Sensory Learning Kit Study Group #3 This video is posted online with the following chapter markers: Chapter 1. Introduction - Welcome from moderators Scott Baltisberger and Sara Kitchen. Chapter 2. Sensory Learning Summary - Moderators share answers by author Millie Smith to questions asked by the study group regarding the Sensory Learning Summary. Moderator Scott Baltisberger shares a copy of his completed SLS. Chapter 3. Parent Interview - Discussion of the importance of conducting a Parent Interview which can provide detailed information about a child. Chapter 4. Arousal State Profile - Initial discussion of the elements of the Arousal State Profile and questions about how observations should be conducted. Sensory Learning Kit Study Group #3 Transcript [ Music ] Chapter 1. Introduction Scott Baltisberger: Hello, everybody. Welcome to the third installment of the sensory learning kit study group. I'm one of your hosts, Scott Baltisberger, Outreach consultant for the Texas School for the Blind and Visually Impaired. And also here is Sara Kitchen. Sarah Kitchen: Hi. Baltisberger: Say hello Sara. Kate Hurst is also here to help -- help out as well. I want to welcome everybody here, all our returning members and anybody else who is showing up new. We're real happy to have you here. And our purpose is to collaborate on learning how to use Millie Smith's new and improved Sensory Learning Kit as an alternative means for a Learning Media Assessment for some of those kids who are at early stages of development. So moving right along. Chapter 2. Sensory Learning Summary Ok, so right now what we're looking at in the Sensory Learning Kit is the Sensory Learning Summary. We looked at it last season and we decided we want to take a little bit more time to let everyone get through with it. And be able to have a better discussion about it. So this portion of the SLS is where you're gathering information [ Slide start: ] and looking at the medical needs and you're looking at any precautions there might be as well as any impact that medical conditions might have on your student's performance. And then you're also looking at all the sensory channels, how they take in information, what information is already available in the paperwork. [ Slide end: ] So last time we did come up with some questions that we were wondering about, some things we were concerned about or just we thought about. And we broke those into three areas. [ Slide start: ] One was how much time should we be spending on this sensory learning summary. We did get some feedback that maybe we were ‑‑ [ Slide end: ] Kitchen: Belaboring the point… Baltisberger: Belaboring the point with it and spending too much time with it. There was also question about the parent questionnaire, [ Slide start: ] like questioning the parent or going to the parent for information, if there was actually a questionnaire [ Slide end: ] or if Millie had something in mind with that. And the other thing that came up with us was we ‑‑ there was no information about the child's communication style, [ Slide start: ] that is, how they ‑‑ how they let you know whether they're happy, they're sad, they want more or if they want less of something. [ Slide end: ] So that was another question we wanted to put to Millie and talk to her about. So first of all, how much time ‑‑ Millie, from her information there's two things that need to take place. [ Slide start: ] One is a Records Review and the other one is the Parent Interview. Those two things have to happen. [ Slide end: ] And she used the term insurance policy. So that's just so that when you go in you're not ‑‑ you're not ‑‑ you know what information is there and you're not going to do something that might be harmful to the child, either physically or just as far as their behavior goes. So you be sure you know what's on the records. What do you need to do before you go forward with it and find out by accident perhaps that you were doing something that ‑‑ doing something wrong that maybe you had prior knowledge that you shouldn't be doing. She did say don't spend too much time on this SLS. Don't belabor the point. Kitchen: Yes, she said she had never filled out one in entirety. It's just all those things are there just in case there's some information about those things, but there won't be information about everything for every kid, for sure. Baltisberger: Right. And some of you guys, I tend to be a little bit compulsive about filling out forms sometimes. It's a habit I developed a long time ago. When I see a blank spot on a form it makes me feel bad. [ laughter ] and really some of that information I ‑‑ I'd really like to know how much ‑‑ or it would be an interesting question is how much ‑‑ was anybody able to get information about like olfactory? I mean, that's something that I ‑‑ I didn't see. Kate Hurst: Well, the one thing I would think about with something like that, Scott, is there are certain syndromes where there are problems that are there, like with CHARGE, often times that's the case. So what I would think you might look for in the records is if you know like with a certain syndrome that there are problems like with CHARGE that you might make a note that their condition has nothing do with that. I think you're far more likely to come up with that kind of information through a parent interview unless the parent has specifically stated something in previous, you know, assessment or whatever. Baltisberger: Right. And that's a real good point about CHARGE and other syndromes. When we were finally able to talk to the parent, a lot of that I felt a lot better about going in and filling in those or not filling in those blanks. And usually what I do is I write “no” or I put an X in that spot. Kitchen: It's like it's filled in. Hurst: And I'm thinking the other thing that might come up is that there may be some known preferences, you know ‑‑ especially I'm thinking of kids who have pretty severe multiple... impairments that maybe have not so much