Description of graphical content is included between Description Start and Description End. Transcript Start [ Music ] [ Title: ] International O&M Online Symposium Welcome [ Title: ] Building Client Motivation & Collaborating to Achieve Goals Sharisse Roberts: So today ‑‑ first I'm going to talk a little bit about myself and who I am because you're probably thinking, okay, who is she? And then I'm going to get into my presentation. So first off, I have been an orientation mobility instructor for five years now. I started in Florida and now I am in Maine. But I have been working with individuals with disabilities since high school, so over 10 years now. I originally started ‑‑ my career started in therapeutic recreation and child life, and then I went back to school and decided I wanted to be an orientation and mobility instructor. So today I'm going to talk a little bit about building client motivation and collaborating to achieve goals. So the objective of today's presentation is that by the end of the session you will be able to work collaboratively and creatively with others to reach client's goals or ‑‑ goal or goals through client‑specific motivation and interest. So first off we need to talk a little bit about the overview for today, what is motivation is the first thing that we're going to dive into. Then we're going to talk a little bit about collaboration, the who, what, where, when, why and how. The carrot concept, a little bit of case studies and then have some time for questions at the very end. So first off let's talk a little bit about what is motivation. And so motivation is defined as one's direction to behavior or what causes a person to want to repeat a behavior. It's also a motive is what prompts a person to act in a certain way or at least develop an inclination for specific behavior. Motivation can be natural, like our drives, our needs, our desires, or it can be rational like reasoning, it can be positive or negative, so it can be pushing you toward a positive stimulus or getting you to run away from one. It can be solitary, doing it alone, or in a group. You can be pushed or pulled to do toward an activity. And it can be intrinsic, internal or extrinsic, external. So for example ‑‑ I'm going to get my screen to load back up here. We're going to move on to the next slide, rational and natural motivation. So first off, natural motivation, so that's our basic need, like food and shelter, water, love, pleasure, survival. And it really starts with Maslow's hierarchy of need. So we're motivated by unsatisfied needs, our basic to complex, and that we must minimally satisfy one level to reach the next. So on the slide there is a picture of Maslow's hierarchy of needs and the order of needs start with your most basic, which is at the very bottom of basically a pyramid. And it says physiological. And so physiological needs are air and sleep, food, hunger, thirst, warmth. The next level up from there is safety in the orange block and that is shelter, protection, safety, health and stability. The next section up is love and belonging, love, affection, family and relationships. The next section is esteem, self‑esteem in society, our reputation. And then self actualization, the fulfillment of our potential. With natural motivators I like to say that I am motivated to make money so that I can provide a loving home for my children, to put food on our table and roof over our head. That's a natural motivator for me. For a rational motivator, humans are creatures of region so we can pretty much rationalize anything. If you just think about it in your own head, all the different things that you do on a daily basis that you rationalize. Self efficacy is basically the level of success. So our confidence in our ability to achieve desired results, and it says one's power to affect situations, make change ordeal with challenges. So for me a rational motivator is I'm motivated to work out so that I can eat junk food, right? Probably not the best rational motivator, but it is one of the ones that I have. So right here you're going to see that there's going to be a poll on your screen and I just want you to share a natural and/or a rational motivator that you do things in your life. I'll give you about five, 10, 15 seconds to enter in your information. I see some really good answers. Food, right, acceptance, love, walking the dog to say fit. That's a great rational motivator, the feeling of reward. Money, working to provide. Health, praise, accomplishment, performing music. You've got a lot of really great one. The motivator is healthy food because I have many food sensitivities so that could also be natural and rational. Obviously you want to stay alive with your food sensitivities. Zumba for fun and fitness. Great. I love everyone's input. You will see pretty much with the presentation you will see a lot of interaction. I think it's really important because this is a webinar and we can't see each other, but we're interacting, so thank you so much for entering all your results. So our next slide talks about positive versus negative motivation. So as we can tell, positive motivations, praise, approval, reward, mastery, accomplishment, sometimes behavior charts like getting stickers, those can be positive motivators. We're all pretty familiar with positive motivators. Negative motivators could be something like fear, something like avoidance. Sometimes punishment is a negative motivator or disappointment that you do something because you're afraid that somebody else is going to be disappointed in you if you don't do very well with that. We might associate negative feelings with training if there's a negative motivator. And these trend to trump positive motivators unfortunately. So one of the things you might hear is when you get a positive praise that's really great, but when you get a negative one it actually takes 10 positive things said to you to counteract that one negative thing. So for me examples, my positive motivator for losing weight, let's say is buying myself a new outfit, a reward. A negative motivator for losing weight is not having to hear comments from my mother about my weight, but also not developing Type II diabetes. It's important not to have that happen because we work in the field