and ambiguous. It is just impossible to say what most utterances mean, or what their intent is, without having some knowledge of the situations in which they occur."  (Wardhaugh R. 1985)

"The child selects and attends to talk that is within reach of his comprehension and ignores that which is not." (Wood D. 1988)

In the classic book, 'Cider With Rosie' (Laurie Lee 1959), Laurie’s sisters send him off on his first day at school wrapped in scarves with a hot potato in his pocket. When he comes home he tells his family about his disappointing day:

​“They never gave me the present!”
“Present? What present?”
“They said they’d give me a present.”
“Well, now, I’m sure they didn’t.”
“They did! They said: ‘You’re Laurie Lee, ain’t you? Well, just you sit there for the present.’
I sat there all day but I never got it. I ain’t going back there again!”

This small snippet from a classic book illustrates the nature of this section extremely well: the language that we use is important. It is not something that we can just take for granted. In doing so, we can create situations which confuse, confound and obfuscate meaning even for cognitively able children.

"One of several striking examples given by Campbell & Bowe (1983) concerns a four-year-old child shown some pine cones:
Interviewer: What are these things ?
Child: Cones
Interviewer: Where do you get cones ?
Child: In the [ice cream] shop."  (Doherty, 2004, page 204)

 "`What is the use of repeating all that stuff,' the Mock Turtle interrupted, `if you don't explain it as you go on? It's by far the most confusing thing I ever heard!'" (Alice's Adventures in Wonderland, Lewis Carroll)

Creber (1972, page 16) recounts a story of an eight-year-old boy working hard at a reading book in which the narrative tells of a woodcutter who finds an injured bear and takes it home. He nurses it back to health whereupon it changes into a beautiful princess. Of course, they live happily ever after. However, when the boy retells this tale to the class he states that the woodcutter chops the bear into pieces when he comes across it in the woods. He goes on to tell the rest of the story which now seems even more implausible as the bear has apparently been savagely hacked into dog food. The boy's teacher worked with the two  accounts  together until she came to a particular sentence,'the woodcutter saw the brown bear':

All was now clear. 'saw' as the past tense of the verb 'to see' had, she realized, no place in David's dialect: if he saw something yesterday he would repeat 'I seen it'. In his dialect 'saw' would only denote an activity associated with precisely such people as woodcutters. (Creber P. 1972)

Thus 'saw the bear' literally meant 'cut the bear' to the child.
​
Bharghava and Jones (2015) define Sensory Linguistics as the study of language use to make explicit the meaning of a sentence or narrative when used with a person or group who, for whatever reason, are disadvantaged in comprehending the spoken or written form of the language. For example, a native speaker of Mandarin Chinese with only a rudimentary understanding of English is likely to struggle while listening to a person reading from a page of an English newspaper without 'adjustments to the text' and additional sensory information to support comprehension.

"Suppose that we had no voice or tongue, and wanted to communicate with one another, should we not, like the deaf and dumb, make signs with the hands and head and the rest of the body?" ​(Plato 428-348 B.C. Dialogues of  Plato, Cratylus: Socrates' remark to Hermogenes)

The language used in any Sensory Story can either support comprehension or detract from it.

"Children who are presented with information in a verbal medium (that is, the spoken or written word) frequently have greater difficulty in understanding or decoding the verbal input than they would have in understanding a nonverbal input(that is, a nonverbal event that is perceived visually or tactually)." (Milgram N., 1973, page 167)

By definition, any Individual Experiencing PMLD (IEPMLD) is very likely to have the most extreme difficulty in 'understanding or decoding verbal input' and, thus, reliance on language alone for any part of a Sensory Story is not recommended. However, one of the things that we hope a Sensory Story will assist is the development of language skills not in the production of expressive language which is unlikely but rather, in the recognition and comprehension of some everyday words and or groupings. As such, how staff utilise language is extremely important:

"Every experience which leads him to conclude that the teacher is 'talking in Spanish' is in effect teaching him when listening is unnecessary and is imposing a restriction upon the range of situations in which he will be willing to trust words. Such a trust is a prerequisite of effective learning in school; the damage caused by a teacher's incomprehensibility is to be measured not in terms of particular meaning loss, but of the cumulative effect of such experiences on the child's attitude to learning. The real danger is that we may so condition him that he learns to accept his incomprehension." (Creber P., 1972, page 30)

Donaldson (Donaldson M. 1978, 1987) has suggested that one of the main problems of Piaget's famous conservation experiments (see Lee V. & Das Gupta P. 1995, chapter 1 for a brief review) is that the child's understanding of the experimenter's requirements may be different from that of the experimenter him or herself:

"... Donaldson argued that young children might fail Piagetarian tasks because the tasks selected made little sense to them, and because they could not understand what the adult actually meant when they asked children a question. Donaldson argued that most reasoning is embedded both in a particular context and in the knowledge we have already; and that interpreting language is more than a matter of interpreting word meaning."  (Das Gupta P. & Richardson K., 1995, page 17)

At this point, we would like to postulate four different types of language use:

Aliacentric: aliacentric language is language that requires no further explanation, that is couched in the language style and within the known language level of the Learner. An example might be a parent asking a normally developed six-year-old child to "go to the kitchen and get your Winnie the Pooh cup". While the child may fail to find the cup in question in the kitchen and have to resort to questions to ascertain its whereabouts, the initiating remark was unambiguous.

"The child selects and attends to talk that is within reach of his comprehension and ignores that which is not" (Wood D. 1988)

Contextual: contextual language requires reference to the context in which it is uttered in order to further clarify its specific meaning. All language is to some extent contextual but, in this sense, the listener has to make a considered study of the environs in order to glean some meaning from another's utterance. Contextual  language may involve the understanding of an unknown word: On the table, in front of the listener, are two objects, one unrecognised and another a saucer; "put the glub on the saucer" The person has no difficulty in taking the unknown object and placing it on the saucer. 

Accommodative: In some cases, a person's understanding of what has been said may be at odds with my their  world knowledge and may create an imbalance which would lead them to either reject the notion or to accommodate it. Thus, accommodative language requires that an individual listener adjusts or replaces an existing point of view to accommodate new information. By definition, all accommodative language must be either aliacentric or contextual but all aliacentric or contextual language is not necessarily accommodative.

Esoteric: esoteric language is language that is totally beyond the comprehension of the individual listener concerned. For example, the following phrase when used with the same six-year-old child mentioned earlier, "An adverbially pre-modified adjectival lexical unit is a parasemantic approach to the political situation", would be completely meaningless. The quote from Bertrand Russell below is also somewhat esoteric as you will see; the individual words themselves are not incomprehensible but, when grouped and used in this particular manner, their meaning becomes unclear. What is esoteric to one individual may be aliacentric to another.

