Phát triển kĩ năng giao tiếp cho trẻ khiếm thị kèm rối loạn phổ tự kỉ 5 6 tuổi thông qua chơi TT TIENG ANH

ơ MINISTRY OF EDUCATION AND TRAINING THE VIETNAM NATIONAL INSTITUTE OF EDUCATION SCIENCE NGUYEN THI THAM DEVELOPING COMMUNICATION SKILLS FOR CHILDREN WITH VISUAL IMPAIRMENT AND AUTISM

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MINISTRY OF EDUCATION AND TRAINING THE VIETNAM NATIONAL INSTITUTE OF EDUCATION SCIENCE

NGUYEN THI THAM

DEVELOPING COMMUNICATION SKILLS FOR CHILDREN WITH VISUAL IMPAIRMENT AND AUTISM SPECTRUM

DISORDER 5-6 YEARS OLD THROUGH PLAY

SUMARY DOCTORAL THESIS OF EDUCATION OF SCIENCE

Hanoi – 2021

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The thesis was completed at: Vietnam National Institute of Education Science

Instructors: 1 Associate Professor PhD Pham Minh Muc

2 Associate Professor PhD Nguyen Xuan Hai

Thesis can be found at:

National Library in Viet Nam Library of Vietnam National Institute of Education Sciences

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INTRODUCTION

1 Reasons for choosing the topic

Research by Gates and Kappan (1985), Kirchner (1990), Rogow (1998) showed that about 49-60% of blind children have other disabilities Thus, the number of children with multiple disabilities, including blind children with autism spectrum disorder, accounts for a relatively large proportion They also need to enjoy the right to care, education, and social integration like other children of the same age

According to many studies, one of the important issues that education needs to

be concerned on children with visual impairments and autism spectrum disorder (ASD) is communication skills (Huebner, Prickett, Welch & Joffee, 1995) The children have less eye-to-eye contact, use gestures and gestures to interact with others Children are also limited in expressing their own emotions and understanding the emotions and feelings of the people they communicate with [8][48][72] Children are less proactive to initiate and have difficulty maintaining communication On the other hand, with the age of 5-6 years old, communication skills are one of the essentialskills that need to be formed for children so that they can study and integrate at a higher education level Therefore, it is very important to develop communication skills for children with visual impairments and ASD 5-6 years old

Studies confirm that through play, children with disabilities have the opportunity to develop language, cognitive, and social communication skills [52][59][76] Play always creates situations and contexts for children with disabilities

to communicate and develop different skills in communication such as listening, feedback, and taking turns Participating in the game helps visually impaired children with autism spectrum disorders develop language, build confidence, reduce negative behaviors in communication situations [43][53][85]

For the above reasons, we chose the topic: "Developing communication skills for children with visual impairments and ASD 5-6 years old through play" to research for doctoral thesis

Based on research and actual situation, the author proposes measures to develop communication skills for children with visual impairments and ASD 5-6 years old through playing, helping them omit to have better communication ability

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through playing in a systematic, synchronous manner, suitable to the children's abilities, needs, and characteristics of communication skills and actual conditions of the schools, it will contribute to improving the results of the development of communication skills for children

5 Research mission and scope

- Proposing measures to develop communication skills for children with visual impairments and ASD 5-6 years old through playing Besides, conducting experiments measures to confirm the scientificity and research hypothesis of the doctoral thesis

5.2 Research scope

- Limit of research content: The thesis focuses on studying 06 groups of

communication skills of children with visual impairment and ASD 5-6 years old, the following skills: Group of skills to focus attention and listen, group of skills to make choices, love request and refusal, skill group to understand and provide more information, group of skills to control emotions, group of skills to interact, integrate into groups, skills to identify and adjust distances and postures when communicating

- Limit of survey audience

+ 30 children with visual impairments and ASD 5-6 years old (blind children and mild and moderate autism spectrum disorder)

