TRANSCRIPT - CVI

>>Donna: Okay. Hello everyone and welcome to Tea Time, Tech T time. I'm Donna, one of your hosts and today we have Lynn Mcallister, Carrie Fage and Sarah Kitchens. Their kitchen. Sorry, accidentally put the S on there. They are going to talk to us today about CVI and we are excited to have them if you, haven't already noticed, we're in a little bit different of a format than usual. We're still on our zoom, but we are in a webinar format. So our chat and Q&A are open for you to submit questions. And I'm going to hand this over to Lynn.

>>Lynne: Hello everyone. We offered to do this training for Donna because we just assessed a very, very interesting young lady. And so we had all this stuff and we had some really. Fun and interesting ideas when we're doing it so we'd love to share that with you. Okay. And. Can I not advance my slide? Okay. So what is CBI? So cerebral visual impairment, also called cortical visual impairment, a disorder caused by damage to the parts of the brain that process vision. And our parts of the brain that transmit the information which would be the white matter. And so it's not, it can be coexisting with a ocular visual impairment, but, it, sometimes it is not. So just functionally, we as teachers, your student may or may not have a diagnosis of CBI, but you know, functionally we can kind of get a good idea if they do or do not. By these 3 elements. So the I report does not match visual functioning. So if I report might say, oh, they have. You know, 2025 in the clinic, you know, they see really, really well. And then you see this kid in the cafeteria and you know, they absolutely act like they're totally blind. So often those 2, Those 2 are, do not match each other. Red flags is a metal medical history. So this would be when you're, you have a new kid or you want to research your student, you go back and look at the medical reports. And these are some things such as Droke, it could be hypoglycemia, could be Down syndrome. It could be, PVL, Perry ventricular, it could be any kind of insult to the brain or anything that prevents oxygen to the brain for any amount of time or and or like hypoglycemia like food for the brain. The third element of kind of a functional diagnosis of CBI is the presence of CBI characteristics. And so, Dr. Roman has identified 10 of these. And so during your assessment, you're going to want to look at all 10 of these. Us you know not usually in isolation a lot of times we're gonna combine several of these together and then depending on kind of like what phase you think they're in, It's gonna change the way you assess these 10 elements. Okay, so how do you know the student displays these characteristics? Well, the first step would be to get this book. And in the book, the entire book is written about the assessment that Dr. Roman invented. And you know, we found it's it's really difficult just to read the book and and know how to do the assessment. So we're gonna talk about later on some some options. For you guys if You struggle with that. If you got the book and you read the book and you still have no idea how to do this assessment. You are not alone. So just know that. Sarah, Kitchen and I recently did a coffee hour that's probably recorded in our archived about the each step in the process. Assessing using the CVI range. So I didn't want to go into all of those steps. For this. Presentation, but if you're interested in it, go back and it's a free viewing to watch that coffee hours. 50 min or so. And so the process is, first of all, the parent interview. And then observation of the student. Direct assessment of the student. You score rating 2. And you get a number. And then you score rating one and you get a number and those 2 numbers are the CVI range. For your student. That range will put them in a particular CVI phase. And then you want to look at the learning media. And you wanna look at intervention for that student. So because we're just talking about the direct assessment today, in that in the book, there are There is support for how to do a direct assessment. There's a procedure guide where Dr. Roman gives you ideas for doing the direct assessment and I believe she goes through different phases. Perhaps I'm not quite sure, but she does give you ideas. And then yes, she goes through the characteristics and she has assessment ideas for each one of those. And then she also has suggestions. For an assessment kit. So along with what we're going to talk about today, I would urge you guys to get familiar with these these support. Forms that are in the book. And guys, if you have any questions about anything, just feel free to put it a chat. I see there's some things in the chat right now, but I can't see what they are. So.

>>Sara: I just added a link that is to that, that it's good. It's like a coffee hour, the CVI range. There's another one on it too, but when I did a search for CBI range in coffee hour, this is what came up and the first thing that came up was our our training on the how to do the CBI range from last year. Right, around this time, February, end of February, 2023. So you can click on that link and, and find that and watch that if, if you'd like to.

>>Lynne: Awesome. Thank you. Okay, so what do you need to do a direct assessment? The first thing you need is a space. Right? So you need an area, a room, or an area that has, you know, some room to move around in if the student is mobile. And you need to be able to control the environment. At different times during the assessment because you you know the assessment itself will ask you about the visual functioning in controlled environments and in typical environment. So you're gonna want a room that you can you can do both of those things in. And so controlled means quiet. It means the lights can be dimmed. And it means it's not. Super, super clutter. So the second thing you need is stuff. So you need objects that you are going to use during the assessment. Process so you can understand what helps this student see better. The questions in the assessment are going to ask you about single colored and multicolored. They're gonna ask you about movement, things that move. And things that have elements of movement such as things that are shiny. And it's and ask you about light and so things that are lighted. And also things that you shine a light on. They're gonna ask you about familiar items and novel items. So these are things that you're gonna have to bring to the table.

