“If You Can Breathe You Can Learn” – Active Learning with Charlotte Cushman

Active Learning is an approach designed by Dr. Lilli Nielsen to promote active participation and engagement among learners with the most significant disabilities.



Valerie: Welcome to Perkins eLearning To Go. This is Valerie. On today’s podcast, we have Charlotte Cushman, who is the Educational Web Content Creator and Manager here at Perkins. She is a longtime employee and, as you will find out, has held pretty much every job available here at Perkins. She is here to discuss Active Learning with us, and it should be a very interesting subject to talk about. Hello, Charlotte, thank you for joining our podcast. We are excited to have you here to talk about active learning. But before we get into this topic, could you please let our listeners know a little bit about yourself?

Charlotte: Hi. Yes, I’m glad to be here today. I started working at Perkins a long time ago; actually over 36 years ago. And since then, I’ve had lots of different jobs. I was a classroom teacher there and left to go join the Peace Corps, where I trained teachers in Africa for several years. And then I worked for Perkins international and New England Center Deaf Blind Project for many years.

Then I went back to school and became a librarian and archivist. And I was the Archivist and Digital Projects Manager at Perkins. And now I work for the Training and Educational Resources Program at Perkins, where I manage Paths to Literacy and the Active Learning Space websites.

Valerie: Wow, you’ve pretty much done every job here.

Charlotte: Well, not maintenance. I think that might be next.

Valerie: When you come back to visit, do you ever go down to the archives and just poke around?

Charlotte: I love going in the archives. It just really gives me a sense of perspective on all that’s happened, all that’s stayed the same, and all that’s changed over the years so. And it shows what a rich place Perkins is. It’s just lots of wonderful things have happened there and continue to happen there.

What is Active Learning and how did it get started?

Charlotte: Yes, the Active Learning approach was created by Dr. Lilli Nielsen, who was a developmental psychologist and a preschool teacher in Denmark. And she worked for more than 43 years with children and adults with multiple disabilities. And one thing that’s interesting about her was that she was the second of seven children and four of her siblings were born blind.

So she really drew from her personal experience, as well as her own professional experience, when she developed the Active Learning approach. She wrote a lot of books and did quite a bit of research on the approach. And she traveled all around the world doing lectures and trainings. She came to Perkins in the 1980s. And that’s when I first met her. And all of us who met her and observed her with our students got really excited about her work. She died in 2013. But her work continues throughout the world.

Valerie: Wow, four siblings who were blind?

Charlotte: I think that’s really interesting because I think that many of us are either teachers or family members. But anyone who has both hats on, if you will, really has a fuller perspective.

Who can benefit from an Active Learning approach?

Charlotte: Well, in my opinion, everybody can benefit. But active learning is really designed for those who have significant multiple disabilities and who are functioning in the birth to 48 months or four-year-old developmental level. And the active learning approach can be used with individuals with various visual conditions like CVI or cortical visual impairment or ONH, optic nerve hypoplasia, as well as those who are deaf blind or medically fragile.

It can also be used with other approaches, like the work of Dr. Jan van Dijk. And he’s really well-known with many practitioners working in the field of deaf blindness and multiple disabilities. It’s also closely related to the work of Jean Piaget and his developmental stages of learners.

And Active Learning has really proven to be effective with anyone who has difficulty accessing the world because of disabilities. So initially, it was developed for learners with visual impairment and additional disabilities. But it’s widely used with learners with cerebral palsy, cognitive disabilities, hearing loss, autism, deaf blindness, and multiple disabilities.

So we’ve heard some people say that there are certain children who cannot learn. But we really don’t believe that. In fact, if you can breathe, you can learn. So one example that I think really illustrates that point is a child who had no independent volitional movement. He would lie on his back. But he couldn’t move his arms or his legs, and he didn’t speak. And his parents were really desperate to find some way to connect with him.

So we put some metal beads on a plastic plate and then placed the plate on his chest. And as he breathed, the beads started to roll around and make a little sound. And they also kind of vibrated a little bit. And as he breathed, he began to recognize that he was the one making this happen. And he learned that just by breathing in and out, he could make the beads roll around. So what started out as just a biological act of breathing became an opportunity for learning.

