Description of graphical content is included between Description Start and Description End. Transcript Start [Music] Fade up from black. Animation: Text for TSBVI transform into braille cells for TSBVI. [Music face out] Fade to black. Chapter 1. Intro & CVI Clinic Promo Sara Kitchen: Hi, everybody. Welcome to the first CVI Study Group for the 2018‑2019 school year. We actually prerecorded a large portion of this-- of this session with Lynne, who could not be here today, and we will be showing you that. But I just want to tell you all a few things. You probably noticed that our study groups are being presented through zoom instead of through Adobe Connect, so it's slightly different, and you have to enter your name and I believe to get into the room. And also your handouts are in a different link in the-- in the invitation you received today they were not in the same spot as they were in Adobe Connect. So if you could please enter your name in the chat so that we'll know who is participating and if you could do that, if there's a group of people just enter everybody's name. When you get into the chat and get ready to enter information, select "All panelists and attendees." It can get selected so that it just goes to the host and that's not me, so then I won't be able to see it. This is especially important for when you type comments or questions. And since this is a recorded session I encourage to you do that and I will respond to them as best as I can. Anybody else also can feel free to respond to any comments or questions you have during the recorded part. And then we'll come back together after we watch that part and we'll talk about a couple of things, mostly doing planning for the rest of the year. So I believe we're ready to start watching the rest of the CVI Study Group, the big portion of it. Right now. [ Webinar Video start: ] Lynne McAlister: Hello, everybody and welcome to the first CVI Study Group of the 2018‑'19 school year. This has been-- what year is this of the Study Group? How many have we had? Kitchen: We've been doing it for five years. This may be the sixth. McAlister: Sixth year of the Study Group and it's been great, we've learned a lot. It was hard to kind of gather input for this Study Group about what you guys wanted to do, so Sara and I decided that we would fill you in a little bit about the what we learned at the CVI symposium at Perkins at the end of last year, last spring. So today's agenda, we have a new PSA, AKA commercial. And for the CVI clinics that we'd like to show you. This is information that the media team here put together from several different CVI clinics we've done, and we've done five of those? Four or five of those. Kitchen: I think four. McAlister: They get better and better. So we want to look at that, that little commercial. After that we're going to dive in to the CVI symposium and Dr. Merabet and you will get a chance to see him and some video clips of him at the symposium. And then we need to plan for the next Study Group. We have four this year, and Sara and I don't want to sit here and be talking heads for all four of. This. Kitchen: And you don't want that either. McAlister: Yeah, you don't want that. So, we need to figure out for the next Study Group does one of you have a kid that you'd like us to look at? Or whatever other interests that you have about this topic. Kitchen: And for anybody who is new to the CVI Study Group, we don't typically record them. If there's a student involved we don't record it. So this will not be something that will be posted on the Internet forever, which would be often times is really helpful for parents to say okay, you know, their child doesn't need to be posted on the Internet. So let them know that, if that is a barrier. McAlister: All right. So let's look at our new PSA. [ CVI Promo Video start: ] [background music] Narrator: Texas School for the Blind and Visually Impaired Outreach Programs and Regional Educational Service Centers have partnered to offer cortical visual impairment or CVI clinics in various locations within the state of Texas to help teachers and parents support children with CVI. Here's what happens at a CVI clinic. Diane Sheline: OK, so if we want to get him using his vision, we need to use yellow, lighted, reflective targets... and movement. And that's where we're at, right now. And that's great! Angelica Robledo: We learned of the CVI Clinic through his... vision... impairment therapist. Sheline: There's a very important... process to go through, before you even start evaluating the student. Of course, you need to get a state of Texas I report-- that's pretty important-- or an i report of some sort. But then the importance of doing a very, very, very thorough parent interview, or caretaker interview, so that they understand that the questions that are being asked all relate to the ten behavioral characteristics of the CVI range. Then, we ask the teachers to... do some short videotaping of... the child and we give them some specific parameters. So, then we bring in the student, the teacher, the parent or caretaker, and we go through and we do the actual... direct evaluation with the- with the... child. Sara Kitchen: All of these people gathered together to look at their child. Lynne McAlister: