I've already picked my at-work colleagues' brains, and my own, so now I'm wondering if my on-line colleagues have any thoughts! I tutor an 8-year old boy who is VERY physically involved. He uses eye gaze to make choices, and I'm trying hard to teach him to use a head switch. That's it as far as ways to express significant amounts of information (he does respond with some facial expressions, but that only gives so much information). Considering his physical needs, he's able to understand a lot. (Definitely cognitively delayed, but not as much as many children at his level of physical involvement). He's getting beyond my basic ideas, and I'm not sure where to go next. Things we do: sorting--I give him an item, photograph, or picture, show him the 2 piles/baskets it could go, and have him look at the right one. (He's good at this). Patterning--simple patterns, what color comes next. Basic listening comprehension questions about a story, using objects and picture symbols. I've been working with him to develop a picture symbol vocabulary. But right now he does not have a good way to access the pictures for himself. I'd love to get him able to use a computerized system someday, but he's not ready yet. He doesn't have the head control for a head operated one, and he's not quite gotten the hang of some of the other more fine-tuned switches. I want to keep him learning in the meantime. I'm trying to develop number recognition, and number/quantity correspondence. We work on sequencing--I have puzzle cards for common activities; also I'll make up simple summaries in mayer-johnson pictures from stories I read to him. I've been focusing on adding more content to what we read together. I would love to see him read or comprehend a little more math, but I'm feeling stuck on how to get there. If anyone has any thoughts, please share. B/c even if your exact idea won't work, it could lead to more ideas, and that's what brainstorming is all about!! Thanks.