TSBVI Coffee Hour
Collaborative Evaluations
05-10-2021

>> Kate: Good afternoon, everyone. We'll get started in just a couple of minutes. While we're waiting, if you all would go to your chat box. There's a little drop down menu. Please make that it says "all panelists and attendees." That way everybody can see your comments and questions. So, again, in the chat box there's a little drop down menu that says "all panelists and attendees." We'll get started in just one more minute. 

>> Interpreter: This is the interpreter talking. I can't see. Hopefully they'll pin me. 

>> Kate: Yes, Kate to the interpreter. You are pinned. We are in webinar mode so you won't see other cameras. 

>> Yeah, you are spotlighted so everyone sees you all the time. 

>> Kate: All right. Well, let's go ahead and get started. I'll give some announcements and I think we have some new people with us today, so that's exciting. Explain a little bit how this works. Welcome, everyone. We are excited to get to spend this time with you. If you have a question or comment during the time that our presenter is talking, please go ahead and put that in the chat box. You're going to want to make sure that the little drop down menu in the chat box says "all panelists and attendees." Your microphones and cameras are automatically muted so you don't need to worry about that. You're not going to suddenly pop on screen or anything embarrassing or anything like that. Again, you don't need to worry about microphones and cameras. The handout for today's session has been shared in the chat and we'll share it a few more times throughout this hour so that you can see that handout immediately. It will then also be available later, along with the recording of this session and all of our previous Coffee Hour sessions. You can find that at our Coffee Hour web page at tsbvi.edu/coffeehour. Once you're on that web page, scroll down under the list of sessions to where it says "visit the new TSBVI outreach Coffee Hour archive" and that's the link that will take you those recordings, handouts, transcripts, and chat information. Just a note about your CEUs or your professional development credit. You'll respond to the evaluation that will be e-mailed to you from our registration website, escWorks and you will enter the code that I will give you at the end of today's session. So, again, no opening code, just a closing code that I will give to you at the end. We will wrap up at 3:55 or five minutes to the hour to give you your code and some closing announcements. I'm really excited to introduce today's presenter. We have Marnee Loftin. I'm going to turn the time over to Marnee. 