Right, all of their-- all of the eyes. Kitchen: It's so important. Sheline: And it was a large group of very experienced teachers for each one of those kids. Kitchen: And yet- and yet the discussions kept coming. Sheline: Mm-hmm. McAlister: Right. Yeah, the discussion was great! Debra Leff: I think it was a nice bonding experience for every one that was involved, even teachers who came just to observe. I think they felt like they were part of it, and they were an important part of it, because they got to throw their ideas out there in terms of what they saw. Kitchen: But to hear people who have... used the CVI Range, a number of times, and are still having these discussions, still learning about it; I feel like, it puts us all on a more even playing field, and it just really emphasizes that we are all collaborators. Christa Utzinger: I think different people on the team, maybe, noticed different things. For me, watching the videos was really difficult. I didn't notice everything that every- that everybody else noticed all the time, and so, that was really instructive for me to hear everybody's thoughts. I remember when we were outside testing and the ball rolled into the shadow of your leg and Ulysses didn't see it. And I probably would have just-- I don't know-- kept going. Kitchen: Right there-- in the sun, but not in the shadow. Utzinger: Having multiple eyes noticing... all the little... the little things that we're looking for. Sheline: A lot of different people work with these kiddos, and everybody needs to be on the same page. We can't have it all just be the responsibility of the vision teacher, and only these types of strategies and techniques are used when the vision teacher is there. Robledo: It was really nice being able to have as a teacher, and not having me to go back and explain, and you know, miss a couple of details-- they were there for everything. So, it was really good to have them there. I think the best part for Eli was just being able to see those things, being able to see them in a different way, with the lighting and the different background, you know, it's not as distracting. So, I think he was liking that he was able to be able to take it in. [background music] Sheline: The parent has a little bit better understanding of how they can adapt all of their routines, and their activities that they do-- daily routines and activities, feeding, brushing teeth, washing face, sitting down, and playing with toys; everything. I'm talking about, how you can encourage that child to use their vision throughout the day. Robledo: Like if I wanted to introduce him-- introduce something new, he would be able to, I guess, learn about it, because we know how to-- we know how to approach him with it. We know how to, you know, show him in a way that he understands. María Ramírez: Pues... lo que yo miro que él mira es cosas... como brillosas, que le llaman atención de que, yo miro que, si les tener atención. Narrator: What I saw was he looked at things that are bright, that called his attention and I saw he gave attention to them. Ramírez: Para él, yo me fije que era muy emocionante para él estar allí. Le gusto las partes que le estaban ensenando. Narrator: I noticed it was very exciting for him to be there. He enjoyed the things they showed him. Utzinger: I think the family were really pleased to participate. I think that they felt like they had access to this- this expert Diane. I think... they felt like they got new information, which was really powerful for them. And I think that they- they left with... some new thoughts or... ideas about what they could do in their home for their child. Ramírez: No sé, como- como expresarlo, como le decirlo, pero estaba muy emocionada allí. Fue muy importante para mí, estar allí mirándolo a él. Y pues, unas cosas que yo fui aprender para él, me gusto bastante. ¡Y gracias por... me llevaron a este lugar, aprender como mirando a él, como puede mirar! Como localizarse para mirar una cosa. Ese fue importante para mí. Narrator: I don't know how to say this, but it was very emotional. It was very important to be there, and see, and watch him. I was pleased for what I learned for him, and thank you for bringing us. I learned by watching him, that he could see, that he could locate and see things. Ramírez: Fue un-- una manera de... de tener yo más opciones... para- como enfocarme con él. Que lo realmente necesito para mirar mejor. En esa manera, me di cuenta yo que tengo que ponerle mucha atención y enseñarle como mirar las cosas; transforma de él. Eso es lo que yo aprendí. Fue importante para mí. Narrator: It was a way for me to obtain more options, and what I should focus on to help him. What does he really need to see better. I have to put more attention to teach him how to look at things. This is what I learned and it was very important to me. Camera person: ¡Muy bien! Robledo: I like the way it was. I like the way it was set up, the way we had a room, and it was just him, and you know, everyone observing him. And I really liked the clinic- just the clinic, itself, how it was set up. Utzinger: Just- just watching it from start to finish. And that was really powerful for me; to be able to see that. You can read the book, you can hear somebody talk about it, but it's not