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!).

Intern 8.2

Well, thankfully CH was somewhat back to her normal self today.  She had on closed-toed shoes but didn't bring her cane ("But how can we do mobility when it's raining out?"  Well, let me show you....)  We got a fair amount of work done so I think it was a good lesson.

I spent most of the day at a low vision evaluation with one of Steve's students or helping with an all-day training for new DBS employees.  For the low vision eval, it was interesting just watching and seeing what the student's vision was like.  She didn't need much in the way of correction, but definitely has significant field losses.  

She ended up with three different prescriptions (near, intermediate, and distance).  The student decided to get bifocals for the near and distance, even though the doctor was somewhat concerned about her already small visual fields being cut off by the bifocals (something I was wondering about too).  Either way, I can't imagine having to tote around three pairs of glasses, plus sunglasses.  

I was curious about her contrast vision, which seemed mostly normal.  One part that I really wanted to see was trying out the different sunglasses/filters.  The weather was not cooperating with us though, so the student will have to pick some when she goes back.  

I also talked to the student when the doctor was out of the room and threw out some other ideas of what she might want to try (what about an electronic magnifier?).  Steve and I had also talked about a monocular, which the student tried.  She couldn't see anything through it, even with some practice, so this was definitely a dud.  But you don't know unless you try, right?  

Intern 8

Had a strange lesson today with CH.  She has low vision is learning how to use a cane.  

Thursdays at the center are "Professional Development" days so the students are expected to dress up.  Last Thursday my student came to class wearing dressy open-toed sandals (students have to wear closed-toe shoes during mobility lessons), which I didn't realize until halfway through the lesson.  I decided to let it pass for the day but told CH that next time I would have to send her back to her room to change shoes.  

So before CH's class with me today, I saw her on campus wearing closed-toe shoes.  Oh good!  I thought to myself.  Well, bizarrely enough, CH showed up to my class after lunch and announced that she was wearing flip-flops, before I even noticed.  So of course I asked her to go back to her room to change shoes.  She just sat there.  Me: Ok, we'll practice your cane skills in the dorm hallway anyways, so let's go back to your room so you can change shoes.  Finally she moves.

Back in the dorm, CH heads into her room but turns and tells me, "I'm not changing my shoes or coming back out of my room once I go in."  Huh?  Really?  I have to babysit you through this?  This girl was quiet when she first came to the center, but less than a week ago she had been bubbly and chatty with me.  

I'm thinking something must be going on her in personal life.  So I followed CH, sat down, and asked her what's going on.  What I really wanted to know was, is this something to do with mobility?  The cane?  The center?  Or something else entirely?  Or maybe even me?  She wouldn't talk (something she had no problem with last week!) but finally I convinced her to get up, change her shoes, and we headed out to practice her cane skills.  

To be honest, I think part of the problem is that her vision is so good that she doesn't see the point of learning to use the cane.  The cane is really for her to use at night, but she doesn't want to do blindfold training.  I'm planning on her receiving night mobility instruction but I've been told it might not be an option by the time she's done working with me, due to the time change and sunset. 

Either way, I hope tomorrow goes more smoothly.

Intern 7.2

Talked to Steve about the concerns I mentioned in the last post.  He didn't really have an answer for me, but I at least feel more confident about where I'm going with the student I was agonizing over.

My newest student is learning how to use a cane so today I showed her how to stay in step.  This is my first time teaching someone cane techniques from scratch, so I'm anxious to do it right and keep my student from developing any bad habits.  So far seems to be going well.

Steve was out today so I took on one of his students who also happens to have Usher Syndrome.  She has a low vision evaluation next week (I'm going with her to the appointment), so I took the opportunity to talk with her about that.  I shared that I was a fellow Usher so we also talked about hearing aids, life with RP, driving,  how to cross streets when you can't hear the traffic that well, etc.  It will be interesting to see how Steve addresses street crossings with this student.