>> Marnee: Hello. It's nice to be here with y'all. I'm still kind of mystified by technology so I don't know if you'll get to see my face or not. But it's a pleasure. I worked at TSBVI for about 28, 29 years and have been retired for the past eight. And wanted to come today to talk a little bit about this whole topic of collaborative evaluation. But before we start, I did want to point out that my e-mail address as well as my cell phone are on the front page. And if there's any time I can answer a specific question, I'm certainly glad to talk to people. Our website -- my e-mail address has a tendency to put things in spam so if I don't respond, give me a call. I'll be glad to help. So let's move on to the first slide and talk about collaborative evaluation. I hear it mentioned a lot and what I hear when I talk to people about what is collaborative evaluation, what I hear is kind of like I talk to the TVI before we get started on the evaluation and throughout this process I want y'all to really think about the fact that it is a process. We'll be talking about the fact that it is an interdisciplinary process. It goes from the beginning, when you sit down and talk with one another to the very end where you try to put the pieces together and come to some sort of consensual agreement. The nice thing about it is that the conclusions tend to be comprehensive. You don't sit in a meeting and everybody have a little bit different take on what this particular student is capable of doing. So let's go on to the next slide because what I have tried to do is talk about what are the responsibilities of a psychologist or an educational diagnostician as they do an evaluation. When you come together and start talking about these things and what is the responsibility of the TVI. What do you bring to the table at the beginning, the middle, and the end? You know, what makes you special in this process? I remember when I first started working at TSBVI, I was already a quite experienced psychologist but they told me to collaborate -- whatever the term was in those days, but I really had no clue of even the questions I was supposed to ask, much less what I expected them to give me and whether or not I could understand it. So this is an attempt to talk about the specific pieces that make it all come together. Nathan, could you change to the next slide? Okay. Psychologists and diagnosticians really have a very unique role in any evaluation that you do. And I think we all need to be respectful of the role that we play. The psychologist is going to be the person that typically has the information about the instruments that are available. A TVI is often going to come into the conversation knowing what the issues are but not knowing what instruments. So the psychologist is going to have to play the leading role in telling us what's available and in selecting the appropriate instrument. Ultimately the psychologist is going to be responsible for determining which accommodations can be made without significantly impacting the results that you're getting. So we'll talk a little bit more about this later. It sounds like a really simple thing but it's a more complex decision than we think on. The final thing that's an obvious thing that they do is they're the person that really knows what the additional eligibilities are. So they come to the table what qualifies a student for learning disabilities, for autism, any of the other eligibilities. I think sometimes the TVI is going to have to talk about what are specific behaviors that are really associated with a visual impairment but ultimately the psychologist is going to take the lead on that part. Probably the most important thing that they're going to do is to choose the instrument. So, Nathan, if we could get to the next one. You know, I long ago gave up in terms of putting together a list of instruments that were recommended for testing students with visual impairment. What I know, now that I am a person that is buying my own test to be tested is there's a constant explosion of new instruments that are available. I just came across one the other day for autism that I had never seen. I think it's really a good measure for children with autism -- autism and visual impairment. I have never heard of it before in my life. So what psychologists have to do is to build up their skill in choosing instruments. So what I did was I put together a list of instruments that I think have good predictive validity. And notice I didn't say instruments that children who are visually impaired can do well on because what we want to do is be able to sort through and have an instrument that tells us which child with a visual impairment also is gifted and which child needs some real special assistance. So it needs to be a test that sometimes the child with visual impairment does not do well on. One of the tests that was developed and was in common use when I first started was the Perkins test for the blind and another version of it for low vision. There's a great chance it had all sorts of items on it that children who had any type of visual impairment did great on. The only problem was that they all did great so we ended up with every single child that we tested being gifted. And that's not what you want. That's not good predictable validity. So what I can tell you is here are some characteristics that make for good predictive validity. Kids who are visually impaired are always going to benefit from guidance with multiple demonstrations. Simply giving verbal instructions is not the way to orient them to a test. Tests that require inferential skills rather than rote memory. Any time, with few exceptions, if you test a child who is visually impaired and give them something like the digit span where it's a series of numbers, they're always going to do very, very well on that, which inflates the other scores. Always the test that requires the least amount of accommodations is going to have the better predictive validity. If you can find it, the important part of the development of the test is that it included students with VI during the test development. I think one of the things that we're seeing more and more in test now is that some test developers are providing some specific guidelines regarding accommodations and how to administer the test. And so look for those when you're looking in the test manual. Okay. So let's go on to the next one, which talks about things that are most predictive validity. Things that have an emphasis on rote memory. Tests that have a significant emphasis on language and vocabulary. Again, children with visual impairment or blindness often have huge vocabularies and little understanding of what those words mean. So the more that you have an instrument that relies on language and vocabulary, the more your scores are going to be inflated. A test that's going to have poor predictive validity is again one of those that has no or very minimal opportunities for any type of demonstration or discussion. Sitting them down and handing them a test is certainly something to be avoided, more so than probably any other group you'll test. Use of small manipulatives is really a confusing thing. If you're giving small manipulatives like a miniature horse or a miniature truck, those are things that kids know realistically are not real items. When you get into some of the other manipulatives and you give them, for example, a toy comb, that's a little more confusing. What you don't want is to have manipulatives that are things that they're going to be confusing with real-life objects. And the final thing is overemphasis of skill unique to students with VI that we talked about on Perkins, so that you're consistently measuring things like tactile discrimination. Again, that's an important skill but it's not going to be an important skill as they go through life. It's not going to be something that they will encounter regularly. 

>> Kate: I was going to say, Marnee, we had one question come in. The inquiring minds want to know, what is the assessment that you like for children with autism and vision impairment? 

>> Marnee: Oh, I knew somebody would ask me that and I have it right here. Nathan, is there any way I can be a person on the screen? That's not me. 

>> We can all see you, Marnee. 

>> Marnee: Oh, you can see me? 

>> Yep. 