the same thing as- as watching somebody do it. Sheline: In this way, we're really doing an in-depth training with a few teachers and hopefully they will... become mentors for other teachers within their districts from given what they learn. [ CVI Promo Video end: ] McAlister: Thank you, TSBVI media team. That was a beautiful commercial. Kitchen: And all the people interviewed for it, especially Ulysses' mom, every time I watch it I tear up. It's good to know what kind of effect it has, especially on parents, especially on parents. McAlister: Uh‑huh. Chapter 2. CVI Symposium & Dr. Marabet Okay. So now we're going to dive in to the CVI symposium, and Dr. Marabet's lecture. If you've watched Dr. Merabet at all, he goes on and on about the idea that CVI results from the brain being under-connected. And so in this last symposium he kind of delved a little deeper into that and explained to us a little bit more about what actually that means. Just to recap here, here's a clip of Dr. Merabet talking about this again, this idea of connectivity. [ Video start: ] Please view this video at Perkins School for the Blind CVI Sypmposium Bauer Bennet Merabet http://www.perkinselearning.org/cvi/educators/symposium/2018 [ Video end: ] Kitchen: So that is a clip of a much longer talk that's on the Perkins website, and the link is in your handout. I believe we're going to show one more clip from that, but first we are going to let Lynne geek out a little bit-- [ Laughter ] about connectivity. McAlister: One thing I really like, enjoyed about Dr. Merabet, is he will say something profound and then say right, like remember? [ Laughter ]. I'm like I don't know what you're talking about. Chapter 3. Connectivity & the Thalamus Okay. On the next slide there's a graphic of the visual pathway. So the vision comes in through the retina, down the optic nerve to the LGN, the lateral geniculate nucleus and goes down to the retinal cortex. What Dr. Merabet shared with us and was a surprise to me, I don't know why, was that the LGN is actually a small part of the thalamus. The thalamus is an organ in your brain that all sensory information except olfactory information, for some reason, all sensory information, other than that, goes to the thalamus and then gets rerouted to the various parts of the cortex that-- for that sensation or that input. So Dr. Merabet shared with us that people in CVI on average have a smaller overall thalamus size than that is typical. So I just wanted to show you this and really the thalamus is what we're going to be concentrating on a lot today, and I think this is where I'm going to geek out a little, as Sara said. [ Slide start: ] Description Start: Title: Visual Pathways Content: Figure 1: Image of visual pathways Description End: So, when I was researching this, I came across two items that I didn't know about, I had never heard before. The parvo pathway and the magno pathway. So on the next slide this is a diagram of those two pathways, the parvo, the P, and the magno, the M. [ Slide start: ] Description Start: Title: Content: Figure 2: Image of visual pathways Description End: And so these are pathways that originate in the retina and they go to the LGN there, the thalamus, and then they continue and they end up in different parts of the occipital lobe, so different parts of the visual cortex. [ Slide end: ] So on the inside those green Ps towards the inside of the visual tract, that's the parvo tract. So parvo fibers carry information about color and form that's very detailed and it's slow. Compared to the magno stream, which is in the peripheries that carries detail about motion only, and that one is very fast. So to go to the next slide, here is some more differences in those two pathways. [ Slide start: ] Description Start: Title: Visual Pathways Content: Table differentiating two pathways. Parvo Cells Majority of cells in LGN: 85-90% Small receptive field Slow conduction rate Low contrast sensitivity Able to differentiate detailed stimuli Color sensitive Processes information about color and detail Magno Cells Minority of cells in LGN: 10-15% Large receptive field Fast conduction rate High contrast sensitivity Able to differentiate only coarse stimuli Color blind Processes information about depth and motion Description End: You know, there's many, many more parvo cells and magno cells. One is fast, the motion channel is fast. The detailed channel is slow. One sees color, one does not. [ Slide end: ] And what I found so interesting, Sara, about this, is that when you talk about CVI and you talk about the ventral stream being the one stream in the-- the what stream in the brain and the dorsal stream being the when stream in the brain. They've so those two streams are differentiated from the beginning of vision from the retinal cells. Kitchen: Which is just another argument that your eyes really are just an extension of your brain that sticks out of your head. [ Laughter ]. McAlister: Right. So, you know, we think-- I have always thought of our visual system as being kind of like separated, like your eyes do this, the optic nerve does this, the retina does this, but just like you were saying, you know, it actually is one big thing. [ Laughter ]. Kitchen: Yeah, happy Halloween. McAlister: Yes. So I just wanted