Active Learning Study Group - March 2016 This video is posted online with the following chapter markers: Chapter 1. Intro & Visual Perception Field Chapter 2. Haptic Tactile Field Chapter 3. Olfactory & Gustatory Fields Chapter 4. Language Comprehension Field Description of graphical content is included between Description Start and Description End. Transcript Start Chapter 1. Intro & Visual Perception Field Silence] [ Slide start: ] Description Start: Title: Texas School for the Blind & Visually Impaired Outreach Programsa Content: left-side text: Active Learning Study Group, March 29, 2016 Facilitated by: Kate Hurst, Stw. Staff Development Coordinator hurstk@tsbvi.edu Matt Schultz, Deafblind Education Consultant schultzm@tsbvi.edu right-side graphic: TSBVI Logo Description End: Kate: Welcome to the Active Learning Study Group for March 29th. I'm Kate Hurst, and joining me today is my... [ Slide end: ] one of my favorite colleagues, Matt Schultz. Matt: Afternoon, y'all. Kate: We've been learning a lot this year going through completing the Functional Scheme Assessment with our group out in... Red Rock Elementary. And we're so appreciative to them for being a part of that, and especially to our student Kam, she's really taught us a lot, taught us a whole lot. It's great. Matt: For sure. [ Slide start: ] Description Start: Title: Poll #1 Content: Which Fields have you completed so far? 1. Gross Movement 2. Fine Movement 3. Mouth Movement 4. Visual Perception 5. Auditory Perception 6. Haptic-Tactile Perception 7. Olfactory & Gustatory Perception 8. Spatial Perception 9. Object Perception 10. Lanuage 11. Social Perception 12. Emotional Perception 13. Perception through Play and Activity 14. Toilet Skills 15. Undressing & Dressing Skills 16. Personal Hygiene Skills 17. Eating Skills Description End: Kate: What we want to know is which fields have been completed so far out of the 17 fields listed there. You can check any that you have completed. Matt: Somebody has done gross motor, fine motor. Lots of gross and fine... Kate: Oh, we're doing well. Somebody has almost all of the... Yeah. We've got everybody has checked everything. [ Slide end: ] So one of the other reasons I really wanted to check on this today is, you know, we've sort of monopolized the conversation with the... fields we were working at, and been able to ask our questions to Patty. But I know that some of you, who have been working on this, have not necessarily had that opportunity to... ask any particular questions you had about any of the fields you completed. Looking at the fields you have completed, if there was an item that jumped up... and said, I don't know exactly what is meant by this. Go ahead and put that in the chat, or just jump in, if it's in one of the fields we're going to be covering today with your questions. Because we want to take advantage of having Patty around to be able to help us know more about how to do this. Okay? Has anyone been able to videotape their student? Matt: Since the last time we met, right? Kate: Yeah. Or even any time actually. I'd be happy for any... any things-- I tell you, our... team out in Red Rock... has shared a lot of videos on our student, and I feel like that's made such a difference in my understanding of understanding where she is. To be able to go back and look at those videos, again, again, you know. And- and do the thing that... Bernadette van den Tillaart taught us-- or no, it was Barbara Miles who's like, "I noticed and I wondered." You know, because there's so many subtleties with the way our student responds to things, that... it's really been-- those videos have been incredibly helpful. Matt: Well, and just helping people... have a collective understanding of how the student is performing a certain skill; to be able to watch the video, and have a conversation with your peer, is just incredibly valuable. Kate: I think it is too. And we've seen, already, with our student, some changes that, you know, we've been-- that she's doing things that we've captured on video that we didn't see her doing at the beginning of the year, when we first started working with her. So, I want to encourage you guys-- looks like several of you have been able to, but if you haven't, you know, take the opportunity. It doesn't have to be a fabulous, you know, video production... but if you've got an iPad or iPod or iPhone that, you know, your school will allow you to use, to just get a little bit of video and just go back and look at it. Both- both in terms of the child playing independently, but also when you're doing something with that student. I think it will be very meaningful to you. Okay. So once again, we're very, very happy to have... Patty Obrzut from... Penrickton Center joining us today. Patty, do you have any of our other staff members here with you today? [ Slide start: ] Description Start: Title: Special Guests from Penrickton Center for Blind Children. Content: left-side photo: Patty Obrzut. right-side graphic: Penrickton Center logo. Note: This slide repeats whenever Patty is speaking. Description End: Patty: No, it's just me right now. So, welcome everybody. Kate: Well, Patty, we're happy to have you... here. And also we've got some... guests from out of state joining us; [ Slide end: ] Charlotte Cushman, of course, from Perkins is... on the line, as well. But I see Martha Veto from Georgia. Hello Martha. And... let's see, I was looking-- there was a possibility we would have someone from the Norbiton School... all the way in... Australia, and I'm just wondering if she's been able to join us. [ Slide start: ] Description Start: Title: LiveBinder Content: http://www.livebinders.com/edit/index/1781034?tabid=6b8f8bd0-10f7-fa99-8868-51a13eb5863b# Videos of Kamryn playing with adults and on her own. Description End: While were going, I want just remind you guys that there is information, there's-- or videos that we've used, have gone up in the LveBinder. If you can't get in the LiveBinder, let me know. I know some of you may have come in... late to the group, and may not have gotten access to the LiveBinder. But if you will shoot me an email, I will be happy to get you in there. I'll be uploading the videos that we're going to