>> Marnee: Okay. The test is -- oh, shoot. I have a copy of the protocol. It's MIGDAS. It's put out by western psychological services. In fact, I sent an e-mail to the person who did the test. I don't know if we'll ever get through to her because I would be really interested in this, maybe if we could gather some data on children with visual impairment and see about developing it a little bit more. It's really got a lot of good information. Okay. So that's the only question? Let's talk about what the teachers have to do because the teachers of the visually impaired really have the most significant roles. I'm watching sign language and watching comments. I must be a little ADHD when things come in. There's a long list of things that the TVI needs. And I guess I would add one thing that I probably will say now while I'm thinking about it, if you're going to a diagnostician or a TVI and you're looking at determining whether or not there's an additional eligibility, what you need to have going into it is some data that talks about the particular condition, the interventions that you've attempted and what the result has been. Even at TSB I had a real problem with that because the teachers tended to want to say I'm a TVI and I've got X number of years experience and I just know that this is what's going on. So I think that professional judgment is always an important thing but you're going to get much better results in referring a child who's already eligible for Special Ed to an overworked diagnostician or school psychologist if you've got really good data to support what you're looking at. Okay. So I didn't even put that down because I am hoping that everyone knows it and that as we used to say in West Texas that we were beating a dead horse. But I think it's something that frequently slips through the cracks. So when you go to them, the things that I did list was having an overview of visual impairment. We're going to talk about these in a little bit more detail. References about evaluation of students with VI. There's kind of a rumor that there's not any information out there and there's really quite a bit, if you know what it is. For the TVI to give information about interpreting the clinical data. The first time I looked at one of those reports it could have been in Greek for all the sense that it made to me. Even the vision. We think that it's very clear but it really is something that a psychologist or diagnostician is not going to be familiar with. Spend a lot of time on the recommended accommodations because you're going to have to determine what can and cannot be done. And then the recommended adaptive devices. You know, that's what you need, again, to come to the table with that information or ready access to it to start the session with the psychologist . Because it is such a complicated process and there's so much work that's involved in learning these things, some of it will be unique to individuals. Some of it will be things that they're going to have to know what a field of vision is for all students that they will encounter. If you can develop a process with your school district or with your assessment staff where you're working with just a limited number of evaluation people, it will be of benefit to all of you, including the student. It's just so much easier if you go in with a basic level of knowledge. Okay, Nathan. Let's move forward and look at the individual things. I think if there's anything that you need to be talking about when you look at this kind of overview of visual impairment, what you need to be talking about is that it's not a single condition. One of my biggest shocks when I came to TSB was I knew there were students who had low vision and students that had -- that were blind. But I didn't think there was anything in between. So it's really important that the person who is going to be working with them know the difference between congenital or acquired. That's going to affect skill development so very much, as y'all all know, but it's important that they have that information. Whether it's total blindness with very little vision or low vision. And exactly what the prognosis of those things is. Whether the condition is neurological or ocular in nature. That, again, is a very important condition in terms of what you might expect in the future or additional eligibility. Can we move to the next one? When a child has a neurological etiology, they have increased risk for other conditions. You know, the optic nerve in the eye are just parts of the central nervous system so any time that you have an injury or any type of deficit in that area, it simply increases the likelihood of other problems. When we look at students with neurological conditions -- and there's actually a typo. Sorry, I did not correct. But particularly with students who are a neurological etiology, 60% to 75% of students will have another condition. Underidentified. I have not looked at the data from Texas in general for several years, but it was running at about 30% to 40%. Those were the only ones that were being identified. Surprisingly I would have thought that the most common condition would have been IV, but autism was really on the rise. There were a lot of kids that came to TSB when I was there with a diagnosis of autism and I thought that simply is not -- somebody who didn't consider the developmental variations for kids with blindness. But there can be a variety of conditions. It may be as simple as a learning disability in a specific area or it may be a child with multiple disabilities. But it's something that's important. People will always ask me and I will answer the question. Why would you want to identify a child who is eligible already for Special Ed? And the answer that I would give you is if there's something else that's going on, it's not being dealt with, it simply has a TVI working with the child. TVIs are not trained in how to deal with a learn disability in reading, it requires a specialist in that particular area to deal well with that condition. So I always hated -- it's such a difficult challenge for someone to have the child evaluated by a specialist. Okay. Let's go on. The first thing that I talked about that TVIs needed to be discussing with the person that's going to be evaluating