"Now suppose that I am looking at a bright red patch. I may say 'this is my present percept'; I may also say 'my present percept exists'; but not 'this exists', because  the word 'exists' is only significant when applied to a description as opposed to a name. This disposes of existence as one of the things that the mind is aware of in objects." (Russell B., 1949, page 168)

The quote from the philosopher Bertrand Russell above, unlike other quotations used in this text, is not used to reinforce the general line of the argument to date but is illustrative of the case in point. Do you understand each word in the quote on its own? The answer to that is probably 'yes'. However, do you understand the quote as a whole? The answer to that is probably 'no'. That is, a person may be able to understand each of the words uttered but not comprehend the meaning of the whole. Philosophical ideas can be notoriously difficult to comprehend and a reader may continually ask, "Just what did s/he mean by this?". We may refer to the context of the text in which it was uttered and retrace our footsteps in order to glean meaning. However, if, in 1949,  we were sitting in a room with Bertrand Russell and he was making the same point, it is likely that he would illustrate his meaning further by making use of items in the immediate environment. With reference to these, we would attempt to understand and make explicit that meaning. In some cases, our understanding of what has been said may be at odds with what was intended. We think we have understood and, if asked, we will say that we have understood but our understanding differs to that which was intended. Thus, 'contextual' can also involve a situation where the individual has some comprehension of each word spoken but not the meaning of the phrase as a whole and yet is able to glean understanding from contextual cues. In other words, without contextual cues, the meaning of the whole would be lost.

Much of the language that is used to communicate ideas to Individuals Experiencing PMLD (IEPMLD) is likely to be problematic:

"The organizer pointed to the group I was in. 'Group B will be in room 2'. A few moments later we were there, seated, expectant, notebooks ready. A small brisk man entered. He looked at us briefly, smiled and began to speak. In Urdu. It was 9.30 a.m. and coffee was not until 11. The door was shut. I suddenly realized that he was repeating something and pointing at me. Having no idea what he was saying, and fearing that he might by some oriental magic have divined my thoughts, I did the only thing possible - try to repeat what he had said. He smiled and nodded; I felt relieved and absurdly grateful... If an adult may be expected to feel exposed when placed in an alien (not necessarily a foreign) language environment, we need to ponder the thoughts and feelings, in a similarly exposed position, of a child who by comparison with the majority of his peers has suffered emotional, material, or cultural deprivation." (Creber P. 1972 page 11)

Simply because a Learner is 'experiencing' sensory input it does not follow that the Learner is comprehending it:

"A distinction must be made here between sensation - the mere recognition of the arrival of a sensory impulse, and perception - the integration of sensations into something meaningful, and there is no doubt that although sensation as such is rarely disturbed in cerebral palsy, perception is often imperfect and the child must therefore be taught to feel intelligently, in other words he must be helped to palpate or to scan and to integrate his sensations into something meaningful" (Foley J. 1969)

The language used by staff in communicating with IEPMLD is not aliacentric but, rather from the Learner's point of view, esoteric and, although use may be made of context and example, not enough time is devoted to working towards and building (and testing for) comprehension. Where staff are certain that a particular individual comprehends a specific word (or a phrase), the word or phrase should be recorded and verified by another (a Speech and Language Therapist might be the ideal person to verify such knowledge). (It should be noted that, where claims of phrasal understanding are made, it may well be that the individual is picking up on massive contextual clues without which no comprehension would be evident. It may also be that the individual comprehends only one salient word in the phrase and not all the other words but behaves as though this were the case.)

Thus, because of the difficulty posed by our use of language with Individuals Experiencing Learning Difficulties (at any level), we must watch what we are saying.

"Unintentionally we often make it difficult for the child to learn language because of the way we ourselves use it." (Jefree D. & McConkey R. 1976)

For some individuals, notably some Learners with autism, there is evidence to suggest that the use of spoken language itself might cause problems and should be replaced (or at least augmented) by a signing or symbol system:

"We suggest that the spoken modality itself may contribute to poor performance and increase challenging behaviours of some individuals with autism, and that some situations may require that staff use augmentative systems to communicate with such individuals, while some may require the use of alternative modalities and avoiding spoken input altogether." (Peterson S., Bondy A., Vincent Y., & Finnegan C. 1995)

Staff must endeavour to make meaning explicit. In the hurly-burly that is the average classroom, it is amazing any pupil understands the meaning of what is being said. The word 'said', of course, conjures up the problem. How is it possible to teach language using language? If the Learner arrives without  language knowledge or does not comprehend every nuance of the language staff may use  to make meaning explicit, then what may be used in its place? 
 
Implicit in the words 'What is being said', is far more than speech. There are the staff member's tone, facial expressions, gestures, and body language, as well as cues given from contextual information. Indeed, it has been demonstrated (Mehrabian & Ferris 1967) that in presentations before groups of people, 55% of the impact is determined by body language, 38% by tone, and only 7% by the actual content of the presentation. As early as 1958, Bruce (Bruce D. 1958) showed that words used in a meaningful context are better understood than language used out of context.  Thus, to make language more meaningful, a multi-modal input strategy should be adopted. This entails focusing on the contextual aspect accompanying the vocal strategy for working with a particular concepts. As such, meaning may be made more explicit if staff were to use the skills used by teachers of the deaf (Quigley S. & Kretchmer R. 1982, Wood D., Wood H., Griffiths A., & Howarth A. 1986):

• use short sentences: Less is more;
• avoid unnecessary words;
• choice of concrete rather than abstract or unusual words;
• use straightforward language (not 'what purpose does it serve?' but rather 'what is the use of?')
• repetition of sentences in narrative;
• repetition of narrative;
• redundancy in narrative construction;
• painting a picture: illustrate word meaning;
• avoid words or phrases which may have a double meaning  (overall, employed, I haven=t got a sausage, a close shave, .....);
• avoid metaphors (kick the bucket, pull your socks up);
• avoid double negatives (He won't get none);
• avoid advanced grammatical forms. Use the active rather than the passive form  ('the boy kicked the ball' and not 'the ball was kicked by the boy');
• slow down speech slightly, but do not highlight every  word ('A ... dog ... started ... to ..bark');
• do not shout;
• talk to the group; do not dance around the  environment whilst speaking; do not talk with your back to the group;
• look at the group while talking and try to gain eye contact;  wait until you have attention;
• try to speak at the individual's/group's own physical level; sit down opposite if possible - it will be much easier for them to follow what you are saying;
• do not assume comprehension; do not assume that an individual understands even if s/he is smiling and looking at you; do not ask the  question, "Do you understand?", rather, test for  comprehension.

