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Graduate student project

“Bear Feels Sick”: Accessible Ideas for Children with Multiple Disabilities

Ideas to make "Bear Feels Sick" accessible to students with visual impairments and multiple disabilities

As part of the graduate coursework for Visual Impairments and Multiple Disabilities in the Teacher Preparation Program in Visual Impairments at the University of Kentucky, students were asked to complete four projects: Story Box, Picture Communication Symbols for Story Box, Tactile Communication Symbols, and Talking Book Project.

We are sharing them on Paths to Literacy and hope that others will use them!  Please add your comments at the bottom of the page. This project is based on Bear Feels Sick by Karma Wilson.

tactile board, story box, and picture communication symbols

Story Box

This project is based on the story “Bear Feels Sick” by Karma Wilson, illustrated by Jane Chapman. This book is good to introduce students to the concept of outdoors, woods, and nature. Children with visual impairments do not see these things as other children see them daily, and therefore lack incidental learning opportunities to understand these concepts. Also, in some cases children with visual impairments do not spend as much time outside as sighted children, either because they are afraid or uninterested in exploring outside, or because parents might be more hesitant to let their child with visual impairments explore outside or participate in outdoor activities. Also, this book has many opportunities for incidental learning about friendship, caring for one another, illness, and routines/rituals that different people participate in when they are sick. Children might have experienced something similar or experience it on a regular basis but do not fully understand it. 

Tactile Objects

tactile objects for the story box        a pillow and blanket for the story box          tactile plant objects for the story box          tactile objects for the story box
I chose the objects in this box to represent real life objects that were used by characters in the story. Also, I chose objects to represent the animals that have distinguishing characteristics that are true to the real animal found in nature. Animals in this story are not animals that students would experience on a typical day in the form of a pet. These are animals that they may never come into contact with, so the defining characteristics would be important to highlight to determine one animal from another. This will give the student a schema to build off of if they were to encounter the animal again in another story or lesson either in school or socially.  The other objects are items that students are likely to encounter, and will either be able to identify already, or having the tactile object will help refine the schema they have about particular objects. 
  1. Plush pillow
  2. Fleece blanket
  3. Teddy bear with shaggy fur
  4. Plush rabbit toy
  5. Badger toy 
  6. Owl picture card with tactile component of brown and white feathers and googly eyes added
  7. Raven picture card with tactile component of black feathers 
  8. Glass coffee mug
  9. Tea bags
  10. Plastic cup
  11. Wash cloth (meant to be cool and damp)
  12. Rice bag (meant for heating)
  13. Maple tree leaves
  14. Sticks from a tree
  15. Leaf crown (made from false greenery flower arrangement filler)

Implementations of the story box:

  1. One way to implement the object would be to allow the student to tactually explore the objects before reading the story together. The student could attempt to make predictions about the story. After reading the story you could discuss if their predictions were right or wrong. 
  2. As the student and teacher are reading the story, the teacher will present the objects as they occur in the story. Student and teacher will explore the objects and discuss specific characteristics of the objects to increase the student’s understanding. 
  3. Have the student hold and explore each object, and then read the story. After that give the student each object in isolation to see if they can identify the object by key characteristics discussed when the object was presented to them.
  4. Present the student with objects one at a time, and have them categorize them based on certain criteria. You could have students group them by character vs. non-character, hard vs. soft, big vs. small, etc. Depending on the level of the student, you could give them criteria to form their groups or allow higher functioning children to do it on their own and then explain their reasoning for putting objects in a certain group.
  5. The student can use the objects to retell the story in their own words. If the student has difficulty expressing themselves verbally they can use the objects to reenact the story that way. If the student has trouble sequencing the story, objects can be used to jog their memory or help them set up their thoughts so they can retell the story. 

