TRANSCRIPT Ð Sound Travels Ð 10/23/23 

>>Kaycee: We're going to be talking about a collection of tools called sound travels today that support collaboration in orientation and mobility for students who are Deafblind. I am Kaycee Bennett and I'm one of the education consultants from the Texas Deafblind Project. We have a nice chunk of our team present today. Hillary, who stepped in to introduce us today is also on our team. My background is in Deaf and Hard of Hearing and then Deafblind education. So we're going to talk about things through that lens. Rachel, do you want to introduce yourself? 

>>Rachel: Hello, everybody. Welcome. My name is Rachel Collins and I am also one of the Deafblind education consultants on the Texas Deafblind Project here housed at the Texas School for the Blind and Visually Impaired. My background is also in -- as a teacher of the Deaf and Hard of Hearing but I spent the majority of my career as a Deafblind specialist working itinerant and in self-contained classrooms. 

>>Edgenie: I'm Edgenie Bellah and I have the pleasure of serving as the family engagement coordinate on our team. I think that's how most of you know me. But I'm also a certified orientation and mobility specialist. I've been doing this for a very long time. It's actually how I started in the field and have continued doing contract orientation and mobility with adults who are Deafblind up until very recently. So I'm excited to have on our O&M hat today. And also wanted to give a shout out to another one of our colleagues who's joining us as a participant today, Heather Withrow. And Heather, while she serves as our transition consultant, is also a certified orientation and mobility specialist. 

>>Kaycee: Edgenie participated in the creation of these tools so she's also coming at this through an author lens. We're excited to have her as part of this. We're going to start off by talking about hearing a little bit and breaking down the hierarchy of hearing. So the very first thing we talk about is detection. Detection just means I hear it. I hear something. This is what we are testing when a kid turns when you say something or raise your hand when you hear the beep. Those are determining detection. Not necessarily -- we can't tell necessarily what it sounded like to them but we know that they heard something. That's the most basic level of hearing. And then next goes into discrimination. Discrimination means I know that those two sounds are different. I know that when that was presented, I can choose between two things and figure out exactly what -- what it was and what it wasn't when I have two choices. So that is discrimination. I know that they're not the same as each other. And then to find the results of those two things, we can get those from our audiologist. When students have their hearing tested, they graph the results of that testing on to what's called an audiogram. And I'm going to open this up and show you what it looks like. This is an audiogram that is put on to what we call a speech banana. And this was a real Deafblind student that I served for a long time. Audiogram put on to a speech banana. The blue Xs are left and the red is right. And it just shows us where her hearing levels are for detection. Okay. So that she could hear something at these levels. Her right ear, if you have never seen the circles with the arrows down before, it means there was no response. She's profoundly deaf on that right side. But her left, she had quite a range, as you can see here. In the normal, which is above the dotted line, all the way down to no response in those higher frequencies. Those are just showing us what she was able to detect. Okay? That information's pretty readily available. We can get detection information pretty easily. We get those all the time from the doctors and often educational audiologists can also gather that information for us. Discrimination, if you're in Texas, you probably have seen a Part B audiological form that looks something like this. We have typically our audiologist complete this and it shows the audiogram but charted on the tables that are on the screen right now. We've got a table listing out the pure tone at the different frequencies and then right, left, and sound field listed. It's a blank chart. And under that it says "speech" and it has the speech recognition threshold and it has word discrimination and quiet. And it has some blanks for them to write in which stimulus they used, at how loud they presented that, how many decibels they presented it. And then for the right ear, left ear, or sound field, how they administered that testing. What that tells us is when the individual is presented with two words -- sometimes they do them with pictures, if the children are young, or sometimes they may do them with printed words, if you're working with somebody who can read print or read Braille or read in a formal mode. They put those in front of them and they play words. And they have them choose which word did you hear, or could you not tell which word it was. That's how they test word discrimination. They do that in quiet, typically. And then they'll do that in noise as well, so we have that data. I will tell you it's lovely if this comes back filled out. I would say 80-something percent of the time those lines would be blank on the ones that I would get back, when I was serving as the itinerant teacher of the Deaf. Ideally we have that information from the audiologist. Realistically we often don't have that information from the audiologist. But that's where you can look to see if you have discrimination information already on file for your students that you're serving. All right. So we've got those two. The detection and the discrimination. And now the next two. We've got identification. I know what that sound is. I know you said my name. I know that was a dog barking. I know blank. Okay? I know what that sound is when I hear it. That's identification. Comprehension is I know what that sound means. I know you said my name because you want my attention. I know that was a dog barking so I need to look arn and make sure I'm safe. Or I hear that dog barking so I need to let it out, because it's my dog. Whatever that comprehension piece is tied to that sound. Okay? So identification. I know what it is. Comprehension, I know what it means. Let me go back one. The thing about these two is that they are not tested by the personal audiologist. This is not something that's going to come in on our eligibility forms or medical documentation or anything like that. These are the things that we have to do functional hearing testing and functional hearing evaluations in order to determine and lean heavily on the people who know the individual best. If the child is able to explain to you what they hear and how they use their information. Obviously, that is very valuable. The interviewing the families and getting that information from them is extremely valuable. And if they've got teachers of the Deaf or TSVIs or COMS that they have been with a long time, they often have a lot of valuable information, and interveners, of course, if the student has one. We can work on getting that information in a lot of ways. And while it's not tested by the personal audiologist and come to us on nice forms, it doesn't mean that we can't work on it. And we can and we should work on these things. And so this is just an example of a goal and some objectives that I had for a student who was Deafblind when I was serving as his itinerant teacher of the Deaf and Hard of Hearing. I worked with our certified orientation and mobility specialist to determine what he really needed to be doing with his hearing as far as that -- yeah, identification and comprehension piece goes on his O&M lessons. Out getting ready to do street crossings. This was a highly academic, very smart young man who was new to our country too. So we had a lot of things we were working on. And so this is just a goal example. And you'll find this in your handout too so don't feel like you need to write it down, if it's something you want to refer to. Just working in a quiet environment that he would use his auditory identification skills to IFHE what the sound is and be able to explain what information that sound could give him. So what this looked like is actually recording some of the sounds that the certified orientation and mobility specialist wanted him to be able to identify and report and comprehend what they could mean to him. Then in a quiet room, if you're an itinerant, you can probably relate to this. But I had a closet that I worked in and so in my little closet where it was quiet, I would play those sounds and we would talk through them. We would start with giving him choices of what they were and work on that discrimination. And then moving forward into identification, what is that sound. What does that sound mean? What do we do when we hear that sound? All of those types of things. That was what was done during the lesson that I had as a teacher of the Deaf and Hard of Hearing with my student. 