>>Sara: I think a lot of times, when you, when, the parent is being interviewed or when the parent can or it could be a different conversation.

>>Lynne: And

>>Sara: You can find out from the parents or the teachers, the classroom teachers, what is, a favorite familiar items to look at for the child and and then you can bring things that are like those things and things that are different from those things. So the, and you can also ask them to bring those familiar items because sometimes it has to be the item for the child to look at it. Not just not just kind of a familiar or like the familiar item, but, the actual familiar. Right.

>>Donna: And then I love how you grouped all this stuff. Together because You know, we're tech T time and we're talking about tech and If we look at our definition of assistive technology, it can be any object that we've adapted to increase the functionality of that student or that person.

>>Lynne: You're going? Go ahead.

>>Donna: So it could be a piece of felt or a piece of background paper that increases contrast and it all is considered their tech whether it's that low tech or a high tech iPad. It is still their tech. And I love how you grouped all of this together for our assessment needs.

>>Lynne: You're going to watch it. Thank you, Donna, and this is depending on your student. You're going to want to experiment with 3D and 2D. Images. So if you have a student that you know is like In phase one. Those emphasis wouldn't really be on the 2D because you have a pretty good suspicion that they're not gonna be able to recognize that but try it anyway because one thing we found when doing assessments is that these kids have amazing splinter skills. And you know, sometimes you'll have a kid that can recognize something that never in a million years would you think they could? And so you have to assess that. You know, that's really important. And so like in the in the evaluation, the assessment we just did. We had the girl was very interested in baby dolls and so a lot of these images revolved around different images of baby dolls. You're gonna want very complex and non complex objects. And we'll talk about like very complex and what does that mean? And high tech and low tech. So the third thing you need to do an assessment is a plan. So, you know, you don't just come in, you don't, you don't walk into the direct assessment with like no knowledge of what you want to assess. You should have been put put the information from the parent interview and kind of penciled it in on the CVI range. And also the information you got from watching the observation. Videos. So you're already going to have 3 quarters of the information that you need to do this assessment before you ever do this part. And so. You know, you should be walking in to an assessment with a really, really good idea of the things that you don't know about yet that you're going to test. So typically when we do an assessment, we won't. We'd like to have the scoring guide printed. Because for every single statement on the CVI range, there's several I guess how would you say it, Sarah? So, you know, for if it says a statement on the CVI range, the scoring guide is going to give you 4 choices. All of what that looks like. And that would be a resolve choice, a plus choice plus minus choice or minus choice. And so you need to have the scoring guide handy so you can look at those different choices and test those so you know which one of them. It's gonna, it falls into best, best describes the students vision. You may want to think about not just, oh, Sarah, sorry.

>>Sara: I also. Oh, I was gonna say there's there are 2 guides for scoring and the other one is in the directions on the very first page of the CBI range at the bottom of the page.

>>Lynne: We're going to say.

>>Sara: Sometimes that works better for people than the scoring. Guide because sometimes the scoring guide, the descriptions are so similar that it's very hard to tease out what, you know, whether it's a plus minus or a plus or you know what and so I think the sometimes the The other way works best where you just choose what, you know, what best describes the student. You know, and what does not describe the student that's a minus, you know, so, so you can also do it that way and sometimes that works really well for people as well. So it's kind of nice to have that as backup just if you don't know this if you look at the scoring and you're like. I don't know what this one means and it so it could describe the student but I might be wrong so I'm gonna go back to the to the other directions and see what we all our team who's doing this thing.

>>Lynne: That's a good point. Thank you. So video is big. We really strongly urge you guys to video the observation and video the direct assessment because there is no way in real time are you gonna catch all the very subtle visual differences as you go through this process, you're just you're just not going to be able even if you have someone dedicated to doing that they're gonna miss so so much. So we video all the time. And we often go back and watch videos multiple times. To say, look, right there, right there, right there, you know, right there she turned her head. You know, right there her her eyes closed or whatever and so

>>Sara: Or exactly how long was that latency period this time? Let's time. You know, you, you can't do that so well in real life, but you can definitely go do it if you can go back and look and it's it's a great way to time travel.

>>Lynne: Yes. Yes. And so, you know, having a test or a video taker and someone doing, you know, having the scoring guides handy.

>>Sara: Of high tech.