+ 60 administrators and teachers at education centres for children with visual

impairments and ASD

- Limited research area: Intervention centers, specialized schools, Centers for

supporting the development of inclusive education have been implementing care and education activities for children with visual impairments with autism spectrum disorders century

- Research period: From January 2018 to November 2020

6 Research methods and approaches

6.2.1 Theoretical research methods

6.2.2 Practical research methods

Questionnaire method; Test method; Interview method; Professional method; Observation method; Case Study; Experimental method

6.2.3 Methods of data processing by mathematical statistics

7 Defended arguments

7.1 The combination of visual impairment and ASD affects the development of children's communication skills

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7.2 Organizine play in different forms is vital to encourage the participation of children with visual impairments and ASD 5-6 years old and strengthen communication skills for them

7.3 Implement a combination of ways to develop communication skills through play should match with the abilities, needs, characteristics of communication skills and play skills of children with visual impairments and ASD 5-6 years old On the other hand, it also suit of practical conditions of special educational centres to create opportunities for children to develop basic communication skills and contribute to enhancing social integration

8 New contributions of the thesis

8.2 Practices

- Assessing the level of communication skills of children with visual impairment and ASD 5-6 years old through research in several cases at care and educational institutions

- Providing a real picture of the development of communication skills for children with visual impairment and ASD 5-6 years old through play in order to researchers, educators, students and parents have database practices in researching, teaching, and supporting children in special education

- Building measures to develop communication skills for children with visual impairment and ASD 5-6 years old through systematic, scientific play and pedagogical testing on 03 children The system of measures to develop communication skills for children through play is a reference document that teachers and parents can use in the educational process for this group of children

- Chapter 4: Experimenting with measures to develop communication skills for

children with visual impairment and ASD 5-6 years old through play

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CHAPTER 1 THEORETICAL BASIS ON DEVELOPING COMMUNICATION SKILLS FOR CHILDREN WITH VISUAL IMPAIRMENT AND AUTISM DISORDER

5-6 YEARS OLD THROUGH PLAY 1.1 Research overviews

1.1.1 Research on education of children visual impairments (VI) and autism spectrum disorder (ASD) 5-6 years old

- The thesis refers to the rate of children with visual impairment and autism spectrum disorder

- Researching the effects of visual impairment and autism spectrum disorders

- Research on how to develop communication skills for visual impairment and

autism spectrum disorders

1.1.3 Research on play and the development of communication skills for visually impaired children with autism spectrum disorder 5-6 years old through play

- Research on play skill characteristics of children with visual impairments and ASD 5-6 years old

- The relationship between playing and developing communication skills for children with visual impairments and ASD 5-6 years old

1.1.4 Assessment of research overview

- Researched issues:

International and Vietnam studies have focused on giving different definitions

of multi-disability, multiple-visual impairment, deaf-blindness, visual impairments with other disabilities; the rate of children with multiple disabilities and its effects on child’s developments The authors also analyzed the specific contents, programs, care and education for children with multiple disabilities Particularly, there have been studies that have pointed out problems related to characteristics of communicational skills, assessment of communication skills and the development of those for children with multiple disabilities, visual impairments and ASD

- Issues that have not been researched yet

+ Age range of children with multiple disabilities is still wide: from 0-6 years old, 0-22 years old, from 5-11 years old without focusing on research in a specific age group In particular, there have been no publications in Vietnam related to the percentage of children with multiple disabilities in general, and children with visual impairments and ASD 5-6 years old

+ The characteristics, content, and methods of developing communication skills mentioned by the authors are common to all multi-disability, have not yet studied in-depth study of each form of disability associated with visual impairment

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+ In the world, there have been several studies on the assessment of communication skills of children with visual impairment and multiple disabilities, but these rating scales are for different ages, not focusing on specific ages, and there is no rating scale of disability associated with visual impairment (exception of deaf and blind children) In particular, there have been no studies on rating scales, contents, and methods to develop communication skills for visually impaired children with ASD 5-6 years old in Vietnam