Valerie: Wow, that’s very interesting. And one of the things that has always– I’m in awe of is the resourcefulness of the people that work with these children and just what they can come up with to help the child or assess the child.

Charlotte: I think that’s really true, Val. And we’re going to talk a little bit later about equipment. But I think that example of the plastic plate and the metal beads shows that anything can be an educational material. If you have the idea in your head that this person can learn, there is no end of ways to kind of approach that.

What makes Active Learning different from other educational approaches?

Valerie: So what makes this different from other educational approaches?

Charlotte: Well, individuals with multiple disabilities often learn to be passive. And things are done to them. For example, their hands might be manipulated using hand-over-hand to touch something. And in traditional education, the teacher usually gives a lot of instructions, like touch this, say that, do this. And learners who have limited mobility and who– particularly if they don’t have vision, they might not be aware of things that are in the environment that they want to check out.

And so as a result, they often become overly dependent on adults to provide an activity or some kind of direction. But in Active Learning, the environment is set up so that the learner can explore as independently as possible. And in the earliest stages of learning, the adult is quiet and simply provides interesting materials for the child to explore independently.

So at that point, there’s no direction and no interruption of the learner’s exploration and discovery. And one example one of my colleagues likes to use is that if you or I were going to learn how to use a new piece of software, we wouldn’t want someone standing next to us saying, how’s it going? How’s it going? Are you doing a good job of learning?

You would want to just kind of get in there and figure it out. And I think we don’t always allow the students that we work with or our children to have that same kind of exploration and discovery. And that’s really at the heart of Active Learning. But I want to really emphasize that this doesn’t mean that the child is just left on his own.

And in fact, the teacher and the therapist and the family, typically they start by doing the assessment, including looking at what preferences the learner has and at what he or she can already do. And then they develop goals together as a team. And the materials that are presented and the way that they’re presented are specifically matched to the individual’s interests and their learning goals.

So Active Learning has its own curriculum, which is called the FIELA curriculum. And it could be aligned with the general curriculum. And a lot of people are unsure about that as well and kind of afraid to experiment with Active Learning because they think it doesn’t fit in with other things happening in school. But that’s actually not true.

It’s not a free-for-all. It’s really carefully thought out. And the student is in charge of his or her own learning. And independent exploration and that discovery that we were talking about through play rather than direct instruction is really what Active Learning is all about.

And finally, I just wanted to mention that another difference that sets Active Learning apart is that it really views the child’s development holistically. So it includes not just motor and cognition and sensory skills, but also really looks at social and emotional development as part of who the child is.

Valerie: Interesting. I like how it’s really up to the child, like you mentioned the software. One of the best ways to learn something is to have to fix it.

Charlotte: Exactly right, exactly right, not by somebody telling you this is how it works, but by doing that problem-solving, that critical thinking; how can I make this do what I want it to do, which is what fixing something is really all about.

What equipment is needed for Active Learning?

Charlotte: That’s a great question. A lot of people are familiar with certain pieces of equipment and believe that using that equipment, especially a Little Room, automatically means that they’re using an Active Learning approach. But we really want to emphasize that Active Learning is not about the equipment. It’s really about setting up the environment so that an individual can explore and experiment and really be an active participant in the world.

And sometimes, this can happen by using specialized equipment. But it can also happen through the example we just talked about with the boy breathing with the plate on his chest. It can be through something simple, like presenting various materials like ping pong balls and golf balls and letting the child compare them.

Or it could be kitchen equipment, like metal measuring cups and spoons or wooden spoons. And we encourage people to use materials other than plastic because they’re really a lot more interesting to explore. And they have more distinct features.

And for learners with limited mobility, it may mean placing materials where they can easily reach them, like suspending them with elastic where they are lightly touching part of the child like on their shoulder or their leg or mounting them on a board or a wall. And this way, they can choose to touch something that they may come into contact with initially by accident. But then that becomes learned, just like the example we talked about with the boy.

Another approach is you can attach these interesting materials to a vest or a belt so that, for example, if you had a student who has cerebral palsy, and their hands are kind of fisted on their chest, they could find something under their hands that sparks their curiosity. Maybe it’s an interesting texture or a sound, or maybe it moves when someone brushes against it.

