TRANSCRIPT - O&M and Aligning the ECC with Developmental Milestones Ð 10/7/24
 
>>Scott: Okay. Hi, everybody. Thanks for joining. We're going to get started, so I'll make sure we have enough time at the end. I just wanted to go over a couple of things with you before we get started, just kind of why we have this topic, what my thoughts are behind it, and kind of what these steps -- why these steps look the way they look when we go through this presentation. First thing I wanted to start out with is just talk to you a little bit about remembering back when I first started in this field. And I had the pleasure of having other professionals that were close to me. They were able to kind of help me with questions. You know, I could bounce things off of people. And so over the years, over my career, I started to get a lot of questions about -- from O&M professionals about how we provide support to our students, what does that look like. You know, just getting a bunch of random questions. And so the other thing that I noticed is that a lot of our O&Ms are working in isolation and, you know, they just don't have those opportunities to learn from others and get that valuable knowledge that others have obtained while they've been going through their career. So that's kind of my premise for this. And as we kind of go through it you'll kind of see where I'm going with a lot of this. Make sure if you have questions to just kind of put those in the chat and we'll address them as we go along. I don't have a problem with stopping and answering. All right. For this session today we're going to talk a little bit about the why. We're going to talk a little bit about the "how." And I have about four points that I'll kind of stop and point out throughout the presentation just so you kind of know what's guiding us. And I want to give you a little bit more about how O&Ms can -- what that looks like for O&Ms. Again, I think sometimes we don't think deep enough when we're doing our instruction. We're not thinking outside the box sometimes during our instructions. And I know that's happened in my career. I'm pretty sure it's happened for some of you guys and you kind of have those questions on what do things look like. And so starting out, I just want to have a conversation and I want to talk about how our O&M support, what it might look like, what it could look like, what it should look like, and what it can look like. And I think that's the depth that I want to go with this. What can our services look like. So to start out with, I think one of our foundational pieces is the early intervention. And I think that when you look at early intervention, those services should be provided to our parents. What are the needs of our parents. What are those concerns that the family has for their child. What's the purpose of the early intervention to support the parents and the caregivers and the development in that competence and confidence in those skills they need to now pass on to their child. And I think sometimes when we're working as O&Ms, that's a role, a huge role that we can play is supporting those families and keep that mindset when we do go into the home that that's one of our primary roles is to make sure we're asking those families what their concerns are and relaying to them how we can assist them. And then further thinking on that subject is developing the child. Right? Reducing that need for that special education services once they start school. A lot of us have huge caseloads. We've got multiple kids coming in all the time. If we can reduce some of that by introducing those skills and providing those services early, that helps us. That helps those students in the long run. Maximizing their independence. Thinking about that quality of life. Not just focusing on those primary O&M skills but just thinking about that quality of life for those friends who really, really, really need it. And building that capacity with the family that they're able to continue to provide those supports when we're not present. When none of the service providers are in the home. And I would say as an O&M, even if that's the services that are being provided by OTs and PTs, since a lot of times our skills are overlapping, those skills that we can provide to those parents go a long way when none of us are in the home or during those days when those students can learn in their natural environment doing their daily routine. How do we go about doing that? Addressing the family needs, like I mentioned before. Sitting down with mom and dad and asking them what are your concerns. What are your fears? What's going on with you? Discussing what that eye condition looks like. How does that eye condition impact the learning? Providing materials or suggestions for toys, things like that. Family members are buying toys for birthday gifts or for Christmas gifts. What types of things are appropriate? What are the most appropriate things that you can do or provide to them? What am I bringing in the home that I determine that are beneficial, that work for me, that there's a like, a dislike, and I can share that information with the parents. Bonding with the family. Encouraging them to get down on the floor with us and enjoy and engage with us within those sessions. Provide you another set of hands. Demonstrating those -- giving them the opportunity to have that hands-on instruction. Modeling those strategies. Getting them on the floor. Again, when we're not there, the parents are the ones that are taking that lead. The parents are the ones that are following through with those recommendations, those suggestions that we're leaving in the home. Okay? It's a lot different for them to understand what we're sharing before we leave. If they've had an opportunity to see it, if they've had an opportunity to participate in it, it makes a huge difference for us when we come back on that next visit. It makes a huge change for that child when they're getting constant follow-through and not