In January 2022, my picture book Seeking Best Friend came out. Around the same time, my sister’s best friend Dana Morgan shared on Facebook an incredible project she had just completed for Elmhurst Public Library (EPL)’s children’s section:

Dana Morgan, M.S. CCC-SLP, is a speech pathologist and mother of an amazing young daughter Maeve who has a rare disease called DDX3X Syndrome. I was so moved by this library collection and immediately wanted to create an multisensory book of Seeking Best Friend for Maeve, the library, and for future storytime events. I checked out the multisensory book collection at EPL in person.

Adapting Seeking Best Friend

I reached out to Dana, and she generously gave me step-by-step instructions on how to adapt my book page by page, and told me what each multisensory book kit should include.

What each adapted book kit needs:

• Talk button
• Communication boards
• Page turner (this can be a popsicle stick, a foam paintbrush, a spoon even)
• Popsicle stick page turners on every page (cover included)
• 3-D manipulatives
• List of materials used and items in the kit
• Parent instructions

Here were Dana’s suggestions for each page:

It’s important to add some texture to each page because it allows children with visual impairments or sensory seeking children a way to engage with the story. The motto I used when adapting was “keep it simple.” As you know better than anyone, the illustrator worked very hard on the artwork so you never want to cover it up or take away from it. The goal of adding texture is to call attention to key visual parts of the story while not overtaking the original artwork. Below I came up with some tips if I were to adapt your book.

Initial page: The little girl is a key character so I would make sure to have a consistent tactile piece on her on every page she appears in. The same applies to the cat since he appears on every page. You could do a variety of things but some suggestions would be (I would maybe choose 1-2 of these but not all of them):

- Adding texture to her bow

- Adding texture to her dress (doesn’t have to cover all of it but you can if you like; a small portion on her dress is just fine too)

- Adding texture to her shoes

- For the cat you could do fur or felt paper, or whatever you choose just make it a small part of him and not the entire thing. You could even just do small triangles for his ears on each page or just his tail.

I would also then stick to the same material I used for her throughout the book. For instance, if I used sparkly blue foam on her dress in a circle I would use this same shape and material for her dress throughout the book. The consistency helps a child with a visual issue feel the same texture and shape and make the connection that this is the same visual across pages.

Page 2: I would add some fur or texture to a small part of the anteater potentially by his nose to highlight that. I would also then use different papers or texture of your choosing to the insect kit. I may again consider using some fake grass for the trees and the background but only a little bit.

Page 3: I would 100% add various textures to the princess on her dress and the flowers in her hair. You could also add some small elements to highlight the scenery such as the egg chair, mailbox and or flowers/books.

Page 4: I would continue to keep the consistent texture you added on the little girl, princess, cat, and then add in some texture to the little boy (maybe on his earmuffs or hat because this is distinctive or his red shirt).

Page 5: I would continue the consistent texture on the previously seen characters and then choose your medium for the robot. Maybe his arms or his legs with some shiny paper. I would also then add a pipe cleaner or circular paper around the bicycle wheel and its spokes but not the entire bike.

Page 6: I would just continue my pattern on each of the reoccurring characters

Page 7: Add texture to the pirate (on his hat or his striped shirt make the stripes raised with paper). I would then add additional texture to some of the treasure like the beads, piggy bank, and maybe even the treasure chest and parrot)

Page 8: I would add texture to all the recurring characters plus add some leaves on the trees and potentially some texture on a branch and the fence

Page 9: I would obviously add texture to the dragon! Potentially a few different parts even! I would also add texture to the sword and the armor

Page 10: I would add texture to each character, the water, the fire, and then potentially the wheel, armor,  and  sword along with the helmet the little boy is wearing

Page 11: I would add texture to the flowers, the characters, the fence (only parts of it and simply not maybe just the top part even)

Page 12: Add texture to the main characters, the insect collection, the cat, and the bike/treasure chest

Page 13: Add texture to any characters, the fence, the hammer and tape, you could add a little texture to the shadows too if you liked or outline them in bubble paint

Page 14/15: Add the consistently used texture to the characters and items before

Here’s the final product:

Dana also sent me the basic CVI and general core boards that go with each kit, and even made me a personalized adapted vocabulary board for Seeking Best Friend.