>>Rachel: Okay. The Informal Functional Hearing Evaluation is a tool that was developed by some members of the Deafblind outreach team and it basically looks at how a student uses their hearing to distinguish and hear sounds within their environment. And, you know, it can be in a variety of settings. It can be at school. It can be at home, out in the community. It can be in a variety of different ways. Kaycee, could you click on it real quick? Thank you. So here is the tool. This tool can be found on our website. It will be in the handout for you as well to be able to utilize. It's broken down into different sections. First it starts off with how to even conduct the IFHE, how to conduct it. What do you need to do, who do you need to involve, like what team members need to be involved in it. And then it goes into another section about interviews. So you are like asking questions to different members of the student's team. It could also be a part of a medical team as well. So you're asking a bunch of different questions to a variety of different people in terms of how a student uses their hearing in different environments. And then you do an observation. It asks a lot of different questions and then you, as a team, you as a team collaborate together to come up with the answers of this questionnaire so that way you can gather all of this information. After you've gathered all of that information, you can put it all together in like a summary. And so this serves as a way to guide the IEP team. It helps to determine what kind of accommodations that may be needed in different environments to help kind of promote getting access to information. This is a test -- because it's called the Informal Functional Hearing Evaluation. This is a test that, you know, sometimes formal testing isn't always possible. Sometimes the student may be non-verbal or there just hasn't been an opportunity to conduct a formal test. This is a way to kind of get started, to say this is what we're noticing in the student's hearing and how they're utilizing their hearing. And that will provide some information to the audiologist and to the teacher of the Deaf and Hard of Hearing to plan for strategies like within the school environment. But also in the home and the community as well. There are -- this is a test that can be done if, you know, there are concerns over, you know, doing an ABR or an auditory brain stem response, because you had to put sometimes -- or many times you had to put the child under sedation. And there are a lot of concerns regarding that. And so this is another way to kind of provide information without having to go through that procedure. Now, this is not to take the place of any kind of formal testing and this should not be used as like the sole documentation for a hearing impairment. However, this is kind of a supplementary, a complementary tool to be used and that way you're looking at those functional ways that the student is using their hearing in the environment. Have any of you guys used the IFHE? Okay. Awesome. Well, I'm so glad we're talking about it then because this is such a great tool, you know, that everybody -- that we all could use. Wow. Oh, I'm so excited! Okay. All right. So you guys need to take a deep dive into the IFHE so that way you can see how to serve your student and how each of the members of the team can look at this together. All right. Let's go on to the next one. Okay. So Kaycee talked about detection, knowing that there's a sound. Discrimination, knowing that there's differences between sounds. Identifying, knowing what the sound is, and then comprehension, what does that mean to me. And then we want to talk about utilization or how do you use this information. What do you do with all of this stuff and how does it benefit you. Okay. 