communication and maybe they've noticed some response from them when certain smells, like when we bring their food to them we notice that they perk up or they quiet or something. And we know that we haven't given them that food to taste or anything, but we can tell it just by the smell of it that they're responsive in either a positive or negative way. But I would think it would be very subtle information unless there was some specific thing, like we know that they have seizures when they smell this smell. And I would think there would be something in that record to show that. Baltisberger: Okay. Yeah. And also, you kind of have to read between the lines or add the information. For example, olfactory, what the information asks for is are there any cautions for the presentation olfactory stimulation. It's not really asking ‑‑ the instrument doesn't really ask for more than that. I think it's a good point to say, well, that's ‑‑ generalize that more. Is there any information about olfactory that there are other things they like, are there things that seem to get their attention? I did that in parent interview. If we could do a quick poll and see how much time do people spend on compiling this SLS, did you spend less than an hour [ Slide start: ] all the way up to spend more than three hours like certain people did. So if you all could take a minute and fill that out. Just estimate. [ Slide end: ] Just estimate how long it took you. And it also depends on how many records you have available to you. And also the nature of your student. We had a student -- the original student we were working with had a lot of medical records ‑‑ [ Slide start: ] and the student we more recently started working with was not quite as extensive. Hurst: Tracy makes a point, she says she hasn't gotten around to being able to do this yet, so I'm sure some of our folks who are listening are in the same boat as Tracy. Baltisberger: Right... Hurst: Haven't started. Haven't gotten that far yet. [ Slide end: ] Baltisberger: Well, it's good for Tracy to know that [ Laughter ] [ Inaudible ] going into it. Kitchen: It's not going to take hours and hours. [ Slide start: ] Done with the poll, guys? Kate: Got four votes. Baltisberger: Ok, it looks like most ‑‑ the majority of the people are looking at taking one to two hours. [ Slide end: ] Chapter 3. Parent Interview And that's pretty reasonable. Although, I'm wondering if people are ‑‑ well, let's go on. Because, the next thing to think about is I was wondering if those people who did the Parent Interview and if that was included as part of that number. [ Slide start: ] So there's another poll which is just whether you did or did not do a Parent Interview. Millie said there's no real questionnaire that she recommends [ Slide end: ] or that comes with the kit. She did ‑‑ when we talked to her she mentioned that in the APH the ECC Essentials, she said there's a really good questionnaire under the Sensory Efficiency part. I don't know if anybody out there has had a chance to look at that. I didn't. Kitchen: I was wondering if we have that. Hurst: We do have that and I can look and see if we could pull some of that together just to share with folks at our next meeting. Baltisberger: Yeah, because she did think it was a good idea. What she mentioned was just... [ Slide start: ] just taking the SLS and kind of -- with the parent going through the sensory channels, just really kind of what you want to do, just kind of more of a conversation. And that's how I approached it, just kind of finding out about their child and using that to guide the conversation. And I got a lot of really good information. And again, you may not complete everything that is in the actual ‑‑ in the paperwork. And it looks like most people were able to do a Parent Interview. [ Slide end: ] Great, because that is something Millie recommends. Hurst: Well, I think for so many of these kids that if you aren't getting an interview with the parents that you are just really missing out on probably some of the most valuable information, because the more multiply impaired kids -- they're going to be the best at home with their families. And if you talk to those parents -- they know ‑‑ they know what is and isn't and works and doesn't work, the likes and dislikes. And I think you're... missing a great resource if you don't do that. And I know it's hard to get to them sometimes; you know, there's special situations... Kitchen: Rene says her parent lives out of town and has not been with her child for the last three years. Special circumstance. Kate: But Rene, but even with you and I know the situation you're in, some of the more regular caregivers within that facility have probably some ideas that ‑‑ or information that they could share as well, which I bet you're already tapping into. Baltisberger: Yeah. I think in some of that information ‑‑ I mean our situation is real different because we don't ‑‑ we're working with students that aren't ‑‑ we don't work with typically. So a lot of the information that we're trying to seek out and get, if we were TVI's going to a classroom on a regular basis, or weekly basis, or twice a week basis we would have a lot more of that information. A lot of it you probably just get from knowing the student or talking to the teacher, as well. You know, I mean some of the things that weren't in the SLS, that I just kind of wondered about were just; can this child move, can they crawl, can they sit up by themselves? Things like that that aren't necessarily in the report or not in too much detail in the report. Going to the -- the other thing we asked about or Sara and I had a question about was the communications style. That is, how does a student ‑‑ how do you know when a student is attracted to something, they like something, when they're refusing something? And Millie said ‑‑ she said ‑‑ when we asked her that question she predicted it. We said the first thing we usually want to know, and she said oh, you want to know their