Another one of my students happens to have a hearing loss on her right side but she is in denial about it.  I brought it up in her progress report today, and she asked me to remove that information because she doesn't want anyone to know about it.  She had a hearing aid when she was younger but she didn't like wearing it.  I talked to her about my own hearing loss and how hearing aids have helped me, in the hopes that it would sway this student's thinking.  She was pretty adamant though and doesn't want to have another hearing test or anything to do with hearing aids.  My concern is that she can't hear traffic very well on her right side, so I really have to get her to understand to pay attention to that side.  

Yesterday I taught two of my students  how to travel on the stairs using a cane.  Both were very nervous about it, but we took our time and by the end I could tell they were feeling more confident.  They both had the technique down pretty well too.  Hooray!

Last night I went to Walmart with the dorm group and worked with my student who is a good cane traveler.  I haven't been able to go on this Walmart trip for several weeks (it's every Wednesday), so I was glad to be able to go last night.  This student likes having a lot of information about his surroundings and is good at developing mental maps.  I told him about the cardinal directions of the store, where the different sections of the store were, what the different textures on the floor meant, and how the main pathways were laid out in the store.  

While this student is pretty smart, he definitely needs to work on self-advocacy and giving appropriate directions/guidance to whomever is assisting him.  I'll just say that shopping with him was interesting: "what exactly are you looking for?  Do you want the toothbrush with the rubbery things on the side, soft bristles, medium?  Does your face wash come in a blue bottle?  No, multivitamins aren't one brand." Oy vey.

Several weeks ago, this student told me that if someone came up to him and grabbed his arm to "help him", he'd just go along for the ride because that's the nice thing to do.  So of course I taught him the Hines Break and threatened some kind of retaliation if I saw him "going along for the ride" again.  Ok, not really, but I think he got the point.

Intern 7

Bit of an interesting week so far.  A trainer from the Seeing Eye was at the center today, and several of my students are possibly interested in getting guide dogs.  The trainer did juno walks with three of my students, which was interesting for both them and me.  I got a refresher on what the commands are and when to use them, and different things to consider when thinking about getting a dog (do you need tactile feedback?  are you willing to give up some control?).  I was surprised at how well my students did and enjoyed seeing how differently they reacted to the opportunity.

This Friday I have progress reports to submit/meetings for two of my students.  The email alerting me to these meetings prompted me to look at the progress report template the center has for mobility.  These two students have been making progress, and I felt like we were working at a good pace.  After looking at the report template though, I realized that there are several areas that I probably need to be doing more.  Now I'm questioning whether I'm moving these students along fast enough.

The source of my anxiety might not make sense, so let me explain.  When we get new students, we do an assessment on them and develop a plan and goals.  With that plan, we say how many hours the student will need to meet his or her goals.  This number is expected to change, which is part of the purpose of monthly progress reports/meetings.  I know how many hours my students theoretically have "left" to meet their goals, and some are obviously going to need way more time or not as much.

So far, I've been operating on the assumption that my students will be able to meet their goals, regardless of how much time it takes (within reason, of course).  Maybe they won't be experts, but they'll at least have a firm foundation of skills to transfer to their home communities.  However, I'm starting to get the impression that if a student is here too long, the decision-makers start getting antsy and want the student to finish and make room for a new student.  Of course there are a limited number of dorms, but the biggest problem is that there is a limited number of students that the mobility instructors can have.

Now I'm starting to see that some of my students are unlikely to reach the goals they have in an "acceptable" amount of time.  Although I might be able to teach these students some basics, it's unlikely it'll be enough for these students to get around independently when they're back home.  Especially considering that one of my students never goes past her mailbox by herself back home.  Will this change?  I'm somewhat doubtful, which is frustrating.

Intern 6

Another week of teaching has passed!  Wow.  The recurring theme this week was street crossings.  Funny, because that's one reason that I wanted to work with adults for my internship.  My reasoning was that street crossings are one of the hardest things to teach, so I wanted as much practice in that as possible.  And who would be working on these the most?  Probably adults at a rehab center more than children in elementary school.