to talk about that a little bit because it was a surprise to me and I don't know if you guys have heard about that before. I had never heard about that before, but I think it's very cool. In the next little video we're going to show-- this is me trying-- trying desperately to imitate a short course that I saw online. The course is through the university of Chicago and it's a free course. And it's called "Understanding the brain, the neurobiology of everyday life." So, the doctor that teaches this life is Dr. Peggy Mason. And this short clip she talks about thalamic attention, so once again focusing on the thalamus and the role of the thalamus in vision. I really would urge you to go look at this course. It's really fascinating and she has several of them. This is just a little five‑minute clip, and I didn't reproduce the entire thing, but we can talk about it after we see it. [ Thalamus Video start: ] Lynne McAlister: So, I'm going to try to recreate Dr. Mason's lesson, when she talks about the role of the thalamus and vision, and thalamic attention. So, she describes a visual system as starting at the retina, and then the visual signal travels down to the thalamus, to the LDN, which is a small portion of the thalamus devoted to vision. And then it continues down to the visual cortex. And she said a lot of people think that's where it ends, and the system just, you know, the information just goes onto the cortex. But actually, what happens is, from the visual cortex that signal is transmitted right back to the thalamus. And as Dr. Mason describes it, from visual cortex to the thal-- to the thalamus, it's so much bigger and stronger, than what is coming in from the retina. And at the same time, information is coming from the brain stem to the thalamus, which has neurotransmitters that actually affect your mood and effect. So, not only are you recognizing and making sense of what you're seeing, you're getting emotions tied to what you're seeing. So, the reason this happens here-- that the feedback loops... you know-- continuously loops back into the thalamus, is that this information coming from the visual cortex is what you expect to see. So, it's everything that you know about what you're looking at, and everything that you feel, or have felt in the past, about what you're looking at. So, when Dr. Merabet talks about CVI being an "under connected brain," this is the whole system that he's talking about. So, the brain isn't-- the visual cortex is finding it much, much harder to give feedback back to the thalamus about the past memories, and emotions about what the person is seeing, because it's so difficult for them to see it in the first place. [ Thalamus Video end: ] McAlister: So I think in a video is pretty fascinating and of course Dr. Mason's video is much more fascinating than mine. She depose into a lot more details. Kitchen: She makes some silly jokes too. McAlister: She makes some really silly jokes. I think it's so interesting that when looking at something, you are maybe remembering something you had seen before in a with a. It's like all that information coming into your thalamus, she talks about the biological it's like boom, the only time you have to process what you're looking at is when you don't expect to see what‑‑ Kitchen: Something new. McAlister: Yeah. If you don't expect to see it or it's something new. Kitchen: Not in your memory. McAlister: So this goes into the CVI for me because I think if that system is under-connected, if it's not working right, every time these guys look at something they have to look at it like it's brand new. They haven't seen it before. So that's why it seems so hard. Kitchen: Until the connections are built. But they're-- they're fewer and that's why it can be so exhausting, I think. McAlister: Right, plus if the environment isn't set up for them to be able to see more easily, they're not-- they're not even getting those initial-- they're not seeing it. Kitchen: Yeah. I think that when you said-- based on what Dr. Mason said was that all of that stuff mostly goes on. It's mostly going on, the stronger connections that are happening between the cortical areas and the thalamus, not between the eye and the cortical areas or between the eye and the thalamus. And that reminds me of something else that I heard recently is that we don't actually remember events, we remember our memories of events. McAlister: Right. Kitchen: That's that strong connection that we make while we're processing information. We're mostly working inside our own heads. McAlister: Right. In a different course that I was looking at that was much, much more detailed and way more scientific, so less accessible, the doctor said that the information goes from the thalamus to the cortex to the thalamus to the cortex. That happens several, several times just for one impulse. So one-- one look. And each time it does it gets more and more sophisticated. And he went into great detail about what that meant. Kitchen: That one was a little harder. McAlister: Higher levels, yes. So Dr. Mason ends her course or this section of it with, of course, you see what you expect to see. So in the next slide before we see it I want to just kind of set it up. This is a slide that we saw similar to one that Dr. Merabet