communication style. So she knew what she was talking about, but she said, you know, really that the SLK is ‑‑ she said you can't fit all the information on one instrument. And really the SLK is looking at sensory learning ‑‑ the Sensory Learning Summary. And the SLK is ‑‑ it's looking at the sensory channels. And rather than trying to ‑‑ it's more concrete. It's looking at what do you know. What is not physically what's there, not what's ‑‑ the communication will come further down the road. I mean, that's what you will be look at as you're doing the assessment. So you're not really interpreting behavior at this point of the SLS. Kitchen: Yeah, I guess that would probably be -- you'd start to think about that during the next phase. Hurst: Well, you know, when she gets into the Symbols and Meanings kit, the SAM, the one that follows the SLK, that's probably when that becomes a big piece of it, I would guess, too. Baltisberger: So I want to open it up for discussion right now and just see in what people ‑‑ what you have to say about the Sensory Learning Summary. Were there parts that were problematic? Were there items that were difficult to understand? If there were items that you felt were not helpful? If there was anything you think you should add? So if anybody would just like to jump in right here... Hurst: Do we want to take a look at that summary maybe and help sort of spark people's... Baltisberger: Yeah, we can look at the one that Sara and I did. It's for a student named Abby. [ Slide start: ] As you can see, I didn't ‑‑ in that ‑‑ in this ‑‑ looking at this student, we didn't have a lot of records. Really basically, all that were in the records that I had access to are the OT eval and the PT eval; and the report to the TVI, the Functional Vision/Learning Media Assessment, and also Parent Interview. So, we found out she had this condition leukoencephalopathy. Kitchen: "encephalopathy" Baltisberger: "encephalopathy" [ Laughter ] Kitchen: "leukoencephalopathy" Baltisberger: "leukoencephalopathy" Kitchen: That's hard to say. Baltisberger: It is. It's very difficult to say. And part of that is she has a seizure disorder and gastroesophagal reflux, and she's identified as CVI. And for my own purposes I just added on what her current handicapping conditions are VIO JSI. The medications -- and that was interesting because that was something that was not in the paperwork. Kitchen: No side effects. [ Slide end: ] Baltisberger: Yeah. Even the current meds. There were meds listed in the paperwork, but when I talked to the parent, she said, "No, no, she's only on this one medication right now, and she's taking it two times a day and has no side effects." Kitchen: That's amazing. Baltisberger: Yeah. I -- Kitchen: I don't believe it. Baltisberger: Yeah. She said that ‑‑ and I would — this is something I need to go back and look at, I think. Look at that particular drug up and get the ‑‑ what's the official word on side effects. Because what the mother may understand about it or what she may experience ‑‑ Kitchen: Or maybe that Abby doesn't have side effects. Baltisberger: Yeah, this is true. She did mention all these medications which she is allergic to. Kitchen: So you wouldn't want to come in giving her any of those medications as part of your assessment. Baltisberger: Don't give her a shot of Penicillin or Phenobarbital. Hurst: But, one of the things that does make me think about that we were talking about earlier about olfactory and the gustatory kinds of issues; if they are on some medication regularly it might be worthwhile to go and look at some of the side effects because it might impact some of those things. I don't know that it would, but that would be one area where that could happen as a result of medication for something they were on. Baltisberger: Right, right. True. Going into all her issues — Kitchen: Common side effects, blurred vision, changes in vision, [ Inaudible ] . I figured there were some of those things. Okay. Baltisberger: And so -- so we can ask some of her issues, nutritional came up, that she has to eat small bites. Her mother said she's gotten a lot better about eating, but she does aspirate liquids, [ Slide start: ] unless they're given with a thickener. No problems with elimination, no problems with respiration. Sleep, sometimes her sleep is a little bit off. Her mom said sometimes she wakes up at odd hours. So that would be -- that's good to know. She has a potential for that that could certainly highly affect the results you're getting. Seizures, she has a seizure disorder, but her mother put it, said she hardly ever has them, just every few months, is the way she wrote that. She's had a lot of them in the past, evidently. And I also asked her -- when I talked to the mom, I said what does she look like when she has a seizure? Because I thought that's really good information to have. You know, some kids look very different when they seize. It's from our point of view because we're coming in from outside and knowing that information is good for us. No food allergies, medical allergies that were mentioned on the other page. [ Slide end: ] And of course, you know with our kids, you get a lot of information on the functional, or more information than maybe you do some other places. Although in this case... you know, CVI, no corrective lenses, no medications, no therapies. As far as lighting, it just mentioned toys with lights. Mom says she's attracted to lights. High contrast. Eliminate clutter. These are all pretty general recommendations. Bring objects close, reach for objects within grasp. Colors, use bold colors. Her mother said red may be her favorite color. She wasn't sure. Central field seemed to be better. Her mother did say she might have a problem with her lower field. Extended time to react to visual stimuli and present items in a central field are near. So hearing... there is nothing about hearing in the paperwork, and... the mother reported that she thought she had normal hearing. She