In the Driver's Seat: Chuck Huss - Rehabilitation Specialist part 4 Description of graphical content is included between Description Start and Description End. Transcript Start [Music] Fade up from black. Animation: Text for TSBVI transform into braille cells for TSBVI. [Music face out] Fade to black. [ Music ] [ Title start: ] Description Start: Title: In the Driver's Seat A Conversation with Chuck Huss Consideration for COMS Description End: [ Title start: ] Description Start: Title: In the Driver's Seat Chuck Huss Coordinator of West Virginia Bioptic Driving Program at WV Division of Rehabilitation Services Description End: Chris Tabb: We're both Orientation & Mobility Specialists. Chuck Huss: That is correct. Tabb: But I'm hoping to glean a little bit of information about... Orientation & Mobility Specialists who are not as familiar with bioptic driving. Maybe they've heard of it, know how to spell it, but that's [lauging] about all that's known. What can that O&M do to... be a little more... educated about bioptic driving and facilitate the process? Huss: Okay. One of the first things that I would suggest for our profession in general, okay, because this is going to apply, especially nowadays, with working with children in their... early elementary years, okay, through their early teens to late teens, and as... young adults, or even middle aged adults. And that is to be sure that they have the four basic, core pre-driver readiness skills, okay, that we encourage be in place before they participate in any type of screening, training, or assessment for driving privileges. Okay? The first is, they have to be able to take in on a typical lesson, whether it's an indoor lesson in a school system, an outdoor lesson in a residential area; they have to be able to take in, remember, and follow instructions. Whether those are verbal instructions, okay, written instructions. However you-- however the individual, if they're... visually impaired, hearing impaired; however they can take in the instructions, they have to be able to be able follow those. Okay? All right? The second is, is that they have to be able to execute a route, from point A to point B, and those peripheral points are going to be further apart as you extend outside. Okay? And beyond a straight line-- it could be a staircase route. It could be transitioning from a residential area to a small business, residential to small to medium, to downtown. Okay? But they have to be able to execute a route from point A to point B, and return, okay, on foot, using a reverse route, or as a passenger-in-car, using a reverse, and possibly the need for an alternate route, based on the traffic flow problems. Okay? The third thing is while executing that route, whether on foot or as a passenger-in-car, they have to be able to detect, they have to be able to identify, and they have to be able to react to, what we call, critical objects or conditions either in or approaching their path of travel, when they go to execute that route. For example, you're working with a child in a school system. And the doors in that particular school system open out into the hallway. Okay? And suddenly a door comes open. Okay? That child has to be able-- whether they're-- let's say it's not at a schedule change-- should be walking down, maybe, the middle of the aisle, versus to one side or the other. Okay? They have to be able to detect kids coming out of the classroom, or coming out of a restroom. Okay? So, the importance of looking up, versus down, and looking out and keeping their eyes moving. Okay? The same skills that we teach preliminary drivers, eye lead time, eye scanning are so important with a child. So, taking in instructions. Okay? Being able to execute route. Being able to detect, analyze critical objects or conditions. And the last thing is, is that once they progress to outdoor travel, they have to be able to approach, analyze, or breakdown, and safely, independently and confidently cross, both intersections controlled by stop signs, as well as, traffic lights. Those four key things. And the way we came up with this was the results of our pilot study, conducted in the mid '80s. And we found, both, as individuals after they completed their screenings on foot, as well as, behind-the-wheel. Okay? For instance, behind-the-wheel, as they would approach an intersection in a controlled screening situation, with limited driving skills, if they had no idea what to do at the stop sign, or couldn't detect it, we knew they were going to have problems. Okay? In the interview process, sometimes, in our pilot study we would find out that the parents didn't entitle that small child, or that young teenager, to execute any type of independent travel on their own. If they haven't developed good safe pedestrian safety skills, they're not ready for driving. Okay. That's pretty common sense. So those four key things. Tabb: And... now that you've said that, we're going to have that recorded. Are there places like your website, for instance, that... an