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cal activity can promote both acceptance and understanding. It can eliminate social barriers and help to diminish the misconceptions and fear often associated with impairments or disabilities. The following recommendations reach across all backgrounds and abilities. General ConsiderationsApproaching topics from a multisensory perspective can enhance student participation in musical activities. Vibrotactile cues, defined for the purposes of this article as sensory triggers that indicate an impending activity or event in the context of an activity, can be provided by instruments such as xylophones, marimbas, or drums. Teachers may also consider placing stereo speakers on the floor. In such situations, children can either sit on the floor in close but safe proximity to the stereo system or in their chairs with their shoes off so that they can feel the vibrations. 8 The latter can best be accomplished with wood or tiled floors. 9 If this is not possible, the gymnasium or cafetorium floor are alternatives. Visual aids, such as sequencing cards and music with enlarged print, can help to reinforce the concepts introduced and ensure that the child is able to follow the lesson. Additionally, manipulatives, such as foam stickers, felt notation cards, colorful scarves, or Popsicle sticks-which are useful for building rhythms and can provide further opportunities for hands-on learning.Manual communication can greatly enhance music instruction for all. Manual communication refers to physical messages received by the eyes. 10 Such messages, produced by the hands, arms, and face, for example, can be presented via body gesture, finger spelling, and sign. 11 Manual communication modes include song-signing, an art form originating from the deaf community in which one or more children sign while singing or sign while listening to music. 12 Such an FIGURE 1Implant (internal component) and electrode array.Note. Nucleus Freedom Cochlear Implant component, courtesy of Cochlear Americas.