>>Edgenie: Hi, this is Edgenie. Thank you, Rachel. I just want to go back to the IFHE and reiterate this is an incredible tool that teams can use together. It is -- we've seen it time and time again that a lot of great information can be found, you know, discovered together, sitting down and having these important conversations. So really encourage you to try to bring this in with the students that you're serving. So as Rachel said, we're going to talk about utilization of environmental sounds. And these, the next four that we're going to talk about are really important for orientation and mobility. I want to reiterate that we know there are individuals who are Deaf, hard of hearing, who also have vision loss that are very successful travelers, especially individuals who are deaf. Sound is not required. It can be beneficial but I just want to state that clearly that we're, by no means, saying that you have to have some kind of residual hearing in order to be a safe, efficient, and independent traveler. But what we are going to explore today is how to benefit from environmental sounds to make sure that you are safe, efficient, and independent. So the environmental sounds that we're going to explore, there are four of them. There's localization, estimation, echo location and orientation. When we consider localization, that is the ability to know where a sound is in the person's environment. It is also knowing if it is stationary or if it's moving. And if it's moving, the person who is reliant on that environmental sound needs to learn how to figure out what direction it is moving and how quickly it is moving in the direction that they're estimating it's going. Localization is not always possible. Depending on the person's hearing, if they have a unilateral hearing loss. Depending on, you know, the types of the aids, like cross aids, et cetera, it can make localization very challenging. We also have to take into consideration a person's ability to localize environmental sounds based on the age of implantation for cochlear implants and how long they've been using any type of hearing device. It also depends on how consistent they are in being able to use the devices. So there's a lot of factors we need to consider in a person's ability to localize sound. And the best way to do that as a team is, again, to have these conversations. Think about the things that might be impacting the student's ability to learn how to use localization. With estimation, that is knowing how far away a sound is and being able to learn how to figure out when it will arrive where the person is. So, again, localization is knowing where the sound is located, if it is moving. And if it is moving, what direction and how quickly it is moving. And then with estimation, it is kind of having a sense of how far away the sound is from the person and learning how to gauge when it might arrive at them. I'm sure you can see some really practical ways that this could be, you know, used in a variety of environments. Probably the most common one is learning how to localize the sound of traffic. We need to know where cars are in environments. So, you know, and being able to gauge what direction they're moving and how quickly. And if that sound, you know, might be coming towards them or away. Being able to anticipate when it might arrive. I hope that makes sense. I'm kind of under the weather here so y'all give me some grace, please. Yeah, go, Kaycee. 

>>Kaycee: Do you mind if I add something real quick I meant to say earlier? 

>>Edgenie: Yes. 