Orientation & Mobility Specialist could access that information... either in print, or other form to be able to have those four concepts, to be able to share, either with the team, with the family, things like that? Huss: I'm actually glad you brought it up because two years ago, when we were here, follow up to a couple of the presentations I made, Kate and others put together a narrative of one of the presentations I made. And it's called... "Step By Step Guide to Reinforcing Basic Pre-Driver Readiness Skills." Tabb: There you go. Huss: "With Novice Bioptic Driving Candidates." Tabb: Okay. Huss: It gets into distance low vision skills, eye scanning, following distance. It gets into... what we call critical object and awareness skills. Okay? Knowing not only were to look at how to look, but what to look for that's going to influence a driver or a pedestrian. Okay? And those are broken down into roadway characteristics, traffic control devices, and other road users. Okay? And then we also get into the use of the telescopic system. Okay. So once you know where to look, how to look, what to look for, then we're going to introduce a combination that's going to allow you to see things in a more distance range, than using approach magnification, and getting closer before you react to it. So you've actually got a 22 page document that's on your website. Tabb: Terrific. Huss: Okay. Under the handout sections under Bioptic Driving Resources. There is already one available. Tabb: Many times, Orientation & Mobility Specialists... they go through their university training. They've had different types of experience in their student teaching, based on where they are in their internship, and they may or may not have been exposed to things, like using a lot of optical devices, binocular telescopes, things like that. Some people feel very comfortable working with and instructing using those. Others are still getting comfortable with them. In addition to that, there's some other things about... driving that... might feel, within the Mobility Specialists, like it's just beyond the realm. Huss: Mm-hmm. Tabb: So, just a little preview of your website-- and it's been a while since I've been there-- but there's a separate certification, just like we have ACVREP certification for COMS, and the NOMC certification. Is there an additional certification that helps to delineate... or, kind of, have a scope of practice... of what the COMS should be doing? So, in other words, this is an example... the low vision specialist might, quote unquote, prescribe a specific type of monocular or bioptic device for that individual... which isn't, traditionally, going to be what the O&M would be doing. So, what are kind of the boundaries, in the scope of practice, for the COMS, so that they know what is safe for them to be able to do, with appropriate training, and what they would want to defer or utilize other professionals for? Huss: Okay. The two fields of O&M and driver education training are relatively very similar. What the O&M instructor teaches an individual to become more independent on foot, starting indoors, and then outdoors, and progressing from quiet residential to highly congested downtown areas. The driver educator starts behind-the-wheel, okay, around a driving range, and then from there advances to residential, to small business, to medium business, to downtown, to the interstate. Do you see what I mean? There is a lot of parallels. So, for individuals, like ourselves, who want to do a little bit more... than the typical O&M instructor. What I did was, two years before I started working with low vision clients as part of the Bioptic Driving Program, I job shadowed with a driver educator. Okay? I observed him teaching classroom. I observed him behind the wheel. And then he used to tell me, "Chuck, because sometimes site challenged individuals are so labor intensive," and by that, I'm talking about they won't learn how to drive in just 5 to 10 hours, like sometimes a normally sighted person will. They need 20 to 30 hours. And I would see firsthands, why. And eventually, what we found out was, we used a concurrent approach. Where instead of doing things sequentially, going from classroom, to passenger-in-car, to behind-the-wheel; we did it all within the same day. Go from classroom, reinforce it as a passenger, and then reinforce it behind the wheel. And do it one-on-one. And that's what we did during our pilot study. Okay? But before, as a mobility instructor, before I was entitled to even teach the classroom, I observed for about two years with a driver educator, working with normally sighted drivers. Okay? And it wasn't until the end of the second year of our pilot study, was I permitted to independently work with the individual in a classroom setting. Okay? Now, what's the distinction between a Mobility Instructor and a Driver Rehabilitation Specialist? Usually a Driver Rehabilitation Specialist, okay, usually, is going to be certified by that state or licensing jurisdiction to teach behind-the-wheel