Low-Tech Ways for Adapting Books for Fine Motor

By: Teresa Loos, EC-SEAT Scholar

Part of teaching children with special needs includes providing them with a least restrictive environment in which they have access to the curriculum, opportunities to participate, and can be supported and accommodated in their education. As an educator, I live by Universal Design for Learning and the National Association of Education for Young Children and the Division for Early Childhood’s Position Statement on Inclusion, which ensures that children with special needs have access, participation, and support.

When people think of assistive technology, the assumption is some sort of device they can use. However, according the Assistive Technology: principles and practices, assistive technology is a broad range of devices, services, strategies, or practices that can be implemented to eliminate or alleviate problems of an individual with special needs (Cook & Hussey, 2002). Assistive technology can also be low-tech and does not require a device but rather some other sort of accommodation to help individuals through daily living. These accommodations could include adaptations by using common household items or cheap materials from the store. Assistive technology is also not only for those that have a significant impairment, disability, or special needs. It is important to note that these strategies can also be used with my students that are not identified and fall into the “average” range of development. 

CREATING LOW-TECH ASSISTIVE TECHNOLOGY SOLUTIONS

In my inclusive preschool classroom, we have many developmental delays in fine motor skills and children who have low muscle tone. As part of the preschool curriculum, books and reading need to be accessible to everyone. In my inclusive preschool classroom, we use stories as a theme for each month and have the children independently look at books throughout the day during book look. I supported a child with down syndrome to turn pages independently with a few inexpensive materials around the classroom. This adaption took minutes to accomplish and was able to save time and frustration for the child. I focused on page fluffers and page turners. Page turners give leverage for a child to turn the pages with the material sticking out. Page fluffers give spaces in between the pages to allow room for the child’s fingers to turn the pages. Each of the materials listed below should be trialed depending on the child. I found some materials that worked with one child did not work for another.

• Page Turners
• Page Fluffers
• Popsicle Sticks
• Velcro
• Blinder Clips
• Rubber Weather Stripping
• Large Paper Clips
• Foam
• Index Tabs
• Popsicle Sticks
• Loose Leaf Paper Rings
• Pom-poms on Paper Clips
• Small Post-it Notes
• Beads of Hot Glue or Puff Paint
• Craft Foam
• Bottle Caps
• Clothespins
• Binder Clips

I also used the classroom iPad to create an album of the theme book we are using for the month. After taking the time to teach the child how to use the iPad as a tool, the child was able to use the iPad to go through the pages, or pictures of the book I took, to follow along with the story. Pages can easily be modified with low cost and low tech materials and allow individuals to access information, explore, and become independent with a skills that enriches daily life.

Read on to Learn more and see examples

In one of my internships working in an inclusive preschool classroom, reading stories is a huge part of the curriculum. Therefore, the students that have difficulty turn pages of a story independently may need an accommodation which can include a low-tech assistive technology strategy to allow them to access and participate in activities surrounding the stories we are reading. Turning pages may be a small and simple action to most people. However, there are many students in my preschool classroom that have low muscle tone and developmental delays in fine motor skills that prevent them from actions such as turning pages which is an important skill in a preschool classroom and later on in life.

I chose to use a 3 year old boy identified with Down syndrome to experiment different solutions for turning pages. This student is very behind in all areas of development, especially his physical development and has overall low muscle tone. He just learned to walk two weeks before turning 3 years old and starting preschool and is progressing with his gross motor skills but had made little progress with his fine motor. Currently, he is doing better but still needs assistance with fine motor skills such as turning pages. Even though there are other students in the classroom that can benefit from the strategies and need help turning pages, I chose to focus on this one child in particular. Some of the strategies I tried can also be used with the elderly or others who have trouble turning pages. I also chose to only use low-tech assistive technology solutions because we are a school with a budget and wanted to share the possible strategies with the child’s family so they can implement them at home. 

TRYING DIFFERENT SOLUTIONS

One of the strategies I started to implement was low-tech ways for page turning such as Tips for Home or School: Making and Using Page Turners (Demchak, MaryAnn, 2008). I first tried Therese’s materials of foamies and double sided tape. I attached a 2 inch strip of foamies onto a small cut of the double sided tape that I put on the edge of the pages. When the child used the foamies to turn the page, it was more flimsy than what I was expecting. It also blocked some of the pictures and words if not places in the right spot. Also, this particular child was getting distracted by the foam and how it felt instead of the story. After that strategy, I realized that I needed to find a material that was sturdy and boring enough so the child’s attention would be on the story and not the page turning material. I tried using solutions I found online as well as materials I had around the house that may also be in his family’s house such as clothespins, binder clips, paper clips, post-its, popsicle sticks and more. 

PAGE TURNERS

I explored the binder clip and clothespin idea first by clipping them onto the pages in a scattered way with some up top, some in middle, and some on the bottom. When I was reading the story with the child, the clothespins often broke and were unclipped from the pages when the child interacted with them. 

However, the binder clips mostly stayed in. I was expecting him to use the binder clips as leverage for turning the pages. However, he was able to turn the pages just based on the spaces it made in between the pages. When using the post-it notes, they were too flimsy, lost its stickiness, and fall off too often. I attached the paper clips thinking they could be used as a page spacer but it was too small of a space for the child to turn. Therefore, I came up with a different idea to try. With the page turners, the binder clips seemed to be the most successful.