and meet people with Type II diabetes all the time and we know what the complications of that is. Also one of the things you can think about is behavior plans. So the poll comes up. Let's hear your positives or negative motivator. I'll give you a couple of seconds to enter all of that information in. We're getting good feedback. High fives. I love high fives. They're wonderful. Praise, positive being independence, awesome. T'ai Chi, increased confidence, learning. Great. Physically able to do what I want. Seeing steps to reaching my goal. Health, self‑worth, a happy face. I like that. Acknowledgment. A special trip. Increased confidence, great. The negative sound of someone's voice. Big impact. For packing the clients in, positive. I want to benefit as many people as positive. Negative, I don't want the waiting list piling up like a black cloud over my head. I think we all get you on that one, yes. Fitting into those jeans again. That's a great one. All right, so we'll move on from positive and negative. Thank you guys so much for your feedback. Now we're going to talk a little bit about solitary versus social motivation. So like we said before, solitary motivation, doing it one's self, learning on your own, et cetera. Social motivation, learning in a group or as a group. It can be tied to one's activity in a group. People are actually more intrigued in performing mundane activities as long as there is company because it provides the opportunity to interact in one way or the other be it bonding, amusement, collaboration or alternative perspectives. Going back to Dona Sauerburger's presentation this morning, that was one of the things that the two ladies from Canada talked about is the young adults that they were working with pretty much said that it was socially motivating to work on those skills of learning how to do those uncontrolled crossings and learning how to be safe in that group setting, and that it really was boring when they did it by themselves. So that's a really great example of social motivation. A person can become more interested in an activity based on the company that they're doing the activity with. So you can turn something that is not interesting to somebody into something that they might be interested in. So like one of the examples also is think of the concept. Going back to the concept of working out for me I don't do well doing myself, but in working out with a group. So one of the ways I do that is playing roller derby, and being in roller derby is a very social environment. You have people checking on you and saying hey, are you going to come to practice? So that's one of the ways that I'm able to motivate me self to do the physical fitness activities and something that I truly love, I really do love skating. So let's hear some of yours, let's hear some of the situations or goals that you need solitary or you need social motivation to accomplish a task. Swimming with a team, great. Cleaning, is it social or is that solitary? I think some of it could be social, sometimes solitary, right? Increasing exercising, boring work projects. Again, probably a team one. Tennis is a group motivation, awesome. Social, quilting, great. The more the merrier, I like that one. Doing yoga in a group. Peer pressure, writing reports. I've never written reports in a group so I wonder if the person that wrote that was thinking solitary or they were thinking social. Someone else wrote solitary, writing reports. Social, rejuvenating my energy, even if it is a cup of coffee. Line dancing, I love line dancing. Taking a webinar with a co‑worker, nice. Like doing music with others. Meditating regularly, solitary. Social, attending meetings. Group hikes, love it. Really, really great. Riding my horse, I saw that one. That just popped out. Oh, with other ladies, so social. Great. Well thank you, thank you guys so much for you'll your feedback. We're going to move on to the next section. So it really sounds like everybody really gets these. They're really understanding the different types of motivation out there. That's wonderful. So push versus pull motivation. So push motivation is like pushing one's self toward a goal to achieve something. It also can be one person pushing another person. So you could be pushing yourself or somebody pushing you. It's easy to get discouraged when obstacles are present if it acts on your will power and that is only as strong as our desire to do something. So sometimes push motivators can actually be kind of tricky. Pull motivators are actually much longer than push motivators. So a pull motivators is a desire to achieve a goal so badly that you feel as if you're being pulled towards the goal. The attractiveness, the expectation, the desire influences a person so greatly that they are ready to go, they just want to get that goal met. So a push motivator for me is actually my family saying that I should go to roller derby, and you tend to use every excuse in the book to kind of get out of it, I'm tired, it's late. I've got work early the next morning. Because sometimes my Will power and sometimes my desire is not really there that day. So we're thinking of the concept of the bringing the horse to water, but can't make them drink. A pull motivator could be winning money or a contest based on the number of times that I actually go to practice. One of the things that our league did once is they said if you come to eight practices a month, then we will comp your fee for the month. And that was a huge motivator. We got a lot of people to come to practice that month because all of our personnel things were going, oooh, I don't know if we can get there, and attendance started to drop. So it was really great to see that. Anyone have any thoughts? We'll put the poll up, what pushes, what pulls you. Ah, competition. Oooh, free stuff, everybody loves free stuff. Pain, yes. Deadlines, yes. I don't like being yelled at by my boss if I'm late at something. Expectations from others. Push, if I don't do it I don't get paid. That's right. Negative comments, extra training, be the best you can be. Look good on a resume. Numbers on a scale. Pull, desire for the desired end result. Job requirement. My husband peeking around the corner at me to see if I'm still on Facebook. Also rather negative