showed at the symposium and, you know, he describes it as I'm going to show you a picture of a messy bathroom, try to see if you can find the toothbrush. And then he showed us this picture. [ Slide start: ] Description Start: Title: Content: Figure 3: Photo of bathroom Description End: [ Slide end: ] Okay. Did everyone find the toothbrush? Do you see it there on the sink? I'm going to show it to you one more time? How about the big bluetooth brush by the toilet.? [ Slide start: ] repeat previous slide [ Slide end: ] So this is an example-- and there was how many people were at the symposium? Kitchen: I don't know. McAlister: It was an auditorium full of people. Kitchen: 60, 80. McAlister: And none of us saw the bluetooth brush, none of us. So this is an example of-- that you see what you expect to see. You don't expect to see a five‑foot tall toothbrush propped up against the wall of a bathroom so you don't see it. Kitchen: Acuity wise the little thing that's on the sink barely even looks like a toothbrush, but that's what we expect. McAlister: That's what we expect. Kitchen: The other one actually looks like a toothbrush, but it's in the wrong spot. McAlister: Right, it's the wrong size, it's in the wrong spot. And so you don't expect to see it. So you don't see it. And I think this is a really good example of CVI as not being like an ocular-- well, it blurry or you don't have good acuity. You actually just-- acuity. You actually just don't register it. Kitchen: A little taste. McAlister: Yes, yes. We thought that was very interesting. So we have another clip for you. This is a somewhat longer clip of Mr. Merabet at the symposium. And he talks in this about three different things. He talks about how vision affects all development and kind of drives all of development. The differences between acquired CVI and developmental CVI, and then he uses my new favorite representation of CVI as an office building. Let's watch Dr. Merabet. [ Video start: ] Please view this video at Perkins School for the Blind CVI Sypmposium Bauer Bennet Merabet http://www.perkinselearning.org/cvi/educators/symposium/2018 [ Video end: ] Kitchen: So I think it's really interesting. It really made me think about how often times when children have CVI, and of course they have it very early, they-- there's an assumption that since the eyes are open and-- from sighted people, since the eyes are open and the child may seem to alert to some of the visual inputs, that they actually have witnessed more visual images than they really have. And often it seems that just because of their behavior we think they're seeing things that they're not seeing, and as far as concept development, I think that's why some of the strategies that Roman talks about with the salient features and the comparative language are so important because that incidental information has not-- has not been acquired by the child and it's really easy to miss that that has happened. And if we can think of somebody who has CVI, even if their vision has improved, their visual memory still has not been built at those early levels. And as we teach concept development to blind children, we assume that they've never seen those things. Well, some of that can be also applied, maybe a lot more of it than we think for children with CVI. Just something to think about. McAlister: Right. What struck me about this when Dr. Merabet was speaking was that I was wondering, he kind of makes a differentiation between acquired vision loss because of an acquired accident or something-- Kitchen: The clock. McAlister: The clock, yeah. And he kind of implied that if it wasn't developmental, if the child wasn't born with this damage, then it wasn't really CVI. Kitchen: Well, it's just a really different thing, I think, like what he was talking about. Because those early loops that are being built haven't been affected by the person that acquired it. Those loops-- they've been affected, but they're there and the rewiring is rewiring. It's not the initial wiring. McAlister: Right. Kitchen: When it's damaged, the beginning, the wiring is the part that is an issue. McAlister: Right. But I just thought-- he said a couple of times in there that that's the difference between CVI and this. Which is not what Dr. Roman says. So anyway, that's just something to think about, maybe ask them the next time we see them. Kitchen: Well, and he was talking about all of the variations, where the damage is, if it's in the thalamus it could be more interruptive. So it just seems like a lot of questions more than any answers. McAlister: Yeah. And I think when you get deeper, deeper, that's what we're doing, we're getting deeper, deeper into the brain. You know, we're not trained for that. So there are-- Kitchen: And I remember when you and I assessed a child who had an acquired brain injury and it was very different, very, very different. We used the CVI range, but it seemed-- it was harder to use it, I thought. McAlister: But that young man that we did do it on, if we're thinking about the same young man, he did have the CVI characteristics. He totally did. Kitchen: But there was a different feel to it. It just-- and there were also other areas that were-- McAlister: Impacted. Kitchen: ‑‑ impacted. But it was like that