said she likes to watch television, she loves music. She's startled by loud sounds. So this might be something to look at, thought, as far as if it's not there, maybe it's there and I just have access to it. If it's not there it's probably something ‑‑ I think you would want to do. I think you need an audiological on everybody. Kitchen: Yeah. Hurst: Well, I think for sure, as someone who works with deafblind kids, [ Slide end: ] I know it's important and I know kids appear to have hearing when they don't. And I think that's one of the issues for a lot of these kids is that we don't have good audiological information on them, and there's a lot of concerns about, well, how do we do the tests, because the audiologists are saying we have to do an AVR and they have been to be put to sleep to do that. And one thing I would like to encourage all the TVI's out there is if they don't know what's going on, is to discuss with their teachers of the deaf and hard of hearing, you know, what they would suggest. If there hasn't been an audiological done, they may want to do it. And it may be something that they just want to get on the parents' radar when they're having to do some other kinds of tests where she's going to have to be ‑‑ where the individual has to be put to sleep, to go ahead and do some audiological testing at that time. But you also can do a lot of functional testing, just by getting some help from your teacher of the deaf and hard of hearing; looking at toys that make certain sounds in certain frequencies, looking at things that they respond to in the environment. Things like that. And then also, especially with younger kids, they should have gone through a screening at birth. And sometimes, sometimes, something was picked up at birth and not followed through on. And so if you can go back and have the parents check to see if they was screening ‑‑ what the screening results were -- sometimes you pick up that they were screened and there was a problem and nobody followed up. And so I think that that's important. But I do think, especially as a teacher of visually impaired, if we're going to be using the auditory channel as a great way to get to these kids, we need to make sure it's really intact. So I think, audiological testing is really important. Baltisberger: Good point. I was looking at some of the other areas. Touch, there's information on the OT/PT reports. One of the aspects of the leukoencephalopathy is spastic uncontrolled movement. [ Slide start: ] That would be something to consider. She did mention that she uses -- the PT uses a weighted vest and a compression shirt during therapy. As far as that being helpful, not helpful, I'm just not real sure how to answer that question at this point. Nobody really seemed to understand ‑‑ Kitchen: I thought if she didn't like it maybe it wasn't helpful. Baltisberger: That could be. Hurst: Well, it certainly would be something you would want to use to motivate her. [ Laughter ] Avoid the shirt. [ Inaudible ] Baltisberger: Perhaps the shirt would be under not helpful. Her mom mentioned that she has a lot of cousins and siblings and they like to play with her and they play with her like kids often do, sometimes rough, and she seems to like that. That's good to know. That is really good information to have. If you notice, I’ve put marks in those wherever there's anything to be put... Kitchen: There's something there. Baltisberger: There's something there. Kitchen: It looks like you at least considered the question. [ Laughter ] Hurst: Even if he didn’t have the info. Baltisberger: I did think about it. And the vestibular proprioceptive... they mentioned she uses a raking movement in order to try to grab things and again she has that spastic movement related to her medical condition. She does roll on the floor. She's starting to begin to crawl on her elbows and knees. She says that she gets real fussy if she's left too long in one position. And that precautions are just to lift her from her trunk, not her extremities, but I think that's ‑‑ [ Slide end: ] Kitchen: I would think that left too long in one position would probably be fading. If she's starting to learn how to crawl she must know how to roll over. Baltisberger: She does. She rolls. But maybe when she's in her wheelchair or in her stander. Hurst: Yeah, where she can't get herself out of it. [ Slide start: ] Baltisberger: They mentioned that she likes all the type of movement, she likes ‑‑ her mom said she likes everything, side to side, up and down, back and forth, fast, slow. I guess we'll see. She said that she will let you know. When she's done with it, she lets you know. The gustatory, basically she said her mom said she likes everything. She loves to eat. So... And on olfactory, she said ‑‑ her mom said she seems to like ‑‑ be more interested in flavors than smells. That was the information there. So that's the information we got on Abby for our SLS. [ Slide end: ] Hurst: Tracy appreciates being able to see a form filled out. I think that is reassuring to all of us. It's not what's on the form, but it's like, you know, I kind of know what somebody else might put. Kitchen: And for your continued enjoyment, there are also in the Sensory Learning Kit book, there -- after the forms that are in there that we copied out of there, there are examples of each of these forms filled out. So you can go into that book and find these forms and find one that Millie did that's filled out to get an example. Baltisberger: Right. In the back of the book there's a whole ‑‑ like all ‑‑ all of the sections are repeated, but filled out. Hurst: I'm curious if others of you have filled out that form, if maybe you would be willing to share it in a confidential way; like take out the student's name maybe and share it where we could put it up for others to just look at, if that is something that people would might... Kitchen: Or send it to Scott and he can share it with members of the group. Hurst: Yeah, that's what I'm thinking. Baltisberger: I think ‑‑ I think that's a really good idea. I think, like Tracy said, it does help a lot just to look at other people's and kind of realize ‑‑ Kitchen: Tracy said she'll do it. [ Laughter ] Baltisberger: Well, it helps to kind of see what other people put in there, and also what they didn't put in there, and just realize that this is the different ways it can look. I'm sure there are other people who filled it out much more extensively than I did and there may be people who didn't fill it out quite as extensively. Sara: They had real words instead of little lines that said, "No." [ Laughter ] Hurst: Well, and I think also, you know, just thinking about for each student you're going to have different amounts of information. I'd be curious to see, you know, those that are kind of going pretty much off of just records and not having the parent interview versus those that are having access to parents, is there a difference in some of the information, and then those that have access to both, is there some contradictions between what the parents are observing and what might be observed otherwise? Because we know these children. At home they look one way and at school they often look very different. Kitchen: Anything like that, Scott? Baltisberger: Any blatant contradictions? No. There seem to be more up to date information from the parent, and I just had a better feeling ‑‑ it was real nice ‑‑ the OT and PT reports and the Functional Vision were good; they gave me some really good information, but it really helped to kind of talk to somebody who knew this child really well. And also to talk about those things like the auditory and the gustatory and the olfactory, that I didn't see addressed anywhere. And just kind of, you know, get that feedback. And be able to mark something in there. Hurst: Yeah. Kitchen: We had our study group participants... who were... who were working with us to make sure that they did these parts, and so that Scott and I would not be the only ones doing it. And so any of you guys, the people who I emailed at the very beginning of this, are you here today? Hurst: Well, Rene said, "Pretty straightforward, but there were some areas that I had not really considered until I read it in the SLS." And that's a really good point. Baltisberger: Like what type of areas, Rene? [ Laughter ] [ Inaudible ] Hurst: Go ahead. Rene: Can you hear me? Hurst: We can. Rene: Oh my goodness. I guess I wasn't muted. That was probably me you heard messing around earlier. Things like, you know, the child that I have that I did mine on, doesn't do a lot of moving himself. And so I never really had thought of like a touch ‑‑ like problems with touch. He doesn't do a lot of touching. I have to bring everything to him. And so I never really did think of, are there disorders of touch. Is there a problem other than, you know, the neurological things that he has and what kind of things other than what I know about him as far as how to present and what to present and what not to present. He also is a tube fed child, so I just kind of skim over olfactory and gustatory, but, you know, his disability is a result of an accident, so, you know, he might still have some smell even though he has a trach. And sometimes kids who don't eat and have trach, they lose their sense of smell because it's not useful to them. So I never have thought about that, so that will just have to be one of those areas that I experiment with as I work with him in using the Sensory Learning Kit items. Hurst: That makes a lot of sense, Rene. It makes me think about in Active Learning Lilli it really talks about for kids who are tube fed, that even though they can't eat that using some things that they can lick, you know, and not necessarily swallow can be really motivating to them. And so in some of our strategies, even though they're not eating, if they sometimes maybe -- it might be highly motivating to them that they're missing that enjoyment of taste, finding out do they have ‑‑ have they ever had any preferences towards things that were particularly sweet or sour or whatever. It might be very helpful. Baltisberger: Yeah. I've had that experience in the past with kids who were on a trach, or tube fed. Because to me eating was always one of the biggest motivators like with Abby, the student we're looking at now, it's a huge, huge motivator. So when there's a kid that couldn't eat, I always felt like you've lost that whole potentially powerful motivation. So, I started doing that, working with like putting food items in ‑‑ I forget what it's called. It's like a bag. Hurst: Like a cheese bag? Baltisberger: Right, or using other items that you can taste. And it's like yeah, they can't eat, but they can taste. Hurst: They can taste, they can lick. Well, you know, we think about taste being always types of food, but almost any item has some taste to it. Kitchen: That's true. Hurst: It really does. And... sometimes taste isn't about nutrition as much as it's just interesting... Kitchen: Informational stuff. Hurst: Informational stuff. Or it's something that -- we may think they don't like that object for one reason when it's because they got their tongue up next to it and they didn't like the taste of it, you know? Because like certain nut shells have certain ‑‑ like walnuts are very, very bitter. And I think about metals have a specific kind of taste. And plastic has a certain kind of taste. Kitchen: Copper tastes different than steel. Hurst: It does. Exactly. So, you know, those are things that, like Rene says, you don't always think about it that way, but when we're talking about interventions for these students, we can be giving them something that was aversive about taste, and not knowing that was what the problem was when we substitute something else. Baltisberger: Right... Hurst: Others of you? Kitchen: It looks like Marla's typing something. It seems really awful to try it, but after you do, you'll be fine. [ Laughter ] Hurst: OK, Marla says, "Right