share today. And a lot of the videos are in longer form, than you're going to see them in our webinar, just because we didn't have time to put the whole... chunk of videos that we had. We just had to pull out little pieces. So, do check that LiveBinder. [ Slide end: ] So let's get right into it. And... today, one of the first things we're going to look at is visual perception. And Liz... Egan is her teacher, her... Teacher of the Visually Impaired. And Liz... do you want to share-- I don't think you have the ability to... voice, because I think you were having a problem with your phone, but start typing, Liz, with the-- if you could share a little bit of information about the basic visual impairment of... our student, and what we know about her. She says that very little is known, as of yet, because they have no eye report. They've been trying to get that from... from the doctor and from the family, and it is proving to be a struggle. She have a prosthetic eye, and that's her right eye, I believe. [Laughing] And she's fond of removing that, when she doesn't want to do the activity. It is her right eye. And she... I believe, correct me if I'm wrong, Liz, that she... has optic nerve hypoplasia. Is that right? Liz says that she's doing some things with her left eye... tracking people and preferred objects-- and I've seen it. And yes, she is ONH. I think that it's important to understand the etiology... for your students for a lot of reasons. But we know students with... optic nerve hypoplasia that there's a lot of other pieces and parts that go with that diagnosis, that we really need to be mindful of, when we're thinking about programming for them. Okay. Liz says that... she prefers shiny objects and objects that move. [ Video start: includes audio description] [Title:] Visual Perception We'll go ahead and take a look at the first little video clip I have looking at her visual perception. Narrator: In this video we will see two short clips of Kamryn that demonstrate her visual perception. In the first clip she is seated at the desk with her teacher, and the teacher is... shaking a... a... red ball that has... jingle bells stuffed inside. And you can... see what appears to be Kamryn looking at it. [background voices] [jingle bells] The teacher picks up the ball and raises it up and shakes it at her and Kamryn raises her hands above her head. She continues to... appear to be looking, and she reaches for... we think first of ball, but then she grabs some beads that are lying in front of it. The teacher again shakes the ball at her. She makes an attempt with the other hand to come across, as if she were reaching for it, and makes contact with another item. [background voices] Again, she appears to be... looking at what the teacher showing her, but most of the devices... or objects that she has in front of her, have some sound associated with them. There's also sound going on with the teacher interacting with another student at the same table, which seems to be somewhat distracting for her. [Title:] Kamryn Tracking In this next video... Kamryn's vision teacher is using the same red ball, but this time she's removed the jingle bells from it, and she rolls it across the table in front of Kamryn; and Kamryn appears to be able to track the ball, as it rolls across the table. Teacher Good looking, Kammie. Sit up one more time. Kamryn! Hold up! Narrator: Kamryn raises her arms in a game... posture she uses, with Liz, to play tickle. [ Video end: ] Kate: So, we saw... some examples of some of the visual behaviors that... Liz described. So, let's take a look at... what we scored on the visual perception section. Matt: Liz pointed out in the chat that... they selected items that- that Kam really liked, and had reached for previously, and that getting her... attention to track was tricky, but you got it. Kate: Mm-hmm. Matt: It was really good footage of her tracking. Kate: Yeah. And I think what was nice about those clips, too, is in the first one, I thought she was doing everything visually, but because there was sound associated with it, it was like, 'Well, is she- is she tuning into the sound, or is she really looking.' But it was so obvious that she was following the ball, when it rolled the second time... Matt: Without the bell... Kate: ...without the bell in it, that we did see that going on. [ Slide start: ] Description Start: Title: Questions about Visual Perception Content: V002; Reacts to daylight visually Description End: I wanted to bring in something quick- quickly for Patty. This is one question that we had, Patty, when we were doing... our scoring on visual perception. There were two items that were one right after the other... that had to do with "reacts to." One was "reacts to sunlight," and then V-002 was "reacts to daylight visually." And we weren't really sure what the difference was, in those two items. If you could, maybe, give us your thoughts on that. [ Slide end: ] Patty: Just me when I do it, I consider sunlight to be-- you know, you really can see where the sun is, and you're looking at the sun versus just normal daylight. So, it can be light outside without it being sunlight, where it's brighter, versus reacting to turning into the sun, which is really, really bright. So, some kids-- that's how I perceive it anyway. Kate: Okay. We weren't sure if it might have to do with something like a phobia, you know, that there was like a-- you know, a real adverse reaction to sunlight... So that-- you know, that gives us some good information to go on, because our student doesn't respond really well to... bright light and glare. Patty: Yeah, if I-- just Kate, for me-- I just know when I'm looking at the sun with-- you can tell the difference between it being bright outside and the sunlight. And I think it just tells you does somebody need to-- you really need to pay attention if the light has to be super bright for them to notice it, or do they notice the difference between a well lit outside area, versus a cloudy day kind of thing. Kate: Deanna asks also, could it be something like sun with shadow, versus an indirect/artificial light? And Deanna, you may need to expound on that a little bit more. Deanna says she doesn't like sun. She