Tactile Symbols

tactile symbols
These tactile communication card we made using siding samples collected from a hardware store. The shapes of the tops of the card were cut using craft scissors. The shapes of the tops of the cards follow the guidelines of the APH tactile communication system. See below for explanation of the cards.
  1. Cave– setting card. A rock  represents the cave in the story because caves are typically holes I the side of large rock formations. Teacher would have to discuss with students what caves look like and how they are formed for students to understand this concept. 
  2. Fall– time/when card. A dead leaf was used to represent this because in fall leaves die and fall off of trees. This is something students would see/feel during fall time of year. The leaves falling off the trees are a characteristic of fall that would set it apart from other seasons. The teacher would have to discuss the different season and defining characteristics of each season to help the student gain the concept of fall. 
  3. Blanket-object card. A portion of a fleece blanket cut off of a full size blanket to make this card. Fleece is the same material as the blanket used in the story box. Because the textures are the same, the student would be able to connect the object from the story box to the tactile card. The student would be able to apply the schema of the story box to this card and be able to identify the object. 
  4. Tea– object card. A real tea bag was used for this card. It is similar to the tea bags used in the story. The student would be able to feel the shape of the tea bag and the texture of the tea in the bag to make the connection from the story box to the tactile card. When using the story box, the teacher and the student would discuss how to use a tea bag to make tea. They would discuss different ways to make tea (tea bag, loose leaf tea, concentrate) and predict how they made tea for Bear. The student would be able to apply the schema from the story bag to this tactile card to answer questions about the story.
  5. Campfire– object card. Sticks were used to represent the campfire because typically wood is used to start and maintain a campfire. The student would have to understand the process of building a campfire to understand that aspect of the story and this card. Teacher and student would discuss a campfire versus fire made on a gas stove or in a gas fireplace. If the student has not experienced a campfire, they might not understand the difference in types of fire. 
  6. Raven– who/character card. Raven is represented with a black feather. The teacher would have to supply background knowledge of different types of coats animals in this particular story (fur and feathers) have. They would use items in the story box to feel a difference. They would discuss similarities and differences. The teacher would also discuss with students that there are multiple birds in the story, and highlight key differences. For example, in the story box there are picture cards of an owl and a raven. The raven card only included black feathers; on the owl card brown/white/gray feathers were used and highlighted the large eyes. For students with some vision and able to distinguish between colors the teacher would highlight the color differences. For students who cannot process colors well or who have no vision, the teacher would be sure to emphasize the eyes on the owl card and explain the importance of their large eyes for hunting. 
  7. Bear– who/character card. For this card a toy bear nose was used to represent Bear because in many of the illustrations of the bear in the book you only see his face peaking out of the blanket, which put a lot of emphasis on his large black nose. The teacher and student would discuss throughout the book how Bear is sick, and bundled up in his blanket, leaving only his head and face exposed. 
  8. Hare-who/character card. Hare was represented on the tactile card using a rabbit ear off of a stuffed animal rabbit. Because a lot of the animals in the story are soft and furry, the teacher would want to give characteristics that would allow for students to distinguish between them. One characteristic of the Hare that other animals don’t have is the large ears. This is something the teacher and student would spend time discussing and feeling when using the story box, and the students would be able to apply to the tactile cards to answer questions about the story.
  9. Head wreath– object card. A plastic leaf off of the fake foliage used to make the head wreath in the story box was used to make this card. This card was made because the incidental learning behind the making of the crown is important for students to understand that the head wreath was made to help comfort bear, and it was an act of kindness from his friends while he was sick. This would be a discussion to be had while using the story box.
  10. Washcloth– object card. A square of a washcloth to represent the cool cloth used to cool down Bear while he was sick. This card was included because it is important to understand how we know Bear is sick- he has a fever. It is also incidental learning to know what we do to treat a fever, and using a cool cloth on the forehead is common practice. This would provide insight to students who may not understand hot/cold or why an adult might use a wet rag on their head when they are sick. This might be something my students experience, but don’t have an understanding of why. It might not be highlighted in any other story or real life incident they have experienced with illness/fevers. 
These card would be used by the student to answer questions about the story. To answer the question the student would be able to point to or pick up the card containing the answer. Some possible questions to use with a student are: 


  1. What drink did they make for bear? Answer: Tea
  2. What season is it? Answer: Fall
  3. What did they use to cool down Bear’s forehead when he was sick? Answer: Washcloth
  4. What did Bear’s friends make for him to put on his head while he was sick? Answer: Head wreath
  5. How did Bear keep warm while he was asleep? Answer: Blanket
  6. How did Bear’s friends cook his tea? Answer: Campfire
  7. Where does Bear live? Answer: Cave
  8. Who was first to ask Bear to play? Answer: Hare
  9. Who was sick at the beginning of the story? Answer: Bear
  10. Who got water for Bear? Answer: Badger
  11. Who gathered herbs for Bear’s tea? Answer: Raven