Which leads to the very in-depth experiences that I had with street crossings in the past week or so.  Many of the intersections here in Daytona are actuated, and it's obvious that they are.  For example, at several intersections, the light on the major street will stay green until a car shows up on the minor street.  Or, the light will not be nearly long enough for a person to cross if they don't press the button/have a button to push.

As I said previously, I feel more and more than I need to teach my students the problem solving skills to be able to assess any crossing that they come to.  I've already told one student that I won't always be there with her, so she needs to be able to confidently make the decision whether or not to cross.

Actuated signals don't seem quite as challenging to teach with my low vision student who can see the pedestrian signal (of course I still want her to pay attention to the traffic).  As for my students who are blind, I think it will be a whole 'nother ball of wax.  My more confident traveler has no problem crossing when it is quiet, but I'm not sure my other two students will be as decisive.  Either way, it is going to take a lot of patience on my part.

The student I have who was struggling with staying in step is still not there, but she is in step more often than she was before.  She also knows how to effectively correct her step as she is walking.  Now the problem is veering.  She tends to turn her head as she crosses a driveway, so she veers in that direction.  This will definitely take more practice.

For one of my lessons with a student who is blind, we recreated a nearby intersection using Tactile Town (with the lane stripes and everything).  It was a last minute thing (it was cold out and had just started raining), but it worked out really well.  The student gained a much better understanding of different parts of the intersection, and she also learned how to identify the corners by their cardinal directions (NW, SW, etc).  She understood where to place the cars (to my surprise) and we talked about when to cross (with the near parallel traffic).  With this experience in mind, I think the Wheatley Picture Maker will be my new best friend on mobility lessons.

+

Intern 5.2

Am done teaching for the week and didn't have too many challenging lessons to teach.  I've been reviewing the basics of cane techniques and sighted guide with my more experienced traveler.  Next week we're going to start doing street crossings. 

Am still in the assessment phase with my newest student.  I've put her in a lot of different environments and so far she hasn't had any difficulty during the day.  She reports having worse vision at night, but I wish there was a way that I could see for myself.  Either way, I'm planning on teaching her cane skills during the day so that she can transfer them to the nighttime.  We can also have her take nighttime mobility lessons.

I'm still working on staying in step with SL, but it hasn't been as much of a focus.  She had been working on a longer route and was having difficulty reversing it.  She finally got it, so I had her go on the route and come back to my office by herself.  She did it without any problems!  The biggest thing she needs to work on is being aware of all of her senses and her landmarks.

I've been working on street crossings with TM, which is something she's anxious about.  We started by crossing driveways and then moved into a quiet residential area with stop signs.  Yesterday I took her to a small lighted intersection.  However, it was a challenging intersection because it was semi-actuated.  So rather than having her wait for the all quiet or crossing with the parallel traffic (which was very unpredictable), I had her use the pedestrian buttons. 

I'm not sure if this was the best way to do it, but I didn't want to put the student in an unsafe situation.  I mentioned this previously- the center has a policy of teaching street crossings in a clockwise motion.  The problem is that this student has a significant hearing loss in her right ear.  At least two or three times she has missed the turning traffic over her right shoulder.  So is this really safe for her?  I suppose I need to work with her more on scanning with her eyes.  At any rate, small, simple, and straightforward intersections seem difficult to come by here.  Or maybe they're not common anywhere anymore?

My last student missed a lot of class this week and she was out most of the first week that I had her, so I've only worked with her a handful of times.  She is working on crossing driveways and is very anxious about it.  She also has a difficult time remembering routes and using mental maps.  It's frustrating to me when she misses so much class because I can tell that there is a backslide in her skills.  Also, she is a very slow walker so it limits how far we can go in one lesson.  Hopefully she'll build up her stamina over time.