>>Lynne: Really just goes back to the fact that this is a difficult assessment and the more people you have doing it together the better information you're going to end up with.

>>Carrie: Yeah, and one little tip with the video, cause I did it last time is in when told me when we were assessing this girl or helping assess is to do segments. So don't like just record for the full like hour that you're maybe doing the assessment, but kind of break it up. So that you're not having to, watch the entire video, you know, as you go through it.

>>Lynne: Thank you, Kerry. Okay, so you're gonna need before the student ever steps foot in the room, you're gonna have to set it up. So for phase one and 2, you might wanna control the environment right from the get go. And then later on in the assessment process, you know, turn the lights back on. Have a conversation and make it more of a typical environment. For phase 2 and 3, what we do and we found really interesting. Is to arrange novel objects. It very varying distances around the room. So this is an example. Of some stuff that we took for this assessment. So there she was interested in baby dolls and so we had A baby doll here and then we had another kind of doll with with a mustache, you know, that she probably hadn't seen before. I happen to have a Marionette, which she had never seen before. We have these Russian nesting dials. And then things like this, HOME in cube. So this is a ball, like it's real small and you can open it. So we just kind of randomly put these around the room and what you're looking for for this is, you know, does she. It's novelty. So does she have a visual curiosity? Does she walk up to these things? You know, does she notice them at all? How long does it take her to notice them and how far away are they? Before she notices them so when she walked in this classroom this ball was relatively by the door and she saw it right away. This baby doll was maybe. 4 feet further away from her and it took her a while before she could see the baby doll. You know, so you're gonna get a lot of information just right out the door by what they pay attention to.

>>Sara: And I think she said a cousin of hers had the ball so it might we might have thought that it was novel but maybe it wasn't novel.

>>Lynne: Right.

>>Sara: And that might be why she saw it more quickly than the big dough.

>>Lynne: Okay, Kerry, go ahead.

>>Carrie: Okay, so yeah. So let's talk about the 10 CBI characteristics and you know some suggestions on when you're doing the assessment. So one of the things that you can have is a light box, with different overlays. And then when you want to click on the.

>>Lynne: Yes.

>>Carrie: So did you all make this, we make this ourselves, right? It's kind of a handmade thing. You can't buy this. Beat

>>Lynne: We're right. No, this is Diane. She lines website strategy to see and what it is is a paint stick stirrer. You can get them for free at Home Depot and then you just hot glue Mardi Gras lights on there. This one we have a single color. You're gonna see this theme pop up. Single color, the red, and then we have a multi-color version. And then you just put a Velcro on the lightbox and on the the wood is stick and you can stick it on there. So this is light. This is movement because the beads are shiny and they also move if the kids touch them. Lot of good information. We had a student, we were assessing a student who, who could look and act on this red curtain. But as soon as we switched out to the multicolor, he got up and took off. Couldn't wait way too much for him.

>>Carrie: And then the spotlight. So,

>>Lynne: Oh, hang on, care. Let me show the images. Here. It was 2 separate.

>>Carrie: Oh, sorry.

>>Lynne: Yeah, it was 2 separate ones. Okay, so this is a screenshot of Diane Sheiline testing a student. Now she has a great idea here. Deep printed so this kid like Spongebob score pants. So what she did is she printed an image of Spongebob on a transparency. And so then she could make it to where she could put it on the light box and it would have those light properties behind it. So I thought that was a great idea if you guys wanna, you know, transparency. They still sell those obviously.

>>Sara: And the thing is that this child would always attend to Sponge Bob on an iPad. And so it was hard to tease out whether he was really looking at Sponge Bob, you know, the color of Sponge Bob or was it the movement and light that was getting and so this one did not move. This is a non moving sponge, Bob. So, and he did indeed look at it. So the like qualities wasn't and was the light quality of this and the colors perhaps. Depending on what he did with other lighted objects on the, on the lightbox. Really we're telling a lot about his vision.

>>Carrie: And so then, and then a spotlight, so maybe the spotlight or like a little flashlight might help the child see the item better. I'm example was we had little animals. That we were trying to see if the little girl could recognize what they were and there was a draft and it she really didn't know that it was a giraffe but as soon as Lin shined the light on it with a little flashlight, then she realized that it was a draft. So. I don't know, Lynn, do you want to talk anymore about that?

>>Lynne: I think we're, yeah, I have those animals in here so we could talk a little bit.

>>Carrie: And then, backlit tech, with CBI apps such as the Big Bang pictures. That's an old one, but it works really good still. Kind of has the Florescent pictures, background.

>>Lynne: You live in Texas and you don't know this, you're probably overpaying for car insurance. Sorry about the YouTube ad. Okay.

>>Carrie: Yeah, so it has the, the black background and then different pictures. Of different colors.