wears sunglasses and covers her eyes. And we have seen this a number of times. I have, just in the classroom, when she's like-- looks up at a light, she'll kind of do this. Matt: Liz says she does not like light, caps- with caps. Deanna says, "Sorry, I was asking if there was a difference... difference between the sunlight and artificial light with this question?" I think she was asking Patty, maybe. Patty: I just think that it's important to notice the differences to them. So some kids might react the same to sunlight as they would a bright light shined in their face, and some kids might react differently to it. And it's just paying attention to each one of those characteristics, and saying she responds the same way or differently. So, that if you know bright, bright sunlight bothers them, then you know that sunglasses that will help somebody, versus another child might not notice the difference between the two. So again, I don't know what Lilli meant by each one. When I'm doing it, I just look at them as the difference between-- does the child like high vibration and low vibration. There are two types of vibration, and paying attention to those details, so you know what type of atmosphere you should be offering to learn from. Kate: Okay, like there are many things that are in these that- that, you know, you can see very specifically tied to a certain age, like zero to three months. You only see children do this, or typically only see children do this at a certain age, but then some of these things, like bright light versus artificial light, doesn't seem to be as much tied to age as it does to just visual functioning. And I don't know, Patty, or any of the rest of you, if you've had thoughts about that, or if that's sort of... something you've puzzled over? Patty: I don't know, with me, if it's just because I'm so used to working with children who have such severe visual impairments, that I should probably pay attention to it more than I do; but most of the kids I have are going to be-- they might only look at lights if they're super bright, so then that-- I'm not paying attention to it as much as... age, because I'm not going to be able to fix their vision down the road. So it just kind of gives me information on what kind of tools I can use to- to have them participate in activities, versus I'm trying to increase development of their vision. Kate: Right. Patty: And I don't know if that's a right or wrong answer. Kate: Well, and that's kind of what I was thinking, too. And it's good to... to hear that, you know, that it really isn't tied so much to developmental level as it is an information gathering tool. And I think that's one thing with this assessment, which can kind of throw-- or has thrown me off before, is... you know, there are items that aren't... or so clearly tied to age, and then there are other items, that it's sort of like... I'm not sure if this is about age or function, you know. So... that's good to know. Let's see, we have. Charlotte has a comment. She says, "I wonder what effect the prosthetic eye has on the left side-- on her left side has on her visual tracking abilities?" And Liz says she will turn her head to continue tracking the item or person if it is preferred. And that brings up a really good point. One of the things we've-- I've-- I wonder-- I noticed and I wondered, and we've talked about it a little bit, is, you know, it seems like... in some cases that Kam has not been-- it's almost like she's not aware of a part of her body. Which makes sense, if you do not have vision on one side, that you may not have the awareness of that part of your body-- along with many- many other things that she's sort of working-- or working against her... in overall development. And... and it seems like since we've been doing this assessment, and we've been doing more Active Learning activities with her, it's- it's like she's becoming aware of body parts that she wasn't that aware of before, because she was very much doing-- she'd do things with one hand, and another hand, and she could do them reasonably equally, but, you know, hands coming together wasn't happening. You know, there wasn't this... real coordination, I didn't think, between the hands, and arms, and legs, and feet; and that seems to maybe be coming along a little bit. So... it just seems like she's kind of waking up to the fact that she's got, just in the little bit of active learning that we've gotten started, with her, this year, that she's kind of tuning in and becoming aware of her body, in a way that she hasn't before. Matt: And we see that through the increased movement, too. Kate: Oh, absolutely. Matt: ...midline, but also, I think, moving her head, using her vision more. Kate: Yes. Yes. Matt: Liz has chimed in, and said she agrees. Deanna has said, "Yes, definitely." Charlotte mentioned she was impressed that... Kam was able to track across midline... and Deanna points out that that seems to be new this year. Kate: Yeah, yeah... so this is really exciting, it is. [ Slide start: ] Description Start: Title: Visual Perception Milestones - Our Student Content: Visual Perception Milestones table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: Okay. So when we looked at our Visual Perceptual Milestones, we... were able to check yes for the zero to three months, but then immediately we went to no's... all the way down the way. [ Slide end: ] [ Slide start: ] Description Start: Title: Our Student 0-3 months Content: Visual Perception; Level: 0-3 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: You can see that she was showing some visual skills, for sure. There's some areas where we didn't know for sure. We didn't see it that much at school. For example, "fixates on big bright areas," like windows or whatever. She's in a classroom with no windows. And her school building has enclosed halls. So there's not a lot of places that she is where we can observe it during the day. We don't know exactly what she's able to do at home, but Liz did note that... she will sort of fixate on the light box, which is one of the... brightest things in her room. One of the other things that we weren't really sure about, and there's a lot of things, I think, with our