motivator too, yeah. That's great. Reaching financial freedom pulls me, nice. Pulls, desire for the and result. Pull, someone says you can do it. Really great. Thank you guys, thank you again. We'll move on to our next slide. So intrinsic versus extrinsic motivation. And I actually was at a workshop last night that was talking about perfectionism and gifted learners and they brought up the concept of extrinsic motivation. I was really excited because I thought hey, I'm presenting on this tomorrow and one of the parents in the group actually asked about what is extrinsic motivation. So first we'll talk about intrinsic motivation. So itself‑desire to seek out new things and new challenges. So analyze one's capacity to observe and to gain knowledge. It's driven by interest or enjoyment, so it's the FLOW concept. I'm not sure if any of you guys have ever heard about the FLOW concept. I'm going to go a little bit into it. And it's genuinely interested in the mastery of the task. So with FLOW, FLOW is basically being in the zone. It's those times when you just lose all track of time, time flies, your focus is so centered and you're immersed and enjoying what you're doing, you're just completely immersed in that task and you lose yourself in time. Sometimes it's not the most positive thing. Sometimes it's negative because if you get too much into FLOW then all of a sudden your day gets away from you, but if you have something that's an enjoyment and it's a positive thing and one of the things think talk about is FLOW is really important for everyone on a daily basis, that we should all be engaging in FLOW behavior and activities. So this intrinsic motivation exists within the person. There's no outside pressure. It's with the absence of reward. It's that curiosity, and that's a critical component in development. And some of our clients that have been visually impaired since birth actually may lack this. They may not have that natural curiosity, that natural intrinsic motivation. An advantage of it is it's long‑lasting and self‑sustaining. They can focus on a subject and you don't have to punish them to get them to do it. They're in. The difference of intrinsic motivation is it does require lengthy preparation that you must know a student to be able to connect with them, that interest with that subject. And the instructor must be passionate also about the subject and they must be aware about how they provide feedback because it impacts the student greatly when they're intrinsically motivated about something. So for me an intrinsic motivator is actually dancing. I find when I'm dancing that the day just flies away and all of a sudden I'm just like wow, I can't believe an hour just passed or two hours or three hours. And I just absolutely love it. An extrinsic motivator we'll talk about on the next section. So let's hear a little bit of everybody else's intrinsic motivator. What is something that really gets you, that you're really passionate about? I'll open that poll. Perfect. Reading a book, love it. Being creative. Music . Sports and exercise, being out in nature. Hockey, horses, dancing. Yeah. Exploring new places. Playing a flute or piano. Traveling, great. Gardening. A lot of really great activities. Spending time with grandkids. I know my mom can definitely say that. Finding new things on websites that help me assist my students, that's great. And that also can be one of those time sucks, right? All of a sudden I'm looking for stuff and then the day got away from me. sewing, spending time with family. My job. Love it. Giving independence as a father of a visually impaired child. Working with my little ones and see them getting the skill ‑‑ I lost the rest of it. I think it said time just flies. That's great. Riding my bike. Writing poetry. O&M lessons. I totally understand that. I can get lost in some lessons. That's wonderful. Thank you. Thank you guys. Very nice. Ultimate frisbee. I saw that one. Gaming. All right. We'll move on to extrinsic motivation. So extrinsic motivation is the performance of an activity in order to attain a desired outcome. This comes from outside the person. It could be money, praise, avoid a punishment, competition, social, a lot of those things we've heard in past type of motivation. The nice thing about intrinsic and extrinsic is that there is a lot of different overlap between the different motivators out there. Need to ask where the person gets their motivation and why they continue to push themselves. Sometimes the extrinsic motivator is not just right there. You're not really sure. So you have to kind of keep asking those questions like why, why do you want to learn this or do this? And then all of a sudden you can hear them go, well, I'm doing it because my daughter said I should do your services? Extrinsic can sometimes lead to intrinsic, which is really great. So for those clients that maybe don't have that natural curiosity built into them, you can be that extrinsic motivator and get them to find it and really be passionate about those services and that orientation and mobility training and all of a sudden they're just intrinsically motivated and excited for the next lesson. We have the ability to create that genuine interest in training and we have the ability to destroy it too and we have to be really mindful about that. Teachers' feedback or teaching style and the learning environment, they all play a factor in the student motivation. Feedback concerning their effort and their strategy leave students knowing that there is room for growth, while feedback directed at the students can impact their mindset and prevent skill development. So this is a concept of six intelligence versus malleable intelligence. They talk about with my daughter at school and they talk about this fixed mindset and malleable mindset. So keep that in mind when giving feedback to a client. We really want them to have that malleable intelligence, that growth mindset, so it's fixed mindset and growth mindset. My intrinsic motivator for working out is being able to fit into a smaller size pants or not being told that I'm overweight by a doctor. Yay! That's intrinsically motivating for me. So we'll open the poll and hear about had some of your extrinsic motivators. Praise, great. Seeing the