>>Lynne: Okay.

>>Carrie: And then there's also audio. That can support it if you want it on. You don't have to have the audio on and it moves to they move.

>>Lynne: Hmm. Yes, so when we did this one, she started waving. She started waving at it, but she didn't really notice what it was before it started moving. Okay.

>>Carrie: And then, yeah, I'll also get for comparing speeds with backlit versus print. And then of course different light colors. Colored like different colored lights. Okay, and, the next, characteristic is need for movement. So shiny things like the, paper, maybe right after Christmas, you might find wrapping paper that's different shiny colors. Christmas ornaments, metal things. Space blankets. Those aren't very expensive, I don't think. But they're that shiny and move and

>>Lynne: Oh, this is a little video. Yeah. And I think you can get these space blankets online and get them in different colors. So you can get yellow ones and red ones. Yeah, they're like a a mega movement.

>>Carrie: And then apps that move, I guess different. You can have different pictures that move in or different items that move or have some sort of movement to them. Maybe like the old slideshow presentations where you would have them. Zoom in or moving. And then mirror, you wanna talk about mirror a little bit more, probably.

>>Lynne: Yeah, so we use a mirror one of the questions is that do they regard themselves the mirror we just use this one where is it Sarah out of the sensory learning kit. Yes. And so it's unbreakable, you know, it's not glass, so.

>>Sara: Yeah, yes.

>>Lynne: I just wanted to show you that one.

>>Carrie: And then the beat curtains that we already talked about and then a slinky. You could have put the little light on the bottom and have it like on and then move this link. So you've got the movement and the light going on at the same time.

>>Sara: And we got that idea of the tap light with Slinky Junior. They fit perfectly together from strategy to see. So if you ever want to go and look up a DIY on making some of these things like the be like the beat curtain on the lightbox or the slinky or CVI den, you can go to strategy to see.

>>Lynne: Okay.

>>Sara: Dot com. I'll put that in the chat too.

>>Lynne: Yes. Okay, and then.

>>Donna: And I love strategy to see it is like one of my favorite places to go and dig around and make things because I love to make things and there's some really great ideas on that site.

>>Lynne: And then putting a little finger light inside of balloons is something else that you could do.

>>Carrie: So the next characteristic is color preference. So testing out to see if they have a certain color. That they, gravitate to, single color or multicolored objects, kind of like the red beads that Lyn was talking about or the ones that had the multi colors. Color overlays. Is that an example of it right there that little is that a little outline?

>>Lynne: No, this is this is an example of like frames. So,

>>Carrie: Oh, that's different. Yeah. And then backlit screens, color pins. So. And is this also where you talk about black and white as well or no? Just color.

>>Lynne: Yeah, you know, testing with black and white is a really good idea. There's just there's There's less. Radiation I guess differences in black and white with just the gray. So we have had students that, you know, really had trouble. Cause could look at colored images and tell you what they are, but had a lot of trouble with black and white images.

>>Sara: And it also depends on, you know, if you're thinking if the child has an ocular condition as well, so then you're adapting for both and some and in that case you might need a lot higher contrast for the child as well.

>>Carrie: And then difficulty with, visual novelty, is the another, I think it's one in the fourth characteristic.

>>Donna: Good.

>>Carrie: And so again, like Lynn mentioned at the beginning, have the novel objects in the room at setup. To see if there's curiosity or if they see them she did like baby dolls and she did the one girl we tested did not see the baby doll at first, but when she did see the baby, she was extremely interested in it. So it just didn't catch your eye because some of the novel things actually might have caught her eye first, who knows. And then real images of familiar items, playground and images of similar but similar. Did you want to explain that a little bit more? What you mean by that? Like, background.

>>Lynne: Well, if she can, you know, if she can look at the playground and say that's my playground maybe you know does she know that other playgrounds are playgrounds as well? You know, I think I've shown kids picture, you just picture images of all sorts of stuff like she knows her backpack. But if you show her a picture of a different backpack, does she know that's a backpack? So it's kind of getting into like, you know, Sure, really familiar stuff she's very familiar with. She knows what it is, but has she generalized the visual characteristics? Of that of that. Death.

>>Sara: The salient features.

>>Lynne: The salient features, yes. Thank you.

>>Donna: The backpackness since I can never remember salient features.

>>Lynne: The backpackness of a backpack, yeah. Right. So it's like, you know, even with some kids, like, you know, show them a picture of their cup. There's a lot of different kinds of cups and so does she generalized, you know, that concept. Which is it, you know, you need to know it. So

>>Carrie: And I think Len's gonna go into the 4 components of visual complexity. Sorry, go in.

