Intern 13.1

Wow, my last week here is halfway over!  This has been a much busier week than last week, although tomorrow will be pretty dead. 

JD and TM are both working on bus travel.  JD wanted to do the route to the plaza on the beach because he might have a job interview there.  This was going to take longer than a class period because it involves going to one plaza, transfering buses, and then getting to the next plaza, so we made plans to be gone for at most 2 hours.  Even though I was with JD, I didn't say anything or prompt him along.  He's very confident and a quick learner, so I didn't need to do anything for the route there anyway. 

Once we got to the plaza, I showed JD the route to the nearby shopping area and its layout.  Then we headed back to the bus plaza and waited for the bus.  And waited.  And waited.  Apparently we must have just missed it because we realized that while the bus might be late sometimes, it was definitely not showing up again for another hour or so.  We got it sorted on how to make it back (yes, I helped, but in my worry about keeping JD from missing another class I was trying to resolve the situation and get us back to the center asap).  He's going back to that plaza on his own tomorrow after school, so I was of course drilling him on which buses to use and the layout of the shopping center.  I'm sure he'll be fine but one can't help but worry. 

When we got back to the center, we talked some more about the Trekker Breeze GPS.  JD has borrowed one from us but hasn't really seen the need for it.  I've explained how it would be more useful in unfamiliar areas, but it doesn't help when the darn thing won't find a signal or gives wildly inaccurate directions.  He has an iPhone so we talked about accessible GPS apps and he decided to try the Ariadne GPS.  A little frustrating so far, but I think if he figures the app out it could serve as a useful tool. 

TM rode the bus to the same plaza today, but I didn't want to take her out of another class.  So we planned for her to ride the bus to the plaza and I would meet her there to drive her back to the center.  She just started bus travel last week so I was a little concerned but she seemed ready.  We reviewed what she was going to do beforehand, and I'll admit that I went to the first transfer plaza to see if she got on the right bus.  I couldn't tell (cue sinking stomach feeling), but hoped for the best and went to the beach plaza.  She actually got there before me and did fine.  This from a student who didn't ever want to ride the bus by herself.

MK is leaving the center next week, but I really don't think she's ready to.  We basically ran out of time in mobility, so while she has a lot of basics, she's not going to be able to go out in her community independently without some more O&M training.  I will say that her confidence has increased a lot though, especially with street crossings.

SL has about another month here, but there too I don't think that's enough time for her.  She's learned a lot, especially about street crossings, but she's still very nervous about crossing any lighted intersection that doesn't have APS (or, all of them except for the one by the center).  She is another one that will definitely need more O&M training when she gets back home, especially considering that she's never used public transportation or crossed streets there.

I'll be going to Walmart tonight, reviewing exit reports with MK and JD tomorrow, and then the students are having a picnic Friday morning.  SL and TM will both be missing class tomorrow.  So it's all downhill from here!

Intern 12.1

What a strange week this has been.

My somewhat bewildering student that would forget her cane or generally be non-cooperative was behaving very bizarrely on Monday.  We found out last Friday that she has what is essentially a mental illness.  My problem was that I didn't think she needed to stay in mobility (based on her past behavior) but I was asked to give her a second chance.  So Monday and Tuesday of this week were pretty frustrating on my part.  Well lo and behold this student ended up going home yesterday.  She said that she will be coming back in a few weeks, but who really knows. 

We were supposed to go to Southeastern Guide Dogs today for a tour of the campus and the students were going to walk with a real dog in harness.  These students have all taken the Hadley Guide Dog Course, several have done juno walks, and they all know guide dog users here on the campus.  I thought everything was good to go for our tour but then I found out on Monday that SEGD was not planning on having the students walk with dogs, get a tour of the dorm, or even get to see the puppy kennel.  We were working on this most of Monday and yesterday, trying to salvage the trip, but were essentially told that it was new policy to just give prospective students a presentation on the school's program. 