just once or twice a week when the providers are there. And it's also connecting those families with those state and local agencies. Those opportunities for them to, again, build that capacity for the family. Okay. Thinking about us as O&M professionals. We go into the home as the specialist. Right? But sometimes we may be a facilitator. What does that mean? Sometimes it may be just that working with the other providers to make sure we're all on the same playing field. To make sure that we're all coming in with a consistent approach to how we're going to support the child. How we're going to support the family. Sometimes it may even be that you're a counselor. Sometimes our families, they didn't expect to have a child with an impairment. So it's taking time for them to adjust to that and we can provide a role for them to have a sounding board, to have an opportunity to talk to somebody and kind of talk through what's our fears. What's our plan of action. To be a partner with them. Sometimes you may even be a friend. And just to think about it, sometimes when we're in the home, a lot of times those parents, those moms and those dads, we may be the only adult that they see for a while. So it's an opportunity for them to talk to us and to build that rapport and to learn from us that we're there to support their child, that we understand what those interests are, and that we have a plan of action on how we're going to move forward with that. Thinking about our Expanded Core Curriculum. Okay. Those are those concepts, those skills that a lot of times our friends are not getting. They can't see mom and dad walking around in the kitchen. They can't see mom and dad walk around the house. They can't see brothers and sisters riding on their tricycles or playing with the dogs. All of those are opportunities that are being missed out on because they're not able to -- they don't have that ability to see that far or they don't have that awareness that there's an environment outside of that space that they're in. And for us as an O&M, I think we have a certain uniqueness to what our instruction looks like. We have a certain uniqueness to how we approach our instruction to our kids, how we work with the families. Of course, I'm biased on that point but I think that there's certainly opportunities there for us to provide those opportunities that are not being established on a regular basis. We have an opportunity through our uniqueness to bring that environment to the child or to take that child to that environment. Right? So thinking about if you're only having an opportunity to work within the home or if you're only -- you only have that opportunity to engage with people in a safe space, how much more information you can get once you're outside of that. What does that look like? How do we facilitate that? That's my mindset for just having that conversation of what -- there's more we can do. There's another step we have. There's another gear we can get into. All right. Thinking about that Expanded Core Curriculum, when I look at compensatory skills, when I look at O&M, of course. When I look at our social interaction pieces, our independent living, our rec and leisure, sensory efficiency, assistive technology, career ed, self-determination. Think about where we fit in. Think about where we fit in. I hear conversations sometimes that, you know, the O&M doesn't do XYZ. I would say that each one of these areas has a component in it that can be addressed through O&M. Right? And, again, it's just a conversation, guys. I just want to talk about where -- let's don't put limits on what our instruction looks like. You know, let's don't box ourselves in. We have an opportunity to provide experiences and a different kind of learning to our little friends because we're able to move around a little bit more. We're able to get them out of that static environment and build that interest, build that motivation. Thinking about our evaluation. And, to me, this is my third point. And I think it's probably one of the most important one. Because before we can go forth and provide support to our little friends, I think an evaluation, we have to have a thorough foundation of what it is that we're looking to provide that support for. Right? To analyze the student's level of safe and efficient movement and recommend the instructional services for current and future mobility needs. And I think that future part is sometimes the part that gets lost. I think we go in and we look at the moment and we make that determination and that's where we kind of leave ourselves. But we're thinking about -- if we're thinking back to when we're talking about that quality of life, that quality of life is going to expand over many, many, many years. So what does that look like? How can we provide support to address those needs, those concerns? And I know there's a lot of tools out there we can use. There's the Oregon Project, the Texas Two STEPS, there's the New Mexico inventory, there's a lot of tools you can use to help you really dig down and get to those areas of needs, what those limits are, what those concerns are, what those strengths and weaknesses are. Right? That we can kind of develop a better plan on how we're going to support our students. Okay. Now, I said all of that just to kind of give some background to kind of help to develop what our mindset is, what I feel like our mindset should be as a mobility specialist. I know when we do our evaluations, we look at things like -- like this, for instance. This is an example of a sequence of skills for an infant that's birth to 3. And you look at the skills that are listed here. Demonstrate awareness of body parts. Body movements. Demonstrate purposeful movement: Rolling, scooting, crawling, creeping, cruising, walking, running. Demonstrating tolerance of textures. Purposeful use of sounds, familiar sounds. Recognize familiar people. Explore and make discoveries within an environment. Search patterns. You drop something. You