So but that being said, there are a number of pieces of special equipment that were designed by Dr. Nielsen. And she calls them perceptualizing aids. And these include The Little Room, which I just mentioned, as well as the resonance board. Those are probably her best known pieces of equipment. But she also designed something called the HOPSA dress, which is a kind of a harness that can be suspended from the ceiling. And it enables learners who are unable to walk to experience movement and being in an upright position.

There’s also something called the Essef board, which is essentially two pieces of wood that are horizontal with large metal springs inside and kind of like a little metal spring sandwich if you can visualize that. And a child can sit on that or stand on that. And it’s a great way to work on balance.

And there are a lot of other pieces of equipment as well. And you can learn more about them and see kids using the pieces of equipment and videos on the active learning space website. So we just really hope that people will think of active learning as more of an approach, rather than a specific piece of equipment.

Valerie: I like how a lot of the examples that you gave are not expensive either.

Charlotte: No, that’s a great point, Val. Because a lot of people think, oh, I can’t do that in my classroom or in my home because it’s too expensive, or we don’t have the money. Well, again, a plastic plate with metal beads, you may not even have to purchase something, right? It just depends on what you’ve got available. And I should just say, as long as we’re talking about the metal beads, you’re not going to use those with a child who’s going to put those in his or her mouth.

Valerie: No. No.

Charlotte: Very different example for this specific boy that we were talking about.

Valerie: So you did touch on the website for active learning. What else can be found on that website?

Charlotte: Well, we’re very excited about it. I guess back in 2015, Patty Obrzut from the Penrickton Center for Blind Children and Kate Hurst from the Texas School for the Blind and Visually Impaired and myself from Perkins, we got together just to discuss a possible collaboration. And Perkins and Texas had been collaborating on the literacy website Paths to Literacy for about five years by then. And we were all really appreciative of the richness that can come through collaboration.

So we also found that it was difficult for people to get clear information about Active Learning. And really, other than the books by Dr. Nielsen, very little information was available. And what really worried us was that a lot of misinformation was getting out there.

And we wanted to create a place where information and ideas could be shared. And we also wanted to provide videos that showed examples of different types of learners illustrating how active learning can be implemented because it’s one thing to read the theory. And it’s another thing to know how to put it into practice. So just so that people can look at it, the website is at And we add new things all the time. I just added a bunch this morning. So be sure to keep checking back.

Valerie: Sounds like there’s a lot on there for a variety of people.

Charlotte: There really is. We have a section just for families. We’ve also got some things for administrators. And primarily, the audience is– or the participants– the users I guess would be the best word, primarily, they are teachers and therapists. But we hope it will be useful to everyone.

How can people get more training in Active Learning?

Charlotte: Well, there are a number of ways to do that. First, we invite people to come and sign up on the website for our free monthly newsletter. And that’s got links to information and new videos and trainings. We’ve also been doing webinars and study groups.

So these are all recorded and archived on our website. And they go back quite a few years now. They started out as kind of a book discussion group where we were reading Early Learning Step by Step by Dr. Nielsen and looking at how, again, her theory could be applied to one’s own students.

And since then, we’ve been really focusing more on various topics each time, like alignment with a general curriculum, functional activities for transition-age students, using active learning with students with CVI, a lot of people have questions about that, hand development, and then the one coming up next month, we’re going to be talking about oral motor skills. So we have a series of online classes or modules that are self-paced. And you can do them independently. In other words, there’s no instructor. You just go in and log on and do it on your own.

Valerie: Nice.

Charlotte: And these are free. And you can get credit for them. And there’s more information about those on our website. And finally, I’d invite people to look at the calendar of events on the active learning space site. And that lists conferences and trainings that are coming up around the country.

Valerie: So do teachers get this training as part of their pre-service training or no?

Charlotte: Typically not. It’s not usually included in pre-service training, although that does vary a bit, depending which instructors know about it or that they’ve tried using it. But we’re hoping to see it included more widely. At the moment, we’re really hoping to see more research in the field.