Intern Part 5.1

What week is this?  Losing track of  how long I've been here and definitely getting into a groove.  Have done a little of everything as far as reports/paperwork goes so pretty comfortable there.  Have a new student this week who has low vision and is very different from my other new student.  She doesn't use a cane and has limited mobility training.  She seems to get around ok at the center but only goes out with her grandparents when she's back home (has never crossed a street independently).  Quiet young lady, a little unsure of herself and probably nervous about being on her own.  Working on establishing a good rapport with her so she'll trust me and be more relaxed.

Doing a "refresher" lesson on cane techniques with my experienced traveler tomorrow.  Brushing up on all that info myself so I can confidently share it (eek!).  Another student has been working on the same route for almost a week now.  She has no problem getting to her destination but reversing the route is a different story.  Trying to get her to focus on her landmarks and what's around her but multitasking is not her strong suit.  My student with the wild and crazy cane arc is still one of my pet peeves.  Broke out my own cane tonight so I could come up with ways to get her cane arc lower and under control.  Tempted to walk on campus tomorrow with my cane and blindfold.  Think I might have some techniques to try with the student too.

One of my supervisor's students has a severe hearing loss, and given my own experience with hearing aids/audiograms/etc, he has asked me to interpret this student's audiogram.  I knew the basics, but it was very interesting delving into the nitty gritty and seeing how the student's mobility skills might be affected.  I went to the instructional plan meeting last Friday, and the student's hearing loss was the main topic of discussion.  I found myself nodding along with most of the statements (sound localization is tricky, why is my hearing aid whistling? how am I going to cross streets?)  My question was, can we make sure a program is placed on her new hearing aids that does NOT mask background noise?  And wouldn't an FM transmitter be helpful for my supervisor to have to teach this student during mobility lessons?  Oh the possibilities.

Oh, and Steve has informed me that he's not going to give me the answer when I have mobility (non-procedure/center rules) questions anymore.  Instead, he's going to question me and help me find the answer on my own.  We'll see how that goes!

Intern 4.2

Another week almost over!  Today was a busywork kind of day; I discussed progress with 3 out of my 5 students.  For new students at the center, their first two weeks here are the assessment period.  At the end of those two weeks the instructors meet to discuss the assessment results and the plan/hours necessary to meet the student's goals.  Also, there are meetings about once a month to get an update on the student's progress towards his or her plan.  I am exiting one of my students this week, so I met with him to discuss my report and his upcoming night mobility instruction (which is contracted out to another instructor).

This week was different from last week; I did a greater variety of things (teaching residential travel where there aren't sidewalks, orientation to a bus transfer plaza, street crossings, etc).  One of my biggest challenges this week seemed to be having a strong enough grasp of the information so that I could provide clear instructions/explanations to the students without confusing them.  Basically, choosing the right words seemed difficult this week.  I'm sure that every time I teach a certain concept/activity, it will be a little easier but it's slow going now.

Yesterday and today were also full of cane-related issues.  My new student showed me a blister that has formed on his pointer finger from using his cane.  Apparently he is using his cane a lot more now that he was at home.  Of course I was wracking my brain trying to figure out why this might have happened; after all, I'm supposed to be the expert here.  When he uses his cane, he rolls his wrist rather than bending it, which I think might be part of the problem.  Will be addressing that next week.

Another student (with low vision) who has been using a cane for awhile has really inconsistent cane coverage (her arc goes from being really wide to really narrow or to mostly covering her left side).  She's another one who rolls her wrist.  Overall she just looks really heavy-handed with the cane and it's definitely not going to help her as much in the dark or at night.  I put a new tip on her cane and really want to get her a graphite cane (she has an aluminum one) but she's so short that the center doesn't have one that fits her.  Argh!

My student who uses a guide dog never got a cane, so I measured him for one today.  This is the first time I've dispensed a cane, so I felt a little unsure of myself.  However, I had two cane lengths and I asked the student to walk up and down the hall with the two.  He is a very fast walker so I went with the longer one and feel pretty confident about my decision.