murky area, you know? It's like what's going on here. So I think that that's just another question Merabet is looking into, everybody is learning. McAlister: All right. So Dr. Merabet, one thing he did say is he said, so I get these people coming up to me all the time saying, oh, this plasticity I hear about. How do I get some more about that? So he went into kind of a short explanation of how can you enhance your brain plasticity. He talked about multisensory and sensorimotor and environmental challenges. So he said learn a new language, play a musical instrument, break your routines, do novel things, all these things challenge your brain. He particularly spoke about exercise as being very, very good for brain health and growth. And then he kind of veered off into this other statement that I thought was very, very interesting. He said the brain is only two percent of your body mass, but it consumes 25% of your daily caloric intake. And that is an inverse relationship with your growth. So during your childhood and early development, your brain is consuming up to 66% of your daily glucose. Once you hit adolescence and you start growing, your brain starts consuming less glucose. So as he put it, your-- in early development the brain grows at the expense of the body and it continues to do that up until adolescence where then the body takes over and uses more of the body's reserves to grow. Which I just thought that was so cool. Kitchen: How does it do that when your body is is done growing? Did he talk about that part? McAlister: No, he just said that the brain-- in childhood the brain is consuming glucose like crazy, you know, which also goes back to the plasticity because childhood is basically when we've all been taught that it's the most chance to regain some vision. Kitchen: You know, what you were talking with the exercise and the multisensory and learning new languages and all that reminds me of something Michael Merzenich who studies neuro plasticity said. And he talks about people aging a lot and the brain changing and he said that when-- you have all these sensorimotor expenses and that is what all of your knowledge is based on. And you-- and then you don't do those things again. And when you don't do those things you remember only your memories and then you remember those memories. And so as you get further from the actual time when you did something like here, I pick up a glass of water. Now that's fresh in my memory again. The actual sensorimotor experience, you don't have a sharp image of that sensorimotor experience anyway. So when they say people are "out of it," when people have-- they are actually, literally, they haven't touched, interacted with the world in that way so they actually need to go out and walk on a balance beam or pick up a rock and throw it in the pond. All those things are images in our brains or they're memories, but when we haven't done them in a long time, they fade and we don't really know-- we don't really know what we're talking about. We have a lot of words to say the things, but we're disconnected from those actual concepts. So I thought that was interesting. And I guess it's a little bit of a bunny trail, but it relates to what Merabet was saying, I think. [ Laughter ]. McAlister: It does, it does relate to it. Because it's that real estate, that concept active brain real estate. If it's not going to be used, something else is going to take it's place. It's too valuable to leave by itself. All right. So on the next slide we have another, our friendly little diagram of the visual pathway. And so if we take all this information that Dr. Merabet has told us, that Dr. Mason ha has shared with us and some of these other resources that are in your handout-- this is actually a quote from Mr. Merabet too because I had a question about this. So where does CVI happen? And... Dr. Merabet in his office building-- Kitchen: Analogy. McAlister: Thank you. Said it's the-- said it's the thalamus, the white matter and the cortex. [ Slide start: ] Description Start: Title: Content: Description End: So in this diagram anything from the eye to the thalamus that would be considered an ocular visual impairment. Anything from the thalamus beyond would be considered CVI. And that kind of brought up a question that Sara and I had maybe for a future topic. The thalamus is directly over and in close contact with the hypothalamus, which for a student with optic nerve hypoplasia, can sometimes be involved, smaller developed, not working properly. [ Slide end: ] And that really raises a whole bunch of questions about is optic nerve hypoplasia merely an ocular nerve impairment or is it a close cousin of CVI? Kitchen: I know that there have been some students that teachers have observed that CVI strategies work with those students even though they don't have a CVI diagnosis, they have optic nerve hypoplasia as a diagnosis. So where is-- I think since ONH is the spectrum of visual impairment and additional stuff going on, maybe it's-- it would be so hard to say, but we do know that there are some things that overlap. More questions. McAlister: Yes. Kitchen: And if you guys have kids that have ONH, but respond to CVI intervention, we would love to be able to see that and just to gather, you know, more