There’s a strong call for evidence-based practice. And people who’ve tried using active learning with their students usually become convinced that it works. But we really need to have a larger body of published research in the field to prove this and to be able to point to it with administrators and families and other teachers and therapists.

So people are often put in a position of trying to make a case for using active learning when they’re talking to administrators or families or other practitioners. But our hope is as more research is done, and more people are using it, that it will be even more widely embraced by the field.

And what a better way than taking a free online class that they will receive credit for or to get a feel for what is involved in active learning and be able to use that to receive support from administrative.

That’s our hope. And who doesn’t like things that are free, right?

Valerie: Exactly.

Charlotte: But our hope is to make things as available as possible to the field, using the website, subscribing to the newsletter. All of that is free. So we’re going to keep it free as long as we can. So that’s the hope.

Valerie: So we know it’s not a new approach. So why do you think there is a resurgence?

Charlotte: Well, when Dr. Nielsen was alive and traveling frequently, she was giving trainings all over the world. Lots of people got to hear her speak. And her techniques were widely known. But when she was no longer able to do this, a new generation came along who didn’t really know her work and didn’t really know how best to address the needs of this population.

So people would be finding pieces of equipment in their schools or in storage closets. And they didn’t know what to do with them or what they were for. So we really owe a lot to Patty Obrzut, whom I just mentioned. She’s an occupational therapist and the Assistant Director at the Penrickton Center for Blind Children in Michigan. And she was mentored directly by Dr. Nielsen, who gave her her blessing to carry on with the training.

So there are pockets around the country and actually around the whole world doing this work. Specifically, there’s LilliWorks, which is based in California, which handles the sales of equipment and books by Dr. Nielsen. Also Texas School for the Blind and Visually Impaired has been doing trainings on active learning for many years.

And many people there are familiar with this approach. And there are a number of schools in various parts of the world that use an active learning approach with all of their students, specifically Narbethong in Australia. And then there are some in Denmark and Holland and Norway.

So I guess in response to your question, really, very few teachers or therapists are specifically trained to work with students with significant multiple disabilities and visual impairment. And a lot of people really aren’t sure what to do with learners who function below a four-year developmental level. And some people may be trained in visual impairment, but not in cognitive disabilities.

And others vice versa, they might be trained in severe special needs, but not in vision or deaf blindness. So as people find out about active learning, they always get really excited about it because there’s such strong evidence that it really works with this population.

Valerie: Well, let’s hope we can keep that momentum going and have more and more people signing up.

Charlotte: That’s our hope too. And I really appreciate your inviting me to talk about this topic. Because obviously, it’s something I feel passionately about and just thrilled to be able to try to get the word out.

Valerie: So is there anything else you’d like to talk about with active learning or anything at all that you’d like to bring up within this podcast?

Charlotte: I think just to encourage people to check out the website. I think if it’s kind of something you’ve vaguely heard about but not really sure what it all means, check out the videos. Those will make you a believer. Some of them are under a minute long, just showing something.

One of the ones I particularly like is kind of a before and after video. Here’s a child who’s falling asleep. And then a few minutes later, several adjustments are made to putting materials around him. Suddenly, he’s active and moving around and engaged in the world. And I think people say seeing is believing, right? So just going and looking at what this is all about I think will make you a believer.

Valerie: That’s great. Well, thank you, Charlotte, so much for taking the time and talking with us today. I very much appreciate it.

Charlotte: Well, thanks for having me. I enjoyed it. And I’m really excited about your podcast series.

Valerie: Great. Thank you so much.

Charlotte: Bye-bye.

Valerie: Bye-bye.


Valerie: Thank you for listening to the podcast today. As mentioned on the podcast, please visit Active Learning Space at

May 21, 2019

Listen to the recording.

Professional portrait of Martha Majors

Martha Majors: Creating waves of impact through mentorship

Portrait of Lidiane

How a mother’s resilience and desire to learn empowered her to lead change Brazil

Family portrait inside a chapel. Flavia, the mother, stands behind her three sons. Her youngest son is asleep in his stroller.

How a mother and Labor Lawyer in Argentina uses her expertise to advocate for children with disabilities