>>Lynne: Yes, and so this is environment array object and the human face. And so the environment. And so this is where like even if you have the room whether you have the room controlled or not. You're gonna have to insert some complexity. During the assessment. So for this girl, we had the lights on the whole time. She didn't all the an extra light helped her like when I shine the light on that little giraffe animal the lights of the room were on. You just say that little extra. Focus of the extra light on the on the animal.

>>Sara: Oh, and it highlights the animal and it decreases the background. So it actually reduces complexity. To just enough of a degree that she could see it.

>>Lynne: But she could see it. Right. And so here it's just like carrying I started to conversation right next to where she was trying to write her name on using magnets. Sometimes I'll turn the music out on my phone. You know, you just want to make the environment as typical as possible. You know, not hugely complex like not the cafeteria. But just like a typical classroom. And then see if there's any differences. And this is another thing that you're probably not gonna be able to see in person, right? This is seen by watching video. Like, is there a subtle change? Does do her eyes move away when that extra noise starts? And then standing versus sitting. So sometimes kids. Are doing they it takes a lot of their brain power to keep their body in in a standing position. Especially if they have motor impairments and so, you know, complexity of the environment is not only of the outer environment, it's also the environment within them. So if they're exerting a lot of effort to stand up or to use like their right hand or their left hand or use both hands together. It's gonna probably decrease their visual functioning, which is important for you to know because you know whatever increases it or decreases it that needs to be in your report.

>>Sara: Yeah, and some kids are, dealing with in complexity of their internal environment as well. And, sometimes kids who like to stand and like to walk are going to be calmed by that. And then, the, and then also the movement of their own body. It helps them to locate targets and know where they are in space. And that helps them to feel more calm. So if a person isn't calm, then it's harder for them to see. And that's another. Environmental thing that we have to think about. So sometimes there's a good reason for a kid to stand while they're doing their, vision tasks and sometimes there's a good reason for them to sit.

>>Lynne: Oops. Okay, so the next element of visual complexity is array. And so. This actually is from Dr. Roman is to give animal figures to the student. And say, okay, I want you to sort these. Or in the case of like our student, she didn't know its sort meant. And so it was like put the ones together that belonged together. And so what what you're looking for here and here's with some other things. What are they, what are salient features are they paying attention to? Do they group them by size? Do they group them by color? Do they group them by spots? If they group them by spots, are the stripes included or not included? There's all sorts of stuff information you can get from doing this, but the student has to have some idea of what sort or prep them maybe a couple days before to like put things together that belong together just so they kind of know what you're talking about. I have to, I have to tell you guys what we're, when we were, That's a little girl. She picked up this camel here. And we're like, oh, do you know what that is? And she said, it's the donkey of the hot. Which will live forever. I'm gonna tell that story for the rest of my life.

>>Carrie: Very cute.

>>Lynne: It was the cutest thing ever. The Donkey of the Hut.

>>Sara: Okay.

>>Lynne: Another thing.

>>Donna: Good, that is a very complex association. That is awesome.

>>Lynne: I know, right? Yeah.

>>Sara: But she didn't know. She knew it. She just didn't know what it was called.

>>Donna: Yeah.

>>Lynne: Hey, So another thing that we typically do is we look for, We put objects or colored cereal or like skittles on fabric of varying complexity. And so that looks like this. So this is just a page. Tray, like it's a choice tray. And it's a tray. And then these are just cardboard covered in fabric and they go in the tray for storage. And so Sarah has over the years collected little strange objects that she finds when she walks. And so we had just have a bunch of little things. You can probably go to a thrift store too and just get little weird little things. So there's a thimble, there's a little bell, this is like a little Lego man. This is a frog. Anyway, so we put different things on these backgrounds and we might tell the kids there's candy. You know, on here or or, you know, find, tell us what you see. And so this tells us a lot. This girl we just tested couldn't find any of the objects on this very complex. Background but she did point out an image of a unicorn I think it's right here and she said that's a unicorn.

>>Carrie: Yeah, there's one up at the top too. Yeah.

>>Lynne: Yeah. But she couldn't find any of the objects on top of it. And so that was that was a that's a splinter skill right there. If an image is that highly motivating to her and she loves unicorns, and you know it's it helps with her with the complexity.

>>Sara: She is a unicorn.

>>Lynne: She's the unicorn. Do you all have any questions about anything so far? Or hey your own ideas? So if you have your own ideas about how you assess. Complexity of array, let us know, put it in the chat.

>>Sara: Or any of these things.

