TIES TIPS Foundations of Inclusion

TIP #19: Creating Accessible Grade-level Texts for Students with Significant Cognitive Disabilities in Inclusive Classrooms

TIES Center | TIES Inclusive Practice Series (TIPS)


Students with significant cognitive disabilities need opportunities to interact with original text to ensure language development and comprehension of grade-level content. When the grade-level text is not accessible in its original form, an adapted text may be needed. Alternate texts are not necessary within an inclusive classroom. Instead, educators can collaborate with one another to find existing accessible options, or to create them when they are not available. This TIPS explains ways teachers can adapt the text and provide scaffolding to ensure each and every student is provided access and opportunity to meet grade-level learning expectations.


Students with significant cognitive disabilities need access to the content in the curriculum at grade level if they are expected to make progress in the general curriculum. It is not enough to simply assign a lower-level book or provide an audio reader. 

Research Support for Creating Accessible Grade-level Text

Research is available that describes how to create accessible text, including the use of several strategies to adapt visual presentation of the text itself. Lee et al. (2015) describes how to add visuals, make auditory accommodations, and simplify the text to keep essential content intact. Research has shown that students with significant cognitive disabilities can be successful if text is paired with response options to match questions about the text and the teacher uses a system of least prompts (e.g., refer to the text, highlight single sentence, point to the answer, state the answer) to teach comprehension (Hudson et al., 2013). When accessible text is aligned with grade-level content, students with significant cognitive disabilities have increased reading comprehension outcomes (e.g., Roberts & Leko, 2013).

Here are five steps (see flowchart) we recommend general education and special education teachers use to make collaborative decisions when adapting a text.

A flow chart of 5 rows and 2 columns. Row 1 step 1. Select or identify the next book in the upcoming unit. Row 2 step 2. Review the content of the book or text selection while thinking about specific student's needs. Row 3 step 3. Consider what type of adaptions needs to be made (physical, content, or both adaptations). Row 4 step 4. Make adaptations according to individual needs of the student. Row 5 step 5. Use these books as a model for future adaptations for this student.

 When adapting books for students with significant cognitive disabilities, teachers should consider not only potential barriers to the text itself (for example, size of the font, length, complexity of language, lack of images in chapter books, decodability or sight word fluency needed to read, challenge level of vocabulary) but also the physical barriers that may exist for students (for example, fine motor or visual limitations which may dictate the need for visual or tactile cues; Lee, 2010). For students who use an alternative augmentative communication (AAC) device, related service providers and educators should collaborate to select and program AAC devices with vocabulary, symbols, voice output options, access modes, and consider the placement of devices for students’ use (Orlando & Ruppar, 2016).

Using Technology to Create and Share Accessible Grade-level Text

Advances in technology have made it easier for teachers to create and share accessible texts. Many teachers create slides for an online adapted book with texts, images, summaries, and rewriting of content supportive of individual students and their identified needs. (see TIPS #18 for an example).  All students may benefit from having access to and using the adapted versions, not just students with disabilities. We recommend developing a school or district-wide library where adapted books can be stored electronically. These electronic resources could be beneficial to future teachers in different grade levels and serve as examples of how texts were adapted in the previous grade for specific students, as well as a way for teachers to see how to do it if they have not before.

How to create accessible grade-level text

A girl wrapping herself like a present has been adapted. The image has been cut out, and a piece of wrapping paper has been added for texture. The page has been laminated and put in a three-ring binder.

Teachers can use two main types of adaptations to make grade-level text more accessible for students with significant cognitive disabilities in inclusive classrooms.