end result of hard work. Showing up to a team sport, not letting your teammates down. A paycheck. High cost of living. Being able to keep up with younger friends. Money. Marathons, that's great. Feeling accomplished in a task. Good feedback. Saving so I can retire. High cost of living, keeping up with new technology. Good feedback. Rehearsing my part for a great symphony performance. Responsibility. Tears of joy from a client. Passing a health screening to get a better rate. People saying I look taller now. Recognized and known in the field, I like that. Recognized for my hard work. Being able to change from TV to Netflix without my kids' help. Seeing a client really get it. Those are the best times. Kudos for a job well done. So a lot of praise. I read that a lot. Filling a staffing role because their presence is needed to cover all the needs in a group situation. Not being on medication. Spending money on better things like traveling. Awesome. Thank you guys again. So sounds like everybody has a good idea of all the different types of motivation so we'll do a little bit of a pop quiz. I have two case scenarios and we'll open those polls up again. We'll start with our first one and then you guys will be able to give a little bit of feedback in that poll box after I read the case scenario. It's also posted on the screen as well. So first off we're going to start with John. John has low vision and he started O&M training with an instructor. He stated he loved mowing his yard and plowing his driveway. He is resistant to using a cane, but is curious about the device and how it might help him. He loves alone in a rural part of town, but there is a sidewalk to a local convenience store and a dollar store. List the following possible motivations. So we've got natural, we've got rationale, we've got positive, negative, solitary, social, push, pull, extrinsic and intrinsic for John for O&M training based on that case scenario. And you can just put one or two in. You don't have to put them all. Just read it over again if you want to. See if you can pick out those different types of motivations he's got. Great, natural, curious, that's right. Intrinsic motivation, yep. Needs to eat, buy food, natural. Perfect. Rational, he has to get in to town, being able to shop and socialize. Solitary. Use cane in the yard. Skilled training using his best vision to do activities. Living alone might lead to depression. That's right. Get gas for his mower, I love it. Negative, being viewed as incapable. Yep. Or feeling his own negativity towards it now that he has got vision loss, he might feel that way about himself. Beer run. Pull, independence, great. Let's see if we have any push motivators anywhere. Intrinsic, start to withdraw and lose skills. Positive, feeling better about himself. Friends are more likely to come and visit if driveway plowed. Very good. Nice job, everybody. Great. One of the things that I was thinking about the push motivators, as his instructor I could be his push motivator. I could be his cheering squad saying you can do it, yes! Moving on to the next scenario, next pop quiz, close that poll box and we'll open a fresh one for you all. So this is Angela. She has no light perception. She returned for more O&M training with an instructor. She stated that she thinks she may lose her job soon due to her visual impairment. She recently transferred to a new office and she stated she is getting lost at her job, which is impacting her productivity as she doesn't get all of her work tasks completed during her day. She needs orientation to the local area around her new office so she can get lunch and do some shopping after her workday before she takes the bus home. She stated she loves being around people and wishes she had more friends. She also loves singing and music. List the following possible motivations. Natural, rational, positive, negative, solitary, social, push, pull, intrinsic and extrinsic for Angela for O&M training. What can you pick out of that case scenario? Fear of losing job, yes. Push, to keep her job, that's right. Join a choir, demonstrating independence. Great. Social, getting with friends for lunch. She said she loves to sing. Maybe you can find a local karaoke joint she can go sing at. Maybe new friends, positive. Push, keeping her job. I think I read that one. Creates confidence. Social, loves people. I like this, social ‑‑ social, pull, intrinsic, keep from being lonely by not making or keeping up with friends. Negative, losing your job, lack of independence. A lot of rational ones, right? Need to eat, yep. And that's the physiological Maslow hierarchy of needs coming in right there. Start a social club at work. Demonstrating independence. Learning to deal with your vision loss. All the motivators for training. Great, guys. Awesome. All right. So now that we've got our motivation concepts down pat, we'll move on to identifying client motivators and how ‑‑ everything I've talked about is going to help you in what you do. So first off, client feedback is so crucial. They really are the key to successfully identifying what motivates them. Obviously family and friends and all those things they can help you and give you some feedback, but client really, they understand themselves and they're your best bet if they're going to give you that kind of feedback. It really can be as simple as asking them the question, so what motivates you? And then getting more specific with if they give you sort of a general concept like I'm motivated to be independent, but why? What exactly do you mean by that? Can you give me an example? So for example, a client says life, and then getting them to elaborate, like what exactly do you mean pi life motivates you. And try not to put words in their mouth if you don't have to. We want them to do all that problem solving and thinking and really getting to that sort of deep down inside this is why I do this, this is why I get up everyday, this is why I want training. And then what do you do when the client has no motivation? So there's really time to dig deep. And I have had those clients that they're just ‑‑ there's no motivation. They feel like they're at the end of their life or they're just young and they don't even understand what motivates them. Their response