training. Now, many years ago, because I've got a history of doing a lot of public speaking, they also entitled me to assume the role of a Driver Rehabilitation Specialist, but not a Certified Driver Rehabilitation Specialist. There's a difference. Our professional organization ADED, it used to be-- we kept the acronym, and it's called The Association for Driver Educators for the Disabled. It's now called The Association for Driver Rehabilitation Specialists. Okay? But that agency has a special test for people who are not only certified by their state to do behind-the-wheel training, but a test that allows them to work with people with all types of physical and mental challenges. Now, my area of expertise, with my O&M background, is strictly with individuals with mild to moderate levels of central vision loss. Okay? And I did that now for close to about 35 years. Okay? So, in answer your question, sometimes it will involve job shadowing, becoming familiar with the materials that a driver educator would use as part of their teaching repertoire. Okay? Companies like Doron Corporation has a complete series of... driver simulation films, called the I-P-D-E series; identify, predict, decide, and execute. You can use those same things as part of your mobility teaching practice on foot. But you've got to become familiar with it. Triple A has some excellent DVDs, okay, on basic signs, signals, and pavement markings. Smith System Driver Improvement Institute, located here in Arlington, Texas... has... some excellent DVDs on, what we call, distance viewing skills, okay, eye lead time, eye scanning, object avoidance, okay, "Communicating with Other Drivers," "Leaving Yourself an Out." That comes right from here in Texas. Okay? They've had that for close to 50 years. We apply it with our low vision drivers before we emphasize the integration of the telescope. So, the mobility instructor needs to become academically orientated to what's being taught for normally sighted people, and how they can place that into their program. Okay? What a mobility instructor cannot do, without specialized training, and that is to teach behind-the-wheel in the front right seat. Okay? That's one skill that you're not permitted to do. It is safe-- okay, a good safe idea, for the mobility instructor to consult with the state driver education association, if they are permitted to do, once... in service trained at their particular agency, the classroom and passenger-in-car. You want to be sure that you don't start doing something where it's illegal. Do you see what I mean? Tabb: Yes. Huss: Okay. And it's the same thing for, like, a VI teacher teaching street crossings that are provided under the jurisdiction of the C-O-M-S or C-O-M-T. Same thing. Tabb: I don't know that this is replicated in other states. It seems that it's unique to Texas that you can opt, as a parent, to be... the instructor for your child. And so my guess is that many COMS would want to be able to support that, if the parent chose to do a parent instruction. So, you had mentioned before about... the different video series, different information that's available for the COMS to familiarize themselves with. Huss: Yes. Tabb: Are there suggestions that you... would provide to COMS, to then relay to parents, about what to have their children doing? Obviously, if it's much younger, they would probably be in the backseat for safety sake. Huss: Right. Tabb: But what to look for, so that the parent can encourage the child to be an active participant in that driving process, whether it's to school, to the grocery store, to be able to become connected with... signage... intersection controls, things like that. How would you provide that? Huss: There's a couple of things, again, I'll go back to this step-by-step guide. Okay. It's written from a standpoint, whether it's reinforced by the mobility instructor, whether it's reinforced by the VI teacher, or whether it's a parent. Okay? And there's exercises that go along with the academics... that you can read it, and then there's an exercise on how to reinforce it, in an actual dynamic situation. There's a publication... offered through the National Organization for Albinism and Hypopigmentation, called, "Albinism Insight." And recently, I put together a two to three page article that's called, "Being Driver Ready" or "Becoming Driver Ready." And in it, I emphasize the four things, that we earlier discussed, about the four basic pre-driver readiness skills, for both parents, and then eventually towards the mobility instructor as they begin outdoor travel away from the home setting. Okay? A second article will be coming out in their spring issue of that, where I... am entertaining the concept of hand-held... monocular telescopes, and how the C-O-M-S can become involved in that in the school system, and then, there from residential to commercial establishments, whether they be a... a supermarket, okay, a Walmart, things like that. Okay? So, emphasizing the prerequisite for monocular telescopes, prior