+ Studies have also mentioned the influence of multiple disabilities on the development of all areas of blind children with multiple disabilities, but have not clearly analyzed the impact of factors on the development of communication skills of children with visual impairments and multiple disabilities, especially children with autism spectrum disorders 5-6 years old through play

- Issues the thesis focuses on research

+ Research on the theoretical framework to the development of communication skills for children with visual impairment and ASD 5-6 years old through play

+ Research on the status of the level of communication skills of children with visual impairments and ASD 5-6 years old and the situation of developing communication skills through play in Vietnam

+ Proposing measures to develop communication skills for children with visual impairments and ASD 5-6 years old through play suitable of children and educational conditions in Vietnam

1.2 Common issues of children with visual impairments and ASD 5-6 years old 1.2.1 Definitions

Children with visual impairments and ASD are children who have both visual impairments and ASD, the combination of these two disabilities affects the areas of development, children's life and learning activities but cannot use the education method specifically for visually impaired children or ASD

1.2.2 Cause of visual impairments with autism spectrum disorder

Many factors lead to children with visual impairment and ASD, which can appear before, during and after birth In particular, the diseases that are prone to have visual impairments associated with ASD including: retinopathy of prematurity (ROP), cortical visual impairment (CVI), no eyeballs, Anaphthalmia and Optic-Nerver Hypoplasia

1.2.3 Criteria of identifying children with visual impairment and ASD

There are four important criteria to identify child with visual impairment and ASD: (1) Visual (vision and visual field); (2) Language and communication; (3) Social interaction; (4) Behavior and ability to respond to sensory information

1.2.4 Effects of visual impairment and ASD on children's development

Characteristics of psychophysiological development of visually impaired children with ASD 5-6 years old follow the general rule of children However, due to the influence of visual disabilities and ASD, children have their own psychological and personality characteristics Children's developmental stages are often slower than those of their peers This includes significant effects on children's speech and language development In addition, children also have many difficulties in perceiving the

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surrounding world, especially forming symbols and imagination

1.3 Communication skills of children with visual impairment and autism spectrum disorder 5-6 years old

1.3.1 Definition of communication skills

- Skill is the use of knowledge and experience to perform actions to achieve a set goal

- Communication is an activity of interaction between people to exchange information, emotions and realize social relations

- Communication skills are understood as the effective performance of a specific action in the communication process by using knowledge, skills, different means and forms of communication to influence the communicator to achieve the set purpose

- Developing communication skills is an impactful process to create a positive change

in the level of a person's communication skills from unskilled to skilled at all levels

1.3.2 Characteristic of communication skills of children with visual impairment and autism spectrum disorder 5-6 years old

- Being limited Understand and provide additional information during communication

- Children have difficulty in focusing attention, limited in actively establishing bilateral attention and expanding communication topics

- Children are less sensitive to emotions and feelings of caregivers and peers, have difficulty controlling their own emotions, understanding questions, and responding, are less likely to listen and wait for others when communicating

- Children often tend to have little communication with friends in the classroom, do not understand the rules when working in groups, and have difficulty being patiently and emotionally controlling when waiting for their turn

- Visually impaired children with ASD show more difficulty understanding and using non-verbal language in communication Most children lack eye contact and use gestures and facial expressions In particular, children have difficulty in understanding the meaning of words and expressing by verbal language, instead of, children tend to use communication by actions, tactile symbols

- Behavior of visually impaired children with ASD in communication: there are typical behaviors to attract the attention of people around, children rarely use communication

to aim jointly create interactions with others or collect information

- Due to limited vision, children with visual impairments and ASD also have difficulty

in determining their own distance with communicators It is difficult for children to observe the correct posture when communicating with others, so they cannot imitate it

1.3.3 Assessing communication skills of children with visual impairment and ASD

- Purpose and content: Determine the child's level of communication skills

- Methods and forms: Direct evaluation and indirect evaluation

- Tools to assess communication skills for children with visual impairments and ASD