data on that or experience with that because it's a question that just keeps coming up. McAlister: Uh‑huh. [ Webinar Video end: ] Chapter 4. Additional Resources Kitchen: Okay, everybody. What did y'all think about that? I know that you didn't type into the chat, but it's probably because you were just going wow, Lynne's so smart. That's what I was doing. [ Laughter ]. But you can still type into the chat if you have any comments or questions. But let's go to-- we have another slide called additional resources. Let's go ahead and go to the link on that slide because this is a really good-- the APH website is really good to-- it's got a ton of information on it from Dr. Roman Christian-Landcy-- I haven't seen a lot from Merabet on there. That doesn't mean it's on there, but I haven't been able to go look at every single thing on there. There's some really neat stuff under the tab "What's new." [ Computer Screen start:] If we can go to that and scroll down a little bit, there's a great movie to watch. It's called-- we won't watch it right now, but it's called the CVI society, changing perceptions of vision. Molly discusses her cerebral visual impairment. Right there. And it might be a really good way like to get-- if the child with CVI explaining her own visual impairment and it might be a nice thing to play because sometimes we have kids who do not-- are not able to describe it to us. And if you keep scrolling down there's one called teach CVI literacy profile. We're not going to click on that, but it can provide you with a nice form to help guide instruction. And it offers ideas at a lot of different levels of literacy. And if you scroll down further to 65 Scotland learning spectrum, that's where you can get really a good use of environmental factors. And a little bit down further is the new book by Dr. Roman, second edition of cortical visual impairment and approach to assessment and intervention. And we're really excited that that's out. It came out in the spring. And it's-- and just wanted to point this out to you because this is not‑‑ the first edition came out through AFB and APH took over and they're also going to be putting out advanced principles for CVI, Dr. Roman's new‑new book. And that's expected some people say November as in like next month. So people say 2019 in the spring. [ Computer Screen end:] So we're hoping the earlier date is the one that we really hope that we can do. That we can get that book, want to get our hands on it. Has anybody used any of the things I've talked about so far, have experience with any of those resources? Feel free to type it into the chat. Let's also go to the assessment and strategies tab and click on Dr. Gordon Dutton. Let's go back to that website. The one we were just on. And click on assessment/strategies. [ Computer Screen start:] And then Dr. Gordon Dutton underneath assessment strategies. Actually, go back up to the link and click that and see-- there you go. Dr. Gordon button. And that-- I wondered if there's a visual skills inventories and strategies that you can download and use as a guide, and I'm wondering-- it differs from Dr. Roman's. It's kind of like a different kind of guide than the CVI assessment. And this link should be in your handout. But it's also provided in the chat. [Computer Screen end:] And Dutton's work pertains to cerebral visual impairment, which is a bigger umbrella than cortical visual impairment, but I just wondered has anybody used the-- this inventory, the visual skills inventory, and how did you feel about it when you did use it? You can type that into the chat... at any time. So the next thing that we need to do is we need to plan the rest of the year. And our Study Groups are going to be from the-- going to be going back to the regular old time slot of 3:00 to 4:00 on Mondays still. And those dates are December 10th and then February 11th, 2019. And then April 15th, 2019. So what we need to do is decide what we want to do with the rest of our time together. And we really find that we learn so much when we all look at students together and offer ideas. And the thing about this group is it's such a tight knit little small group that we really have discussions even just using the chat feature, and give each other ideas. So we would like for someone to sign up for each of the study groups, the date, and to gather a little bit of video of your student and then we can look at it together, we can look at that video and see if we can offer you any ideas, any suggestions, and then you can try some things out and hopefully those things will help you. So go ahead... [skip to end of program] Kitchen: And like I said, Lynne will be in touch with you to start planning on how to share video and if you need a media release, we can send you that and et cetera. So thank you, guys, so much. It's great to have everybody here. Let me make sure there's no more questions in the chat before we go. And I do not see any new questions, so yes, thank you so much for coming out here. It's really rainy. And yes, I can hear it on the roof and now I can't anymore, so that's good. All right. Y'all take care and enjoy our Halloween efforts. Bye. [Silence] Fade up from black. Animation: Text for TSBVI transform into braille cells for TSBVI. Fade to black.