Week Three

Margaret and I are into a pretty good rhythm now on these Fridays.  I settle into her van with my lunch, water bottle, notepad, and purse.  We catch up on whatever is new and head over to Stacy's school.  When we arrived, we quickly found out that Stacy had a meltdown that morning which resulted in her parents deciding that she would not participate in gymnastics that day.

Margaret once again took this opportunity to give a different perspective on Stacy's behavior; being visually impaired can mean that disruptions to Stacy's routine will upset her more, because it is so difficult for Stacy to control her environment.

We went to where Stacy was painting on paper at a desk.  Margaret briefly talked to Stacy about what happened that morning and quickly seized some learning opportunities.  Stacy had painted two green blobs on her paper, so Margaret had her feel where they were and incorporated concepts like top/bottom, left/right, big/small.

Margaret even managed to compare the blobs to dots in a braille cell (where does this woman get her creativity???).  When she discovered that Stacy had been painting on three sheets of paper so that the ink had bled through, she showed Stacy how the paint blobs were small/medium/large and were a little smaller on each page.

It had rained all night and morning, which meant there puddles all over and the cars were wet.  Stacy mentioned that her mom used the windshield wipers on the way to school, so Margaret decided to take Stacy out to her car to let her feel the windshield wiper and her windshield.  Stacy was very hesitant to touch  the wipers and the wet windshield (seems like things that make noise bother her), so Margaret encouraged Stacy to ride on her hand as Margaret touched the moving wiper.

What was truly amazing was that this little three-year-old made a connection between the wipers and her cane: "It sweeps like my cane".  To me, this was a serious YES! moment because it showed that Stacy understands the concept of sweeping to the point that she can compare it to other things (I mean, wow).

After that we took a nice leisurely walk around the school/church grounds which again made me wonder how people get paid to do this.  The church sign was explored, puddles were splashed in, and a one-story tall spiral staircase was climbed.

When we left the school, Margaret and I talked about making a tactile map for Stacy; it was clear that it should be small, simple, and focus more on shapes than textures.  I'll be making a tactile map for Stacy this week, so there'll be an update next time on how that worked (or not!).

Before I move on to the other students, it really is interesting how many more concepts and skills Stacy has to learn than the older students.  This is probably stating the obvious, but just from an observing/writing point of view there seems to be a lot more learning taking place with Stacy.  I'm not sure if it's the specific students that Margaret works with for the rest of the day, but the others seem to either already know it all (at least of what I've seen) or be focusing on very specific skills/routes.

At the middle school, we found out that Joe's (previously called student A) hand preference is still in question.  When his PT and OT work with him, he seems to prefer his right hand.  Yet for some reason every time Margaret asks him which hand he wants to hold his cane with, he always reaches with the left.  Interestingly, Joe also has better control of the cane with his left hand too.

It seems like for now Margaret, the PT, and the OT have settled for Joe having different hand preferences depending on the activity.  I personally didn't understand the controversy over it; my boyfriend is right handed in many activities but very much left handed in others, and I'm pretty sure he's not the only human being like that.

We worked with Joe on walking up and down steps with his cane while his PT watched.  From what I've been told, PTs focus on safety whereas O&M specialists focus on independence.  This might be a potential source of conflict but probably also provides balance.  It will be interesting to see what other conversations the PT and Margaret have about the students.

Next we went to pick up Mike for his lesson.  First we went to a restaurant to get some food, and then he practiced a route in his neighborhood.  One of the first things I noticed is how much more he uses his cane outdoors than indoors.  I didn't get it until Margaret pointed out how much Mike uses echolocation.  Then I remembered how much more sounds echo in buildings than outside.  Definitely something to keep in mind for my future students!

Week Two, Part Two

During the first week of my observation, Margaret (the O&M instructor) taught Mike (the high school student who is blind) a college campus route in preparation for Mike's class starting the next week.  All went well and Mike was able to find the classroom on the first day of classes.  He sat there for approximately half an hour, but no one showed up.  Eventually he called his mother to say the class must have been cancelled or moved, and she came to pick him up.  The two of them found out that there was sign on the door to inform students that the classroom was changed; how is a student who is blind or has low vision supposed to get this kind of information?

What should Mike have done instead?  Maybe he could have been taught how to find the admin building, just in case.  Or, he might have walked out of the classroom and asked someone if they knew where the class was located.  His solution to the problem was probably typical for a junior in high school, but he will not always have his mom, TVI, and/or O&M instructor there to help him.