student, where you- you think maybe something is happening, but it- it's so tentative. [ Slide end: ] And one of those things is about looking at a face and eyes, because there are times when she really does appear to look at specific people, especially the... aides and her classroom teacher. You know, she really seems to be looking at their face, or if her parents are around, but- but I'm not really sure what she's seeing and how well-- whether it's the face she's responding to, or something else, because we don't see-- or I haven't seen much in the way of... you know, any kind of imitation or- or differentiating facial expressions that produces a response in her. So I think that that's kind of interesting. [ Slide start: ] repeat previous slide. She did have a number of yes's, but she also had a couple of no's. Looking to and from objects without any cue or sound. We're didn't-- we're not seeing that too much. And then looks at black and white figures with fascination. [ Slide end: ] And that, we didn't know whether... that might be something, because I know with... with babies, the black and white is the big thing, but it doesn't seem she does that; and we think that she's probably outgrown that. So it's sort of a positive/negative. [ Slide start: ] Description Start: Title: Our Student 3-6 months Content: Visual Perception; Level: 3-6 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: Then at the three to six‑month level, she had a few yes's here, but she dropped off pretty quickly with things. We could, now, say yes, she does follow a rolling ball with her eyes, because we hadn't done that when we first graded that, so we could give her one more yes. We weren't... exactly sure if this was a negative thing, that we were supposed to judge, eye/hand coordination, reaches towards an object without making contact with it. [ Slide end: ] Patty, can you tell us is that something that we're looking at that's related to more depth perception, or is that, again, some developmental, age‑related thing? Patty: Yeah. I would say, if you reach for something, but you don't always hit it dead on, that's okay because it's-- at the age you're looking at, you might miss it, because you're still coordinating your movements, versus at an older age you could have it dead on. Kate: Yeah. And she is good-- her hands and ability to grasp are not that great just yet, but she seems to get to where she wants to go with one hand and then the other. [ Slide start: ] repeat previous slide We felt like some learning this begun. We're beginning to see a couple of instances where we think she might be looking at her hands; but she's truly, just in, I guess maybe since like the first of the year, guys, we've seen her really begin to- to play with her hands and have her hands touch each other, and to do those sort of things that we didn't see at the beginning of the school year. [ Slide end: ] And I don't see-- I haven't seen a lot of evidence of her really looking at them, but I think we felt like that there had been some occasions where we thought she might be looking at her hands. [ Slide start: ] Description Start: Title: Our Student 6-9 months. Content:  Visual Perception; Level: 6-9 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: We felt like we had topped out, but we went ahead, just for grins, and did the six to nine month. And you can see she drops off pretty significantly at that point. Which was not really a big surprise. [ Slide end: ] [ Slide start: ] page 2 of 6-9 months table. Again, I think that... looking at her... that we're really beginning to see her sort of come into awareness of what she can do, in a way that wasn't there before. [ Slide end: ] Patty: Hey, Kate, I just have a question for you about her. Kate: Yes. Patty: Does she grasp and hold on to objects then? Kate: Yes, she does. Patty: So when she's grasping and holding on to an object do you think she ever looks at the object as she's grasping it, or is she pretty much listening to... the auditory quality or the tactile quality of the object? Does she pay more attention to that? Kate: I... would personally guess... tactile or auditory more than visual, but you guys weigh in. I mean, she definitely uses her vision, I think, to see something, but once she has it in hand, I don't really see her regarding objects that much. Patty: The only reason why I was asking, is because I know a lot of the questions in the beginning have... to do with the hand. Because a child at that developmental age typically doesn't grasp and hold on to things. So they're looking at what's available to them all the time, which is the hand. So if you have a child who is now grasping objects, it can be that they-- you know, you can ask the same questions about, are they looking at what they're holding in their hand, versus their hand anymore; because they might have gone past wanting to play with their hands, and they're playing with an object now. You have to keep it all in perspective, I think, when you're doing this section. Kate: And let's see, Liz says she looks at beads in her hand, when she has them. And beads have been one of her favorite things all along... Matt: As well as wind chimes. Kate: She says she looks at the wind chimes. And that's, Liz, where I'm not really sure if she's looking at it, so much as she's listening to it, you know. Matt: And I think on video, we've seen both. Kate: Yeah. Matt: And it depends on kind of... the day, and how Kam is feeling, what her movement looks like on that day. Kate: Right. Patty: It's really important, too, that you pay attention to, yes, she's got chimes in her hand or beads in her hand and she looks like she's looking at them, but really she's just facing that direction and paying attention to the tactile quality, that you don't get faked out into evaluating vision when they're using their other senses. Charlotte: Okay. Kate: Yeah, I think that's a really good point, and... you know, that's the thing that I- I... I struggle with her knowing, but I kind of lean toward-- I think that she looks, she sees it, she reaches it, but once she gets it in her hand, I think she's paying more attention to the tactile and audio qualities than she is to the visual. Because, I