We put this up to the students, and they rightly decided that it wasn't worth our time to drive down there just for a presentation.  And then this morning I found out that the director of training had contacted Holly at 6:00am and said that he would make sure we got what we wanted when we showed up today.  Unfortunately it was too little, too late.  Hopefully a tour can be rescheduled, but I know Steve and Holly are pretty disappointed in SEGD at this point. 

Another one of my students has been struggling with depression lately.  She cried through most of my class yesterday (because of several things) but basically feels that nobody cares about her or listens to her.  I was trying to be sympathetic and help her, but I'm not a counselor.  She ultimately went to talk to one of the case managers on our staff who also happens to be a counselor.  I'm not sure how this student will be doing today; there really wasn't much we could do in class because of her emotional state.

Overall, I'm trying to wrap up with my students and get as much instruction in as I can before I leave next Friday.  It has been slow here at the center as far of the number of new students coming in while I've been here, but apparently that is going to change dramatically in the next month or so.  So while Steve and Holly both only have three students right now, they will have seven students apiece when I leave (one student for each period).  This doesn't leave any time really for planning, writing reports, or much of anything.  They need to hire a third mobility instructor but apparently approval for that won't come easy.

Intern 11.1

This week has been pretty predictable and easy so far.  All of my students are working on some stage of street crossings.  A few are still focusing on how to align themselves, but I have two other students that will probably be done working on street crossings this week.  Then it's on to bus travel!

Speaking of bus travel, I'm struggling to figure out how to teach my students who are blind to plan routes.  The website for Volusia's bus service isn't really accessible.  There isn't any kind of function where you can enter your origin and destination and find out what some suggested routes are.  The bus route map provided on the website isn't very detailed, and even the schedule doesn't really tell you where exactly the bus goes (the routes are very meandering). 

We have an excel spreadsheet with the schedule, but not all of my students can use excel.  I'm beginning to think that my students might just have to call the bus office and tell them where they are going and find out what route to use. 

Anyhow, CH has been interesting lately.  She started out at the center being very quiet, and then she opened up and became very social.  Then apparently some relationship issue occured, and she became withdrawn and wasn't coming to classes or actively participating in lessons.  Last week there was a change for the positive again and it seemed like she was coming around.  She even asked for the long white cane back on Monday, although she couldn't give me a very good reason why.  When she returned it to me last week she said that she didn't like identifying herself as a person who is visually impaired (in so many words). 

Well the improvement seems to be short-lived.  She was late to class yesterday and was very withdrawn again.  She did what I asked her to, but it was back to feeling like I was pulling teeth.  She's supposed to be in my class now but she's meeting with one of the case managers.  I think the source of all these issues is the rocky relationship she has with an older student who was here about a month ago.  That student left, but he's returning in just a few weeks to start another program.  It's frustrating for the instructors because her mood and behavior changes so dramatically from one day to the next. 

SL has been working on aligning herself at intersections.  We talked the other day about what she sees herself doing when she finishes here.  There is an apartment program in the dorm but she said she doesn't want to do it because she isn't going to live on her own any time soon (she is 26).  She is planning on going to a community college near her home, so I asked her how she is going to get there.  She said probably paratransit but that she didn't really like using it because they can be late to pick  you up, but you can't be late for the bus.  Either way it's sort of disheartening because the goal of being here should be independence, but she doesn't seem to have much interest in it.  She's learning new skills here, but how much will she be able to keep using them if she goes back home to live with her mom?

On a final note, I only have about 2 1/2 weeks left here.  There are 5 students on my caseload, so I'm trying to get as much done with them now and possibly exit 2 of them from mobility by the time I leave.  That's looking increasingly difficult though, so I'm not sure how everything is going to pan out.  I really hate to leave and dump all of my students on Steve and Holly.

Intern 10.1

Wow Tuesday is already over!  Been a good couple of days.  Mostly working on street crossings with my students and the theme seems to be "how not to veer" (and how to make sure you're in alignment with your parallel traffic).  Some of my students have more difficulty with this than others, and each student seems to have different things going on.