Blank and Marquis (1987) have shown how staff utterances should contain 'considerable redundancy':

"The effect of the comments is that the adult's utterances contain considerable redundancy. These are restatements of bits of  information in slightly varying form so that each statement builds slowly on the preceding one (The orange needs to be cut; a knife is good for cutting; get a knife)." (Blank & Marquis 1987)

Thus, the language used by staff should build in considerable redundancy such that each sentence builds into the next and helps to ease Learner comprehension:

"The alteration in the teacher's pattern of language has definite advantages for language disabled children. As noted above, the expanded verbalization is largely redundant. As a result, if children attend, they have the opportunity to have the information reinforced. By contrast, if their attention wavers, they still have the opportunity to hear the message that might have been missed. In addition, the expanded messages provide children with more time between questions, thereby meeting their needs to have longer periods in which to process information. Finally, in making the implicit explicit, the demands for inferential reasoning on the children’s part are reduced, thereby bringing the conversation within manageable proportions." (Blank. & Marquis,1987)

This portion of this article therefore strongly suggests that we should use mostly aliacentric and contextual language within Sensory Stories. However, do we know what (if any) language is understood by each member of our group or are we just assuming understanding? In terms of context, what language should we be using? Do we make explicit the language that we are trying to teach to Learners? Does a Learner's IEP make reference to any particular words or concepts that should be prioritised? What language / vocabulary should we teach and in what order? Should we teach 'chair' (for example) before 'food' before 'spoon'? Do we pay any attention at all to the language content of our Sensory stories? If not, why not? Is there anything that may help us in this matter?  

Before we attempt to give at least some basic responses to the above questions let's take a step back and look at the provision of context language within a Sensory Story. First, the above questions the above questions should make us ask, 'do we start with the story and give context to the language within' (the typical approach) or do we start with the vocabulary and select (or create) a story to suit? Let's assume that we have adapted an existing Sensory Story to contain certain concepts that we wish to teach ( a mixture of the two approaches mentioned). As far as is possible, we would amend the remaining vocabulary within the story to be as aliacentric as possible and remove all superfluous words. Then we could focus in on the contextual aspect accompanying the vocal strategy for working with the specifically selected concepts providing our Learners with several channels of input concerning each concept. Suppose, just for example (and we are not suggesting that this word is necessarily an early item of vocabulary to be taught), we have selected the concept 'cow' as a vocabulary item to be taught. Some might assume that the word is already understood by the Learners and is therefore aliacentric in nature. Some might just assume that the Learners within the group all have seen a cow and know that spoken word the relates to the animal they have seen. Without assessing such a concept we should not be making such claims: the Learners may have no idea that the word 'cow' relates to any animal they have seen and, indeed, it is likely that some of our Learners may have no knowledge of the animal itself let alone the label it has been ascribed within our language.

"Children will not learn speech, if they are exposed only to speech sounds. Even if the child hears a spoken word a thousand times, e.g. 'dog', there is no way for the child to discover the meaning of the word unless some environmental clue is provided - in this example, a dog or a picture of a dog. Even abstract words must be learned in some such way." (Steinberg D. 1993 page 17)

'The Do -Tell' strategy outlined earlier suggests ensuring real life experience of cows prior to starting the Sensory Story such that staff are assured that the Learners have at least seen such a beast. If staff have not actually ensured that the Learners have seen an actual cow, a video of cows and models of cows might be useful although what an Individual Experiencing PMLD takes from either a video or a model is questionable. Even if a Learner has been taken to a farm to see a cow, staff should not assume the Learner has made any connection between the animal the Learner has seen and the name given to it in any language even if the staff were saying 'we are going to see the cows' and 'look at the cows' repeatedly during the trip. Thus, staff saying the word 'cow' during a Sensory Story does not necessarily equate to a Learner conjuring up images of a bovine animal. What might help link the word to the concept? Any associated sensory cue may help the Learner in this respect. Thus, if an image of a cow is shown and, at the same same, the sound 'moo' is heard, the Learner may now be assisted to focus on the intended meaning. If the image and sound is also accompanied by a sign for cow, a further association is made possible. However, while images, sounds, and signs accompanying words aid and can improve cognition (For signs see Sacks O. 1989), the use of any for a word that has no conceptual 'coat-peg' for a Learner is problematic.  Consider the following simple sentence:

   "The snazzle was ser the hunbot and it flyxxed very gyphfli"

or even:

  "Twas brillig, and the slithy toves did gyre and gimble in the wabe"

while we might know that the latter is the first line from the Jabberwocky poem by Lewis Carroll, what do we understand by it? Of course, we bring a great deal of knowledge to the table when we attempt to assign meaning to such a nonsense verse. We know it's a nonsense verse and therefore have some leeway in how we imagine the world portrayed. However, even so, what is a 'slithy tove'? Is it big or small? is it animal, mineral or vegetable? If animal, is it furry or scaly? Does it walk or crawl? Unless you have witnessed such a 'thing' then you have no real idea of the 'toves' meaning and you have a well developed cognition. How much more confusing then for an Individual Experiencing PMLD? If we inform you that the seemingly 'nonsense' words, in the first story line above, are in fact everyday vocabulary simply encoded then what does this story line concern? It really is a complete nonsense to us unless the language is reinforced by sensory objects, actions and experiences that we already can comprehend.

It may be argued that the comprehension of language is a simpler process when the word / concept in question is an everyday noun. However, what if it is an abstract adverbial? If an abstract adverbial is being used within a story to be told to a Leaner, is it reasonable to assume that  the staff believe his or her cognitive level to be higher than that of the individual learning the noun 'cow'? That is unlikely: It is just as likely that the story using the word 'cow' also contains even more advanced vocabulary unless the story has been 'screened' and such items have been removed. Take the word 'gradually'. Let us suppose that the story line is:

          "The cow moved gradually along the field to the gate."

How could 'gradually' be made transparent? From the Learner's perspective, the word is very likely to be meaningless. Is it possible to present a 'gradually' to a Learner? No? Is there an image, a sound, or a sign that makes the meaning explicit? If you took this image, sound, or sign out into the street and asked 100 passers-by (who had no prior knowledge of sign language) what word to these things refer, how many would immediately say, "gradually'? Not many? Then what is to be done? We could:

remove the word entirely: "The cow moved along the field to the gate"
replace it with a more suitable alternative: "The cow moved slowly along the field to the gate"
alter the syntax to remove the adverb but leave the same 'feel': "The slow cow moved along the field to the gate"
Focus only on saliency: "cow goes gate"

Which, if any, is the better approach? If are unsure whether our Learners are even understanding any vocabulary, then none of the above seems to meet the need! That's crazy? Maybe ... but just imagine that you are sitting in a lecture hall and the presenter walks in and says: 

    牛走到门口  (Niú zǒu dào ménkǒu)

what would you understand (we assume that you do not speak any Chinese)? We assume that you would understand nothing. What is the difference between you in that situation and the Learner listening to the Sensory Story? Of course, we are not using language in isolation from other cues especially as this phrase is occurring within a Sensory Story and therefore the essence of the vocabulary and the phrase is conveyed through imagery, sign, sound, smell, taste ...
 