the child is the difference in developmental patterns. I included an addendum that talks about the different patterns of development for children in multiple areas. So it's got the motor. It's got the language. It's got the social and it's got the cognitive skills. And it's important for people to know, for example, that children with a severe visual impairment are going to be [Inaudible] because there's less motivation for them to get moving in the environment. So when we see a 2-year-old who is walking, it may be highly significant in a child with normal vision and it's not that significant for a child who's visually impaired, particularly if they have not had a whole lot of early intervention. So it's important to have that information about development. Okay. Let's look at the next one. I think, again, the degree of difference that you're going to see is going to be based upon the degree of vision loss, the age at which it occurs, whether or not they had early intervention, whether there's neurological, and the opportunities for experiential learning. What you see is when kids get older and want to start venturing out is parents are very hesitant so the kids don't have any experience going into a store and making change. Don't have the experience of calling Uber and getting them to come. So it's always important to kind of do some type of clinical assessment of what are the opportunities. It sounds terribly judgmental when you talk about it, but it's, again, such an important part of growth for students. Potentially for kids in kind of the pre and early teens, it's important to see how those things happen. It's also equally important for a very young child who may have come from another country and who has not been the in-home family support that they may have required. So look at those differences and interpret with the knowledge of these multiple variables. And I can give you an example. One time there was an intern at TSB and there was a student that they were working with and doing an adaptive behavior assessment. And this child had lost vision as a result of a traumatic injury at the age of 15 and had come to learn Braille. Now, that child, there's all sorts of variables that were in place but he had all of these variances to benefit a child with vision prior to the time he lost it. So you have to be really careful not to rely on the fact that he couldn't do the washing, for example, on the fact that he did not have vision. That was a deficit that occurred, whatever, and it was truly a deficit. Okay. So on to the next one, which I think I've already talked about. In the addendum -- there's three addendums and here are the areas that are covered in specific detail. There's lots of books on it. This is just kind of what I thought was important for a TVI to share with someone who's going to be tested. Okay. The next one -- I'm trying to watch my time. I'm such a yakker. I think the TVI, one of the important things that they also do is to talk about reference materials to read -- and that's included in the handout. There's an ever-increasing amount of those that are available, as well as testing materials that are available for purchase. There's a lot of instruments that are available through American printing house for the blind, in particular, and so I would encourage you. I think all of those are available. Some of the areas have decided that those things are going to be purchased by the service center and checked out by different school districts. In the past TSB did them but did not loan them out because they're always actively using those materials, but there's some that are available, and that's ever increasing, thanks to the American printing house for the blind. All right. Nathan is keeping me on target. The next thing is the references. Remember, I said there's a lot of references that I included? One of the important ones that I'm hoping that we have time to talk about is the position paper that was developed and is posted on the American Printing House for the Blind website. This was I thought a really nice attempt. They get their three psychologists who were very experienced in testing children who were visually impaired or blind. And they developed a position paper , you know, talking about whether or not we felt it gave good information to test children with instruments that were not necessarily developed by them. And so what did you need to do to be sure that you got the best measure possible. I was one of the psychologists that was chosen and so a lot of what's in the workshop are things that are just -- but I did attach the position paper as addendum two, I believe, and what it has is it's got the ten key points. It doesn't have the narrative with those points but you'll be able to read it in its entirety if you want to. There's also a NASP article on students with VI that appears in the previous book helping children at home and at school. That's available on their website and if you can't find it, I've got a copy. There's a book from the American printing house for the blind that's entitled collaborative assessment. It's like the book that I did. It's not absolutely current. It was published probably ten years ago or maybe even more, as I get older. But a lot of the information is still the same. It has a chapter on collaborative assessment with each of the disciplines that are involved. So it's a great reference for OTs, PTs, speech and language pathologists, et cetera. And the book from Texas School for the Blind and Visually Impaired, making evaluation meaningful, which I did. It's on determining additional eligibility and we have a revision which I think is done and I think it's ready to go. I think that -- I think it's helpful. It's hard to say things about your own work but I think it's got a lot of information in it. Okay. Back up, because we're always talking about what are the things that are available that the TVI needs to be talking about. The first things that we have listed are the Woodcock-Johnson IV. I don't know if y'all are aware of this, but the Woodcock-Johnson IV is available in Braille and large-print edition. The full battery is available through APH. Well, I say the full battery. It's got the academic. It's got the oral language and it's got the cognitive