JD is usually very good at aligning himself, but today we went to a bigger intersection.  He kept turning himself so he was facing the middle of the intersection, which made him think the parallel street was actually his perpendicular street.  Definitely need to work on this some more.  However, he was able to tell that it was unsafe for him to cross a side of the intersection because he could not consistently detect the parallel surge.  When I went to this intersection this past weekend, it seemed like a crossable intersection, but the traffic was different today.

MK is going to be taking 2 hours of mobility/day starting next week and until I leave.  They don't normally do this at the center, but she only has about a month left here and she hasn't even got to crossing lighted intersections yet, much less bus travel.  My biggest concern with her right now is veering.

SL is at about the same level with MK on street crossings, but my biggest concern is her decision-making abilities.  I'm not sure that she would be able to accurately tell me when it's ok to cross a street.  Will continue working on this too.

Working with CH has been interesting.  She had the procedure on her big toe last week and then she showed up yesterday with a mean looking blister on the bottom of her foot.  She could hardly walk so once again mobility was nixed.  She's been having issues with skipping classes, tardiness, and being rude to the instructors.  She's friendly with me personally, but she seems to lack any motivation to do the work.  I think a lot of this is a maturity thing, so I really question whether she'll still be here next week (i.e. she'll probably get kicked out).

TM and I went back to an intersection that she was too nervous to cross last week, but she crossed it yesterday with flying colors.  She was watching her parallel traffic, crossing at the perfect time, and didn't seem to have a bit of anxiety.  So happy for her!

Intern 9.3

Yesterday and today were much better days.  Steve came back, to my relief, which meant that I had one less student and don't have to do the  new student's intake assessment after all.  I was able to get some of my projects done, and since I'm staying here for the weekend that gives me time to finish things too.

Most of my students are now working on street crossings.  Some are just learning about intersection layouts and others are learning when to cross.  They may not be making stellar progress, but they are learning and developing new skills every day.  I think the biggest challenge for all of them is going to be confidence, which will come with time and practice (I hope).

During the staff meeting yesterday, I found out that CH has been having issues in all of her classes (tardiness, absences, refusing to do work, etc).  This is the student that was coming to my class wearing flip-flips and not bringing her cane.  I'll admit that it was a relief to hear that I'm not the only one having problems with her, but I'm not sure what the endgame will be.  CH was telling me that she was fine having a cane, but I never saw her using it and she was begrudgingly participating in lessons.

I talked to Steve about CH yesterday, and he said that if she didn't want to use the cane, then fine, have her give it back (her vision really isn't bad at all - I've seen in her in all kinds of environments and she's never bumped into anything or tripped on anything.  However, she says her vision is worse at night).

So today I decided to lay it on the table with CH.  I asked if she even wanted to take mobility, and she said that she liked having this class.  The point I was trying to make is that I don't want to waste her time or my time, and the longer she is in mobility, the longer other students will have to wait to take this class.

Then I asked CH whether or not she really wanted to learn to use the cane, and if not, she might as well return it to me.  Well return it she did, without any kind of hesitation whatsoever.  I have mixed feelings about this, but feel like I have to respect her decision.  And it's nice to not feel like I'm dragging her kicking and screaming.  Ultimately, we'll be working on some street crossings and bus travel.

On another note, we're doing a community outing to Bike Week tomorrow.  Wish us luck!

Intern 9.2

Holy cannoli man.  Steve was out again today, so I had to cover for his new student during first period.  Apparently Steve is really sick and might be out the rest of the week, which means that I have to do the intake assessment for the new student.

So today I had 6 students total, on top of trying to plan for my lessons tomorrow and writing a TAPS assessment on JD, a Functional Travel Vision Assessment on TM, a report on a nearby intersection, and the assessment for the new student.  And I don't have an assistant to help me with daily reports and keeping track of daily miles/destinations on the car like the other mobility instructors do.