to the prescription, or screening, fitting, evaluation for the bioptic. . Okay? So those two things. Now, other things that are available. There is an... interesting website called "Bioptic Driving USA." It was put together by Dr. Richard Windsor and his daughter Laura Windsor, both of whom are optometrists working out of the Indianapolis, Indiana- Indiana area. That gets into all kind of aspects of by optics and driving. Okay? The address again is www.biopticdrivingusa.com. That would be good-- one good website that I would encourage you to go to. Okay? There is a webinar that I put together back in 2011, called "Steps to Becoming a Bioptic Driver," that's available on YouTube. Okay? And I did that for NOAH, several years ago. There's also an excellent... webinar offered by the American Foundation for the Blind, this past year. Presley did the narrating of it. I was one of the contributors of information for his webinar. That's excellent! Okay. And it's available at a nominal price. I think it's $40 or $50. Not all the people that-- who will want to explore driving, in reality, will eventually become drivers. Okay. And there's an excellent resource guide put out by APH. And this was done a few years back called "Reclaiming Independence: Staying in the Driver Seat When You No Longer Drive." Okay. And it gets into all different type of alternate means of transportation but still being independent in that process. And that's available. I think it runs like $60 for a DVD copy. But that gets into working with mobility instructors, using public transportation, paratransit, and things like that. Tabb: I think the "Finding Wheels" curriculum, I don't know that that's still available but... Huss: It is. Anne Corn's. Tabb: Yes. Huss: Okay. And that's another alternate. Okay. And Anne's thing, it also includes bioptic driving. Okay? But it goes through a... sequence similar to what... "Reclaiming Your Independence." Okay. And it's a good publication. I think the difference between the two; Anne's came out in 2000, and the other came out... I think it was about 5 or 6 years later. Tabb: More recently. Huss: Yes. Tabb: As far as the... COMS' role... in helping that process to move forward, obviously as we've talked about, the COMS is not a driver trainer per se or a... rehabilitation specialist, in that regard. If COMS were asked by a school who was providing driver training to students, could you provide that component to help the schools, or the district's driving instructor, with the skills they might need? Do you think that's something that a COMS could... basically be a consultant about using those? Huss: Yeah. Again, I think the four basic things we mentioned at the beginning of our discussion of what we call the four basic pre-driver readiness skills, okay; the directions, the route traveled, the critical object awareness, and the ability to cross streets at stop signs, or traffic lights. Those... four things have to be in place before the individual would be even considered as an applicant for a program that's offered by their high school, or through a... private commercial driving estab- establishment, etcetera. Now... could you also incorporate, as part of your job, the use of a telescope? I think you could. Okay. I think with limited staff and service training; and we could provide that in West Virginia. Okay? The thing that-- the services that we provide is, is that, if you work with, or have a long... long standing contract with, a state agency that deals with clients that will be required to go to work, or look for work, okay, either voc rehab or with the state blind services agency, we should be able to train you, okay, for free. You pay your own expenses when you come. Okay? And then, if you don't have that long standing contract, and you're working as a consultant for that, let's say, private driver rehab establishment, then you pay $40 an hour, for any number of people coming from that sole agency, okay, for the training. So, you take 40... and multiply it times 12, okay, and you come up... with... a figure under $500. That's pretty cheap, you know, for multiple people being trained. Orientation Mobility Specialists, in general, have that, just like the occupational therapist, a scope of practice, where we say that you'll function within this zone. And... for students who have... multiple impairments, for instance, or... cognitive challenges would not necessarily be working within Orientation & Mobility Specialist, and Travel Trainers, who might work with them, are... agreeing, we'll say, to not be working with those who have visual impairment. But if someone were going to... move into the area of working with students with low vision, in order to help them to increase their independence by becoming a bioptic driver, do you think it would be helpful for an Orientation & Mobility Specialist to have that full gamut, of being able to work with those who do have multiple impairments, multiple disabilities? Huss: Yes, I do. In fact, how often times... do you