lost an object. Explore unfamiliar environments with an adult. Travel independently within the home. Right? Mobility. Mobility skills. And oftentimes what happens is we feel like we have to put those skills in a sequence, right? We feel like, you know, you have -- we do an evaluation on a student. We make this determination. This is where they are. We've been taught what O&M skills are and what they look like. And this is what we do. We put them in that sequence of skills that we're going to start introducing to them. And, of course, the natural step is what's beyond that. If we're traveling independently in the home, if we're moving independently in the home, then that now transfers to our classroom. We use landmarks. We use clues. Identify those sounds. We heard them before, now we're going to identify those things. We're utilizing what's happening within our environment. We start introducing those social skills. How do they function on the playground? How do they move around the school? What's happening in PE? What's our role as an O&M specialist within the PE setting? What's our role as an O&M specialist within the cafeteria setting? To me, I think a lot of times this is our comfort zone, right? This is our comfort zone. These are things that we know automatically. This is where we're going to go. This is easy. This is the easy part. What about these? What about those barriers? Sometimes these barriers that we do encounter will affect what our outcomes are, right? Whether that outcome, good or bad. Whatever that outcome is, if it's during an evaluation, if it's during a time of instruction. Those barriers often have an impact on where we go as specialists, what we're going to do as specialists. The evaluation, guys, it's just a snapshot. It's hard to make a determination on what a student is really going to need from us in that short moment of time that we enter the home or we encounter them in a play-based assessment, in a school setting. Whatever that is, that's a short window of time. It doesn't give us enough time to learn the child, it doesn't give us enough time to learn how that child learns. That takes time. That takes time. You don't know what you're looking for, right? Again, that's the conversation I want to have with you guys today is thinking about what does -- how much time do I need to learn what responses our students are giving us so I know how to collect that data, so I know that they understand what information I'm trying to relay to them and they're relaying it back to me. Do I have enough time to build rapport? Right? Just like many of us -- and oftentimes when you're working -- in your real world, in your real life there are things, there are people that you don't enjoy but you have the option of being able to walk away from it. Keeping that in mind when we're working with our students. You know, how are we going to get the data that we really need if they don't like us? If they're upset with us. Right? Again, identifying what their likes, their dislikes are. If I'm presenting something to them that they don't enjoy, of course they're not going to respond in a positive manner. And then what am I going to do? Am I going to document that as a negative? Or is it the fact that I didn't present something to them that was in a safe space for them. That was in a pleasurable introduction to them. That's going to impact where we go. That's going to impact what we're looking at. Thinking about those students that have those sensory concerns. Right? Could it be that you're talking too much during your instruction time? That's why they shut down. You're talking too much as a new person in their home doing an evaluation. That's why you don't get any information from them. They don't move. They don't smile. They don't laugh. They don't show any type of response to you being there because there's somebody new in my home that I didn't expect to be here. You're too touchy feely. Okay? That's a conversation I want to have. Think about that when we're introducing ourselves to our students. Whether you're doing your evaluation, whether you're in the middle of your instruction or beginning your instruction, things to think about. Because that does have an impact on where we go, whether or not we make that determination of eligibility or not. Right? Whether we identify what the appropriate area of need is or not. Because sometimes I don't understand what you're communicating to me. It could be us and what our approach is. It could be that you have on too much cologne, too much perfume. It could be the smell of the soap you used to take a shower that morning or your shampoo. Those are things that our little friends can't communicate to us and tell us I'm very offended by that. And so since I can't communicate that to you, this is how I'm going to communicate to you. I'm going to shut down. Okay? So just things to think about when we make that approach to providing that support. Physical limitations. They're not walking. I hear that one a lot. They're not moving. I hear that one a lot. That's what brings me to this conversation I want to have with you today. That's what brings me to that conversation I want to have with you today. I think sometimes it's important for, as O&M professionals, to get outside of that comfort zone. We know that we're working on how you travel in your environment. We know we work on how you get from point A to point B in the home. We know that when we learn -- we teach and instruct on how you're going to travel within the home that our natural progression is going to be what does that look like in the school setting. What are those skills going to look like in the school setting. But if we have those students who have those barriers, right, and we're doing those evaluations for what those current needs are going to be and those future needs are going to be, are we getting accurate information at that point? Think about what the development looks like. Think about what the quality of