Needless to say, feeling a little overwhelmed.  I know I'm supposed to be moving my students forward through their curriculums, but some have so many gaps in knowledge (like how an intersection is laid out, that there will never be both stop signs and lights at an intersection etc), that I feel like I need to address these first.  How else will they be able to map out an intersection and cross it independently?  Some of these students may not get to the point where they can do this on their own, which really makes me wish that I was working with them in their home area and not at some random intersection.  And then it doesn't help that Steve is asking me to do these other things with my students that I don't feel are as important or as relevant for getting the student finished here in a reasonable time.

Part of my problem is that right now we have more students taking mobility than both Steve and Holly can handle on their own.  Therefore, if I don't exit some students from mobility by the time I leave, Steve and Holly are going to be super overwhelmed.  I know it shouldn't be my responsibility, but I don't want to leave everyone in the lurch.  Ok, rant over.

Intern 9.1

Wow what a long day!  After having one student out all last week and only two students on Thursday, I was beginning to get a little bored and restless.  All of my students were back today and Steve was out sick too.  When a mobility instructor is out, the other teachers are supposed to pick up the slack.

As my schedule is now, I have students during periods 2-6 out of 7 periods in the day.  Steve's new student started first thing today, and he needed to be given his schedule and shown where all of his classes are.  So after a quick Monday morning staff meeting, I met this student and started talking to him about his schedule.

[Sidebar] Every two weeks the schedule at the center changes.  This allows students to enter new classes or drop out of other classes as necessary and also makes room for new students in the schedule.  On the Friday before the new schedule change, the residence staff are supposed to give each student his or her schedule for the next two weeks.  This was done, but the schedule was actually changed this morning.  This meant that virtually no one knew where they were supposed to be and when, and I seemed to be the only person with the correct schedule.

So while I was trying to teach SM the route to his classes, my other students were coming up to me and asking me where they're supposed to go (this also happened many times throughout the day).  Did I mention that SM uses a guide dog and wears hearing aids?  Whenever I left him for more than a few seconds, he was headed off in the wrong direction.  I felt bad by the time I was done with SM because he was clearly very bewildered and disoriented.  I reassured him though that there would always be people nearby on campus to help him if he gets lost.

SL and I have been working on street crossings, and somehow cardinal directions have become a major part of this.  She really struggles with cardinal directions (tends to think North is always in front of her), but today she was on it and even getting a kick out of keeping track of the direction she was facing.  Very good news for her!

MK has been getting a refresher of the campus.  She seems to have difficulties developing mental maps and she also needs a lot of practice to remember routes.  She also tends to pay attention to her cane more than anything (i.e. not so much sounds or echolocation).  She does fairly well with problem solving but definitely needs to work on her memory.

Steve seems to think there is a cognitive issue going on and wants me to find out what it is, but I'm not sure what the purpose of that would be.  MK also walks with somewhat of a blind gait (toe out, waddling side to side), but she can move pretty quickly when she is in a familiar area.  Steve wants me to address this too, but I feel like if this is the way a person has been walking for two decades, I'm going to be hard pressed to change it.  And isn't this an issue for a physical therapist?

Speaking of, he also wants me to address the gait and posture of another student (TM), who has more pronounced issues.  I've seen her reading print, and she will literally double over all the way down to within inches of a page, which has surely contributed to her rounded upper back.  Will I be able to just tell her that she needs to stand up straight, point her toes straight forward, and walk heel to toe, and it will magically happen?  I doubt it.

CH has been working on her cane skills, rather reluctantly.  She was wearing closed-toe shoes and always has her cane with her, but she doesn't even want to use her cane during mobility.  I think it's a case where she doesn't want to identify herself as being as "that" visually impaired (like some of the other students).

This week and next week I am leading a discussion on the Hadley Guide Dog Course.  It is only three students, but it's a fun group.  The students ask a lot of questions about guide dogs that aren't in the readings, which makes it more interesting.  JD is one of my own mobility students that's participating in the group, and he is a riot.  He's very confident and learns quickly.  He's also my only student who argues with me, but it works because it challenges me as a teacher and him as a student.  And at the end of the lesson, we still respect each other's opinions (unless it's non-negotiable of course!).