test, or part of the cognitive test. I have kind of mixed emotions about that. The cognitive test, what they did was they took out all of the things that deal with memory and they don't have a lot of other items in it. So I tend to get a little bit higher scores. I would be very cautious if you decide to use it. It does have the wonderful advantage that all evaluators like of being able to plug in scores and get kind of a comprehensive summary. The other test that they have now that I enjoy is the Boehm test of basic concepts. The Boehm is kind of a readiness test. Again, it's available in Braille, large print. It's got tactile drawings, tactile graphics that make it easy to administer and to get the information on the same concept. And then there is a process -- I think they're almost done and Debra Sewell may know this better than I -- on the key math test of achievement. And that's an academic test as well. So those are things that are available through APH. The Woodcock is expensive to buy. I think it's about $1500 for the kit and you have to also have the regular print kit but it answers questions about the quality. I think I've got time. One of the things that happens is when people start making Braille copies on their own, the problem is that a lot of times the Braille transcriptions are not the best. Time after time, even at TSB we would try to do it. We would typically have a Braille reader go through and see what the errors were. So I would discourage people from doing that unless there's no other option. The other thing that's a problem about just transcribing Braille is that concepts, particularly in reading, don't occur in the same linear function. The scope and sequence is not the same in Braille as it is in print, so you may have something that's a third-grade level on the print copy and it's got to be a fifth grade, so you just end up with a pretty messy hodgepodge of data. So I would discourage you from that unless it's a really, really simple test and unless it's a really fluent Braille reader to look at it, rather than just doing it by the machine. Okay. Now, next one, please. When you look at the clinical information about visual impairment, it's important -- and I was talking to somebody from out of state, at least in Texas you have to have a clinical report. You have to have an ophthalmological or optometric report, and I hope this has not changed. There has been a lot of discussion as to whether or not those need to be current or if the one-time shot ten years ago was fine for a child that has little or no vision. I don't know what the jury has decided about that but it has to be one that is going to be reflective of the current ability of the student. And that has to be a starting point. The next thing, the next slide is the functional vision and that's where -- Nathan, the next slide, please. The functional vision's going to be your gold standard as far as evaluators looking for information. I made a rule when I was working with folks that the functional vision had to be current within three years before testing. I thought simply that was the way I got the best information. You are supposed to have functional vision before you start testing the student. It tells you what accommodations you need to make, what adaptive devices that need to be there. It's a very, very critical piece of information and it's an approved plan. Once it's in place, that tells you what needs to happen with accommodations, with adaptive devices. So you need to read that. You need to understand that. And, Nathan, let's go to the next one. Accommodations. Accommodations, by definition, are things that you do to material that do not modify the difficulty level of any task. It simply allows the students with VI to access a particular task. Accommodations have to be planned in advance and they have to be documented. They have to be recommended in either the functional vision or the clinical. So you can't get into a testing situation with a student who is not using a magnifier, for example, and suddenly decide that might be a good thing to throw at them and see if they can read. Things need to be documented. I would say that one of the things you need to also be certain of is you need to be certain that you know how to use the adaptive device. I can't tell you how many times I've gotten in with a student, no TVI around and a device I did not know how to work. Be sure you know how to work it. Be sure you know how to problem solve it. The final, the one that I talked about first is the do not modify the difficulty level of a task by using an accommodation. One of the things that will frequently come up is a child is not -- a child is changing media so they don't have a media that they're fluent in at this point in time. Their vision is not adequate to do reading and they have not learned Braille. Well, I made this mistake when I was early in the game because what I did was on the reading comprehension I decided it would be really neat to read the items to the student and check what their reading comprehension was. That's a fatal, fatal flaw. So they may be reading to the students in the classroom, that may be way that they're gaining information, but that's an accommodation you cannot make on a test. The school psychologist or diagnostician will be looking at that to see if it changes the difficulty level. The other thing that's a frequent source of discussion is whether or not they could use a calculator. We get a lot of students who may use a calculator in the room but when they're actually doing a test it's going to be an abacus or, if they have enough vision, paper and pencil. But using a calculator is going to significantly change what we're looking for so sometimes you just have to document that they did not use it -- they were not able to use their accommodation and so you had to do -- you did not administer that particular part of the test. What I will typically do is talk about the fact that they're using something else in the classroom and I'll do an informal assessment as to how well they're using it and report it within the body of the report saying, again, it was not used in calculating scores. Be sure when you're writing the report that you specify what accommodations you use. Three years down the road