This entire scenario highlighted the importance of so much of what is taught to students with visual impairments. They must learn how to self-advocate, they must be able to problem solve, and they should come up with back-up plans.  Margaret informed me that she and Mike had gone back to the college campus the day before his class started to review the route again.  Margaret saw that one of the professors was in his office and wanted Mike to introduce himself to this professor.  Mike declined and the two left.  

The point was that Margaret knew that talking to this professor might provide useful information about the class, but the decision of whether or not to do so was up to Mike.  Mike is at the point in his O&M instruction where it is primarily based on teaching him to learn from mistakes, plan ahead, and ask for assistance in an assertive manner (and not demanding it!).  

To me, this is a hard lesson to teach because it requires a lot of hands-off and letting the student get into difficult or uncomfortable situations.  However, it is absolutely necessary in order for these students to be able to get things done on their own once they graduate from high school.

The goal of this week's lesson was to teach the route to Mike's new classroom and to the admin building, where he wanted to double check that the electronic file of his textbook was being delivered.  As we walked, I paid closer attention to how Mike traveled.  Interestingly, Mike has great travel skills but hardly uses his cane.  He tends to hold it slightly in front of him without tapping it on the ground or having much of an arc.  

Instead, Mike travels mostly with echolocation; he is able to locate doorways, hallways, and stay on a sidewalk mostly with his hearing.  I have heard about these kinds of skills before, but never saw them up close.  Apparently Mike developed these skills naturally and with little help from O&M instructors.  To me, it is very fascinating to watch because I had such a difficult time travelling in a straight line when blindfolded and using a cane.  

Anyhow, Margaret seems to let Mike decide how to travel and has not given him prompts to use his cane, probably because she respects his ability to make that decision.  If Mike was one of my new students, I would be tempted to have him use his cane more.  But as I am learning, every student is unique and has different strengths and needs.  There is no cookie-cutter answer.

Week Two, Part One

It's interesting how what we think we know about ourselves turns out to be wrong, but more on that later.  Anyhow, despite my first day with the O&M instructor going well, I was still nervous about this second day. Why? I'm really not sure, but I think it has something to do with not wanting to look like a fool in front of a potential future coworker.

Today started at the preschool again, which is quickly turning into my favorite school to visit. The classroom was sitting at the big table and playing with flubber. That's right, the green gooey mystery material just like in the Robin William's movie. The mounds of gloop had been pressed, cut, and prodded into all kinds of shapes, which the students were only too happy to show me and let me touch.

 The O&M instructor (who shall be called Margaret) began helping the student we were there to see (who shall now be called Stacy) roll the flubber into different shapes; a snake, a pancake, and a really loooong fork holder. Clearly this was a great activity for Stacy; she could develop her concept of shapes, her hand strength, and her tactile awareness.

When the activity was finished and the students moved on, the classroom teachers mentioned Stacy's reluctance to touch the flubber at first, but that she eventually got used to it. Margaret took the opportunity to explain how sometimes, touching an unfamiliar material to the child's arm or leg first might help them work up the courage to touch the object with his or her hands. She used a great explanation that I've heard before; the hands of a child who is visually impaired are like our eyes, and should therefore be treated carefully.

Margaret tries to take Stacy for a walk every time she sees her so cane skills can be worked on. First, she helped Stacy use protective techniques in the classroom to find a shelf, and then trail a cabinet to the classroom wall. Even though Margaret was telling Stacy to trail the cabinets, Stacy began walking toward Margaret by following the sound of her voice (meaning she is already actively using sound localization).

Eventually we made it outside, with one of Stacy's classmates joining us for the walk. Stacy tends to hesitate in making decisions or not want to take turns with others, so Margaret has decided that in those situations to let Stacy's classmates decide where to go on the walks. This is a great example of how so many other skills can be reinforced during O&M lessons!

After a quick elevator ride and a visit to a small garden space, we went back inside for the class's tumbling lesson.  This is such a great opportunity for Stacy; body parts are mentioned, different body positions are used, and she gets to do things such as hop, squat, walk on her tip-toes, and bounce on a springboard.  At this time, she needs one-on-one assistance to participate in the activities.  This makes sense, but eventually Stacy starts over relying on the adult assisting her through the activities.  I find myself wondering if she would do the activities on her own if we let her (when does a child start becoming a prompt junkie again?).

As we left to go the middle school, I thought to myself, "I could be paid to do this all day?  Go for walks and play with flubber?  Sign me up!"  At the middle school, Margaret started with student A by walking with him to the cafeteria.  Student A is one of those success stories; for the longest time no one thought he could walk unsupported and even crossing a threshold would make him lose his balance.