Now we have added symbolic imagery to accompany our language it may help a little. However, if you really did not comprehend one word of the language would you really be able to make sense of the symbols? Couldn't the above equally well be used for 'a cow saw a snail in a field by a gate' or 'the cow saw a sign for the field next to a gate' or 'a cow shot a snail in the field by the gate'? You can probably come up with many more interpretations! Sure, the symbols go some way further in helping us to understand the meaning underlying the sentence but are they sufficient? What else can we add into the mix? Sound, animation (we could make a cow move across a field slowly in PowerPoint for example), smells, textures that Learners can feel, models of cows, fields and gates, etc. However even if we believe that some combination of these will enable us to convey the meaning of the sentence to the Learners, we still wouldn't be certain they had understood! 

That's crazy!  The Learners don't need to understand every word in a Sensory Story they can just enjoy the process.
If enjoyment is the only goal then why bother with a story at all? Why not just do things that we know the Learners like? There must be more to a Sensory Story than enjoyment although we would agree that enjoyment is an essential component.

OK they would be learning something as well ... new concepts and relationships for example.
So that raises several questions: 'What new concepts and relationships?'; 'What other language should be involved in telling the story?'; 'Does this other language require teaching?', 'How do we know the concepts and relationships selected are been learned?' 'How do we support the teaching of new concepts and relationships?'

The latter of these questions has already been addressed: in summary, we need to ensure that:
the Learners have the necessary experiences that will underpin new learning;

​"It is further necessary that the speech to which children are exposed be related to objects, events and situations in the environment and to experiences in their minds." (Steinberg D. 1993 page 17)

"There is an acute need for teachers / therapists / care-givers to develop tools and strategies to use in developing young nonverbal children's experiential knowledge, ..... and to develop a way of transitioning classroom learning to home and community situations that facilitate experiential and world knowledge development."  (Kovach T. & Sementelli C. 1990, page 81)

We make use of multiple modalities of presentation using as many sensory MSP (managed Sensory Perceptions) as are possible.

"The 'total communication' movement, a philosophy stressing the importance of multimodal communication, began during this period (1960s) as well (Denton D. 1970; Vernon M. 1972; Garretson M. 1976; Evans L. 1982). Proponents of this approach advocated the use of all appropriate means of input and output (e.g. manual signs, speech, graphic symbols) to facilitate communication and learning."  (Zangari C., Lloyd L., & Vicker B. 1994)

We don't assume understanding, we check for it

“Most of our assumptions have outlived their uselessness.” (Marshall McLuhan )

"I mean if a person cannot communicate his/her thoughts, others will do it for the person and assume they know what the person means and what's best for the person. Their intentions are well meant, however, the whole concept is... bull!" (Kitch R. 1995 page 4)

"...often claim that 'he understands everything I say', not realising they are using massive non verbal situational cues in their communication, so that difficulties in receptive language often go unnoticed. By the time a delay becomes evident there may already have been more serious difficulties concerned with the understanding of symbols  and in verbal comprehension, both of which can interfere with intellectual development"    (Cooper J., Moodley M., & Reynell J. 1978)

"Children use many clues to help them try to make sense of what they hear. They use knowledge of the world, familiarity, the situation and many other clues. Therefore we must be careful when drawing conclusions about children's abilities, because what may look like complete comprehension at first sight may not be full understanding due to mastery of language." (Beveridge M. & Conti-Ramsden G. 1987)

"There are many examples where children and adults have been credited with a considerable understanding of speech, but careful observation has revealed that it was not the words that they understood, but rather the gestures accompanying the speech, or special conditions in the situation." (Von Tetzchner S. & Martinsen H. 1992)

"While the ability to utter speech sounds, such as 'dog', in appropriate situations (when a dog is present or is barking, for example), is a good indicator that the child knows the word, simply being able to utter the sound form is of no significance. This is like someone being able to repeat the Japanese word inu. Anyone can do this but unless that person knows the meaning of that word, which is 'dog', we would not say the person knows that word. A parrot can learn to utter many words and sentences but we do not regard the parrot as having knowledge of language in any significant sense. What is critical is that the child know the meaning of what is uttered. Even if a child learns to imitate some words, we would not say that the child knows those words unless the child demonstrates in some way that he or she knows the meaning of the words. We can judge this is the child uses the word correctly, or if the child responds appropriately in some behavioural way, such as by looking, pointing or following some command." (Steinberg D. 1993 page 17)

While, in the main, agreeing with the philosophy of Steinberg above we would want to add a note of caution to the last sentence in the quote concerning an appropriate response. Sometimes an appropriate response does not demonstrate understanding of the meaning of the words spoken. Put a fly in an upside down jam jar with a  hole in the lid. Tell the fly that you are about to turn the jar over and it is to find its way out through the hole. Turn the jar over. The fly escapes. The fly understands the English language! Of course not but, be careful, this phenomenon can also happen with Learners. There are only a few ways of being certain an Individual Experiencing PMLD has comprehended a concept. One of these is Blind Assessment. It involves not knowing the question when testing a Learner's comprehension.

"Thus, if one wants to provide a natural context in which the child can learn how to answer questions, the person asking the questions should not know the answer." (Beveridge M. & Conti-Ramsden G. 1987)

This can be achieved in a number of ways including:

Play your cards right: The concept is displayed as a drawing, picture, or photograph. From the rear, the image can not be seen. The card is mixed in among other cards displaying similar as well as dissimilar items. For example, suppose we wanted to ascertain whether a person understood the concept shirt. We might begin by finding (or creating) a picture of a shirt on a piece of card. This can be mixed in among other images. The pack is shuffled and presented to the user one item at a time. It is important  the person presenting cannot see the face value of the cards. In this way, no contextual cue can be given and no delay can be unconsciously added in the presentation of one card to give a cue to the right answer. The person is tasked to indicate when the shirt picture is reached. If the selection is correct, there is a reasonable certainty that the user understands that this is a shirt. If the response is incorrect the user should be given a second chance. The cards are remixed  and  the exercise repeated. If there is still a failure, the assumption must be that the user does not recognise the picture as a shirt or does not have the concept. There are other reasons for failure. For example, the Learner doesn't understand what is required, cannot produce an appropriate response at the correct time, cannot associate an image of a shirt with a real shirt, or simply may not wish to cooperate in this exercise. While incorrect responses cannot be taken as inability, repeated correct responses are indicative of understanding. However, this approach requires that the Learner is able to indicate by some means when a correct image of an item is reached.