>>Lynne: Yeah, any of them. Oh, so array goes on. I wanted to show you this. I think it's a screenshot. I don't think I put the video. Okay, so we were assessing this young man. And. I don't know if you can see, but over here right in front of this book. His bottle. And that was his one of his most favorite. Objects that he would grab. He, he could. So, he would have visually got it reached pretty much only for his bottle and his spoon. But in this very complex situation here. He also had motor problems and you know, she his teachers helping him sit up, but he's still not super supported. He could not see his bottle at all. Whereas typically a fat book wasn't behind it, he would just reach out and grab it. And then you're gonna wanna use 2D images of various complexity. For this young lady, we use some books. Okay. And so here. You know, we could share this picture of this book. Can you find tell us what you see and then We turn the page of this book. And then this is a the cluder. Right, so probably very much easier to see the image. Although the images are not real life photographs, so that's their extra level of complexity. I had I found this this might be something interesting too if you have a student that's really in to animals. So this is just camouflage animals. And can they can they see it like this is really hard. Okay, then the complexity of the object itself. So this is in the assessment one of the questions is can the student look? An object that produces music. And I don't think she's limiting to music. I think it's just sound. So this is where the Big Bang picture can show you a lot of things, right? It's showing movement, it's showing backlit, light, and it's showing this. Complexity of the object because it also produces noise. Anything that's going to be multicolored is going to be more complex than a single color or pattern.

>>Sara: You remember, Lynn, there was a student that we assessed a long time ago who likes to play with the she had a little toy accordion that she liked to play with and one of the things that she would look at more often was vertical stripes and she was trying sometimes kids do this that they try to work on their vision themselves and just you know the object that produces noise I remember her playing that accordion and it would make noise and

>>Lynne: Yeah. Huh.

>>Sara: she kept trying to look at it and she would, trip, you know, as she played it and she could only look for a second. So it was like she was trying to look and listen at the same time and she kept practicing it. We didn't tell her to do it, she just wanted to do that. So sometimes you see kids. Doing the things that they need to work on during. That was a very interesting thing about her and I've seen other kids do that kind of thing too.

>>Lynne: Right, especially if it's so highly motivating, like I think are that young man who likes Spongebob could look. Added even when the sound was on, which you wouldn't ever think he would be able to do that just because of, you know, all of his, he was a complex kid. With a lot going on. So here's some images that we used, with the young lady. We just. Tested. So she like babies. So these are real photographs, but they're somewhat complex, you know, she kind of almost didn't even recognize this, correct? Kerry, she didn't recognize the images at all, right?

>>Carrie: Yeah, no, she didn't.

>>Lynne: Okay. And you would think she would because she can't recognize pictures. But these were just novel and like this, you know, it was just too novel and too complex.

>>Sara: But it's not. Wow, that one's even baby shaped, sort of. The other one wasn't baby shaped because it was only part of the baby.

>>Lynne: Right.

>>Sara: And it was the base which is the hardest was the hardest thing for her to look at.

>>Lynne: Right. Well then, you know, you can move into images like this, which is super highly abstract. She said this was a cowboy because she was looking at this and must have reminded her of like a, Larry.

>>Carrie: Yes.

>>Lynne: So she wasn't even able to look at the whole thing. She looked at this.

>>Carrie: Yeah. Yeah. Very abstract. Okay.

>>Lynne: And then. This one, oh, same one. So. So anyway, when you when you're looking, you know, testing images, get some real life images. And then, you know, I think it's in What's the phase? Advanced principles. I think Matt, has a chapter on the complexity going from real, photograph and then to very complex line. Black and white line jarling. Alright, let me get rid of some of these. So I don't run out of room.

>>Carrie: Okay.

>>Lynne: Okay, so complexity of faces. You're gonna, one thing we do is we take, we ask the parents to take pictures of themselves, maybe with their hair covered. So for this assessment. The mom and dad took a picture of themselves in the car and they both were in caps and they were both wearing sunglasses. We did this part of the testing pretty early on in the session and the young lady said, that's daddy. And then we're like, well, who's with daddy? And he said, that's mommy. And we were kind of blown away because I'm like, there's no way. So as testing, When on and we got to the part where the dolls, right? With the doll with a with the mustache. She said Like daddy and she pointed to the mustache on the doll. And so, you know, later on, her teacher showed her a picture of Steve Harvey, which I guess has a big mustache. And she said, oh, that looks like daddy. So he was not recognizing her father from the photograph. She was recognizing the mustache. And kind of generalizing that everyone with a mustache is going to be daddy. So watch out.

>>Sara: And anyone who's with daddy in the car with the matching outfit is probably mommy.

>>Lynne: Would be mommy. Right. So this is another thing we did with her. This, this was her aide, the classroom aid, and we brought him in with just a scarf over his head and he didn't talk to her and she did not recognize him. And so he took the scarf off. And she still did not recognize him. And so then he said hi and she knew who he was.