>>Kaycee: So in looking at the four areas that I covered earlier and then these under utilization that Edgenie just covered, that we are looking at a hierarchy here. And so oftentimes -- or maybe not oftentimes but sometimes we'll see goals and objectives that are written for things like localization or estimation for orientation and mobility goals. But this student only has detection. They're not able to discriminate whether that's a car or a lawnmower or what those things mean to them. And so they are not at the level. They're not at that point in the hierarchy to be able to make progress on these things like localization and estimation. We have to go back and make sure that these are all mastered, the four that I covered, as the foundation before we move into these areas. 

>>Edgenie: This is Edgenie. Kaycee, thank you for emphasizing that. What an important piece to really keep in mind when we're doing evaluations. As we mentioned earlier, you know, some of these evaluations may come from audiology and other sources. But as we're doing orientation and mobility evaluations, we're working with, you know, other members of the team. We need to make sure that we're considering everything in this hierarchy. I appreciate that. Okay. So next, with the use of environmental sound is echolocation, which is the ability to perceive reflected sound. There's two ways this can happen. One is passive where the person may not be doing anything in their environment but are able to detect that, you know, a sound is reflecting in such a way that it will kind of fill in a bigger picture of what's happening in the environment. What that environment might be like. For example, echolocation can be used in a hallway to determine how wide the hallway is and how tall the hallway is. It's an incredible orientation and mobility strategy that many people can learn to use very effectively. And then there's also active echolocation and that may be where somebody is doing something intentionally to be able to get that reflected sound back. It could look like somebody clicking their tongue to try to get sound to reflect around the environment and come back to them to help fill in that picture. They could clap, you know, slap the side of their leg. There's many different ways people have either taught themselves or through instruction learned how to do active echolocation. To, again, kind of learn more about their environment and use that as a strategy to not only be oriented but to move about that space. And then the other way we can use environmental sound is with orientation. And that can include spatial updating, planning travel, and maintaining travel. As we consider all of this, we really need to think about how we're doing programming for hearing aids, to make sure that, again, this has to be a team approach. And I know we're going to get into this a little bit later but, you know, we have to think differently in how the hearing aids are being programmed. Because if we're not being very thoughtful about it, we could put out important environmental sounds that will help the person know what's going on in their environment. And then, in turn, make good decisions on their travel skills. I'm not going to go into detail because we're going to visit that later. But, again, just wanted to cover with you in this hierarchy of using our hearing that, you know, these four areas are really important areas to assess and to make sure that programming is happening for students so that they can benefit from learning all the orientation and mobility skills that they're going to need to be safe, efficient, and independent. 