is like, my mom and dad make me get up everyday. So you have to really kind of dig down and just sink in your boots and get that information out. Getting to know your clients, their likes and dislikes. Elaborating on your own motivation, your own likes and dislikes. Sometimes that can be helpful because then they're like oh, okay, yeah, actually, I like playing cards. You could make some suggestions, give them some ideas. And you could also do some piggybacking. So you can try to do something and see if it interests them and tag your training to that interest. So if they ‑‑ they used to go bowling or they're interested in bowling and you are just using that as sort of a motivator to get them out of the house and say hey, let's go to the local bowling alley and we can work on your skills there and just using that to be able to support your training. So instructors' impact on motivation, it's important that you identify your impact. As previously stated, you can build and you can destroy motivation. Remember, it's not about you. It's about your client. It's about their goals, their needs. Sometimes I really have to remind myself to take a step back and say you know, I really want this for the client. I really want them to be successful and independent, but maybe they're just not ready and they need to kind of ‑‑ I need to pull in my reins a little bit and try some different strategies to support them. And sometimes we have to close clients because they're just not ready and not motivated. And that does happen from time to time, but I have to again remind myself it's not about me, not about my goals for the client. It is about them, it is about their goals. Client focus, client centered. So our next section is about collaboration. And collaboration is defined as the process of two or more people or organizations working together to realize or achieve something successfully. I'm sure everybody probably is very familiar with collaboration. Many of the instructional areas, like DRT, O&M, PTs, OTs, speech, et cetera, they overlap and it would be better served as a team rather than individually. Itinerant services, which is what I do, are very different than center based. Collaborating can be a way to bridge the gap and to create a more holistic service for our clients. Collaborating allows resources to be combined so that the client is instructed a as whole person and in real life situations. And it allows for different viewpoints, for better assessments and for skills to be taught or addressed as they come up on a lesson, those teachable moments. If the client needs more in‑depth training the individual instructor can set up time outside the collaborative lesson to teach the skill. Create a group setting which supports social motivation and can encourage a client to do a task even if they see it as unnecessary or mundane. So we're going to start off with collaboration, the who. So who is on your client's team? Who can you ask to join their team? Maybe somebody who is not necessarily there. You can think about family, think about friends, co‑workers, teachers, other specialists, like the other O&Ms in your area, VRTs, ed techs or one on one aides. I'm not sure what you guys call them. They're called different things. Other clients, other community members even. And you're always keeping in mind that it is client choice so you do have to get permission and approval first because there is that confidentiality. Don't want to just invite somebody to do a collaborative lesson before you've gotten that client to say yep, that's good by me, and maybe you even need a permission signed on that person to come on a lesson with you. So collaboration, the what. So what's the goal or goal? What's the purpose of the collaboration? What do you want to do? This is where we come up with those ideas for those joint lessons, those collaborative lessons. The ideas based on the client's motivator or motivators. Involving the client in the process of deciding the what. Creating that buy‑in. And that's where we go back to that client‑centered services. Now we've figured out who we're going to do this with, what exactly are we going to do? And this really does help if you're trying to get permission from a school to maybe get a collaborative lesson or trying to get permission from a supervisor, they're going to say to you what are you going to do and why and who. So if you can get that all established you can really make a better sort of selling point to get people on board. Next section is where and when. When you have your who and what we think about where and when. That's based on the availability of the resources in the area where your client is. You have to maximize time for all involved. And frequency is based on the needs of the client, but also the availability of the team. And we want to get creative when we think about where and when. Locations, we want to think about those familiar locations, but also some unfamiliar ones. So here in Maine, I have VRTs that are coming up from the Rockland area from an hour, hour and a half south of me, and so we have to kind of be very flexible when we talk about the timing for our collaborative lessons because we want it to work for the client, but we also need to respect that the client only lives 30 minutes from me, but that's an hour and a half north for that VRT to travel. So we want to make it the best that we can. And maybe that means I drive the client halfway and we meet in the middle and we do something in an unfamiliar area to again challenge the client, but also using those motivations like, for example, I had a client that was motivated by tools and going to home improvement stores like Lowe's and Home Depot, and so we could find a place between the two instructors to meet and to work on these skills together. So lastly, why and how. So this is where you're going to sell your collaboration to the client. If they're not already in, because some clients aren't, they're high on the fence, and sometimes the team members are kind of on that fence too, but this is where you're going to sell it to them. Why do you think the collaboration is important? Why is this better than just individually working with the client? That question comes up all the time for me, can't you do that