Boxing Clever:  an object is placed out of view of the questioner - in a box,  behind a screen, etc. such that only the Learner can see the item. A staff member who does not know what is in the box and cannot see inside is given a list of items and is told that the box contains one of these. The staff member has to 'ask' the Learner to let her/him know when s/he says the name of the item within the box. Is the Learner able to do this? Once again, repeated failure does not equate with a lack of Learner ability however, repeated success strongly suggest comprehension.
Guess what: In this situation, member of staff  B is sent out of the room while a set of objects is arranged in front of a Learner. Another person A selects an object and without looking at it or touching it in any way tells the user its name. A then leaves moves completely away. B re-enters and points to each item until the Learner indicate 'yes'. The technique could be modified however so that A points to an item without stating its name or points and names to give more cues.

Shop Keeper:  An object is shown to a Learner, named, and its symbol pointed out. The Learner is then sent to the opposite side of the room to 'purchase'  the item from a role-play shop. While the 'shop keeper' may prompt and help the user to achieve the desired goal during training when assessing comprehension no such assistance is given; indeed, the shop keeper should not know what item was selected.

"The method of recording and testing that seemed to have been most interesting to Washoe was the series of double-blind procedures used in her formal vocabulary testing. During the first of these tests, she would find herself seated in front of a box that front time to time would be opened by a human companion who would ask Washoe what was there. Washoe, although perhaps bewildered as to why the human observer could not look into the box and see for himself, would accommodatingly reply, and the observer would write down the first sign she made. The point of this procedure was to prevent the recorder from giving Washoe any cues as to the nature of the object, which would be placed in the box by another experimenter who neither Washoe nor the observer could see. Washoe did not seem to mind so much identifying the obvious to her slow-witted companions as she did the long waits while the exemplars were changed. Furthermore, if the exemplar was a Coke, she would, on occasion, abruptly terminate the game by grabbing it and running up a tree." (Linden E. 1976 talking about the testing of the chimpanzee Washoe who was taught to sign by R. & B. Gardner. Page 26)​

The language we use within our Sensory Stories is not secondary. If is of equal importance to all the other aspects of the presentation os the narrative and therefore must be carefully considered. It is likely that the Learners will not have sufficient cognition to understand all of the vocabulary used (if any at all) and, even if they do comprehend some of the words may not fully understand the story as a whole. To better enable Learner comprehension we need to evaluate the language we use and how we use it. Restricting language to both common and simple vocabulary will help as well as several repetitions of the vocabulary within the narrative. Also ensuring that each sentence in the narrative builds on the former without using deixis or anaphora is important. Therefore, the narrative needs to include either considerable redundancy or be so simple that such grammatical forms are not used. Thus, 

"John took the ball. He carefully positioned it on the table top."

becomes

 "John took the ball. John put the ball on the table."

In an interesting article in the PMLD Link magazine, Blake (2011, page 7- 9) writes about an interactive Sensory Story session around the 'Cinderella' fairy tale. While we would not rule out the use of Cinderella as a Sensory Story, it does contain magical and mythical components (the appearance of a 'fairy godmother' for example) which are fairly abstract concepts. However, our main concern was with the language used in the narrative:

"Scrub, scour, wash and clean, those ugly sisters are really mean, really mean, really mean!" (Blake 2011 page 9)

We would want to replace words such as 'scrub', 'scour' and 'mean' with simpler forms. Rhyming in such a context makes it more difficult but not impossible:

'Cleaning the rooms, cleaning the rooms, makes Cinderella sad,
those ugly sisters are very bad, very bad, very bad' 

Sure it's not quite the same but it is still in line with the story plot and uses simpler language. Why change 'mean'? What do we mean by 'mean'?! Already we have two variations of the word in everyday use. Let's try to avoid such confusions. Blake goes on to say as a part of the narrative:

"Cinderella went to the ball and danced all night with the Prince" (Blake 2011 page 9)

Again, there are issues with the vocabulary in use here. How is the word 'ball' for example likely to be understood by those experiencing PMLD? It is likely they will think that Cinders went towards a toy ball. Why not simply change that line to read, "Cinderella went to the dance and was happy all night with the Prince"? We also may need to question the concept of a 'Prince'. Indeed, why does he have to be a Prince at all? A liaison with a Prince fits into our frame of reference as a fairy tale ending but we ought to question whether it is the same for the Individual Experiencing PMLD. It might make more sense to replace the word Prince with something more likely to be comprehended by our audience: "Cinderella went to the dance and was happy all night with this good man." Where the good man could have been previously introduced into the story line at the point where they meet.

While it may seem that we are critical of Blake's article, we do not want to leave you with this impression. In fact, we found the article both interesting and inspiring as she relates how she manages the sensory perceptions of her Learners. Indeed, it is not unusual to hear Sensory Story narratives utilizing such vocabulary (it may be the norm) and, therefore, we are simply trying to draw attention to this issue by using Blake as our example  but we could have cited concerns over language use from many other sources (so our apologies to Miss Blake!).

How do I decide what vocabulary to use in a story?

There is no one simple answer to that question. However, we can perhaps give some guidelines for consideration.
If you have selected a story book from your library then the vocabulary is somewhat given. However, it does not follow that you cannot edit it in such a way to take into account all that we covered on this page and yet still relate the basic story as set out in the book. 

If you are creating your own story keep words simple and sentences short. Avoid the use of advanced grammatical forms and the use of pronouns.
Avoid and replace advanced forms of words which have another more concrete and everyday meaning. For example, don't use 'back' as a verb (back to school) rather use 'go' (go to school). Learners are likely to be confuse by 'back' meaning a part of their body and back meaning 'return'. Maintain the simpler more concrete meaning only for the present.

A Sensory Story can be an ideal vehicle through which to promote the development of targeted key concepts and relations. Do not stuff a story with such concepts rather be selective and build gradually as new stories are introduced.
You may decide to focus on concepts which are:
seen as important for Learners to understand in order to realise greater control over their lives;
simple and basic;

only one key piece of information per story line / sentence. 
part of the core vocabulary of English and therefore have a high frequency of use in everyday language within special needs environments and within family life;

normally considered as fringe vocabulary but are utilised frequently within the Learner's everyday environment (words such as 'Physiotherapy' for example)('Toilet' is also a fringe vocabulary word but one that it will benefit a Learner to recognise)
necessary precursors to more advanced forms that are aspired to be targeted;
Ensure that all staff are aware of targeted concepts and they are reinforced across the curriculum in as consistent a manner as is practical.
Avoid advanced word forms: for example, use the word ‘make’ instead of the word ‘produce’ or 'construct'
Focus on concrete lexical rather than auxiliary verbs. Make the actions as you say the word as this will alter the both the tonality and the experience for the Learner. Don't just say 'move' but, rather, move (your arms  and the top part of your body) as you say 'move', for example. 
Do not relate stories about concepts with which the Learners have no prior experience and are not likely to have at any future time. Stories about travelling into space or even sailing on the high seas are problematic. Dinosaurs, rocket ships, aliens, galleons, Romans, war poets, gods and many more topics are likely to be problematic. Go there at your own risk!
​​
Are there other tips?
Yes there are!