life is going to look like. It may be something very minimal. But if we're looking at the quality of life, it's huge. It's huge. If we're not making that determination that they need our support, are we missing out on those opportunities for learning? Is there something that -- an approach we could have taken to get us to that point that there is an opportunity for learning? And I would say my argument would be that we're orientation and mobility specialists. To get away from the mobility part. We already know that one. And think about the movement. Think about the movement. Think about developmental milestones, prerequisite skills. Think about orientation. Because, to me, I think that has, if not equal value, more value for a lot of our friends. Right? If they're not moving, if they're not walking, orientation. What does that look like? Those prerequisite skills? What does that look like? Think about what that movement looks like. How does that impact it? If you're not moving, if you're not having that opportunity to move, then there's no motivation for you to do anything. Right? If I don't know that there's something out there, then I'm fine just being in the space that I'm in. That's my comfort zone if I'm not able to move and get to it. Whether that's my finger, my toe, okay? Movement, that visual impairment's going to affect our students in a lot of ways. It's going to affect that motivation piece. My willingness, my interest. It's going to affect that. Because I don't know anything. It's going to affect that poor body image. It's going to affect our motor system. It's going to affect the development of the concepts that every other kid is getting. Think about your definition of what the ECC is. It's going to affect all of those things. It's going to affect your poor social skills. Again, get mom and dad on the floor. Get mom and dad involved. Get brother and sister involved. Oftentimes when we go in the home, you start bringing out toys, you start engaging with brothers and sisters and brother and siblings come along. Don't run them off. Have them be part of your sessions. That's motivation for brother, sister Those fears are also impacted. If you don't know that there's something outside of your space, there's no reason for me to go there. I don't want to go there. I'm afraid of what that is. If I don't know what those sounds are that are happening in the kitchen or when someone comes in the room or there's a ring at the -- the doorbell rings or something like that, those things are fearful to me because I'm not aware of those. Right? I guess my point, guys, is not to focus so much on what we feel is our comfort zone, which is that mobility piece. Think about those other skills that are out there that we're missing, we're bypassing. What prerequisite skills can I put in place that need to be in place, that need to be developed that are going to lead to those mobility skills that I'm comfortable with. My final point is just thinking about developmental milestones. And there are a lot of things out there that you can use. You can just do a Google search and find a lot of them. There's a lot of them out there. And I'm not saying that any particular tool is a tool that you need to go look at. My point that I'm trying to make is to make ourselves more aware of what they are. What are those developmental milestones. What are those skills that our students should be meeting or close to meeting or being a ballpark when we're thinking about development. Not talking about stages. I'm not saying that we need to go out and just follow a bunch of developmental stages and put all of our kids in that. That's not what I'm saying. I'm not saying that we even have to sequence all the skills. My point that I'm trying to make is -- I'm trying to facilitate that conversation on how we can best support our students. And one way that I feel we can best support them is being more aware of what those developmental milestones look like so when you're doing your evaluation you know what you're looking for. When you're determining what your activities are, what your IEP goals are. You know where the gaps are. When you're looking for or when you run into those teachable moments. You know how to stop and address another area that's involved in what you're already doing. That's the conversation I want to have. It's just making ourselves more aware of. As I was talking earlier in my introduction, it's where when you're out in that isolated world, you don't have anybody to bounce things off of. You don't have anyone to learn those little tips from. To share. So if we can make ourselves more aware of what those levels of development are, then I think it benefits us as professionals, makes us stronger. It benefits our students, our parents because now we're able to truly identify what those needs are and we know how to go about addressing them. I'm going to go through a couple of examples. Just to kind of pull the whole point together, just so you guys kind of understand what I'm talking about. If you look at -- like I said before, there's a lot of pediatric tools out there. There's a lot of checklists, charts, that kind of thing. But if you look at them, many of them will kind of be broken down into categories, much like what we follow today. And what we're used to, what we've learned in our coursework, that sort of thing. Most of them are broken down that way. And if you look at them, an example would be the area of cognition. And when I asked before about all the areas, what areas are applicable to O&M, right? This is where I'm kind of going with that. So if you're looking at cognition, you're talking about those compensatory skills. You're talking about that concept development. And if you haven't already noticed, a lot of times when you're working on a particular area, a particular skill set or particular gap in skills, a lot of those skills are going to overlap. So if you know what you're looking for and you know how to identify and come