someone is going to be looking at it and wondering if the reason that they scored so low was because they did not have access to the accommodation. So be sure that you document it so it relieves the question in anyone's mind. One of the things that I always struggled with -- and if you test teenagers, this will come up. There are so many teenagers who have low vision and have wonderful glasses and you never see the glasses on their nose. You know, you've done everything in the world. I will do everything. I will call the mother beforehand. I will have a note sent home with the child. When I've been doing it in public schools, reminding them of a need for glasses. If they don't show up with their glasses and if the teacher indicates that that's an ongoing problem, I will go ahead and test them and make notes everywhere, number one, that they did not have their glasses and I think it probably represents a minimal assessment but it is a reasonable assessment. And the second thing I will always do is recommend a VIP or behavioral strategist to help encourage that student to use their glasses. Accommodations that you need to be sure are always in place and are appropriate are having raised line drawings, having real-life objects that you bring in for testing. Presenting things in Braille, that's an obvious accommodation, and then extension of time for completion of items using a pre-determined formula. And typically that's going to be an hour and a half. They shouldn't have unlimited time but they should have extended time. And that should be in the function vision. Okay. We talked a little bit about that already. The adaptive devices, you document them. If they don't use them, you document them. Nathan, let's go on to the next slide, which is the final report. The final report. As you can tell it's going to take you longer to test a child with visual impairment. I always estimate it's going to take at least twice as long a period of time. And so I think administrative staff need to be aware of that when they're looking at case loads and I think there's tremendous, tremendous emphasis right now on getting reports done, getting everything moving along. But I think you need to really talk to them about how much longer it does take. It takes longer to write the report. You need to really document your consultation. The modifications and the environment. You're going to have to change lighting, you're going to have to change objects in the room because of the flutter factor with many children. You're going to have to document the different accommodations and modifications. Observation is key when you're testing a child with a visual impairment. Because you're not going to have as strong a rapport, the data is going to have less -- I hate to say the word "valid" but it certainly is not the way it would be if you were testing a middle class child who had been raised in the typical Anglo environment. Those are the kids the tests were designed for. There's always going to be some cautions that you need to put in and you really can improve it by having observations. If the child or student has refused to use any of their devices or accommodations, I have seen children over the years that insisted that they could read regular print while they're clearly struggling and need the large print. But you document those things and probably cast significant questions about the results. You need to be really cautious in interpretation of the results. If you ask people who work solely in the field of visual impairment, what you'll typically get is that we believe that most of the tests will underestimate the abilities of a student, you know, that they're probably capable of a higher level of performance if the test were a little bit different so you need to advise caution in interpretation. I think an example of this would be if you're looking at intellectual disabilities and you've got a student right on the borderline, I would certainly give them the benefit of the doubt. You know, I would wait on pushing that ID eligibility until they're a little older, until it becomes the crucial years of the developmental period, but I would not rush to add it when they're 7 or 8. That's probably the most common call that I get when people are talking about that. So be cautious in interpretation of results. You need to make a final statement using your professional judgment. All things considered, everything that you've done, the changes that you've had to make, what do you think? What do you think about the validity? Would you go to court and stand by the results that you did or do you have some doubt and want to circle back around next year, possibly and re-test the child. Hopefully you've made enough changes, you've talked to enough people that you have a rapport, that you feel is a good picture of that child but it needs to be something that you feel is a good solid estimate of ability. Okay. I think one of the cautionary statements that I always recommend that you put in -- feel free to copy it if you like. It's just what I always do. I always say that it is going to be an estimate without the validity and reliability of an instrument administered as specified. It's an estimate but we do feel as though it's an estimate that's consistent with other data and observation. You know, if you've got a child and one of the examples would be if something came up the other day and I got a call. They were looking at a student in high school that across the board was on grade level. You know, she was a Braille student but she was doing beautifully in every single course. Straight As in every single course and her math scores were about second-grade level. And so everybody was refusing to do anything about a learns disability because she was blind and they didn't feel like that would be appropriate. And that's about as clear as example as a learning disability as you get. So you have to look at all the data and feel as though it's consistent with your observations and other things that you did. And, again, not refusing to test them just because they're eligible for Special Ed. So, I would love to go through the position paper. I think we've got time. Kate, do we have time or are there enough questions that I need to just refer them to the addendums? 