When getting the group to focus always use the same words and actions. For example, you might say, "Story time!" followed by "Everyone listen" while facing the group and signing at the same time. It is important that you do not vary the 'everyone listen' language or signing; indeed, it would be beneficial if this were common practice across the entire curriculum. "Story Time" is used to begin every Sensory Story session.
When seeking the attention of a specific child always use the same single word (name) and sign or symbol. Wait until you believe you have their attention before proceeding.

Always start a Sensory Story the same way. Perhaps with a phrase such as, "It's story time" accompanied by the reading sign and an Object of Reference for this time in the classroom. A further idea is to have a special place and or position/orientation within the room that is only used when it is story time (as such it acts as a sensory cue. You may wish to have a special arrangement of the group such that the Learners are sitting in a specific order only used during Sensory Story periods. This will help the Learners to anticipate what it to follow. 
Try to select times during the day to use as Sensory Story times that are the least likely to be disrupted and in which the Learners will be the most alert if possible. Try to stick to the same time for each Sensory Story if possible.
If a Sensory Story is to be read by a staff member aim to use the same staff member each time if possible (see technology section further down this page).

Do not vary the Sensory Story. No surprise insertions or language.
Have an efficient plan to deal with internal disruption and ensure that all staff are aware of this procedure. For example, if a Learner has a particular problem and needs to leave the room. Plan to ensure the minimum disruption. Remember, it does not matter if a Learner misses a Sensory Story session entirely or partially as the story will be repeated on many occasions and the 'missing' Learner will have other opportunities to experience it.
Note what appears to work well and what does not. Then it is possible to amend a story to be used for a new group at some future time.
Ensure that each member of the staff team understands their role within the story and does not deviate from it unless under special circumstances or on your instruction.

A story is not to keep staff entertained! While all should have fun the primary focus must always be the Learner.
It is possible to have choice within a story such that each member of the group can opt for something different while working with a single member of staff before coming together to continue the story as a group. For example, if the story is about going for a walk, each member could be asked to choose an item to wear on the walk (hat, scarf, etc). Indeed, the choice be of one item (for example a hat) but between different colours and styles of said item (every one ends up with a different hat). Such 'choice' sessions should be managed so that they run smoothly during any Sensory Story period.

Ensure that staff use the same language within choice session and do not vary 'choose' with 'decide' or 'select' for example.
Use an adapted 'OWL' approach (Hanen Program) where OWL stands for Observe (observe and see what interests and motivated the Learner and work with their word), Wait (give the Learner a chance to respond to the stimuli in the story; don't rush ahead), and Listen (as our Learners are unlikely to be chatting away, listening here refers to watching how they respond to the story and the sensory input. Notice their body language and any movement. Where are they looking?)
We advise keeping all the resources for a single Sensory story in a some form of labelled container with lid. In this way you can build a bank of such stories for future use. You do not have to keep inventing new stories although you might seek to adjust and improve older ones and bring in new technology etc.

Keep a copy/backup of your planning for a Sensory Story on a memory stick within the storage container. If you should ever lose the main copy to a virus or some other reason then you will always have a back up of your work for future use.
Do not use Objects Of Reference that are in use in your establishment within a Sensory Story in a pretend way. For example, if you have an OOR for food preparation which means either that a Learner is going to moves to a specific classroom or that food preparation is immediately about to follow in the same classroom, do not use this OOR to reference food in a Sensory Story. The Learner will be anticipating preparing food either after movement to a new room or within the classroom. If this does not follow then the Learner will be completely confused. 
If you have the time, go through the Sensory Story script with your support staff BEFORE doing it for real with a group. Get some of the staff to role play Learners and some staff to role play staff. Ensure that each member of the group knows her/his role. Ask for ideas for improvements and if anyone has any concerns. Staff can brainstorm problem solving methodologies. Ensure each staff member understands what is to happen and why.

What about Sensory Stories on religion? 
All religion is an abstract concept which is very unlikely to be understood by an Individual Experiencing PMLD. We would suggest that you avoid it as a topic within Sensory Stories. However, it does not follow that religion cannot be addressed in another area of the curriculum. If a Learner attends a church regularly then concepts such as 'church', and 'prayer' are part of the Learner's regular routine and, as such, concepts that need to be taught and checked. Concepts such as 'hymn' might be better substituted with 'music' and or song' (see 5 above). Religious communities are generally welcoming and religious practices are typically repetitive; the same sorts of things tend to happen in the same order. Furthermore, religious areas tend to be peaceful:

"Amerdeep goes with his family to the Sikh temple at 6 pm every day. He is welcomed by the community and joins in as much as he can. He enjoys the routine of the process, the prayers, the music and the calm atmosphere" (Lacey, 2012, page 9)

An exception to the general guidelines on abstractness is the concept of death. While highly abstract and almost certainly beyond the cognition of our Learners to grasp they will unfortunately experience its effects repeatedly at some point in their lives. When a friend or a relative suddenly seems to disappear, a Learner may find it very distressing and yet not really understand why.  PAMIS have developed the concept of the Sensitive Story which, as its name implies, addresses sensitive areas of concern for Individuals Experiencing Learning Difficulties.

Technology and the Sensory Story

In these modern times, with the pace of change being so rapid, it is almost foolhardy to write of technological support for sensory approaches to the special education curriculum as what we recommend is certain to be out of date or, perhaps worse still, out of production as you read this. Thus, in this section, we will speak of the use of technology without actually mentioning many pieces by name although the naming of a few will be inevitable to highlight specific approaches. While we may name a few current items of technology, it should be recognised that there are alternatives to those we state from different manufacturers and sources as well as different approaches to reaching the same ends. In the section to follow this, we will list items that might form a basic Sensory Story system / kit. 

If, like us, you believe that one of the primary goals of education (if not the primary goal) for Individuals Experiencing PMLD (IEPMLD) is control then the role of the staff during any Sensory Story session is not to take charge of every aspect but, rather, to facilitate the handing of control to the Learners themselves such that they have continually increasing successful experience of controlling their environment )as well as the people within their environment). Presently, too much is done (by staff) to and for Learners (as opposed to by Learners) in a Sensory Story session. The Learners are passive recipients of the narrative and action. In Learners being mostly passive participants, it is very difficult for others to ascertain their level of comprehension. However, in passing control to the Learner, staff can more readily glean evidence of understanding.