up with a plan, you're not making 15 infant activities. You're not having 20 IEP goals. Because a lot of the skill areas from the ECC are overlapping. Okay? So here's an example. So if you're thinking about cognition -- and we're thinking about our little friends who are not moving or who have that limited movement, right, who may or may not be a student that we work with. Okay? An example of those prerequisite skills would be looking back and forth at two objects. Simple. Explore in a variety of ways. Putting things in your mouth. Bring them up to your face. Waving them in front of your face, in front of your eyes. Kicking your legs. Okay? If you don't know what your body does, if you don't know that you have those body parts, how are we later going to work on body image? How are we going to work on body concepts? For our little friends that have that limited mobility, that limited movement, our instruction could be that simple. Once I build my rapport, once I get to know you, once I build that trust, what can you give me? If I look at it only in a snapshot of the moment that I do the evaluation, I may not come up with anything. Because you're shut down. You're not showing me what your potential is, what your skill set is. But it's there. We just need to provide that time to be able to identify that. So it could be something just as simple as getting our students to kick their legs. Right? To move their hand. That, to me, is movement. That's not that mobility piece that we always tend to focus on. That's movement. Because that gives you an opportunity to build on something. Right? Whether you're just kicking your feet and you're kicking them against my leg and we're going back and forth, that's movement. Because then later I can introduce something to you that now makes a sound, plays music. Now I gave you some motivation. I've developed your interest. I've piqued your interest so now you're willing now to show me a little bit more of what you have. Again, we can't go and start talking about those headlines, right, of skills that we always address that we know that we're comfortable with. If our students don't have that foundation and we had that opportunity to develop that foundation. Can they play with a rattle? Do they touch you to start an activity or if you stop doing the activity, do they make a movement that indicates to you that I want to continue that? It could be a smile. It could be simply looking at you. Communicating that piece to you that, hey, that's something I enjoy. Let's continue to do that. Can they hold things in both hands, in one hand or the other? If we're not there working on these basic concepts, then how do we know if they can or they can't? If it's not been introduced. Again, thinking back to where we began. What's the concerns, what's the issues that the family has and how can we facilitate setting up opportunities for learning for that family, for our sessions, for those other service providers that are coming in. How can we help facilitate what their sessions may be for them to be able to reach their goals. Playing a game, clapping hands. You got that child engaged with you now. That's learning the body. My hands, these things that I have in front of me, they can make a noise. As an O&M, again, we're giving those opportunities. If I can give you the opportunity to make a noise, can we now build off of that? Can you reach for something now that you have an interest in? Thinking about communication, social, emotional. Language, literacy. The skills that I'm showing you are in that birth to 12-month range but you kind of get the idea, right? There are some things that we're kind of skipping over or we have a tendency to skip over. Imitate sounds. Moves the body to music. Initiates social contact. Again, do they put their foot out just to touch your leg? Do they reach out to touch your hand, grab your finger? Extend their arms in a position that they want to be picked up. And that may be part of your transition within your sessions. Do they show a preference for a certain toy? Do they play peek-a-boo? Do they reach and touch a book. I can't get you to read a book if you don't know what a book is. That's as simple as I can give it to you. So, again, as that O&M professional, that's an opportunity for us to facilitate those learning opportunities to give those experiences, to develop that play. Through that play, now we're engaged with one another. We're learning from one another. If I'm involved in music, then music can be part of my routine. It could be my break. It could be my opening activity. It could be my closing activity. Again, it gives you an opportunity now to start working on parts of the body. If you look at the skills that we just read through, I see a lot of social interaction there. I see self-determination there. They're overlapping. There's no need to write multiple goals for each single thing, you're working on them. And you guys are probably working on them right now, you just don't know it. Or you haven't thought deep enough to say, hey, I did cover that. Or I'm addressing that. Because before -- in this situation, before you're able to turn pages of a book or work on turn taking, expressing your desires, things like that, there are other skills that can be developed to get to that point. You will see a lot of times this heading as adaptive. Enjoys taking a bath, pulls off their socks. Feed themselves finger foods. Independent living things. Self-determination things. Right? Rec leisure things. If you like eating, feeding yourself finger foods could be your rec and leisure. but if you don't get those opportunities to do so, then those experiences are not there. Those true experiences are not there. I would argue also this is an opportunity when you're talking about those beginning stages for us to push in and work with that family during an eating activity, eating routines. During lunch, during snack. There's a lot of things that are there. We can support that family. 