would sort of expect her to bring it up and really, you know, get it up close to that one eye, or move it to one side of her face, in a way-- I haven't personally see her do that a lot. So... I'll have to look at that. Matt: Deanna says she wasn't noticing her hands before, but now she's starting to... and that she really is focused on- on the sound that things make. Liz says that- that her eye is on her hand, with the chime in her hand, and her fingers are moving it without activating the chime. Kate: Okay. All right. So we can say for sure 'learning has begun' on that. So that's really good. [ Slide start: ] Description Start: Title: Our Student 9-12 months Content:  Visual Perception; Level: 9-12 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: We went ahead and did nine to 12, but as you can see, that again dropped off pretty significantly. We're not seeing a lot there. [ Slide end: ] Chapter 2. Haptic Tactile Field [ Slide start: ] Description Start: Title: Kamryn discovers her fingers Content:  left-side photo: View looking down at Kamryn seated in her wheelchair. She has her arms raised and her hands together behind her head. right-side photo: View looking down at Kamryn seated in her wheelchair. She has her arms raised and her hands are touching her pony tail from both sides. Description End: Okay. So next we come to... some pictures related to haptic tactile. I thought these were great. Thanks for catching these, Liz. You did a great job. But this is something that really, she truly, truly, truly was not doing, when I first met this child. And now, she really is all about those hands. [ Slide end: ] You're going to see a lot of examples of her doing things with those hands of hers. And she's so delicate with them... but it's really-- it's very cool to see. I'm excited about it. So, when it comes to haptic tactile, do you want to run through some of that, Matt? [ Slide start: ] Description Start: Title: Haptic-Tactile Perception Milestones - Our Student Content:  Haptic-Tactile Perception Milestones table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: Matt: Yeah. So you can see in the zero to three months-- well, on the milestone sheet first, we checked yes for zero to three, tactile receptors around the mouth are activated by physical contact with objects. And we checked yes on the three to six, that the receptors around the mouth are used to recognize the nipple, teat or hands. But after that, it was all no's, from six months and up. [ Slide end: ] [ Slide start: ] Description Start: Title: Our Student 0-3 months Content:  Haptic-Tactile Perception; Level: 0-3 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: So, if we look at that... that first sheet for zero to six months in the Haptic-Tactile Perception, you see we said, yes, to three out of four there. The no was that the receptors on the tip of the tongue are activated by... sucking activity; and the team pointed out that she's not sucking, she's tube fed, so she doesn't really have an opportunity to... to use that- that function. And then as we go up to three to six months, we see a couple of yes's, a no, and a 'learning has begun.' The learning has begun was the receptors around the mouth are used to recognize the nipple, the teat in her own hands. She's biting her hands... perhaps with some... more frequency than was seen in the past. [ Slide end: ] Kate: Well, I think it's in a... different... way. It's hard to tell, but I know at some point, she does sort of bite or... mouth on her hand in a way that... is more self‑stimulatory, or... or seems to be expressing some kind of frustration, or whatever. But... but I've seen a couple of instances of where her hand has gone in her mouth, where I didn't feel like it was as much for that purpose, as it was just sort of a... it's there, I can get my mouth around it. Matt: And get some information. Kate: And get some information, yeah. Matt: The team noticed that she's not kicking or pushing with her feet. I think that's kind of an area where some instruction is being directed right now. Patty: When you're talking about somebody who is g‑tube fed, as well, I think it's important to remember, that even if they're G‑tube fed they still might be able to suck on something, not necessarily food. So, and the question is whether or not she's allowed to suck on things, or does that cause increased saliva, where then she would have a problem or not? Kate: Deanna says she is allowed-- and I have-- in fact, you're gonna see in our little... video clips, that we have about... haptic tactile perception, that she does actually put a couple of things in her mouth. But this is something that I have only just seen recently, that she actually gets something in her mouth. And I think that is something we've talked about, how can we, you know, try to ensure more things that might... be something to induce her to want to do more exploration with her mouth. Cause it's pretty-- what I've seen, and you will see in the video, it's more she'll get stuff around her lips, but I only saw, I think, the bells go actually into her mouth, maybe one other thing. Matt: Liz and Deanna are talking about how... she loves chocolate pudding, and that more stuff is being offered to her at her mouth, really since the January or February time frame this year. [ Slide start: ] Description Start: Title: Our Student 6-9 months Content:  Haptic-Tactile Perception; Level: 6-9 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: Matt: And if we look at the six to nine month level of the haptic tactile perception, you start to see more no's show up. "Learning has begun" on using the tips of her fingers for tactile orientation. The team had a really nice conversation about what that looked like, and that... that there was some excitement that she's starting to do that more. So "learning has begun" there. But then a lot of no's. She does not use her lips... and tongue for tactile searching of objects, although it sounds like with this increased focus and increased opportunities, that could happen soon. Kate: Yeah. Matt: She doesn't use bare feet for tactile exploration... She does repeat activities of haptic tactile nature, and the team wrote, or noted