>>Rachel: Okay. So we talked about a whole group of team members that come together, that work towards gathering all of this information for the IFHE, the Informal Functional Hearing Evaluation. So who are those people? So we're talking about the audiologist, both the educational audiologist as well as the personal audiologist. The TDHH, or the teacher of students who are Deaf or hard of hearing. The speech and language pathologist, SLP, this is going to be important trying to figure out how our students are utilizing their hearing. The teacher of the students who are Deafblind, if there is one. Hopefully there is. Maybe it's the TDHH. Maybe it's the TSVI. Either one. The intervener, if there is one who is involved, because they're going to be the ones who have the most contact with the child on a daily and regular basis. The COMS, for sure. And then the TSVI. Those are all the specialists that come together to gather this information for the student. And so what role does everybody play? On our website, there in the orientation and mobility section under sound travels, there is a document called delineation of roles document. Kaycee, could you click on that, please? Thank you so much. And so in this document, it goes through each of the roles that people play. And so there's the audiologist and what kinds of things that the audiologist, you know, could be expected to do or could participate in. What kinds of things. The COMS. Like, how do the audiologists and the COMS communicate with one another in terms of trying to work on those -- and program those hearing aids or map those CIs. And then the intervener. The intervener's observations are going to be vital for the COMS and audiologist to have. And families. Of course, families are the ones who see the child and all sorts of environments. That information they have is going to be crucial to filling out this document. And then the TDHH. So, you know, whenever we're looking at how these things mapped and things like that, this is how the student can use their hearing and how their hearing aids and CIs can be programmed while they're traveling. But there's going to need to be some ongoing training in terms of distinguishing, detecting, identifying, comprehending, all of these different sounds. This is where the TDHH can create goals where they target these things, making it very specific about what the student is going to be, you know, focusing on. And then the teacher of -- the TDB, this is a role where, you know, they're going to have that expertise and that dual sensory impairment and knowing -- and having all the pieces of information, like where the student's vision is best and also, you know, which side to focus, like instruction at. Like if their hearing is better on the right side, you know, you want to make sure that the instruction is being given on that side. Just somebody who is going to have that information offhand. Because not a lot of people are accustomed to working with students who are Deafblind. So this would be a great time to bring all those pieces together. And then the TVI to also give that information on where to present the information visually. All right. So this is going to require collaboration from all team members. As we have often said whenever we have a student who is Deafblind and service providers are presenting themselves to the next new team. We come with an entourage of service providers. It's going to need all-hands-on-deck to be able to utilize and maximize that hearing and functional vision. And then we want to make sure that we're addressing the Expanded Core Curriculum. Now, TSVIs are used to hearing, you know, the Expanded Core Curriculum for students who are blind and visually impaired, because it is required as a TSVI to present and teach that material. But there is also ECC for students who are Deaf and Hard of Hearing. Teachers of the Deaf and Hard of Hearing are aware of this documentation. They are not necessarily required by law, as TSVIs are, to cover those areas. And the new ETT DBE, essential tools of the trade Deafblind version, there is a new document called considerations for the Expanded Core Curriculum for students who are Deafblind. And this kind of takes the ECC for VI, for blind and visually impaired, as well as the ECC for the Deaf and Hard of Hearing. And kind of fills in the gaps of where there are pieces that are missing. Because we know it's not Deaf plus blind, it's deaf times blind. There are areas that are kind of missing and need to have special care and considering that. I don't know, Kaycee, do we have that offhand to kind of show? It is on our website, the Texas Deafblind Project website, and it's under topical resources. I'm sure that that is going to be in the handout to click on, but it can be found -- and maybe Hillary can find it. But it is on the website to be able to look at those different areas. And I encourage you to address those areas when you are looking at the ECC for blind and visually impaired to also factor in those extra pieces. Are you talking about for Deafblind? Lori. Yes. There is going to be a link. There is a link in the handout that will -- that you can get to. And one of us will be able to link to that specific Deafblind ECC considerations. This is not an official thing but it's just considerations to be thinking about. 

>>Kaycee: Yes. We will also have a full Coffee Hour session on the Expanded Core Curriculum considerations for students who are Deafblind during ECC month. 

>>Rachel: Woohoo! All right. Oh, can I go back to the other slide really quickly? I do want to point out like the differences between the educational audiologist in comparison to the personal audiologist. So the personal audiologists are the ones who are typically doing a program and then mapping for student's hearing aids and CEIs. They're usually not the ones in contact with the COMS or certified orientation and mobility specialist. So the educational audiologist can help program and train on those devices. But usually they're only looking at hearing aids. And we're seeing less and less of those hearing aids that are being used. So it's -- we're going to need to have some extra work that plays into being able to coordinate that COMS with the personal audiologist. But it's really super important to be able to maximize that functional hearing to be able to -- for safety and travel and just for accessing that information in the environment. I just wanted to make sure that we pointed out the differences between that educational audiologist and the personal audiologist. 

>>Edgenie: So real quickly. Let's just take a look at some O&M speak that I think highlights the reason that we need collaboration and the opportunity to sit down and learn from each other. Now, there are many of us in this Coffee Hour that will totally geek out and enjoy this paragraph that is written here. And then there may be some of you who are scratching your head going what was just shared. Let me take a moment and read those and have a very quick conversation about it. Traveling with the parallel traffic surge using auditory alignment strategies when crossing at a multiphase intersection in a metropolitan area with a fully actuated signals that are equipped with vibro-tactile APS. All right. In the chat, tell me what you think. Did you understand that? Did that come naturally to you? Or would you be one of the people who might be scratching your head wondering what this means. I think everybody must be having to read it a third time. Understood it! Joanna, brilliant. Thumbs up. I knew Heather would get it. Kaycee said, no, not me. Yeah. Christy's got it. Jessica, made sense to you. Understandable, Leslie. Thank you. So we kind of got a mixed group. Many people understanding it. Sarah Mossberger, another member of our team, mind blown. Understandable. That's great. 