by yourself? And I have to discuss as to well, but I'm not a VRT, and it's really great if we can work together because we can work on all the skills in that environment. And then why is an important addition to their individual lessons as well, which a lot of times is that real life practice. It's about applying those individual skills you're learning with just the O&M, just the VRT or just your TVI and then doing it in those sort of real life situations. As real life as you can make them because sometimes we have to kind of set them up for success a little bit. How will this benefit the client and how will it benefit the team? How can we accomplish collaboration? Only ‑‑ I'm only my own expert in my own expertise and I need you! I need you on my team. Setting up ground rules for the collaboration obviously is very important. Transparency and communication is important too because sometimes when we get specialists into the same room and because there is so much overlap, some people are like oh, you're stepping on my toes. So those ground rules are really important. We'll see a scenario about a VRT and O&M meet with a client who they are working collaboratively with and I respect her expertise and I understand she has had a little bit of training in O&M so there are areas where I'm totally fine and I say go ahead, step in. And I was focused on something else and she brings it to my attention and I'm saying yeah, go with that. And I have worked in the capacity as the VRT in the past, but I ‑‑ I'm not a VRT. I'm not ‑‑ I'm not certified as a VRT. So I ‑‑ we talk about it and I say hey, can I step in and handle this? Or I see she's struggling with something, like maybe money management skills. And I can step in, but I also don't want to step on the VRT's toes. So it's about having that, like I said, ground rules set up ahead of time. So now we're going to talk about the carrot concept. So the carrot is that ultimate motivator. It's that thing that makes ‑‑ that means the most to someone. Some clients need a carrot to motivate them or help them to accomplish the necessary tasks and your job is to find their carrot and to utilize it. Some examples of a carrot are: Going out to eat, continued services, attending center‑based programs, moving into their own apartment, going for walks around their school, time away from their parents or school, and sometimes it's recreational activities. So we're going to open up the poll and I want you to think of a client, a particular client that you're working with right now and I want you to throw out a carrot into our poll box. What do you think could be their ultimate motivator? Or is their ultimate motivator right now? Coffee, yes. Employment, very good. Model building, great. Music . Candy. Tim Horton's. Yay, I love Timmy. Independence. Little Caesar's, awesome. I saw chocolate. Attending O&M sessions in order to get a guide dog in a year, very great. Find a partner. On route to a place where we can meet other people and avoid loneliness and boredom. Awesome. I saw doing to Dairy Queen and purchasing a treat. Hot chocolate at the end of a session. Traveling to ‑‑ teenage girl, lip gloss and shopping for clothes, that's right. Going on a date without my mom as a chaperone. Freedom from parents. Learning voiceover on the phone to make medical appointments and communicating with friends, including hanging up the phone after leaving messages. Paralympic athlete. Awesome. Learning how to ride the subway. Learning how to ride the bus in a large city. Independence. I love how some of these are very specific. Buying batteries for an iPad. Not being lonely anymore. Moving into their own apartment, socializing with others. Time on the playground. It can be very simple, exactly. Singing in the school choir. Cheesecake. These are great. Getting out of the house, yes. Thank you, guys, great feedback. We've got that carrot concept down pat. All right. So our first case study is NC. And all of the pictures that you see of any of the case studies I've gotten permission from the families or the students to be a part of the presentation today. So this is NC and he is a 12‑year‑old male ‑‑ at the time. He's not 12 anymore. He did get older. And he has the high condition of [indiscernible]. He lives at home with his parents and attends public school on an island so it's a very, very small school. Like each grade is two grades together and there's six to eight kids in a class. So what we did was we started doing collaborative lessons with his teacher of the visually impaired, and we started branching out from there because he had some other interests that he wanted to work on as well. I'm going to see if I can pull up my pointer. There it is. Let's see if I can move it around. So the green arrow, that first top left photo is his TVI and there's me and there's the student. And in this collaborative lesson we were working on going to the grocery store and doing some shopping. So his TVI had already done some individual lessons with him at the grocery store and now I had done some individual lessons with him as well, talking about how to use a cart and how to solicit assistance and she had done the same sort of similar lessons. So we wanted to give him that real life situation and real life scenario to do some grocery shopping together. In the photo to the right of that here's our student here and there's me, and these two gentlemen here in the photo are the Bangor city engineers. So we had come across a situation where there was some construction work that was being done on the sidewalk and he almost fell into a very large hole because it was not barricaded correctly. And he was also struggling with crossing some of the streets in downtown Bangor. So he had actually brought up the idea of hey, can we set up a meeting to chat with the Bangor city engineers? And I said sure, great. This gentleman here John is very receptive to that and I had worked with him with previous clients. So we did set up a meeting and the student took the lead on the whole meeting and it was really positive, really impactful lesson for everybody. And now the student, you know, can advocate for himself and he's made those connections, which is really wonderful. And in the photo it's just the four of us standing