that she likes to pull elastic pop... over... the board, which I think-- Kate: She pulls back and pops them across. Matt: Gets a rise out of it, right? Kate: Yeah, yeah. Matt: So, she does repeat those activities. She doesn't suck her toes or touch the food using her fingers, although they do say she sometimes reaches over to her other... her classmates' food trays. So, maybe that's starting a little bit. That's really where she tops out, as you can see, there was a lot of no's, so we didn't go any higher than that. [ Slide end: ] Kate: Just so we can show you just those few examples we talked about, if we could look at the haptic tactile video clips that we had. [ Video start: includes audio description] [Title] Kamryn; Haptic-Tactlie Perception; January 2016. Narrator: We will view three short clips of Kamryn that demonstrate haptic tactile perception. [Title] Kamryn scratches her tummy and measuring cups In the first clip Kamryn lies on her back on the resonance board. She moves her left leg to the right and left, and pulls up her shirt. She makes a scratch like movement with her right hand on the bottom of the plastic measuring cups offered from above. Then she scratches her tummy. She explores the cups again using her fingertips. [Title] Kamryn explores with fingertips and pulls on elastics In the next clip Kamryn is playing at a position board. She grabs an object by the elastic and pulls it back, so she can flip the object over the back of the board. She attempts to flip a bell over the back of the board, but can't. She explores the bell with her fingertips before trying to pull it again. [Title] Kamryn explores silk cords with fingertips In the next clip Kamryn is playing in the little room with a wooden wind chime. She takes a break from the wind chime and fingers some sill silk laying nearby. Then continues with the wind chimes. [Title] Kamryn Uses Her Mouth to Explore Kamryn is tube fed and does not mouth objects very much. Here are two clips showing her bringing things to her mouth. Kamryn is on the resonance board and she brings a jingle bell attached to a bracelet into her mouth. Then she taps the base end of a toothbrush that has been turned on against her mouth. Then she rolls over and brings her right wrist up and puts it in her mouth. In the next clip she brings the base end of a toothbrush to her mouth and taps it against her lips. [ Video end: ] Kate: So, I think that those are... the most that I've seen, and pretty typical of her exploration... with her mouth, for sure and.... then, the things that she's doing with her hands at this point. Chapter 3. Olfactory & Gustatory Fields [ Slide start: ] Description Start: Title: Olfactory & Gustatory Milestones - Our Student Content:  Olfactory & Gustatory Milestones table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: We went ahead and did the Olfactory Gustatory Perception, in part because we felt like it would be a pretty quick one with her, at this point. And it was. It didn't take that long to do. When we looked at the milestones on that, we did not know about her ability to recognize her mother by smell. And I don't know if any of you guys have found out any more information about that, since we went through this the first time. She doesn't get liquids, that are real liquids, because she's tube fed, and so we don't-- that is not-- doesn't apply to her. Smelling food before eating it, again, we're not-- she's not really given the opportunity for that. But she does seem... to have some preferences for sweet taste, when she's offered a little taste at school of some things. That we gave her a yes. [ Slide end: ] [ Slide start: ] Description Start: Title: Our Student 0-3 months Content:  Olfactory & Gustatory; Level: 0-3 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: So, what we ended up doing is... because there was so much we weren't sure about, on the milestones, we went ahead and dropped all the way back to the zero, and just came on up. And as you can see, there was a lot we didn't know, and a lot of this has to do, I think, with just her age, you know, that... she's not being breastfed at this point, for sure. You know, milk is not something we-- as far as we know, that she's had access to. And for a very long time, we didn't know about recognize her mother by smell, but we said that she doesn't refuse sour things, because she does like lemons. When they give her the taste of lemons, she really seems to like that. [ Slide end: ] [ Slide start: ] Description Start: Title: Our Student 3-6 months Content:  Olfactory & Gustatory; Level: 3-6 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: Then, three to six months, again, there was some we didn't know about her ability to distinguish between people by their smell. That didn't happen. And they said that they hadn't noticed her responding to particularly icky smells, in any way. So, there was just a whole lot that we didn't know for sure, but again no liquid, didn't really apply, and pureed food didn't really apply with her. So... Matt: I think that was it. [ Slide end: ] Kate: I think that was it. I think that was as far as we went. Right now for her, there's not a whole lot. I would like to find out more about her sense of smell, and I think that's something to explore for sure, but I don't know... where-- whether we're in a place to really get a good sense of that just yet. We'll see what the team says. So, Liz I think says that according to her stepmom, she does recognize people by smell. And that her teacher has her smell the food that she's offering her before eating. Matt: I think Liz was saying that mom has exposed her to things like coffee and ice cream, at home. They haven't been giving her that at school, but Dee was saying she likes salsa and lemons; so, some strong, sour taste. Kate: You got it right, Matt. [ Laughter ]. Matt: Thanks Liz. Chapter 4. Language Comprehension Field [ Slide start: ] Description Start: Title: Language Comprehension Milestones - Our Student Content:  Language Comprehension Milestones table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: Kate: Okay, we decided we would go ahead and do our language one, this week. We wanted to get to that, in part