Last but not least, the student whom I have been working on staying in step with is making definite progress in this area.  Today she was in step about half the time and walking very close to her normal pace.  I think part of her problem is that she has very little experience in coordinating her movements (ie minimal athletic/gross motor skills).  I must say though, when she is walking in step she looks like a very competent cane user.

Intern 4.1

Day two of teaching this week.  Things are going well so far.  My biggest challenge now seems to be figuring out what to do with my students the next day.  Many of them are ready to go out into the community and tackle things like street crossings and commercial travel, but we have to drive to these places (and there is only one hour).  Nevertheless, I did take my new student to a commercial area today (and he did fabulously as usual).  Another challenge is that because I'm unfamiliar with this area, I have to do a lot of investigating to find places that would be suitable for my lessons.  The other instructors helped me with this a bit, but I need more "minor" intersections.  Everything here seems to be either a major 6-lane intersection or a residential area with no sidewalks.  On another note, I am feeling more confident about what to do with my new student and guesstimating how much time he'll need in mobility instruction.

Intern 3.3

Didn't have any students today but I did have some progress update meetings to go to.  At these meetings we talk about what the student is doing well and what he or she still needs to work on.  The primary point of the meeting is to figure out how much time the student needs to complete his or her training at the center.

Steve and I went over the biweekly evaluation together, and overall he is pleased with how things are going.  He wants me to work on my confidence, making sure I end lessons on time, and think about what kinds of standards I want to have for my students (what will I be picky about).  He wants to go over TAPS with me and highlight the kinds of things that he thinks are important and also to give me a refresher.

So far I've had to do a referral for a student to receive night mobility (this is contracted out to another instructor) and I'll also be writing a justification letter for why this student needs the Trekker Breeze.  Next week I'll be doing his exit report, which is similar to the progress reports that I've already done.  Definitely having to learn the ropes quickly.

This weekend I'm planning to learn the main bus routes for the area and scope out intersections/street crossings that I can use with students next week.  Should be interesting.

Intern Part 3.2

Second day of teaching this week went much better!  I showed SL (who is blind and is working on staying in step) how to "kick the cane" to the opposite side, and she started walking much faster.  Not normal pace yet, but I think the repetition is finally catching on.

TM (low vision) is working on street crossings.  Today I had her close her eyes and point to the direction that the cars were traveling in.  We also talked about cardinal directions, which is something she struggles with.  We finished with setting up an intersection on a Chang board and talking about when you should cross the street (with parallel traffic).  Her anxiety level seemed to be less today too.  

DT (low vision and uses a guide dog) is working on the Trekker Breeze.  We successfully added an address as a landmark and I showed him how to rename and delete landmarks.  Much smoother lesson today!  My new student JD (who is totally blind) is still a bit of a challenge.  He has such great mobility skills but I was able to find out that he wants to work on big intersections.  Deciding how much time he needs in mobility instruction will be the tricky part.

Just like in student teaching, the part that I'm enjoying the most about this so far is the "lightbulb" moments my students have.  It's so great to see when they're figuring something out and building their confidence.  

Intern Part 3.1

Had my first full day of teaching today.  It was interesting - I was by myself with the students, which was nice.  Since I'm just starting with these students I spent time talking with all of them before we got started on an actual lesson.  There isn't really a set curriculum here that all of the students follow, but there is a sort of natural progression that is used.  The students learn the route to their classes, the immediate campus, expanded campus, and then out into the community.

Several of my students are just starting to work on street crossings.  They are both nervous about it so I am trying to both establish a rapport with them so they're comfortable with me and also give them enough time and information so that they're comfortable with intersections.  I think my challenge with both of these students will be pushing them just enough (not too much, not too little).

Another student is learning how to use the Trekker Breeze.  I've been learning myself, but haven't mastered all of the features of it yet.  Today the student wanted to do a function that I wasn't familiar with.  Not pretty.  We fumbled our way through and finally figured out what we were doing but then ran out of time.