>> Kate: No, I think we've got some time. We've got about 12 minutes left of presentation time and just some comments have come in about really enjoying making evaluation meaningful. Some people have called it their Bible. 

>> Marnee: Oh, that's nice. 

>> Kate: And one question about resources, but we just directed them to the handout. 

>> Marnee: Okay. Terrific. That will be amazing if I leave [Indiscernible]. So the first one talks about the developmental differences between -- I'm prone to try to click it myself. Nathan, can you switch to the developmental differences real quick? You've got the motor development. And I'm going to point out the ones that I think are really critical. Self-stimulatory behavior. I think we're seeing a decrease in self-stimulatory behavior but for a child who's totally blind it's not at all unusual for self-stimulatory behavior to be occurring as part of the motor development. So it's not necessarily a sign of autism. You know, I don't even know that it's high risk. You know, there's other variables that are but that's kind of a glitch in the motor development that as they get a little bit older it is better. Okay. So let's go on to the next one. Social development. I think the one that I always try to point out -- because I think it's often mistaken for Aspergers is the fact that particularly as they move through pre-teens and early teens what you'll see is a real egocentric approach. They're often pretty self-centered, a lot of overidentification of adults. So, again, before leading to an Aspergers, difficulty in maintaining peer relationships, peer culture. Before leaping to an Aspergers or high-functioning adult, whatever your district is allowing, I would be certain that I worked behaviorally on some of these issues. I guess the next one language development. Again, these are things that often mimic autism, which may ultimately be that. But a young visually impaired child, particularly with little or no vision, is going to have a lot of echolalic speech, a lot of tangential or egocentric conversations about strange things. There was a speech therapist that worked at TSB for a number of years and what we decided working together was one-third of the students, you know, just need to magically move through that stage and move on to more meaningful language. One-third really needed a lot of services from the speech therapist. And one-third of them did progress into some type of autism. It may be a significant factor but I would say at least until the age of 9 don't be alarmed. Just continue to work with the speech therapist. And I think that's something to share with parents sometimes too. Okay, Nathan, I guess the cognitive development. There's a whole thing that appears -- I think on paths to literacy about the cognitive development and abstract thinking. It's really difficult for kids who are visually impaired to move on to the cognitive process in the information. You'll see it in their reading as questions become more inferential. You'll see it in the different intelligence tests as you're asking them to problem solve. They had a real difficulty in focusing on multiple elements, many of them, so that's an important thing. If you see it in the testing, discuss it with the teacher in terms of coming up with some strategies. Okay. Now I think we're on the last -- the position paper, which they continue to move around on the APH site, but I promise it's there. When I put the handout together, that was the case. I think one of the things that I wanted to stress was the three psychologists who were on the panel all wholeheartedly agreed that when appropriate practices are followed, cognitive testing of children with VI provides good information. We didn't think that the baby should be thrown out with the bath water. We felt as though it was important for people to know what they were doing and be cognizant of the differences and how you could or could not accommodate. But it provided useful information. So we came up -- and, like I say, most of the things are covered in what we just talked about but I want to just highlight it quickly as we finish up. Let's see, Nathan, if you can help me. Go to the next one. So, again, made a statement about the overall. And I guess one of the things that I should point out when you looked at this is it's not referenced in both the Woodcock-Johnson information and the information in terms of looking for information about testing students with visual impairment. And I couldn't tell you exactly where the reference is but it's there and I need to look it up, so I can. We did say that administrators need training but you can't really come out of a school site program and know. You know, the little bit that you get on children with -- I can't even remember what the title of it was, it's been so long. But Special Ed testing is essentially what it was and it doesn't really give you what you need, so you need some way to get that additional information. And y'all have done a part of it today. Need to be very specific about what the reason is for the evaluation. The initial NBT as to what they need to do. The TVI, the classroom teacher, the family, and if possible the individual need to be involved during the planning and the evaluation and during the report writing. It's not something that you do at a desk and then just present to everyone. There needs to be some consultation. Okay. Evaluators need to be aware of the medical history, developmental history as well as the implications of the eye condition. Probably the most common eye condition that we think about is cortical visual impairment. If you take a child who has a cortical visual impairment and put him in our standard testing environment, which is whatever a spare space someone has, they're very distracted by all of the things that are on the wall. It's going to be important that you know those specific implications so you can plan what you're going to do. The next one, the accommodations. Even I read this and I get confused. But what it says in a nutshell is that you need to have accommodations that do not change the concept of the difficulty level of the test. That you need to think about it and plan it in advance. It doesn't need to be done on the fly and it needs to be done in collaboration with the teacher or rehab professional. And, again, that sounds so easy. That probably was the thing that was most difficult for me because when I said notes in accommodation, it was never pleasant. It got to be easier but it's a tricky thing sometimes. So I guess on to seven. I think we covered that. The importance of how do you present graphic information and the TVI will be able to help you with how best to do that. Talked about the importance of evaluation include observation in multiple situations. As with any child, it should be in the lunchroom, not in the classroom. Okay. When you do decide to use things that are visual and spatial -- and sometimes an experienced evaluator will do that. They will administer performance subtests, just to see. But it should be used only for clinical purposes, regardless of how well a child sees, it should never be used -- anything that's a visual and spatial should not be used to calculate a score. And the final one talks about what we talked about earlier. Needs to include the procedures, any changes in standardized administration, and description of the performance. So that's a very short summary of a very long position paper. Cautionary statements is something that should be included. And I think that's spread throughout. And then the reference and testing materials. Those are the same things that I talked about earlier and hopefully those are the right -- I did not know what happened to the print on this one, and my sincere apologies. It is the tiniest print known. What it does is it talks about the materials that are available through APH and it has the cost for the Braille and for the large print. And then there's another one that I did not mention at the time is the scales for independent behavior, short form for visually impaired that's available through Riverside Publishing. I would never use that as my sole measure of adaptive behavior but it's a good thing to help parents understand what skills need to kind of come next. It's almost like a sequence. Oh, so we have three minutes? 