>>Carrie: No.

>>Lynne: So one of the interventions we suggested to this teacher is to teach her a social skill script. So if she's standing next to someone and she doesn't really know who they are. Or if there's a straight if they're a stranger or they're a friend she can say something like How's your day going? To prompt them to talk so that she has a clue about if she knows them or not.

>>Carrie: Yeah, and it's you could tell she thought she might have known him who it was but she it just until he spoke. She did not know.

>>Lynne: Right. So, you know, That's that's as the kids progress into phase 3 and they act you know they use their vision all day long and they act like they can have typical vision and they don't bump into anything and you know as a TVI or O and M. What you might do is do some of this stuff with people because they're a big deficit in phase 3 is social interactions. Because the kids typically can't recognize people by their faces. And they can't read emotions on people's faces. A So they may have really. Odd social interactions that people might find off putting. Yes.

>>Sara: Right and not being able to see facial expressions is also interferes with mirroring and that's you know a big so that's a big social interaction skill that we constantly constantly employ. And it helps us with empathy and everything like that. So that's, that's something that you're gonna have to really pay close attention to. It children with CVI at phase 3.

>>Lynne: So with using the mirror, we asked the TBI of the TBI and the child will look in a mirror together and then ask the child the TV I would say touch my nose in the mirror. You wanna see how are they on this? Are they accurate? Are they nowhere near it? Are they are they looking where they're doing it? Usually mirror because it's very reflective to the lights and you're gonna see everything behind the kid, which might totally throw them off. Very complex to look at the beer. And then we ask them to imitate facial expressions. And so for the kids we've done that with, we've noticed they can imitate the shape of the mouth. But nothing above the mouth. And the mouth, you know, moving all the time and everything, but it's red. And then we use this little book. To talk about do you can you tell you know, so even, you know, what is this a picture of? Our girl said it was old, old person. She didn't have enough clues about the body or anything to know that it was a baby. And then she couldn't. She couldn't tell you what. The baby was doing. Good. Right. And these are straight out of the assessment. So this is what you're going to have to test this anyway.

>>Carrie: Alright, so difficult with this distance viewing. So during the assessment, Lynn, Took a little pompom at different points and then would kind of put it in the students visual field. At different distances to see if she would, Look at it or it would catch your eyes at testing it at 3 feet 4 to 5 feet. And then 6 feet in beyond and so I don't remember the levels of which feet she recognized it. Further away she did not. Right.

>>Lynne: Say about as well just, you know, write it down.

>>Carrie: And then, Diane, she lines complexity at distance posters, on teachers.

>>Lynne: Yes. So these, this is Diane maybe, they're like $5. They start off as being very, simple.

>>Carrie: You wanna show them that? . Yeah

>>Lynne: So you want you want to test this at those different distances. But it's the same thing. It just gets more detail. So she asks, she asked the kids things like, where's the star? You know, where's the heart? And then that would be a more typical one. So you can get all of these for $5 per amount on poster paper. And you.

>>Sara: And it's interesting. Because those are kind of like what a teacher might use chalkboard, you know, on the chalkboard or, or, you know, any sort of visual display that is sharing information with the students and so, you know, being able to share what the child can and cannot see with the teacher can be. Great to have these cards and also to talk about how close they need to be to be able to see you know this level of complexity.

>>Carrie: And then looking at a typical visual reflexes, Blink to the touch so touching the bridge of the nose. Kind of like that, right, Lynn? And then move the hand, towards the face like fast. I don't know how you did that with her, but Like don't hit. But testing those different, you know, visual reflexes.

>>Lynne: Just like that.

>>Carrie: She was interesting. Yeah, she, should recognize the touch of the bridge of the nose, right?

>>Sara: Yeah, because you hit them, it's going to touch. Okay.

>>Carrie: Pretty good. Did she see all the hands?

>>Lynne: Right. No, and so, you know, the assessment choices are going to be, you know, like, 50% of the time, this percentage of time. And so this is another, this is another big one that the video is going to help you. So you typically blink to touch comes before and is more consistent than blink to threat. So

>>Sara: And then you also might wanna make a note about whether, you know, it's intermittent or delayed, just because that could be a safety hazard if the child doesn't close their eyes when something's coming forward towards them.

>>Lynne: Right.

>>Sara: It's really something that we do instructional programming for.