find mobility instructors, in addition to their daytime job, doing private contract work, where often times the individuals they work with are multiply handicapped. And sometimes the most handicapping condition are not the blindness or the low vision factor, it's other cognitive factors, etcetera. Okay. We have-- our professional organization has an annual conference every year, which deals with varying aspects of driver rehabilitation training and assessment. So, some years we may have an emphasis on ADHD, or... different types of, let's say, individuals requiring... hand control usage. Okay. Or, the senior citizen population. Okay? Individuals with acquired cognitive loss. So, each year we have a little bit of something where the driver educator, okay, the Driver Rehabilitation Specialist is going to have to be, have some basic knowledge of. Okay? This is why when you take the CDRS test, to become certified by that national organization, questions on that test are from a variety of physical and mental disabilities, and not just, quote, let's say, vision alone, or anything like that. There are some questions related to vision. Some... are related to bioptic driving. But- but it's a full gamut. Okay? So, it's out there. I would like to see more mobility instructors become involved. I think it's really that there's a misconception that you're going to be required to do the behind-the-wheel training, and you're not certified, nor legal by law, to do that. So, you don't have to worry about that. Okay? But should you go back and get short term training so you could? Some will. Tabb: COMS are coming into, possibly, more involvement with these activities. What would you, kind of having a- having done this since '83, looking at the... field of orientation mobility, knowing how that's changed, what would be your hope of... how COMS would... take this into their practice? Huss: There is a program that's available... at the Indiana University of Pennsylvania, right outside of Pittsburgh, that offers an intensive 12-hour program, I believe it is, that teaches individuals, with an education background, to become a certified driving instructor. Okay, 3 weeks. 3 weeks you can become a behind-the-wheel instructor. So, my suggestion would be, is to go through a normal COMS program or COMT, like they called them at... Salas University, and then get that add on instruction, by either going to a school like Indiana University of PA, and becoming a certified driving instructor, so you can do, legally, all the aspects. You've got the legal recourse, you know. You become certified in your jurisdiction to do classroom, passenger-in-car, and behind-the-wheel;because of that CDI certification that you get. Okay? You have to take a test after you take the coursework. You got the Academy certification as an O&M instructor. Okay? So... you'll reach the full gamut. And if you think about it, when we call ourselves an Orientation & Mobility Specialist, should we not have the credentials to be able to allow the people we work with to achieve the highest level of orientation mobility skills, which would include operation of a motor vehicle. In years past, a lot of mobility instructors didn't feel comfortable in their clients, okay, driving. Okay? At least that was my feedback that I got. Okay? And so, a para-- I won't call them paraprofessionals, but a professional that began to do a lot more than mobility instructors were doing, was the occupational therapist. Okay? A lot of OTs now, in fact, 50 percent of our professional organization have an OT background. And OTs, you know, originally, were generalists working within a clinical setting. They are now into driver evaluation, driver training, van modifications, okay, etcetera. Okay? So, they've expanded, and they've also expanded into our areas; and there was some concern, years ago, that they're expanding a little bit too much. Okay. But they're getting that additional professional expertise. And when they do so, I don't have any problems with that. Okay. I don't have any problem with doing in-service training with people of various professional disciplines. Okay? In fact, I'm tickled that they're taking the initiative, because we don't have a formalized program of Bioptic Driver Training and Assessment in every one of the 51 licensing jurisdictions. We only have it in approximately about 25, or so. Okay? So, there's a significant need. We've got people-- bioptics in driving is now recognized in 49 of 51 licensing jurisdictions. The only 2 states that don't recognize it, is Utah and Connecticut. But yet, those 2 states will allow you to drive with mild to moderate levels of central vision loss; Utah to 20/100, Connecticut to 20/200, without the use of a scope. Okay? We're almost at the point now where you can live anywhere. Okay? And there's as- as minimal as 22 states, now, that now recognize driving down to, including, 20/200. [ Music ] [Silence] Fade up from black. Animation: Text for TSBVI transform into braille cells for TSBVI. Fade to black.