1.4 Play and developing communication skills for children with VI and ASD 5-6 years old through play

1.4.1 Definitions

* Games: Games are children's special activities, reflecting their interactions with the surrounding environment: objects, groups of friends, natural and social events; Games are considered as ways of organizing educational activities to solve goals and develop knowledge and skills for children to adapt to the reality of social life

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- Classification of games: This thesis chooses to approach the classification of games according to the purpose and genre of the game In which the purpose of games that the thesis uses is to develop communication skills for children

* Play: According to the Vietnamese dictionary, play is an action that expressing participation in the game voluntarily, happily and comfortably, thereby achieving a certain purpose (relaxing, creating relationships, develop skills, etc.)

* Game organization: Game organization is an arrangement of activities according to a structure to achieve the goals of games Play organization includes activities such as determining the purpose, content of play, specific play activities of children, interactions between children and participants in the play process

1.4.2 Playing characteristic of children with VI and ASD 5-6 years old

- Characteristics of development of play stages: Children are delayed in playing stages compared to children of the same age, especially having difficulty in functional and imaginative play

- The interaction with you and others in the play process, the forms of play: mainly play alone, difficult in associational and cooperative play with others

- The ability to solve situations during play: Children have many difficulties handling situations that occur during play with friends

1.4.3 Steps of play organization for children with VI and ASD 5-6 years old

Play organization for children with visual impairments and ASD 5-6 years old

to develop communication skills needs to four steps: (i) Step 1: Prepare to play; (ii) Step 2: Make a game plan; (iii) Step 3: Proceed to play; (iv) Step 4: Evaluate the results of the game

1.5 The process of developing communication skills for children with visual impairments and autism spectrum disorder 5-6 years old through play

1.5.1 Purpose and significance of developing communication skills for children with visual impairments and autism spectrum disorder 5-6 years old through play

Through encouraging children with VI and ASD to participate in differently organized play activities to suit their psycho-physiological characteristics, abilities and needs in order to develop children's communication skills It includes paying attention and listen skill, expressing needs, choose, refuse, understanding and providing more information, skills to understand and express feelings and emotions, skills to identify

be distanced from the object to communicate with, alternately interact in the group

1.5.2 Contents of developing communication skills for children with visual impairments and autism spectrum disorder 5-6 years old through play

In this thesis, the content of developing communication skills for children VI and ASD 5-6 years old is focused on six skill groups: (i) Focusing and listening skills; (ii) Group of using different forms of communication to express their needs; (iii) Skill group to understand and provide more information in communication; (iv) skill group

to control emotions in communication; (v) Skill group rotation, group interaction; (vi) Group of skills to adjust posture and distance in the process of communication

1.5.3 Method of developing communication skills for children with visual impairments and autism spectrum disorder 5-6 years old through play

There are many methods of developing communication skills for children with

VI and ASD 5-6 years old; and the thesis focuses on analyzing the main methods:

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Developing communication skills through free play – Floortime; Developing communication through interactive play – INREAL; Developing communication through the play environment (Environmental Communication Teaching - ECT); Develop complementary and alternative communication/Total communication through play and practice practicing communication skills through play

1.5.4 Forms of developing communication skills for children with visual impairments and autism spectrum disorder 5-6 years old through play

There are many different forms to develop communication skills for children with VI and ASD through play Within the thesis, it mainly refers to the forms that can

be organized including through: (i) Through playing in individual lessons; (ii) Through playing in group lessons by topic; (iii) Through playing in fun activities, picnics; (iv) Through play in daily activities (mealtime, bedtime, pick-up time) The forms of playing can be implemented for visually impaired children with mental retardation at 5-6 years old to develop communication skills in the above forms such as: playing freely, playing alone with adults, letting children play with friends, playing in association, or play cooperatively with friends in small groups, large groups