I also had a student that is brand new to the center today and he is totally blind.  I talked with him a bit about his interests and also his mobility skills.  I showed him where his classes are; this guy has really good mobility skills (echolocation, mental mapping, etc) and is a regular user of paratransit and the bus system back home.  I'm assessing him this week and next and have to present a plan for his mobility instruction by the end of next week.  At this point, I'm wondering what I'll be able to throw at him that will be challenging enough.

Another interesting thing I observed today: there are two mobility instructors here, and I am taking on two students from each instructor.  Watching the students work and being aware of what they have been working on in mobility class previously, it is clear that the two mobility instructors here focus on very different things.  One of the students from the other mobility instructor doesn't stay in step or have good coverage with her cane on her right side.  This is something my supervisor would have been working on for weeks.

On another note, the student I've already worked with on staying in step is still moving very slow.  I tried a metronome app with her today and it didn't seem to help her pick up the pace.  It will be interesting to see how she does over the next couple days.

Intern Part 2.1

This week was still stressful but not as overwhelming as last week.  I taught several lessons (two on-campus routes and one street crossing).  I wasn't really teaching the students anything brand new; it was more that the students were demonstrating their knowledge.  I was also able to observe mobility, technology, and personal management lessons with a variety of students; a guide dog user, a power chair user, and individuals who are blind and some with low vision.

A group of students went on a community trip to a clothing store during the day on Wednesday, so I went along to help out.  I gave one of the students sighted guide and assisted her during the experience.  I've also observed this student during lessons and have taught one of her lessons.  She'll be one of my students when I start my full caseload next week.  She presents an interesting challenge; her cane techniques are pretty good, she travels in a straight line, and she has good echolocation skills.

However, she can't stay in step unless she walks very slow; basically by breaking down her walking into moving her feet and the cane separately.  Her pace has improved slightly, but not enough for her to be able to use this technique outside of mobility class.  I asked her to try practicing to a song that she likes that has a catchy beat.  A metronome might be in my near future.

During an outing to Walmart, I was with a student who has a guide dog.  I also saw this student during a lesson with his mobility instructor, and there are clearly issues with how he handles his dog.  It seems like he is following the dog more than him telling the dog where to go (and the dog basically has what would be called "bad manners").  The student doesn't take criticism very well.  I'm not sure how in a situation like this you get the student to handle his or her dog more appropriately.

Another student is working on building his confidence with street crossings because he has been hit by a car in the past.  He has done well with several different intersections but still gets nervous.  He won't be one of my students, but I've been thinking about how else/how long I would work with him before exiting him.

A big part of this week has been learning about the case management/assessment/reporting system here at the center.  Daily notes have to be taken on the lessons, and every two weeks there  is a meeting on how the student is progressing.  There is an initial assessment and then an exit report.  Much like student teaching, it seems like the hardest part of this job will be the paperwork.

Next week when I start my new caseload, I'll have four students that I've at least met and observed a bit, and one new student.  With the new student, I will have two weeks to assess his skills and determine what his goals are.  Steve typically asks students what they can/can't do, but he suggested that I have the new student demonstrate his skills.  This seems like a great idea to me, but I'm wondering how I'll fit everything in to two weeks.  As far as the decision making of goals/etc, I'm somewhat comforted by the fact that I can at least get the student's input and see what their comfort levels are.

I'm both excited and nervous about starting next week.  Like Steve has said, I'm going to be developing my own style as a mobility instructor and different things will be important to me.  Even during the brief time I've been here, it's obvious that the two mobility instructors at the center teach in very different ways.  I'm expecting that I'll be asking Steve lots and lots of questions, but he doesn't plan on observing me during every single lesson I have (which is kind of nice).

Some other random mobility related thoughts I've had is, when do you use indenting?  Why do the students all shoreline outside and then try to walk in the middle of the hall when they're inside?  How many different intersections does a student need to cross?  How much information can I cram into one lesson before a student implodes?  How will I remember everything from my mobility classes?  I know there isn't a silver bullet.

[I meant to post earlier this week, but time got away from me!]