How You Can Adapt Your Picture Books

Dana gave me permission to share some of the content from her Adapting a Book presentation. Thank you, Dana!

Adapting a book is so important because it:

• Helps children with complex motor, communication, and cognitive needs learn important language and social skills through literacy.
• Promotes independence which so many children with complex needs lack during their daily lives
• Promotes inclusion and acceptance
• Benefits children of ALL abilities

Here are the key components of an adapted picture book.

Adapted Book Components

Page Turners

Material Example: Popsicle Sticks

• Look at the size and make of your book before deciding choice of material and placement.
• Board Books: Smaller sticks
• Paper Based/Hardcover: Larger sticks
• Never do more than 3 color choices if doing colored sticks. Reduces visual distraction of colors.
• Place sticks at the top right corner (when possible). This helps children with motor planning issues.
• For some paper pages, Dana found it was easier to place popsicle sticks in a staggered fashion to avoid pages from becoming too heavy and hard to turn.

Other page turner options:

• Raised foam or cut up sponge on the top and bottom edges of the page
• Binder clips on each page
• Small cotton balls (Dana said she personally didn’t have much success with these)
• Cut up piper cleaners at the bottom interior of pages

Some children have difficulty reaching, grasping and releasing with their hands. This makes it very hard for them to do this every time they have to turn a page, even with adapted page turners available. Providing a single object that they can hold throughout the story and simply slip between the pages helps solve this issue.

• Ideas: foam paintbrush, popsicle stick, flat small child spoon, plastic paint scraper

Tactile Input

Materials: Textured paper, fake grass/fur, buttons, pipe cleaners, raised stickers, felt, foam, bubble paint, pom poms, raised stickers

Additional supplies: scissors, hot glue gun, Gorilla Glue

• Less is more. Do not cover up any major characters or items completely. We don’t want to visually clutter each page
• Think of characters or objects that occur repetitively. Try to use the same texture for those items throughout the book.
• Consider choking hazard if item ripped off.
• Gorilla Glue works much better on board books for certain objects. The exception for this are felt, pipe cleaners, and cotton balls
• Textured paper and foam sticks the best!
• This is the most time-consuming part. Make sure to leave page open to dry so excess glue doesn’t cause pages to stick together if possible
• Avoid overdoing it with the bubble paint. It can cause the pages to stick together if not careful.
• Be creative!

Physical Manipulatives

Materials: Felt, copied pictures from story, Microsoft Word–created puppets, toys/real life objects

Available at Michaels, Amazon, thrift stores, etc.

• Try to think of items that would help a child really act out the story. Who are the important characters? Are there any recurring items that should be included?
• When possible, providing real life plastic objects would be ideal as they are easy to clean!
• An affordable option is making items yourself by copying pictures from the story or using word to make your own. Laminating and placing these on popsicle sticks makes easy to clean puppets.
• Think of sustainability and choking hazards!

Book Stabilizers

• There are some pre-made ones on the market. Some allow you to place the book on a stand which is great for children who are in a wheelchair or need to be at a table-top to read.
• Lap book devices are also available and nice as well.
• A cheap and easy way to keep books in one spot is using a strip of dycem. This is anti-slip fabric and keeps a book in one place.
•  You can also attach Velcro to the covers of a book and stick to a hard surface like a piece of wood or cutting board.

Communication Boards

• Low-tech picture symbols sets containing both common vocabulary (think highly used verbs, prepositions, adjectives and nouns) and book specific vocabulary are important features to help children with communicate impairments learn and express language concepts.
• Children who are complex communicators may not have a conventional way of communicating. By providing them a visual system they can point or even use their eye gaze to express themselves. These boards given them the opportunity to communicate.
• These boards also help children with communication delays or impairments develop language as it provides visual input which research has found helps language growth

AAC Development 

Components to consider when designing boards

– Organization

• Color scheme
• Number of cells per page
• Spacing
• Vocabulary placement
• If using core board words on book specific pages, Dana kept them in the same location (e.g. row 2, column 3)

– Sizing matters

– Vocabulary selection

• Core board: Dana chose highly functional commonly used words that could be combined to create a variety of phrases that could be used while reading or doing any activity
• Book specific board: Dana chose words that frequently occurred in story. A mix of nouns, verbs, descriptors and when possible commenting/social words child may want to use (“Funny!” or ”Oh no”!)