>>Kaycee: All right, all you COMS. Let's see how you do in audiology speak. All right. Here is a little paragraph that a real audiologist wrote on this topic. We need to consider mic directionality and the effects of noise reduction and suppression and how these effects might be exacerbated by the lack of earmold venting. This is especially true for clients with devices employing compression with binaural amplification and/or using multiple programs. Of course another consideration is the potential use of FM + mic setting. Good? All of you understand that one as well? I like that emoji. The crazy eyes. Nope. This one makes perfect sense to me. This is just an example, both of these things talking about students who are Deafblind and working with them for orientation and mobility and both professionals wrote these statements but if the other professional can't read it and understand it and apply it to their work, they don't do a whole lot of good. We have to work together and make sure that everybody understands all of the pieces that we're considering and evaluating in order to plan and program for students who are -- for all students but especially for students who are Deafblind because there's so many complicated pieces that are involved. 

>>Rachel: Okay. So where do we even begin with all of this? The Texas Deafblind Project created the IEP quality indicators for students who are Deafblind. And this was designed to help teams develop appropriate IEPs for students who are Deafblind. They may -- like if their items are present, that means that this is a well-designed IEP. Now this doesn't cover all the elements of a well-designed IEP but these are specific areas to the unique needs of students who are Deafblind. And so if the item is present, then that means, okay, you guys are considering all the different items that are crucial. But if it indicates that there is not included or mentioned in the IEP these certain elements, then that may indicate like a need for training or like a revisit to the IEP to kind of make sure that all of those factors are being considered. Do we want to click on it real quick so we can show what it looks like? This can also be found on the Texas Deafblind Project website. And so it is a lengthy document. However, it's one that carries on with the student, you know, through multiple years. And it just goes through various areas that are target areas for students who are Deafblind that often get overlooked or missed. And so these are areas to target and make sure that, like, let's make sure that we are considering all the different facets that really -- that we really want to make sure that don't get missed but the students have access to the information. And so this is the quality indicators. We talked about the IFHE already. And then this tool is like one of my most favorite tools. And it is the Audiology and Orientation and Mobility Collaboration Tool. This tool here is specifically for the audiologist and the COMS. However, with students of mine I've brought in the TDHH as well as myself as the TSVI and TDB to kind of collaborate and look at a student and how they utilize their hearing out in the environment. How they utilize their hearing, what are some observations that we made. What are some things to note and some considerations that we want to make sure that are taken into account. And then it really -- this tool really kind of opened the eyes of the educational audiologist to say all this time we are totally, like, knocking out all of these sounds to maximize speech. You know? But what I never realized is we are cutting out all the information that helps the student be safe as they're traveling around the environment. And then it dawned on our educational audiologist that things are things that need to be targeted, not when the students are about to leave school but when they're little. Like, we need to start training now when the students are little, if they have functional hearing and if this is something we're wanting to maximize and target. Again, there is no one size fits all. We're not saying that. However, if that is, you know, if there is functional hearing and we do want to maximize it, then we need to start early. We need to start targeting and focusing that instruction. And so this is something that you want to be able to collaborate with and so that way we're looking at safety and travel. Okay. So here are two documents that are also found on the website. And so this is environmental sounds considerations for the audiologist and COMS. Sorry. That's a lot of words. And it just basically talks about how noise is information. Like it's not just -- exactly. Noise is information. It is not just extraneous. It can be but there are specific purposes and specific times that you want to utilize that noise to your benefit and how to ask the audiologist to help program so that way you can use it during O&M instruction. May not be all the time like during class instruction. Maybe you don't want to hear all those extra noises. You want to be able to hear only the teacher and during instruction. However, there are specific times and different uses for different environments. And then the developing auditory skills. Just for students who are Deafblind that do use amplification. Like learning how to hone in on those auditory skills is going to be important and it's going to take specific instruction and very direct instruction. And this is where we want to bring from our TDHH to help develop those goals. So that way we are targeting those specific skills. 