now we don't have anyone that falls into this caseload. Yes, Sara, but I'm going to go back to one and see how he'd perform." So okay. [ Laughter ] Baltisberger: Thanks Marla. Kitchen: Thank you, Marla. Baltisberger: I guess if we're through talking about the SLS, we can start to talk about the SLK. Kitchen: Yeah, and we don't have very much longer, Scott. Hurst: About 15 minutes. Baltisberger: Well, okay. Chapter 4. Arousal State Profile So right now ‑‑ so there's five parts of the SLK and we've just completed the SLS, the sensory learning summary. So next month our assignment is to do the Arousal State Profile. [ Slide start: ] So now we're actually going to get into doing some observations. So let's look at the... ASP. [ Slide end: ] [ Slide start: ] So this is everything you have to do for the ASP, identify when you're going to do your observations. You know, meaning like which days and what times of the day yours going to do it. Determine the recording interval. Now, originally the SLK recommended three days, at least three days of observations. And really when we talked to Millie, Millie said, "You know, that's not realistic." She realized that really people just don't have that much time to do that. And she said, "If you can do a day, that would be great." And then she said, "Really, what you need to do is make sure that the team agrees. You've got a typical selection of time for that student." So the amount of time ‑‑ it doesn't have to all be contiguous, you have to start at 9:00 and end at 12:00. You could do observations ‑‑ pick different observations at different times, but you do want to ‑‑ [ Slide end: ] you want the people on the team to say yes, that is typically how that child behaves. And taking into account some of those factors from the SLS that would have influenced that. I think the part before that, develop the code for arousal states, that is where you really have to look at ‑‑ why don't we bring up the document? We can look at it from there and talk about it. The arousal state profile. There it is. So that's just information. Let's look at the form itself. [ Slide start: ] Okay. So this is the Arousal State Profile. And Millie said ‑‑ in the book it says you want to find a recording period, which is number one. So you would be looking at whatever periods are representative, get a representative slice of that student's life. Again, it doesn't have to be ‑‑ I think if you could do three days that would be great. That would be wonderful. If you could do three half‑days that would be great. If you could do a couple of half-days here and there, whatever you can do, but you do need to check with the team and in your own experience if this is a typical sample. The recording intervals, which is number two, Millie recommended ‑‑ she said that it really kind of depends on the student. [ Slide end: ] Because you're trying to look at what ‑‑ you're trying to look at kind of a consistent ‑‑ a period of time where they're behaving in a consistent way or they're reacting to certain stimuli. So it's like ‑‑ she said it's usually ‑‑ five minutes is typically what people look at. You really need to set a timer for that, so that you know you're getting every five minutes of what's happening there. Hurst: So Scott, I'm a little confused. If I'm going in and I'm doing an observation, I'm going to take an activity or I'm going to take a series of activities and I'm going to sample in sort of five‑minute increments? Kitchen: That's the recording interval, five minutes? Baltisberger: Five. Right. But it might be longer for some kids or even shorter depending on what their... arousal style is. Some kids react much more slowly to information and some are a lot more ‑‑ react a lot more quickly. So those kids you might be potentially looking at, I don't know, maybe a 10 minute session or three minute? Kitchen: So, If you're going to be in there for an hour, I mean, we just start with five minutes and then stop for awhile and then do another five minutes? Baltisberger: Yeah, I mean, if you look at the... if you look at the form, I mean, this is it. [ Slide start: ] So you've got... plenty of spaces to fill out. Just look at all -- It's a lot. Kitchen: Boy! Hurst: So could you or would you or would Millie suggest that, you know, [ Slide end: ] say you've picked a certain day you're going to do this, that you go in and maybe set up a video recorder to sort of keep... keep a record of it and be able to go back and view it again with the team, in any way? I would find it pretty hard if I was an individual spending all morning trying to keep track of five‑minute increments and doing my coding as well. Kitchen: It wouldn't be every single five‑minute increment. Baltisberger: Well, I think ‑‑ I mean, I think that's one idea, but I don't know ‑‑ honestly I don't know how the resources people have to be able to go in and videotape. Hurst: I guess I'm just confused when you're saying five‑minute intervals. Is she saying get a five‑minute sampling several times during a period or ‑‑ that's what I'm not sure of. Kitchen: That's what it sounds like. Baltisberger: Right, So you'd be going in -- if you're going to be doing an hour observation, you're taking five‑minute intervals. Now, keep in mind, originally she was saying do three days of observation. She said look at something that's more representative of their time. Now, when Sara and I originally talked to her, she said just look at ‑‑ just look at the times that they seem to be ‑‑ the student seems to be motivated, the student seems to be engaged. And then we brought up -- said, would it also be good to know when they're not? When they seem to be in a subversive state. She said, "Well, that’s a real good point, maybe so." But I thought about it again and I thought what you're looking for here are their optimal states for learning. So I don't know that ‑‑ that's really what you're looking for. If you look at here on the first page, [ Slide start: ] you want to look at the six different