1.5.5 Affecting factors on the development of communication skills for visually impaired children and autism spectrum disorder 5-6 years old through play

There are subjective and objective factors affecting the effectiveness of the developing communication skills for children with VI and ASD However, the thesis focuses on analyzing objective factors (factors that affect children outside) Affecting factors on the development of communication skills for children with VI and ASD through play including: Classroom and school facilities (light, seating, play corners, ect.), utensils, toys, the interest, knowledge, skills and experience of the teacher, awareness, interest, support of the family, the cooperation between the family and the school (teachers and parents), the relationship between friends and family, friends in class, in school, program, content, time to develop communication skills for children

Conclusion chapter one

1 Children with VI and ASD are children who have both vision difficulties and problems related to communication, social interaction and behavior Particularly, the combination of these two visual impairments and autism spectrum disorder has caused significant limitations in children's communication with those around them

2 Communication skills of children with VI and ASD has many different characteristics: the ability to focus and maintain attention, use language in communication (understanding and expressing in language), the ability to wait alternately when communicating, typical behaviors when communicating, difficulty understanding and expressing emotions

3 Organizing play and developing communication skills for children with VI and ASD have a close relationship Through play, visually impaired children with ASD can easily access activities to implement basic communication skills

4 Developing communication skills for children with VI and ASD through play needs to

be researched with reality of children, class characteristics and support programs that centers, schools are implementing In order to develop communication skills suitable for children with VI and ASD through play, it is necessary to research specifically and

propose measures and implementation methods for teachers to easily apply

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CHAPTER 2 REALITY OF DEVELOPING COMMUNICATION SKILLS OF CHILDREN WITH VISUAL IMPAIRMENT AND ASD AGED 5-6 THROUGH PLAY 2.1 Organizing survey of the situation

2.1.1 Purpose of survey

Evaluate the developing communication skills for children with visual impairment and ASD 5-6 years old through play to propose measures for the development of basic communication skills for the children

of evaluating criteria for communication skills of children with visual impairment and ASD aged 5-6 (Cronbach’s Alpha constant) The result of testing showed that variables of observations have suitable total correlation (≥ 0.3) Cronbach’s Alpha constant is 0.96 ≥ 0.6, which matches the reliability of the measurement

Survey instrument of developing the communication skills for children with visual impairment and ASD aged 5-6 include: Survey forms for teachers, managerial staff; interview forms for teachers and parents; Observation forms of children’s activities

2.1.4 Objective and location of the research

* Location: Specified center, schools supporting children with visual impairment and ASD in Hanoi, Hai Phong, Bac Ninh, Ho Chi Minh city, Dong Nai,

Da Lat, Da Nang, Khanh Hoa

* Evaluation form: The thesis has deployed the evaluation of communication skills for 30 visually impaired children with ASD aged 5-6 (blind children with average the level of ASD) studying at educational centers in the location of evaluation

The thesis also surveys 60 teachers that have been teaching visually impaired children with ASD at schools and centers under evaluation

2.1.5 Stages of the deployment of practical research

Stages of practical evaluation: (i) Step 1: Build tools for evaluaion; (ii) Step 2: Deploy tools for evaluaion; (iii) Step 3: Gather, process the survey results by using statistical formular, softwares

2.1.6 Evaluate the result of survey

Quantitative data: Analyze the meaning of gathered statistics by handling the results from SPSS software and statistical formula

Qualitative data: Analyze, elaborate gathered results with deep interview and opinions of subjects taking part in the survey and observation forms

2.2 Reality of communication skills of visually impaired children with ASD 5-6

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Range = (Maximum – Minimum)/n= (3-1)/3 = 0,67

There are 3 main levels of evaluation for communication skills of visually impaired children with ASD partake in the survey as followed:

(1) 1,00 – 1,67 Cannot execute skills even with support

(2) 1,67 – 2,34 Correct execution of skills with the partial or the full support

of others (3) 2,34 – 3,00 Proficient execution of skills without support

2.2.1 Levels of execution for 6 groups of communication skills for visually impaired children with ASD aged 5-6

Bảng 2.2 Tổng hợp so sánh mức độ thực hiện 6 nhóm KNGT (6 tiêu chí)

Deviation

Rank

1 Focusing and listening skills 1.85 0.46 1

2 Using communicational forms to express needs 1.78 0.37 3

3 Understanding and providing additional

information

1.55 0.42 6

4 Identifying and expressing emotions 1.79 0.39 2

5 Alternating and interacting in group of friends 1.59 0.49 5

6 Adjusting posture and distance in communication 1.67 0.46 4 The statistics in the table above have shown hat six groups of communication skills of visually impaired children with ASD 5-6 years old remain at a level with an average score of 1,55 to 1,85 “cannot execute skills even with support” or “Correct execution of skills with support.” In which, the skill group which children excel in is

“Focusing and listening skills” with = 1.85 With skill group of “identifying and expressing one’s emotions” ( = 1.79) and “Using communicational forms to express one’s needs” ( = 1.78), visually impaired children with ASD aged 5-6 can begin to execute with support Other skill groups have been met with difficulties and most children cannot execute

2.2.2 Level of execution by group of visually impaired children with ASD aged 5-6

- Criteria 1 (TC1): Group of maintaining focus and listening

Table 2.3 Comparison between levels of executing communication skills in criteria 1

1 Responing to calling the name 2.23 0.50 1

2 Turn to the communicational person 2.07 0.52 2

3 Listen, pay attention to the other person

while speaking

1.67 0.55 4

4 Draw the attention of others to you 1.73 0.64 3

5 Transfer the attention of others in which

children are concerned

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Table 2.4 Comparison of levels of communication skills in criteria 2 (TC2)

6 Using body movements 2.27 0.45 1

7 Using gestures, facial expressions, and sounds

to express one’s needs” is not high with an average score of 1,33 to 2,27

- Criteria 3 (TC3): Skill group of understanding and providing additional information

in communication

Table 2.5 Comparison between levels of execution in criteria 3 (TC3)

13 Anwsering yes – no question 1.67 0.66 3

14 Listening and comprehending questions, and simple information

- Criteria 4 (TC4): Skill group of identifying and expressing emotions

Table 2.6 Comparison between levels of execution in criteria 4

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emotions”, the communication skills of “Expressing comfort/satisfaction/happiness” and “expressing discomfort/dissatisfaction/anger” is best expressive with = 2,07 and 2,03 All children can do these with supports of others

- Criteria 5(TC5): Skill group of alternating and interation in a group

Table 2.7 Comparison between levels of execution in skill group in criteria 5 (TC5)

22 Waiting your turn to play 1.57 0.57 3

23 Meeting others’ requirements 1.53 0.57 4

24 Sharing toys and gadgets with others 1.50 0.51 5

25 Participating and following directions during group activity

1.63 0.56 2 Statistics in the chart above showed that performance level in communication skills of Criteria 5 were not high ( mostly remained at 1,5 – 1,73 – Cannot execute skill) Execution level of each communication skills in skill group “Alternating and interacting in a group” has little to no difference

- Criteria 6 (TC6): Skill group of adjusting posture and distance in communication Table 2.8 Comparison between levels of execution between skills in criteria 6

27 Adjust your posture and appearance

to suit the person communicate with

2.2.3 Comparison between communication skills of visually impaired children with ASD 5-6 years old about their gender

Levene testing analysis: Value of Sig in Levene testing (testing F) > 0.05 proves that the variance of 2 overalls (level of communications of visually impaired children with ASD both male and female) are identical, with no differences (Reference 6) Independent-samples T-test analysis: Sig.(2-tailed) > = 0,05 which indicates that there is no difference statistically on the level of execution of groups of communication skills of visually impaired children with ASD It shows that the gender

of visually impaired children with ASD has no impact or affect on the level of