>>Kaycee: All right. And then places to find resources on these things. So there are LiveBinders. Some people were talking about Chris Tabb's LiveBinders and asking if they are still live. And they are. And Susie Tiggs also has a ton of really great stuff in LiveBinder. And hers are still live as well. So we've got those links for you on the handout, so you'll be able to check out both of those massive LiveBinders. I'm pretty sure between Susie and Chris Tabb they make up a bajillion LiveBinders on the internet. So you definitely want to check those out. And then websites that can be helpful to you. We've got the National Center for DeafBlindness, NCDB. They have some great resources. You can check out their website. The TSBVI website, Texas School for the Blind and Visually Impaired has a lot of great stuff on the main TSBVI website, including this Coffee Hour and other Coffee Hours that you may want to access. And then Perkins School for the Blind has a lot of great resources as well. And their main website is linked there for you also on the handout. Some other things that might be helpful to you. There are some apps that read the decibel level of what's going on around you. In fact, if you're an Apple watch user like I am. I'm quite obsessed with my watch, it does this. Like, it comes with an app on it that does this. And so basically what I mean by that is if I am at the grocery store, I can open that app on my watch or on your phone and it will tell me approximately how loud it is, in decibels, at that moment. Okay. Based on the mics that are picked up on your devices. So how that might be helpful is if you're not in the hearing field, if you come from the vision field, which most of you do, that are in attendance today, you may not be just super familiar with decibels and what that relates to like our everyday experiences. And so that can be really helpful just to kind of help you be more aware of, oh, man, that noise, when I'm sitting here, this is 30 decibels and my student can't even detect until 45. So this is not -- there's no way for her to access this. Just kind of be a little bit more aware of what -- how loud things are in our everyday environment. Another thing that could be helpful are there's some apps for like audiological screening. I want to make very clear this does not replace the need for real audiological screening or evaluation but sometimes it can be months before a child can be seen by an audiologist and if you've got a kiddo who you're working with who can raise their hand to the beeps and respond in a more formal way like that, that you could do in the meantime. Just so that you have some basic information to start with, a starting place. It can also be helpful if you've got somebody who thinks they hear fine and you know they do not hear fine. It can be helpful to go, really? You did not do well on this screening app. Let's go see a professional. Let's go see a doctor. It could be used for that as well. Like I was saying earlier when I was talking about the goals, the recordings of environmental sounds, you can record yourself on your devices and/or use YouTube. YouTube has so many videos of like traffic, cars driving by, buses honking, dogs barking. You can get so many different sounds. Then there's apps with different sounds on them as well. And so that's another great tool and resource. 

>>Rachel: Okay. So we want to look at the IEP quality indicators and look at Section 7 which covers orientation and mobility. Being Deafblind affects the ability how our students will know where they are and how to go from place to place. They get less information from the environment. They have less reinforcement to explore their environment. And being Deafblind affects the identification and the use of sound cues. We want to look at the different areas of orientation and mobility, specifically when we're looking at the quality indicators. When we're going through this, I want you to think about your student that you have in mind that is Deafblind, or several, and think about whether or not this is something that you guys have addressed in the IEP or have not and need to, need to address it. 

>>Kaycee: We are actually out of time and so we won't be able to go through each of these but I'm going to click through real quick to show you that there are five underneath Section 7, which is orientation and mobility. So we've got 7.1 through 7.5. And you'll be able to check those out on that IEP quality indicators document on our website, which is free. It's on the handout as well. And then the other one that we wanted to point out to you that can be related to orientation and mobility is under the 8 section, which is related and supplemental services. And so you can find considerations there as well that relate. Before I turn it to Hillary, I just want to point out that on the handout you'll find the link to our website, which is the Texas Deafblind Project. It's TX Deafblind Project.org. We have so many resources on there. Check that out for sure. That's where you'll find everything that we talked about today 

>>Rachel: And lots, lots more. 

>>Kaycee: And lots, lots, lots more. There's an entire orientation and mobility section of that website that has all the sound travels documents as well as other great things on orientation and mobility, direct links to Chris' LiveBinders. So many awesome things. All of those are on the handout.