Picture Symbol Cards

picture symbols
The picture communication cards were made with a child with CVI in mind. Because of that, very simplistic icons to represent items, characters, or setting were chosen. It is desirable to avoid visual clutter that could be too complex for a child with CVI to process. Also a dark background was used for most cards to create visual contrast. For cards that had darker images, a yellow background was used to create the contrast. Also a red boarder was added to help get the student’s attention and help them focus on the image. For the sequencing cards two versions were created: one with text only because the screen shots have lots of details, and if a student is unable to process that they might find it less visually busy to just have text on the card. For a child who is rated higher on the CVI scale, they might able to use the picture cards to help them sequence the events.  Below are description of each card created.
  1. Head wreath– green vine shaped in a ring. I chose this symbol because while reading the story we would discuss how his friends made him the head wreath to try to make him feel better. This would relate to a conversation we would have about different customs in caring for others when they are sick.
  2. Blanket– red blanket with white edges on the width sides. I chose this symbol because it is something my students can relate to. When they feel sick their guardian would wrap them up to keep them warm and comfortable. 
  3. Tea– I chose a yellow tea cup with a brown tea bag. I chose this object because the tea cup appeared several times throughout the illustrations of the book, and was mentioned multiple times in the story. Tea was more than just something Bear drank, but also was used to comfort him, and warm him up when he was shivering. It shows how much his friends care about him. 
  4. Cave– brown dirt cave, brown dirt floor, dark opening to the cave. I chose this because I thought it was important to establish the setting of the story. We would discuss where Bears live, what a cave was, and how it would look and feel inside a cave. I felt this was an important bit of information because the characters in the story are animals, but are humanized by talking, making soup, drawing pictures, and caring for each other. We would have to discuss that the animals in the story are wild animals, and therefore they wouldn’t live in a house like humans do, even if these animals are fictional and act very human-like. 
  5. Fall– Single yellow leaf. I wanted to create an inferential question, which I think is important for all students. Being able to answer recall questions about the story is an important skill, but being able to use information they see or hear to draw their own conclusions is also important.  For example, in this story there are leaves blowing in the wind and all over the cave floor in all of the pictures (which we would discuss as we read the book).  Students with visual impairments might not see the leaves changing like a typically developing child does, so they might not understand the different seasons or how to identify them.
  6. Wet cloth– Yellow washcloth with black speck to represent texture. There are three small blue water drops dripping off the cloth. This would be important to talk about because in the store box we would use the rice bag and the wet washcloth to talk about fevers and how when you have a fever you have to cool yourself down. While we were reading we would discuss the different animals trying to cool Bear down. We would discuss what their parents do when they have a fever (Do they put a wet rag on your forehead? Do they give you medicine? etc.) 
  7. Bear– brown simple bear illustration on black background. Bear is the main character of the story and would be in a lot of the discussion of the story.
  8. Badger– picture of real life badger on a yellow background. Badger is mentioned frequently in the story as the friends are caring for Bear. I chose a realistic picture of a badger because the illustrations look like racoons, and I wanted to make sure my students understood the difference between a racoon and a badger. 
  9. Raven– Black illustration of a raven on a yellow background. Raven was another character mentioned frequently in the story and it would be important to discuss his actions to make Bear feel better. 
  10. Hare– brown rabbit illustration on black background. Hare in the story is a cream color, but I chose to leave the picture card brown because the contrast was easier to distinguish than when I tried to make it lighter. Hare is an important character in the story because he is the one who orchestrates the friends pitching in to help Bear feel better. 
  11. Campfire– red, yellow, orange camp fire illustration. I wanted to highlight that they cooked the soup and tea over a campfire. This is connected to the humanizing of the animal theme that lead me to discuss the cave setting of the story. This would connect to the fact that they are wild animals, and wouldn’t have a stove or microwave in the cave; that wouldn’t make sense. We would discuss how differently we cooked food in our homes. We could discuss times you would cook over a fire (camping) and when you wouldn’t. 
  12. (4) sequencing cards with screen shot pictures
  13. (4) sequencing cards text only
These card could be used to answer questions about the story.

Some questions you could ask the student about the story are:

  1. What drink did they make for bear? Answer: Tea
  2. What season is it? Answer: Fall
  3. What did they use to cool down Bear’s forehead? Answer: Wet cloth
  4. What did Bear’s friends make him to put on his head? Answer: Head wreath
  5. How did Bear keep warm while he was asleep? Answer: Blanket
  6. How did Bear take care of his friends? Answer: Tucked them in to bed
  7. How did they cook Bear’s tea? Answer: Campfire
  8. Where does Bear live? Answer: Cave
  9. Who was first to ask Bear to play? Answer: Hare
  10. Who was sick at the beginning of the story? Answer: Bear
  11. Who got water for Bear? Answer: Badger
  12. Who gathered herbs for Bear’s tea? Answer: Raven
  13. Put the event cards in order that events happened in the story. Answer: (use picture cards or text only cards) 1. Bear gets sick 2. Bear’s friends take care of him 3. Bear gets better 4. Bear takes care of his friends.

Talking Book

A talking book was created for this story using PowerPoint. Students can use this as an independent reading activity in which they could listen to the audio version of the story and click through the powerpoint themselves. 
title page of the talking book
Colored illustration of animals with alphabet letters A, B, C, D
Activity and strategy

Alphabet Objects


Ideas for Teaching Tracking and other Tactile Skills

Alphabox showing an apple in the position of dot 1 in a braille cell
Activity and strategy