  • Physical adaptations to the book
    • Physically altering a printed text (see image for an example)
      • Cut pages out and laminate them
      • Bind the book or put it in a three-ring binder
    • Adding images or symbols the student will recognize and that do not require inference skills to interpret meaning
      • Add age-appropriate and relevant pictures at the beginning of chapter summaries
      • Pair symbols or images with important keywords
      • Add tactile pieces for the student to track or follow along with the text
        • Cover the title in foam letters
        • Underline important information in puff paint
        • Use pipe cleaners to frame important words or images
      • Adding materials to make it easier for the student to turn the pages of the book (see image for examples)
        • Attach different color piper cleaners or clothespins to pages
        • Use foam stickers between pages to make the pages not stick together
Two children’s board books have had colored clothespins and tabs added to the pages for easier turning.
Adapted text has bolded vocabulary words. A table below the text asks students to write each vocabulary word next to its definition. A space is provided for the student to write notes about the word or draw a picture.
  • Content adaptations to the book
    • Defining original vocabulary in a less complex way and including fringe vocabulary (for example, low frequency vocabulary words that are specific to an activity, typically nouns; see image for an example)
      • Prepare AAC devices to include all vocabulary ahead of the lesson
    • Shortening the text based on individual students' needs
      • Leave in as much detail as possible without making text too long
      • Use technology to rewrite the text and paste it over the original text for younger students
      • Create a new chapter book for older students with dialogue and as much detail as appropriate to mirror the intent of the original text
    • Rewriting the text as a summary
      • Pre-read the text and summarize each page or chapter to capture the main idea
      • Rewrite the page or chapter using a summary statement
      • Reduce the Lexile level closer to the student’s reading level while still maintaining the content from the grade-level text
      • Use a predictable structure or repeated story lines

As you make content adaptations, consider what essential understandings all children should have after reading the text (see the 5-15-45 collaboration process for more information). Ensure that students with significant cognitive disabilities will have the content needed to answer the questions you will ask all readers (e.g., literal, inferential, recall, or summary).

An example adapted text where small, simple, descriptive images have been embedded in the text directly above keywords.


Creating accessible grade-level text requires planning by general education and special education teachers and staff. Districts can also take a lead role in this area by supporting general education curriculum adaptations, such as adapting critical science and social studies texts and adopting accessible curriculum materials. Teachers can become responsible consumers of resources that are readily available (e.g., TIPS #18: Choosing Accessible Grade-level Text for Use in the Inclusive Classroom)  by knowing the key features of a well-adapted text. When teams work together to create adapted text for students who need them, rich literacy experiences which may be embedded are possible for all students.


CAST (2018). Universal Design for Learning guidelines (version 2.2). 


  • Hudson, M. E., Browder, D., & Wakeman, S. (2013). Helping students with moderate and severe intellectual disability access grade-level text. Teaching Exceptional Children, 45(3), 14–23.

  • Lee, A. (2010). Students with significant cognitive disabilities: Adapting books – A PowerPoint  presentation for professional development. Modules Addressing Special Education and Teacher Education (MAST). Retrieved from

  • Orlando, A., & Ruppar, A. (2016). Literacy instruction for students with multiple and severe disabilities who use augmentative/alternative communication (Document No.IC-16). Retrieved from

  • Roberts, C., & Leko, M. (2013). Integrating functional and academic goals into literacy instruction for adolescents with significant cognitive disabilities through shared story reading. Research and Practice for Persons with Severe Disabilities, 38, 157–172.

TIPS Series: Tip #19, May 2021

The information in this Brief is not an endorsement of any identified products. Products identified in this Brief are shared solely as examples to help communicate information about ways to reach the desired goals for students.

All rights reserved. Any or all portions of this document may be reproduced without prior permission, provided the source is cited as:

  • Wakeman, S. Y., Reyes, E., & Johnson, H. N. (2021). Creating accessible grade-level texts for students with significant cognitive disabilities in inclusive classrooms (TIPS Series: Tip #19). Minneapolis, MN: University of Minnesota, TIES Center.

TIES Center is the national technical assistance center on inclusive practices and policies. Its purpose is to create sustainable changes in kindergarten-grade 8 school and district educational systems so that students with significant cognitive disabilities can fully engage in the same instructional and non-instructional activities as their general education peers, while being instructed in a way that meets individual learning needs. TIES Center is led by the National Center on Educational Outcomes (NCEO) at the Institute on Community Integration, University of Minnesota, and includes the following additional collaborating partners: Arizona Department of Education, CAST, University of Cincinnati, University of Kentucky, University of North Carolina – Charlotte, and University of North Carolina – Greensboro.

TIES Center is supported through a Cooperative Agreement (#H326Y170004) with the Research to Practice Division, Office of Special Education Programs, U.S. Department of Education. Opinions expressed do not necessarily reflect those of the U.S. Department of Education or Offices within it. Project Officer: Susan Weigert

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