With the paperclips, I attached one to the top of each page. This strategy can also be implemented with the binder clips. With a magnetic wand, or a stick tool with a magnet on the end, the child was able to connect it to the paper clip and turn the page. The magnetic wand is a material that the child was familiar with which is why I chose to use it. While some children who are not familiar with the tool may become distracted and not listen the story, this child was able to use the strategy successfully because we use the wand and paper clip tool for many activities in preschool. I felt this strategy was most successful out of the many materials that I tried with him for turning pages. After showing him a few times what to do, he was able to do it independently. I am not sure I would use this strategy for other students in the classroom because they would get distracted, impatient, and tired. Looking at books is a motivator for this child so he was able to sit and work with the materials. The limitation to this strategy is having someone put the paper clip or binder clips on each page before the child can look at the book. The magnetic wand also costs around $15 for a set of 6 wands and is not a common household item. Therefore, the child’s family would have to purchase him one if they wanted to use the strategy at home. Going along with the magnetic idea, I also went further by thinking about the elderly and other ways to use magnets. If a magnetic wand was not available or person did not have the coordination to connect the two magnets, putting a small magnetic piece into the finger of a glove may also help so the individual just has to swipe their finger over the paper clip for the magnets to stick. I came up with this idea on my own but did not test the strategy with this particular child because of sensory needs and distraction. However, on a side note, I am wondering how it would work with the elderly or someone with arthritis.

PAGE FLUFFERS

In addition to page turners, I also looked into page fluffers for when the child develops more in his muscle tone and fine motor skills. The page fluffers are adaptions to a story that provides spaces in between the pages. I got most of my ideas from looking around the classroom and through research with an article called, Tips for Home or School: Page Fluffers (Marty Elquist, 2005). The article suggested hot glue dot on the corner of pages, Velcro, rubber weather stripping, foam, paper clips with pom-poms, popsicle sticks, bottle caps, and more. Many of these items can be found around the house. However, I found the paper clips with hot glued pom-poms to be the most simple and useful because you can remove them and not damage the book. I did not try any of these ideas with this child because I had already found solutions that worked but looked more into it for future reference and to possibly try with another child in the same class. As the child I am working with grows in his fine motor skills, the size of the pom-pom can also be reduced to scaffold his development. Many of the low-tech articles that I found on page turning consisted of page fluffer ideas that can be made with various household items. 

CHOOSING SOLUTIONS

In my preschool classroom, we have a circle time story that involves a group setting in which the teacher reads the story and the students sit and listen and we also have a book look time in which students look at books individually. Therefore, I found one solutions for each of the occasions that he interacts with a story. During book look, I am choosing to use the binder clips with him to get him accustomed to turning pages with the option of the magnetic wand if he wanted to use it. Both methods allow him to learn the motion of turning pages. Eventually, I would just like to use the page fluffer strategies with paper clips and pom-poms or just the blinder clips in which he has to touch the pages. However, he needs to be scaffolded and gain more muscles for fine motor skills. However, during group story time we often give students that need one-on-one aids or students that have low vision such as this particular student their own copy of the book to follow along with. In this case, the student needs to follow along more quickly. Therefore, I decided to use the iPad and take pictures of the pages and create an album for the book like we learned in Therese’s J-Term class. The student’s one on one would have to go into the album to open up the pictures. However, the child has learned over time to swipe through the pages. This child has limited exposure to the iPad but is becoming more familiar with it overtime. At first, the iPad was a distractor and toy to him until I was able to teach him how to swipe and keep up with the story. An adult often has to sit with him to prompt turning the pages but this strategy is more successful for him for this particular activity. 

OTHER SOLUTIONS

Out of curiosity, I also looked into page turning devices you could purchase for a variety of needs and ages. There are clear vinyl triangle page pockets that are magnetic that slip on the bottom corner of each page. It comes with something similar to a magnetic wand to turn pages (Demchak, M, 2008). There are also wearable page turning tools that an individual wraps around their hand that connects to a rod with a rubber end that can turn a page in one motion. In addition, there are also electronic page turners that turn pages with a switch or button activation. Many of the electronic devices are costly and range from hundreds of dollars. The wearable page turners can be recreated with Velcro and dowel rob and possibly a pencil eraser. I think there are alternative materials that can be easier to access and cheaper to obtain. Overall, I found the need of simple page turning to be necessary with individuals with disabilities and the elderly population. It is finding the right tool for the unique individual that is important. 

Overall, the two solutions for the two different page turning activities (group story and book look) are the most successful for this individual child. 

The two solutions are also the most low-tech and cheapest solutions I could come up with. Because I am in this internship two times a week and am constantly using these strategies, I am always adapting and fixing them to be better. The stories that he reads are often board books. As he progresses with this fine motor skills and gets older with paperback books, I would like to rethink some of the strategies I am using with him and choose different materials next time. Many of the strategies I researched I would also love to try on other children or individuals. I think this particular accommodation and materials used depends on the individual’s needs and preferences. I absolutely loved looking into ways to accommodate this skill using assistive technology because it seems like a simple action but can create frustration to those it does not come easy to. These solutions also prove how a few materials and simple assistive technology can be implemented and save individuals and children time in their daily lives. Pages can easily be modified with low cost and low tech materials and allow individuals to access information, explore, and become independent with a skills that enriches daily life.

RESOURCES

• Cook, AM & Hussey, SM (2002). Assistive Technology: principles and practice. (4th ed) St. Louis: Mosby.

• Demchak, MaryAnn (2008) Tips for Home or School: Making and Using Page Turners. Nevada Dual Sensory Impairment Project: Reno, NV.

• Elquist, Marty (2005) Tips for Home or School: Page Fluffers. Nevada Dual Sensory Impairment Project: Reno, NV.

• National Association of Education for Young Children and Department for Early Childhood (2011) Position Statement on Inclusion Concord, NH.