VIDBE-Q Volume 65 Issue 2
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and the myelin sheathing that coats and protects these neural "highways" are
strengthened. Blaha (1996) presented concrete, observable examples of learning,
including: habituation (getting used to something, for example, a sound that used
to make you startle, but now you don't notice); association (demonstrating
understanding of the connection between objects or experiences, for example,
associating a spoon with pudding); and, surprise ("a mismatch in expectations," for
example, if the spoon is presented with no pudding and the child reacts with
frustration).
Children who have multiple disabilities and/or deafblindness may struggle to
maintain alertness throughout the school day for a variety of ecological reasons,
including both internal and external influences (NCDB, n.d.). Internal influences
include biophysical factors, such as the specific implications of a child's etiology
(for example, the proprioceptive and vestibular dysfunction often experienced by
children with CHARGE Syndrome [Brown, 2011]), sleep disorders common to
children with congenital visual impairment, the impact of seizures and medication,
and the child's history of experiences with unanticipated touch and physical
manipulation (hand over hand instruction). Children with complex health care
needs including central nervous system impairments may also have difficulty
regulating and maintaining equilibrium. External influences on learning may
include such environmental and ambient conditions as the temperature of the room,