One fundamental feature of good practice in the use of Sensory Stories within a special education classroom is ensuring the story is narrated each time in the same way as it was on previous occasions. This is not always easy for staff to do. However, technology does not have such a problem. There are several ways that technology can be utilised  to tell a story one line at a time. Furthermore, such technology can be in the control of the Learners themselves: the staff's role being to ensure that all goes smoothly and the technology behaves itself. For example, the story could be narrated via PowerPoint. If the text is written to the PowerPoint screen, with each slide containing one line of text, there are a number of text readers for PowerPoint that will read the text as each slide is displayed. Alternatively, using any suitable recording system on a PC a staff member can record each line of the text and embed it into PowerPoint such that, as each slide is advanced the storyline is read out in exactly the same way (seemingly by a member of staff). Is it possible to control PowerPoint by a single switch such that any Learner can advance the slides? Sure it is! The image (above left) depicts a BIGtrack which is an enlarged trackball system (basically an alternative to a mouse) that will plug into any USB socket on your computer  (PC). The BIGtrack comes complete with two switch sockets (one for left mouse click and one for right mouse click) and thus a switch can be attached to provide a left mouse click which acts to advance slides in any PowerPoint show. In the image, the switch has been replaced by a Jelly Beamer receiver which receives radio signals from a jelly Beamer transmitter which can literally be anywhere in the room. The Jelly Beamer transmitter is a switch in itself but, if this is not something that a Learner can operate, any switch may be plugged into the transmitter such that any Learner can operate the advance of the PowerPoint slides remotely. We should state that this is not the only way that such remote operation of PowerPoint is made possible and many other products on the market will perform an equally fine job.

While PowerPoint can handle both the graphics and the narrative as well as additional sound effects, this is possibly not the most ideal way in which these things should be handled. There are several pieces of technology currently available which will permit a narrative to be stored and read back on line at a time. For example, the BIGstep from AbleNet permits storage of one line of text to be recorded (as an audio file) at a time until the entire narrative is complete. The BIGstep can then be used to replay the lines one by one simply by activating its surface or by attaching another switch. The problem with using a BIGstep (or equivalent device from another manufacturer) is that if the BIGstep is then used for something else, the recording of the story narrative is lost: the story cannot be stored in its memory for future use and therefore has to be reprogrammed each time it is required for the story unless it is set aside specifically for that purpose (which seems like a waste of valuable tool). Of course, if you purchase a BIGstep with levels you could keep a story on one of the levels but there is every chance that a staff member will accidentally erase that level by forgetting to switch between levels when recording some daily message. A better solution would be to use a Bookworm to store the narrative. The Bookworm is a recording device with a memory card such that stories are unlikely to get accidentally erased. As such, a whole library of stories can be maintained on a single card for future use. The Bookworm can be controlled by a single switch. Each time the switch is activated, the Bookworm will read out the next line of the story. Thus, one Learner can be activating the Bookworm to create the narrative (which, by definition, is identical each time) and, yet another Learner, can control the advance of imagery on the screen by advancing the PowerPoint slide. 

If we take one further step, it is possible for PowerPoint to handle graphics, a Bookworm to handle the narrative, and a BIGstep to handle the sound effects. All of this technology can be controlled via separate single switches. In a class of eight Learners, we can ascribe every Learner a specific role in the story line. The staff's duty then become to assist the Learners to create the story and ensure that everything happens at the correct point along the way. Of course, at some time or other, a Learner is going to activate a switch at an incorrect moment and a pig is going to squeal (for example) when there is no pig on the screen or in the story! That is a given and has to be accepted but this is the fun of giving the control over to the Learners! If we record a repeated story line onto several BIGmacks then each member of the group can be encouraged to repeat this line at the correct moment in the narrative. While it is unlikely to be in harmony, the earliest Learner to activate his/her BIGmack might act to remind the others to do the same. Thus:

• we have technology to narrate the story line;
• we have technology to illustrate the story line;
• we have technology to create sound effects;
• we have technology to allow Learners to join in with a repeated story line (which should always follow a specific event in the narrative such that this acts as a prompt for each Learner).

Suppose, however, we wish too create a special effect at some point in a narrative such as the wind blowing and leaves flying around. Can we do this via a single switch? Yes! We will need a good quality fan (most educational establishments already will have at least one of these) and then we require a device that can switch mains electricity. There are a number of systems that can do this, the PowerLink is one of these. The PowerLink allows a mains electrical device to be controlled via a single switch either directly or remotely. Many educational establishments will already have such a system (or an equivalent). When the fan is plugged into the PowerLink, a single switch can then be used to control the fan with absolute safety. The staff can drop real leaves into the 'wind' or create paper of cloth leaves for such an event. Better still perhaps the Learners themselves could create paper leaves in an art sessions perhaps using finger painting techniques.

It should be noted that almost any electronic item can be controlled via a single switch: it does not matter if its power comes from the mains, or a battery, or a USB socket ... they can all be controlled by a single switch (there are some exceptions to this rule). If you want to play snippets of music at any point in the narrative this can be achieved in a number of ways:
add the music into the PowerPoint (it is easier if the music is a .wav file);
put the Music onto a BIGstep or a BIGmack;
Obtain a CD player that is operated via infra-red and purchase a switchable infrared control system. The one we recommend is the Doozy switch interface from Switch-Ed. The switch interface then will send a signal to the CD player to start to play and, when the music is no longer required a further switch selection will pause the player and thus terminate the music.

What about the Learners creating appropriate smells to illustrate the narrative? This is a little more problematic. Once a smell pervades an environment it is not easy to remove it and thus, if a temporary smell is required it may be better for staff to provide this in the form of a scented sponge (or some such methodology) which can be introduced near to a Learner (a home made form of vinaigrette).  If a scent pervading the environment for a long period is not problematic, there are electronic scent dispensers available on the market; however, it may be just as effective to use a small fan to blow air over or through a homemade scent source. There are portable scent diffusers available on the market and although they are pretty effective they can also be pretty expensive! Again, why not create your own?

With the use of technology comes certain dangers not the least of which is the recognition of 'fly-swatting' as evidence of comprehension. It is not!. Fly-swatting is defined as a learned response to a particular stimulus without cognitive engagement. This implies that we may actually be teaching Learner's to fly-swat! If a Learner is presented with a BIGmack (or any equivalent device) and the Learner reaches out and activates its surface  (to say a repeated story line, for example) it does not follow that the Individual is cognitively engaged with the story, the sentence, or the concept suggested by the sentence: it might simply mean that the Individual concerned has learned that s/he is always to perform this action (activating the BIGmack's surface) when staff place it in front of her/him. This is fly-swatting: a Learner does it because that is what s/he has learned to do and not because they understand anything about it's actions or consequences. A Learner who repeatedly activates a switch or a BIGmack several times in any one presentation is likely to be fly-swatting.

Choosing Sensory Stories

It is often surprising what may be achieved with very simple equipment. If a group has been used to hearing two or more Sensory Stories then it is feasible to give any member of the group a choice about which is to be presented. Typically, children will select which bedtime story to hear their parents read and parents often become frustrated when a request for the same story is made over and over again!