arousal states, sleep, drowsy, quiet alert, active alert, fussy and crying/agitated. So the two stages you want are the quiet alert and the active alert. Everything else is really not going to do ‑‑ do good learning at those points. That's what you're trying to find. When you do these observations you're looking at -- okay, they were at a quiet alert stage -- state right now, and then you look at what are the possible environmental factors that brought that on. Kitchen: So when you do the description you're describing the environment, the precursors to the quiet alert state? Baltisberger: No. Kitchen: You're not describing their behaviors? Baltisberger: In the arousal state descriptions you're describing what the behavior is that represents quiet alert, active alert, fussy, crying/agitated. [ Slide end: ] Kitchen: And then later on you go through and code it when you see it? Baltisberger: Right. Because these -- again, these states might look real different for different kids. And -- particularly if several people are going to be doing the coding over several days, you need to all agree on ‑‑ you're all looking at the same thing. Hurst: So the team would really have to sit down and do some planning, even if one person was doing it, there would have to be some discussion and agreement about what are we looking for to call sleepy, drowsy, all of that. But I'm still going to go back, because I'm confused about the reporting period. Do I take say an activity or a time of day, a block of time and observe, and say, observe for five minutes and then wait, and then 15 minutes later do another five minute sample? Or... do I do it for five minutes during one activity and then the next day with the same activity get five more minutes and sort of see? That's what's confusing to me. Baltisberger: Right, right. Well, and I don't know that ‑‑ what do I think? Kitchen: Well what's your plan for tomorrow? [ Laughter ] Hurst: What are we going to do? Kitchen: Well, I mean, we're going to go out there tomorrow and do some of this observation. Baltisberger: Right. Well, my plan is to try to do ‑‑ I would try to do ‑‑ I don't think ‑‑ I'm planning to be there most of the morning, for like two or three hours. I don't think realistically I can observe effectively for three hours at five‑minute intervals the whole time. I think what I'll do is go in and observe ‑‑ maybe pick like 20 minutes here, 30 minutes here, during different activities and try to catch her in some of these states. Now, there's a thing about -- there's a change in the states, I guess is what also you're looking for... Kitchen: That's what I would think, that you would ‑‑ when you say a change, you would begin ‑‑ you would begin and you would look at right before that change and then you would ‑‑ what happened right before that, and you would make some comments about that ,and then you would see how long it's went on and what were all the contributing factors to it. Hurst: Well, Rene says, "I think you record every five minutes for the hour or so you are observing." So every five minutes you take note of the state. Which would make sense. Kitchen: It could, but he might be in several states during that five minutes or ... Hurst: Right, but in that what it's about to figure out... Kitchen: How much they fluctuate? Hurst: Kate: And also what's happening within that five minutes that's -- that might be impacting it and making them move through different states. Baltisberger: Right. I mean that's -- you put the time and you code it, what their state is. And then the comments would be what was going on. What were the environmental factors. Because you don't really need to write in there what the child was doing, because that's the state. They were crying. You don't have to say crying because this, this or that -- you say this is what happened. This is when presented this object or when this noise occurred, or when staff grabbed the student's hand, that would be the key right there. I think. Hurst: Rene says, "So that you can see what activities may cause a change in states." And I would say also within an activity is there a piece or a part of it that causes a change in state? Baltisberger: Right, right. Right, so I think you do want to kind of have that continuous period of time, but perhaps throughout the day several different times of the day. So... does... anybody else have any comments? About or questions to bring up about the Arousal State Profile? Kitchen: Yeah, and if you're not sure, just fill it out. There's always another one you can do. And we'll look at it and see what kind of ‑‑ like I would use this, you know, check sheet, but also do what you feel makes sense to you. Hurst: Well, I would for sure videotape it, if it was me, with my iPhone, because I don't -- I have a hard time observing and taking notes at the same time. I mean, I could sketch some out, but I would want to go back and look at the video to sort of jog my memory. Kitchen: I probably would, too; if it were allowed. With some kids you can't do that. Hurst: Some kids you can't, that's true. [ silence ] Kitchen: Shall we go back to the PowerPoint? Baltisberger: Sure, let's go back to our PowerPoint. And if anyone would like to -- if anybody, when you do the ASP, if you would like to share that, that would be really nice for everybody to look at. Hurst: Yeah. And talk about how you do it. What strategies you used that worked for you. Baltisberger: That will be a lot more potential for really good discussion to help each other out in discussing this. So any of you guys, if you would please ‑‑ Kitchen: Any of you girls. Baltisberger: Any of you girls, please, volunteer to share your ASP, that would be great. Hurst: I'll enter Scott's email address again just so if you want to do it and send it to him, to share with everybody, that would be good. Baltisberger: I'll probably send out an email like a week before the next session. Asking you again. Kitchen: When is the next meeting? I think it's... Hurst: December... [ Slide start: ] Kitchen: Oh my gosh, there it is! [ Laughter ] Baltisberger: It's December 15th, same time, 3:00 to 4:00pm. So if you will send me ‑‑ if you haven't sent me an email yet, go ahead and send me one. I'll include you in the group emails, because I do start planning to request ‑‑ ask you guys to share your forms. And register for the next meeting at, as always, at h-t-t-p, w-w-w, t-s-b-v-i dot e-d-u slash training events. [ Slide end: ] Hurst: And I think we will let our captioner go now, but we can stay in the chat and online for a few minutes more if there are any last minute comments, questions or notes you want to share. Rene: This is Rene. Can you here me? Baltisberger: Yep! Rene: Ok, does the book — I’m sorry I am without my materials today, because I was at a workshop and I didn’t think I would get back in time. And I got back in time to my house to do it, but not to go by school and pick up my materials. So, does the book not explain how to do the five minute interval thing or whatever? Kitchen: I think it does. I think we just... weren’t like exactly sure what it meant. But we probably need to look closer at that. Baltisberger: Let me look at what it says… Rene: She said before it explains the different states. Sara: I think mainly she says, the recording interval would be different… Baltisberger: She says, "Decide how frequently you will record arousal states based on the state patterns of the individual learner. Intervals of five minutes are typical, intervals longer that 15 minutes or shorter than one minute do not typically yield very reliable information." Kitchen: So I guess that is dependent on the pace of the child. And how much the child is changing... in general from your knowledge of the child. Baltisberger: Right. I don’t think Millie meant -- again when we talked to her, she was saying you might do some here and you might do some there. I don’t think she meant doing five minutes here and there. I do think she meant to do five minutes — like 30 minute or an hour or two hours -- or whatever it is, but five minutes of an hour -- five minute intervals of an entire hour, or five minute intervals of an entire two hour session. Rene: Right and then, if the child is at school, especially if the child is at school for all day long, you can catch them for an hour or so in the morning, and then an hour or so in the afternoon, or around lunch time, or whatever, so that you can -- especially if the person who's working with the child, kind of knows when and how they fluctuate, it will give you a clue to -- especially if that is a problem. Baltisberger: Right. Rene: If they had problems dropping off to sleep, then that would be the time for you to observe, and say ok what’s going on. Because -- why is this child dropping off to sleep, at this time every day or, you know, whatever, to see if that is something that you are doing, or if it just the medication. Kate: Well, Rene, here is my question, are you -- when you are doing this -- I guess I am trying to figure out the logistics this. So I go in to observe the child, and say I'm going to do an hour in the morning. So, I would observe for five minutes, and then I would wait for five minutes, and then I would observe for five minutes more? Or am I doing every five minutes I am taking an note? You know, like within the first five minutes I am going to take note of where they are, and then five minutes later I am going to take note of where they are, and five minutes later take note of where they are. That is what I am confused about. Kitchen: That might be a good idea Rene: I think that’s what you are supposed to do. Hurst: Say again. Rene: [ Inaudible ] Every 5 minutes jot down what state they're in... Kitchen: That makes more sense to me. Rene: Take note about... there was a fire drill, you know, the teacher was working with another student so he dropped off, or dropped off asleep. There was a fire drill and there was lots of movement and activity. If the only thing your — my problem is that I am working with the kids, I wouldn't have time to work and take the notes. I would get my paraprofessional to take the notes with me while I am working with children, but if you are the observer only, you don’t have to write down a whole scenario of what’s going on because you could say that the teacher started a math lesson. And so for 15 or 20 minutes they're going to be doing a math lesson, maybe, and you can just jot down that he was attending, or five minutes later, you know, he wasn’t attending, or he was still active alert or passive alert, or not quite alert, or whatever. Hurst: The fire bell rang, [ Laughter ] he shut down. Rene: The what? Hurst: The fire bell went off -- he shut down. Rene: Right. [ Laughter ] Hurst: Well, that makes sense. Again for me, I would take my iPhone or iPad out and record it, because the other thing about that, you really could -- when you're going back -- if you're having, like you say Rene, having one of your parents take some of the notes, you all can go back and review together and watch for what triggered -- or was there something obvious that triggered this change of state that you might not have made note of or it just didn’t register on you, because you are just so dang used to hearing the bell ring that, you know, it didn’t dawn on you that may have had some impact. Rene: Right. Another set of eyes see things completely differently too sometimes. Hurst: Absolutely. Absolutely. And especially with these kiddos it is so subtle, you know, what's going on with them sometimes. Rene: Right. Hurst: Well, that makes a lot more sense to me. That’s how I would do it. I am glad that I agree with Rene. [ Laughter ] Kitchen: If you are unsure check with Rene. Rene: Get the iPad or the video recorder going. Hurst: That's right. That's right. Well, thanks Rene, That helped me get clarity. Well, I think we're done. I'll see you next time. Bye bye. Baltisberger: So long. Kitchen: Bye. See you in a few weeks. [ Music ]