>>Lynne: And then these, these characteristics we don't test like in isolation really. We kind of just test it throughout using all the other stuff that we're doing. The visual field preferences you know tends to be pretty obvious the kids are they doing a centric viewing are they moving it a certain way and then latency that that'll come up. So this young lady we just did had had visual late she had very good visual attention. Directed like I'm one thing and whatever she was looking at she was looking at and then if she had to shift her gaze to look at something else There was latency there. And then visually gated reach is another thing you're gonna pick up on in video because she's gonna have so many things. Some be novel, some will be familiar, so does she use this visually gotta reach all the time? Does she only do it with super familiar things? Only with light a thing. You know, only with moving things and so, you're gonna, that'll kind of come in with everything else. Okay, so if, you need help with this assessment, your regional service center person should be able to help you. Or you can contact outreach and we can come. Help you do a process. It's called CVI range coaching where we will move through the assessment process with you. And you do it, right? But we just move through it with you and support you. Maybe give you some ideas. And we'd be happy to do that for you guys if you were interested.

>>Sara: This is. And this is done through Zoom Meetings and videos and a lot of it is just scheduled as, you know, what works for you. So it's kind of a more of an on-demand type thing. It's, not a it's very flexible and And so that can be pretty helpful for people schedules and such.

>>Lynne: Right. And so it's really to help you guys feel more comfortable with doing this assessment because it's not a really easy assessment. But it does give you amazing information.

>>Sara: And it's also to help us learn because every, you know, if you meet a student with CVI, you met a student with CBI.

>>Lynne: All right. Do you all have any questions? I'm gonna go ahead and get out of this.

>>Sara: Yeah.

>>Donna: Thank you so much, and Kerry. We have about 7 min so we can field any questions you have that come through.

>>Lynne: Yeah, give us some ideas of what you guys do if you've done this assessment. We're always looking for new ideas. There is a hand out, Terry. So please guys if you're gonna write the chat right to everybody so you know people might have the same questions you guys have. We do have a handout. I think, David? Nathan, it's in the, it's.

>>Sara: Do we have a link to that hand?

>>Lynne: I said it, I sent it in the email, I sent a link to Nathan.

>>Donna: And it will also be posted in our learning library.

>>TSBVI Media: Yeah, Donna, I don't know where you normally posted the link. I don't know if we were going to use the same link for coffee hours or if you had been doing the weak link, the handout link differently.

>>Donna: We are going to transition to the same process as coffee hours, so we're keeping consistent. In having those cards with the handouts all with the recording and everything.

>>TSBVI Media: Copy that.

>>Donna: So you'll be able to retrieve all of the handouts and such when you Come and check out the videos. And. We have a comment here about balloons are always a hit with the kids. Love balloons.

>>Lynne: Bloons are a big, balloons are a beautiful way of teaching. That your body can make a visual change in something. So tying a Mylar balloon to us to his kids wrist. Even if they have very limited move movement anytime that kid moves, that balloon is gonna move.

>>Donna: Sorry there, I was just sharing, what some new things we have up.

>>Lynne: Okay.

>>Donna: No problem, Terry, no problem at all. And looks like Sara has linked the handouts there in the chat.

>>Sara: I hope that works. I just got it out of my email and downloaded it.

>>Donna: It looks like it did. Alright, so we wanted to share a few things on our way out.

>>Lynne: It's like.

>>Donna: This evening, I think, should be able to see my share now. Compass is new from Perkins, it's a 9 month virtual program for college aspiring high school. Students designed to help them to proactively explore and develop the plans for building those critical academic skills. And blindness skills for post-secondary gold. Go, so our kiddos that are getting ready to make that transition into work. School or trade. It's a great program just new coming out. Check it out if you've got a kiddo in that age range. 24 is coming up. At the beginning of April, registration is now up and ready. Hotel information is up. We also are looking for more nominations for TA-E-E-R Awards. This is an amazing way to recognize. The incredible work going on here in in Texas and those links. Are available. I will get them over into the chat in just a moment. Mark your calendars for upcoming T times. We have a reschedule from the fall. And that is Bob Boom is gonna come talk to us from in vision about the in vision glasses. So mark through your calendar for next week. That's gonna be Thursday. The eighteenth. January 20 fifth we're wrapping out the month with a unique perspective a parent who is also a TSVI. So we're excited. To have Belinda come in and talk to us about that unique perspective. Being a professional in the field and also having a student who. Has a visual impairment. February is Behavior Month. We're going to start off the month with Lane Pethic from region 10 who's going to talk about behavior in general. Emily leaper is going to follow Amara fifteenth with proactive behavior strategies the 20 s of February we will have no session that's Texas Focus Week so join us at Texas Focus.

>>Lynne: Which is about behavior.

>>Donna: And then we'll wrap. Which is about behavior. Thank you, Lynn. And then February, 20 ninth math, nymph code step by step guide. This was a session that I've been trying to get scheduled. All fall, we've finally got them in the same. Room in the same virtual room. That's Dr