Providing choice can therefore concern a group selecting which story they would like to hear. However, it can also be about choices within the story itself. For example, if part of a story involves putting on a hat, it might be between choosing between two hats (errorless choice) or between a hat and a glove (assessment choice). As the 'goal is control' (see earlier), and having choice is an element of control, all good Sensory Story sessions should build in at least one choice to the narrative at some point. The choice may be errorless (whatever the Learner selects is correct as in the choice above between two hats) or assessive (where one of the choices is incorrect: can the Learner pick the correct choice?) and should fit seamlessly into the story line. Indeed, a choice might alter the story line such that on one selection, the story line proceeds in one direction whereas with another selection the story moves in yet another direction. Now you might be thinking that might require several stories but, if you create your story to include such diversions, varying choices can be built in. For example, if the story was about a person who sometimes woke up happy, sometimes sad, and sometimes angry and what ensued then the narrative can incorporate these three aspects. The Learner can choose what mood the person is in using wooden spoons dipped into paint and decorated with different expressions to depict an emotion (see image upper left). If a Learner picks the 'angry spoon' then the story follow with the angry section. If the Learner picks the 'sad spoon' the story continues with the sad section. However, the story contains all three emotions and can proceed with these in any order such that it does not matter which spoon is selected. However, once a spoon has been selected it is removed from the next Learner choice such that the story does not repeata part previously presented. Best practice would dictate that the Learner s themselves are involved in making such spoons with the colours reflecting the emotions. Of course, it is possible to add hair and even clothing to the spoon figure if you wish. 

Choice may be errorless. If a section of the story involves putting on a hat (for example), a Learner can choose from between two or more hats which one they would like to wear. It does not matter which one is chosen as each is a correct response. While it does not tell us anything about a Learners concept of a hat (as opposed to a shoe, for example) it might provide us with increased awareness of a range of other Learner abilities; for example:
Is the Learner able to reach out and select a hat?
Will a Learner clearly eye point to a desired hat?
If a staff member holds up a each hat in turn will the Learner indicate when a desired hat is reached?
Does the Learner attempt to put the hat on without prompting?
Does the Learner appear to show a preference for a particular hat each time the choice is provided?
After several re-tellings of the story, does the Learner show any indication of anticipating the hat selection to come?
Does a Learner change behaviour over time when a hat has been selected? For example, if a Learner simply drops the hat when it has been chosen, does the Learner hold on to the hat after experiencing the story on several occasions?

Choice may be errorless. If you have been using books as the basis for your Sensory Stories (not  necessarily the best approach but also not necessarily an incorrect approach) then a Learner may be given the choice of one of two or three books to select the Sensory Story for the session. For example, if simplified, linguistically adjusted, and sensory versions of 'Goldilocks and the Three Bears', 'Jack and the Beanstalk', and 'Little Red Riding Hood' had all been previously presented then a Learner might be shown all three books and tasked to select just one. As any Learner selection would result (errorless choice) in a subsequent Sensory Story, no claim can be made of Learner cognizance.

Choice may be errorless. Remember, 'Errorless learning is terrorless learning'. Don't scare them at the start, place them on the pathway to progress peacefully.

If a particular object is utilized within a particular Sensory Story and it becomes associated with that particular Sensory Story and only with that story, then a range of objects from different Sensory Stories can be used as a means for a Learner to select the Story s/he would like to hear. While it cannot be claimed that selection of such an object is indicative of Learner understanding (as all objects lead to at least one story (unless 'bogus' objects are included in the mix), it still is a useful process because the Learner may come to understand that the object chosen is linked to the story that follows over a period of time.

Choice may be assessive. With assessive choice staff are looking to ascertain if a Learner can select a 'correct' item from a choice of two or more where one of the items presented is 'incorrect'. Of course, if two items are presented a Learner has a 50% chance of obtaining a correct answer by chance alone. However, should the Learner continue to select the correct item in subsequent telling of the story then an assumption of Learner comprehension becomes more likely. Staff may also note specific behaviours of a Learner, for example: a Learner may always select the item that is presented on the right side (positional preference/bias) and should therefore vary the side on which the correct response appears. A Learner may also be selecting on the basis of a specific item attribute (for example colour) and not on the basis of the story at all. It is therefore important for staff to note all as many aspects of a particular choice as is possible such that patterns may be detected at some later date and addressed if necessary. Best practice in assessive choice requires the use of 'blind' assessment by staff in which staff are unaware of either the items shown or the positions of the items shown and thus cannot be providing the Learner with unintentional cueing. One way of doing this is through the utilization of choice boxes. It is beyond the scope of this section to detail this procedure in full.  A choice board and box kit is available commercially for such a purpose if required.

Narrative Therapy with Individuals Experiencing Learning Difficulties

Narrative therapy is a technique utilized in counselling using a story-based approach that assists individuals to put a more positive spin on  a story about an aspect of their life. This approach has is in its early stages of development with regard to its potential for use with individuals experiencing a significant learning difficulty but is nevertheless of some interest and worthy of inclusion on this page:

"Narrative Therapy is a counselling technique that is growing in use in the mental health area. The approach uses a process to identify the problems that people may be having and the stories that dominate the person's life, and then encourages the development of more useful stories about the person. Therefore, problem stories are deconstructed and then the aim is to support the person and those in his/her support network to reconstruct stories that lead to better outcomes. While the approach is in its infancy with regard to people with disabilities and the research to validate the approach has not yet been done, we have found the approach to complement well the positive behavioural and cognitive behavioural approaches that we have used in our work with families over the last six years." (Matthews, B. & Matthews, B. 2005)

Sensory stories not only assist with communication and literacy development, but they also can be a useful approach to address the indivdiual's  social-emotional skills. The narration of the story can be a useful approach to help reduce behaviours of concern by helping the individual understand complex social or behavioural events. The narration of the sequence of events provides the platform to explicity state the thoughts, plans, reactions, and emotions of the individual and the other characters.  This strategy can can be used as part of a comprehensive approach to providing positive behaviour support and reinforcing the importance of the appropriate alternative behaviours.
 
When Narrative Therapy forms a relationship with a Sensory Story the outcome would probably be akin to a Sensitive Story (See the work of PAMIS) in which sensitive areas of development are addressed through the use of mutli-sensory (sensitive) story lines.

Summary

We doubt that there is a single person on the planet who doesn't like a good story well told. IEPMLD should not be excluded from such an experience. As discussed in this article by using sensory stories we can discuss daily experiences by weaving together communication about situational contexts, characters, actions, motivations, emotions and outcomes. Telling a Sensory Story is a skill that should be developed by all involved in the delivery of Special Education. It should be a joy to experience for Learner and the Story Teller alike. Have fun!