smiling. In that first photo of the grocery stopping I'm standing against one side of the aisle, the TVI is in the middle with the cart and then the student is actually trying to find plastic bags, and he really wanted to do everything himself. He did not want to ask for assistance, even know he knew that was an option. And so we were problem solving how do you figure out which box of bags is which? So maybe he had to use some technology with that. He was just tactilely trying to figure out if he could just tell the difference, which not in those boxes as far as we knew. And then in our bottom two photos, the bottom left photo is a collaborative lesson at the discovery museum, the children's museum in downtown Bangor, I had reached out to them. I'm here in the photo at the end of ‑‑ he's standing at the end of an aquarium type tank. It's a touch tank. So there's a bunch of different items in there like lobsters and I think some oysters and scallops and crabs and clams, all the different animals we would find off the Maine coast. So there was an instructor there. The hand you see here reaching out was actually his father's hand. And they were teaching me about the lobster that the student has in his hand because his father is actually a lobsterman. And so they were teaching me how do you tell the difference between a female lobster and a male lobster. And I can't tell you off the top of my head right now, but they did tell me. But it was a really, really fun lesson. And after the lesson ended and the instructor from the museum explored the tank with the student, they actually gave us free rein of the museum, it was closed that day, so we could practice using elevators and practice using stairs and navigate through the environment. So just an example of using community members in your collaborative lessons. And lastly our fourth photo here in the bottom right corner, here is our student. He's sitting at a radio console and there's a computer here. It's his personal computer. He's reaching out and turning some knobs on one of the equipment. And then there's a radio deejay standing over his right shoulder in the corner of the photo. So again this is another collaborative lesson. The TVI had actually set up an interview for him because he wants to be a radio deejay as a future career. And so she set this up. He went and he did an actual job interview with the radio deejay. And then the radio deejay said do you want to jump on the air and play some songs? So he did. He took full advantage of that opportunity. And now from this whole experience he actually has a weekly show at that radio station, the radio station is at the local college in his area. So transportation was provided by ‑‑ I'll turn my pointer off. Transportation provided to Bangor and to the city of Machias by his ed tech, which was his parents. And it was approved by his school. We also utilized the city bus in Bangor. We utilized Uber on some of our collaborative lessons and also walking. The O&M goals that he was working on included cane skills, orientation skills, residential and urban travel skills, self‑advocacy, problem solving and environmental awareness. And the carrot for NC was really just being away from his family and being social with his instructor. And the carrot for his family, because we think about what is the carrot for our student, but sometimes what's the carrot for our family? Is that they really, really wanted him to get O&M services, so that was really important. And they would go pretty much anywhere to get them. And his ed tech did not come on lessons most of the time. Sometimes he kind of would hover in the background at a distance and take photos of the lessons and that's really how we got all of these photos here. But for the most part she was not present on the lesson and he really ‑‑ enjoyed that. He was being a normal kid and going out and doing what he considered to be fun things, but they had so many goals and so many skills just right in there. All right. We're going to move on quickly to our next case study. So that is JM. She is 21 years old, a female. She has congenital glaucoma and cataracts as well as Asperger's. She lives at home with her parents. And our collaborative effort started with the VRT and they've continued with the VRT. The VRT would do individual lessons with the student and then I would do individual lessons with the student for O&M and then we would get together once a month for these collaborative lessons. And the photo on the slide is a funny photo, but it means a lot to the student. On this photo is the VRT with a bunny rabbit head on, like one of those stuffed character animal heads. And then student to her right has a panda bear and she's making a "rarrr" hands, and this is a fun photo that we took, but it was really an important lesson for her because she never went to Walmart to just go and look around and just explore the environment. She was always there with a mission with her family or by herself with instructors. And so we just stopped in the Halloween section and just started exploring what was there. And it was so great because there are so many things that she didn't even know existed in the world and she had that opportunity to just be a young adult and even the VRT and I talked about the fact that do you remember when we were young and we were in our 20s and we would go to Walmart and just play around and hop on bicycles and mess with the balls in the ball pit thing and put on funny hats and do all that type of stuff? And she never had that experience, so we he wanted to give it to her. So it was really great. So our lessons actually take place in three nearby cities. The client lives near Newport. Bangor and Waterville are the two major cities on either side of Newport. The VRT instructor actually comes from the Augusta area so it's about an hour and 50 minutes southwest of Bangor. And so it was important that we put those lessons closer to Augusta, which Waterville is closer to Augusta, but also then to Bangor because those are two major cities that the client might go to or does go to, but close proximity for that VRT. Our O&M goals were to live independently, including cane skills, self‑advocacy, problem solving, orientation skills and environmental awareness. And for