>> Kate: Actually, we are just about out of time. 

>> Marnee: I am so sorry! 

>> Kate: No, that's okay. We've got time for a couple of questions that have come in. One just -- Ashley was wondering are there any current lists that you are aware of that have like font sizes across various tests? So if someone is trying to find a test battery that might already be accessible. Do you know of any lists that list that out? 

>> Marnee: I do not. Debra Sewell, I would guess would be a good source on that. 

>> Kate: And then Marcia is wondering about helpful information on students with dual sensory loss or students who are Deafblind. That's a lot of on the presentation, huh? 

>> Marnee: Yeah, that's almost a separate workshop. If you want to call, we can talk about that. 

>> Kate: Perfect. 

>> Marnee: Or e-mail. 

>> Kate: I did want to say too, so we've updated the link in the handout. There was a link that didn't work, Marnee, the APH position paper link, but we've updated it in the handout. So you may just need to refresh. I'll also put it in the chat again so you can grab it from there. 

>> Marnee: Wonderful. They move that thing about every six months, so I apologize. 

>> Kate: Yeah, for sure. Okay. Well, let me go ahead and give the closing code and some closing announcements. But first of all, just big thanks again to Marnee for doing this. You know, this is one of the areas that we get the most questions on throughout the school year and so just to have some of these basics of evaluation. Keep this handout as these resources will be invaluable to you if you or your school site or parents or whatever, family members, if you are in that evaluation and assessment stage for these students. And, Marnee, we're just going to have to bring you back next year to do a part two. 

>> Marnee: Well, I'm sorry I went over the time limit. It's my worst flaw. 

>> Kate: Oh, my gosh. You're just fine. All right. Just by way of information, this Thursday, May 13, we have a special two-hour session as part of our collaboration with western regional early intervention conference and this session is titled early intervention face to face and virtual with Karen Borg, yes, there's a relation there, and Julie Maner. That will start at 11:00 a.m. central time. So an hour earlier than we usually start on Thursday. On May 17 we have genetic testing and emerging gene therapies for people with inherited retinal diseases, and that's with the foundation sighting blindness. On May 20 we have Christine Roman CVI Q&A. That's a special session as well and you're not going to want to miss. You can sign up for information for all of our upcoming sessions at tsbvi.edu/coffeehour. Again, to obtain your professional development credit or your CEUs, respond to the evaluation that will be e-mailed to you in a few hours and you're going to want to put that code in and that CEU certificate will automatically generate upon completion of that evaluation. You can find, again, the handouts and recordings of this session on our Coffee Hour archive page you can get through to that Coffee Hour website. Please just on the evaluation, a couple of notes. If you in the comment boxes will let us know what you would like to see next year in terms of some topics, what times work for you, et cetera, et cetera. We'd love to hear from you so that we can plan these out to meet your needs. So thank you, everybody. Thank you again to Marnee. Thank you to our captioner and to our interpreter. We appreciate everybody helping to make these possible. We'll see you on Thursday. [ End of webinar ]