because-- we'll share later, we have some plans for what we would like to do on this last one. But Kamryn doesn't use any language. So, we sat down-- I sat down with her speech therapist and we did this together. So, looking at the milestones for language, beginning with comprehension, she was-- we checked no all the way down. And we'll talk about that in a minute. There are several things I think we would like to talk about there. In terms of her non‑verbal language, we checked yes for her... smiling as a reply to smiles and statements, and I have seen her smile at certain people when they're talking to her, especially her-- one of other aides, JoAnn, likes to chat with her in Spanish and she smiles back at her. She turns her head away-- she actually turns her whole body away, when she doesn't want you, or doesn't want to do something. I noticed that one of the first times we met her. And that she uses a certain movement to call for an adult. And this is something that I sort of think it's there, and I'm not sure if everybody on your team agrees with me. But she vocalizes with a single type of sound. [ Slide end: ] She does an, "Aaaah" kind of sound. But I have seen her... vocalize, and when she caught the eye of somebody that she knew, raise her hand up and vocalize at the same time. And I definitely took that as trying to get your attention, you know, and- and letting people know. ...I'm not sure if you guys would agree with me, but that's sort of why we checked that. Matt: Yeah, Deanna says certain cries and sounds for getting attention... from the teacher. Liz says yes. Yes Kate. [ Slide start: ] Description Start: Title: Language Non-verbal Milestones - Our Student Content:  Language Non-verbal Milestones table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: Kate: Okay. Good. Good. But after that she pretty much dropped off, in terms of the non‑verbal language. And then in terms of verbal-- and this is no big surprise, we've kind of checked no down the line with that. [ Slide end: ] [ Slide start: ] page 2 of Language Non-verbal Milestones. This was on the very beginning levels. It had opens and closes hands. And it was part of language. That's item S‑14, which is actually at the... Matt: three to six... [ Slide end: ] Kate: Three to six‑month level. And I wasn't exactly sure what this meant and so I wanted to check with you, Patty. I went back and actually went and found videos of kids at that level; typically developing kids. And the only thing I could come up with, that made sense to me, that looked like a communicative function with hands, was when you see babies kind of do this sometimes, like they're wanting something or they're wanting you. They'll do their hands like this. And the same thing with, I think the one right after that, is flop arms, is sometimes they'll do their arms to sort of get your attention. What do you think, Patty? Do you think that's what they were-- Lilli was getting at? Patty: I think that's what she's getting at. I want to say, when you see a kid look almost like they're trying to wave hello and good by, and they make that open and close hand movement... Kate: Okay. Patty: That's kind of what I view that... open or close-- open and closes that hand, like, "Yes, I'm trying to get your attention." I agree with what you were demonstrating on the video. Kate: Okay. Good. Good. That makes me feel better, because we weren't real sure about that one. All right. So Matt, shall we go down the... the language in the zero to three month level? [ Slide start: ] Description Start: Title: Language 0-3 months - Our Student Content:  Language; Level: 0-3 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: Matt: So we had-- it was kind of mixed at the zero to three level. There was some yes's. "Learning has begun" on open and closes mouth. The... yes for performing mass movements to express joy and interest. I think that's something that the team reports they see a lot. No for contacts by hitting the adult's face use case a clenched hand. Kate: Yeah, we didn't think we had seen this. Matt: Yes in cries in indiscriminate way, which is kind of what we talked about. No gurgling, but we do hear babbling, "aaah" sound, like you said. You know, we put no, here, Kate, for cries in a varied way, but it sounds like today we're having some discussion that suggests that maybe she does that. [ Slide end: ] Kate: ...We've got a question from Charlotte that says, "Patty, can you talk more about how you look at recognizes the names of relatives?" Patty: if you say the name of mom or dad to a kid that young, sometimes they'll look at an adult, but they do recognize... auditorily that someone said someone's name, and it means a different person. Matt: Mm-Hmm. Patty: So, I would be marking that as do you think that child recognizes when you say mom or dad, do they recognize that that means a different person. That's why she's got it under comprehension. Matt: Patty, it makes me think of my son. If I'm home with him before my wife comes home, when he was that age, and I would say-- and I hear the car move in-- pull in the driveway, I'd say "Oh, mom's home," and he would look towards the door, anticipating mom walking in there. Kate: Yeah. Absolutely. Patty: Right. That would be a sign that he recognizes her name means-- usually that means she comes through that door at that age. Kate: Dee says... if ask where is mom or where is dad, they can look at or otherwise identify where they are? And I think, yes, that would be another thing, if they're both in the room somewhere, that they would look for them, and if they could see them, that they would sort of hang- hang on that face, and- and know that's who you're referring to. Patty: Kate, I think what's hard is, then, to pay attention-- cause, if you ask them, "Where are they?," and the parent isn't making any sound at all, and it's a child that can't see them Kate: Right. Patty: You know, that's that -- Do they recognize that mom means a certain person, even if they visually can't find that person, because they can't see? Kate: Right, right. Good points. Very good points. [ Slide start: ] Description Start: Title: Language 3-6 months - Our Student Content:  Language; Level: 3-6 