– Symbol selection: Chose low-clutter pictures (aka less detail)

Cortical Visual Impairment (CVI)

• CVI and visual impairments are a common but often an undiagnosed issue, especially in complex children.
• Providing high contrast pictures with low-clutter pictures is ideal. Low clutter means less detailed drawings.
• Black or gray backgrounds are best. Black background with yellow, red, or white symbols works the best.
• Providing spacing between symbols also helps

• Read a story by a plain white wall
• Avoid sitting directly below a  light would help keep children from being distracted. Children with CVI are often drawn to light which can be distracting.
• Avoid reading next to or in front of a window, have these children sit up front if you are doing a group read.
• A 3-D printer to create visuals is an option. This could be used to create 3-D visuals in terms of vocabulary as well for children! There is a ton of research to support the benefit of raised symbol use for children who are visually impaired.

Tips for Reading with Your Child

Reading with your child is a great way to develop language skills. Below you will find some tips on how to engage your child while reading this story!

• Use fun voices, sound effects, and intonation patterns to keep your child engaged! Think about changing your pitch, volume, or even accent to vary it up.

• Call attention to words beyond nouns! It’s natural to point to a picture of a dog, car, or balloon but vocabulary is so much more than nouns. Make sure to highlight a variety of words such as verbs (i.e., jump, go, laugh), prepositions (i.e., in, on, up, under),  or adjectives (i.e. big, furry, slimy) to help expand your child’s vocabulary.

• Keep your language simple. All children are learning new words and concepts every day. It’s hard work, especially for children who may have communication delays or impairments. Overloading them with too much language can lead to frustration and a missed learning opportunity. A good rule of thumb is to model language one level up from where your child is at expressively. If your child is primarily using single words then use 2-3 word phrases when speaking with them. If your child isn’t yet verbal, use 1-2 word phrases. If your child is using short 3-4 word sentences then move up to 5-6 words in a sentence.  

• Avoid asking too many wh-questions. It’s very tempting to ask wh-questions throughout a story ( “Where is the duck?”, “What is he eating?”).  If we are constantly asking a child questions throughout a story, we are turning a reading task into a test rather than a fun experience. This adds pressure on the child which can lead to disengagement. Asking some questions is okay but we want to vary it up. Try some of the following:
  • Use carrier phrases and see if your child will fill in the phrase given a few seconds of wait time (i.e., I see a….., “Cool, he’s….” “Oh no, the cow is….” ).
  • Encourage them to describe the scene with prompts like “I wonder what’s going on here!” or “Maybe you can tell me about this!”
  • If your child is not verbally expressing themselves yet, simply talking through what you see is a great option instead of questions (i.e., “Oh, I see dog. Dog barks. Dog is big. Silly dog). If you want to help them interact more you can point to the items together while you narrate (“Let’s touch dog! Yay, brown dog!”)
    
• Do not demand language. It is a human right to choose what and when we want to communicate. If your child doesn’t respond expressively, that’s okay! A child learns simply by listening and watching, so your language modeling is enough! Forcing a child to express themselves can actually be detrimental as it makes communication a stressful and negative experience.

• Honor all forms of communication. This is especially important to remember for children who struggle with communication. If your child points to a picture rather than verbally labeling it, that’s communication. If your child gazes in the direction of a visual vocabulary picture, acknowledge it as communication (i.e., A child is looking at a car picture intently, the parent then models “Go! Go car!). Pointing, gestures, vocalizations, facial expressions, eye gaze—these are all forms of communication and we want to encourage that!

• Don’t worry too much about the grammar. It’s okay if your small child isn’t using proper tenses or grammatically complete sentences yet! You can repeat back what they say using the proper grammar if you like, but do not force them to repeat it to you.

• Have fun and follow the child’s lead. Nothing is more motivating than feeling heard! If your child goes off on a tangent go with it. Honor any language they want to talk about while reading! They will learn the most language when they are talking about what THEY want to talk about.