the VRT was to live independently as well, including self‑advocacy, money handling, activities of daily living, note taking and communication skills. And the carrot for JM is that she always gets to select the restaurant for our lunch during our lessons and she gets social interactions with staff. And the staff are close to her age. The carrot for her family, again, is receiving services because that's very important to them. And when we started working with JM, we had a very hard time figuring out what actually motivated her, but when we started sort of asking questions and trying to get feedback from her when we brought up food, food was huge. And now we actually hear her making suggestions on lessons rather than just going on with what's planned for those collaborative lessons, she will say hey, it's Christmas time. Instead of going and doing this lesson, would it be possible that we could go Christmas shopping? And that was really amazing because she did it all on her own, again, intrinsically motivated to make that lesson more specific for her, and that's ‑‑ that's come uploads from just being motivated by food. So that's really great. So the last section just talks about case studies of transition age students. I've worked in a variety of programs over the past 10 years in Florida and now in Maine that have been focused on transition age students, that 14 to 82‑year‑old students. Every time that we've done activities in the Florida area, the activities were selected by the teen so that was that carrot, and the instruction was provided based on that selection. So if they decided they wanted to go ice skating or drive‑in movie theater or theme parks, malls, farmers markets, they got to select the carrot. And that many teens actually lack experiences. So combining the VRT and O&M skills, they aren't missing out on any instruction. When we found out we were doing just the O&M in those environments, really we were just missing things. We're like oh, okay, we can't talk about money handling skills because it's kind of outside our expertise area. And at that time I actually was not an O&M, I was just a transition teacher. And so it was really important that we decided that we wanted to have these collaborative joint lessons and it made a huge, huge impact on our students. The camping activity that I talked about we did this fabulous activity where we actually took them to an island to go camping for the weekend. The students had to use walking, the city bus, then we got on a train to go to the ‑‑ close to the island. Then we had to use a taxi to get to where the island began, so get on a boat to go to the island. And then they walked to the camp site. So it was a variety of different transportation opportunities. And then while we were there all the students had to cook over an open fire and they had to do dishes with buckets of water instead of like in a sink. And it just was so powerful of an experience. And they all walked away from the activity just feeling so confident that they got to do all these things that they've never done before. And now they went back to their home environment saying hey, mom and dad, like I cooked over an open flame. I can cook over a stove, that's no problem. And I have a VRT that will work with me and show me those skills and I can show you I can do them and that's so awesome to me. So that's the end of the presentation. Hopefully you guys have gotten a lot of information. Quick and fast. But if you can think of a particular client, the poll is open where these strategies would be helpful. And just submit your votes. That would be really great. It's great feedback for me to see if you guys feel like this was a helpful presentation for you, hopefully it was. And now we'll also open up for some questions. Also on the screen is my contact information as well at the university ‑‑ university. At Maine.gov. It's just my first name at Maine.gov and also my phone number if you would like to reach out. Thank you guys for all that feedback. So far we've got 42 yeses, three maybes, which that's totally fine. Sometimes we have to mull over the concept and hopefully you will change to a yes and use it in the future. Kassey Maloney: So we have to try to make this as quick as possible. I actually said that like two minutes ago. Let's see how long the loop back is. But one question is do you write reports after and who receives them? And another we question is typically what is the duration of your lessons when collaborating? Sharisse Roberts: All right. So yes, I definitely write your reports afterwards. And the reports in our area go to if it's an adult client, then it goes to the VR counselor or our IL counselor. And VR stands for vocational rehabilitation and IL stands for independent living. And I also share that report with the VRT or with the other person I'm collaborating with. And with students a lot of the times I will share it with the school if they require those reports. Sometimes in our area our reports for students are actually on a quarterly basis or once a year, which is crazy, but that's the way they do it. So then it will go in my sort of overall report for the whole year or for that quarterly report. And then you said duration, so it's really just depends on the lesson itself. We are in a pretty rural environment so sometimes with my students like my upcoming collaborative lesson on Monday with JM is two and a half hours. And that's because she's going to be using the city bus and our bus only runs ones an hour and she will be going to the mall. So we had to give her enough chunk of time that we could do that with her. Sometimes those lessons are two hours, sometimes they're an hour and a half. I've never done a collaborative lesson really less than that with our adult clients. With students they're usually about an hour, sometimes hour and a half where an ed tech is involved in the school setting. If there's transportation, obviously we've got to work that into that lesson time. If I'm providing transportation or if the school is providing transportation that really depends. With NC his lessons are actually three hours in length because they were finding a far distance to get to us. [ Title: ] International O&M Online Symposium Thank you [ Music ] Fade to black.