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: So, on three to six months we saw a significant dropping off in some areas. We're not seeing a whole lot of communicative functions consistently used by our student, and that's one of the things that really concerns me, of course, coming from a background of deaf ed, it's like language is so, so, so important. So I think that's something we really got to think about, a lot, and try to think of some strategies for. We do see some vocalizations for her-- from her, for sure, but it's kind of a one note thing. And with her hearing, as it is, we can feel fairly certain she's getting information in... and so, you know, again, "I notice and I wonder" if a lot of why we're not seeing more from her, vocally, has to do more so with her being tube fed. [ Slide end: ] And just the lack of development of the mouth muscles, and everything, as a result of not... not doing a lot of mouthing, and not doing, you know, a lot of things with her tongue and tips. Patty: I mean, definitely in just watching her videos, and watching how-- she brings things so much up to her mouth that, to me, she's a prime candidate for wanting to do oral motor activities... where she's given the opportunity to explore. Because, then, how can she develop the language skills, if she doesn't develop those oral motor skills? And then the other thing I was thinking, as you were talking, is just to remember how hard it is to imitate behavior you can't see. And so all of these language things... are so learned through the visual field, that when you're playing with the kids, to try to remember to... use your moments, and let the kids feel your movements, and how you're expressing yourself non‑verbally. So, that maybe there's a chance that they can imitate you... through non‑verbal means. And then, I do-- Deanna wrote on here, "To express joy too is it a positive-- equals a positive negative? I wasn't sure what she meant by that... but definitely, if the kid is kicking their legs to express that they're happy, that's a good non‑verbal communication. Eventually, when the kids get older and they use their hands... to express joy, they don't have to kick so much. But it depends on the person's, I think, physical... impairments, whether or not... if that goes away is a good thing or a bad thing. Kate: Well, and I am thinking, Deanna, that... one of the early videos I got of her was with her laying back in Tony's lap, and Tony had been playing with her feet, with the bells. And... at one point she kind of lulls back, and sort of crosses one leg, and kind of slings it around. She just looked so happy, and I kind of look that as- as that-- again, that whole body movement as sort of expressing that she was content and happy, because she was enjoying the interaction, or being with Tony in that way. And I could be wrong for that, but I think that, you know, I could still see a little of that going on with her, I could. [ Slide start: ] Description Start: Title: Language 6-9 months - Our Student Content:  Language; Level: 6-9 Months table from Functional Schemes Assessment Reference: refer to PDF handout for table and input data. Description End: So, you can look at the rest of these, again, six to nine months she kind of went to no on most of these. [ Slide end: ] [ Slide start: ] Description Start: Title: LAssessment Summary Content:  Assessment Summary table showing which fields have been completed. Reference: refer to PDF handout for table and input data. Description End: We're not completely finished. We still have one, two, three, four, five, six, seven more fields to do on her to complete the whole assessment. But just looking at what we've done so far, I think we're getting a really good picture of where our student is functioning in terms of her-- her developmental levels. One of the things that I wanted to think about, and I'd like some feedback from the group on this, is as we are getting this picture we're now beginning to think, "So, what does this mean in terms of programming and in terms of IEP development?" And what we thought we might propose to do next time, is to try to take a look at some of this and give some ideas, and maybe brainstorm some ideas around the IEP. We're going to be having a team meeting, between now and then, because our last meeting won't be until May. But I thought that that might be helpful to some of you guys. [ Slide end: ] The other thing is... if there are... other folks-- we haven't really seen other kids' videos or other things. I would really, really love it if you had anything you felt like you could share. [ Slide start: ] Description Start: Title: Contact Kate Content: Fax: (512) 206-9320 ATTN: Kate Hurst Email: hurstk@tsbvi.edu Description End: So if you do, could you let me know, now, if you have something we might be able to share, so that I can get in touch with you, before our next meeting, and make arrangements to get some of the video you might have taken of one of your students, and let you share a little bit about that? Also I would love to see examples of the functional schemes assessments that you've done. You can share those with me without a student name. You can just Xerox them, and- and fax them to me. Or if you have them in electronic form, you can email them to me. That would be fine as well, scan them and email. But the number is 512‑206‑9320. And you can send it to the attention of Kate Hurst, and that would be terrific because I would like to use that last meeting in May to be able to share information. [ Slide end: ] I hope that this is proving beneficial to you. I- I feel like I have learned a great deal this year. I'm excited about this... So, let us know what you think and how you feel about this and what you need to learn for next year, as we're planning for our next year's webinars already. [ Slide start: ] Description Start: Title: Thank you for joining us! Content: left-side text: Active Learning Study Group, March 29, 2016 Facilitated by: Kate Hurst, Stw. Staff Development Coordinator hurstk@tsbvi.edu Matt Schultz, Deafblind Education Consultant schultzm@tsbvi.edu right-side graphic: TSBVI Logo Description End: We'll sign off for now. Thanks again. Kate & Matt: Bye now.