Now, he can walk with minimal assistance and is working on using a long cane.  This student's hand preference seems to be in question though, so Margaret is experimenting to see which hand is better for him to hold the cane with.  The lesson here is that there is a lot of trial and error in O&M and determining what is best for the student.

The next lesson at the middle school was with two students as we searched for a suitable route to the band room from these students' classroom.  These students are in a varying exceptionalities class.  One is totally blind and one has low vision.  The difference between the two was interesting; the totally blind student had much better cane technique, asked far more questions about the environment, and moved slower.

The low vision student needed frequent reminders to  keep his cane tip on the ground and use his cane.  He also had many more suggestions of how to get to certain locations on the campus.  Overall this was more of a discovery and exploring lesson, but I think the totally blind student might have benefited more from learning the exact route first and then exploring the area around it.

So back to the statement I started with.  I always thought that my preferred population to work with would be middle schoolers, high schoolers, or maybe even adults.  It was nice to be proved wrong and thoroughly enjoy working with the preschoolers as they discover the world (and play with flubber).

Week One

Last Friday was the beginning of my 50-hour journey with an itinerant orientation and mobility (O&M) instructor. The itinerant aspect was expected and prepared for; I met the O&M instructor at a local Panera Bread so I could ride around with her for the day. Because I would be stranded with only the things on my person, I also brought lunch money, my driver's license and student ID, as well as a heavy jacket and a light sweater (note to self: an itinerant teacher should wear layers and keep back-up clothing in his or her car).

The two of us started the day at a church preschool where we spent about two hours with a bright little girl who has a tentative diagnosis of Leber's, which is an eye condition that causes very restricted visual fields. As I watched this little girl, I kept thinking back to my orientation and mobility classes where I navigated through buildings, across streets, and around neighborhoods with a blindfold on and cane in my hand (and not in the most graceful manner).

Some random thoughts that were rapid-firing in my brain as I watched: "How did she find that doorway so easily? She used the cane to get up the stairs way better than I ever did! How long has she been using a cane again? Nine months?! Look at that arc! I wonder what exactly she can see?" Basically, this little girl blew me away, and if she was the only visually impaired child that a person ever came across, I think they would have very high expectations indeed.

The word I took away from this lesson was: Opportunities. Four of us (the O&M instructor, me, the student, and one of her classmates) took a walk around the church grounds to see what could be discovered. As the O&M instructor spoke, I realized that virtually everything we came across was an opportunity to learn. There is so much knowledge and information that I take for granted, which made me realize that I need to peel back those blinders and see from the perspective of one who hasn't seen it before.

After leaving the innocent and wide-eyed preschoolers practicing tumbling, we were transported to the alternate universe of middle school. The difference between these age groups is so great that I likened it to culture shock. Apparently teaching 3-22 year olds every day is going to take some getting used to.

We were here to teach three students that are in varying exceptionalities classrooms, but first the O&M instructor wanted to consult with the PT, OT and classroom teachers: "Is there a better way for this student to hold his cane?", "Do you think this student has sufficient vision and cognitive ability to use a power wheelchair?", "How has this student's behavior been?" For this population especially, collaboration is so important for making sure the students get what they need.

The word I took away from this lesson was: Expectations. The first student I met was in a stander and working with a PT. He seemed to understand what people were saying to him, but he didn't talk at the time. I foolishly assumed that this meant the student must have limited cognitive abilities and be limited to a wheelchair. Well, he does use a wheelchair...but it is a power wheelchair...which he drives...by himself. The O&M instructor even had to remind him to "only" go up to level 3 (do we have a future speed demon on our hands here?)

We followed this student out the classroom, out of the wing, down the hall and to the cafeteria. He opened all of the doors on his own and knew exactly where he was going. Maybe my expectations were too low, and I shouldn't have been so impressed by this, but to me this student's ability to travel were significant for his future independence.

We worked with several other students at this school who took us to the chorus room, the library, the main office, the nurse's station and the classroom. Then the O&M instructor and I moved on and made the less jarring transition to a nearby high school. The student there is very similar to the little girl I started the day with, and what some might call "vanilla blind", meaning that blindness or visual impairment is the only disability they have.

The word I took away from this lesson was: Flexibility. As an itinerant, changes are to be expected, whether a student is sick, on a field trip, or forgets to tell you about a change in schedule (oops!). The O&M instructor had intended to work on a street crossing in the student's neighborhood, but the student needed to be oriented to the local college campus to be ready for a class starting there the next week.

Fortunately, the O&M instructor is allowed to transport students in her own car which allowed us to go to the college campus and make sure the student could find his classroom. I wonder what would have happened if the instructor had to sign up for a district van in advance only to find out that there was a change of plans at the last minute?