>>Kaycee: Scott, this is Kaycee. We had a question in the chat asking if you have suggestions for specific Deafblind resources. 

>>Scott: I don't that I use specifically. I would say when it comes to -- my approach when working with my Deafblind students is very similar to what I do with my typically-developed only VI students. The skills are still the same. Right? The communication piece is where the breakdown is. And so as far as just a resource that I always go to, I don't really have one, I would say. It's still a compilation of a lot of what we use for any of our other students, to be honest with you. Talking about routines as far as what the family does in their natural environment, what their family -- what the family uses as far as -- or what they engage in as far as their daily activities. Working with those parents on what utensil can I use. What does that look like? Is there a specific color of a spoon or a bowl? What's my contrast? Those are opportunities we can have as far as working with our families. Putting your shoes on at the beginning of a session. Taking your shoes off. Right? Two concepts, on and off right there. You're verbalizing that. You're opening up a snack container. There's opportunities to develop concepts there. If you have students who enjoy taking a bath, you're talking about that the water is cold. The water is hot. It's wet. Let's get a towel so we can dry. There's a lot of concepts there that I think sometimes we don't really bring to mind or we don't really address specifically that can be incorporated with the family's activities every day, if they know that can be beneficial. What do the lotions feel like? What do the lotions smell like? But setting up that routine, giving those students an opportunity to develop those skills within that setting. Talking about more of those mobility things, that physical development, that health, that motor -- you'll see that a lot of times. There's a lot of things that are going on before we can begin walking. Okay? And, again, my argument would be in this situation every move, it counts. Every move counts. Not the walking, we're not really focused on the walking, but what are those prerequisite skills I need to have before I get there? How does the child roll over? Can they roll over? What if they stretch their legs out? If you think about your nieces and your nephews when they're very little and watching their siblings, they're watching them to learn what they're doing. You will occasionally see them kick their legs when their siblings are running around doing things because they're trying to associate what they're seeing to how their body operates. And as O&M specialists, that's a role that we have to play. If we have those students who are not moving, we have those students who are not walking, we facilitate that. And it may be through that manipulation. But not to bypass it all together because there are skills that could be learned. Can they sit supported, unsupported? We may need to manipulate them to get into that position so they understand that my body can go from just this flat, prone, or supine position to something else. How do I pull to standing? Do we support them? To get them to that point there's a lot of steps we can take before we get to that focus on walking. And just to think about a couple of other areas real quick. Self-determination, rec leisure, as I mentioned before. It's going to be in almost every single activity that you do. Right? If we're providing an opportunity for learning that our students enjoy, that's what we're looking for. If there's an opportunity that they enjoy, then you have an opportunity for rec leisure because they're learning skills that they would more than likely follow through on later. If we give them that opportunity to respond to those requests that we're giving. Give them an opportunity to respond to something that they like and that they dislike, there's self-determination always happening. It's just an opportunity to make things enjoyable and not bypass those things. Developing those routines. If you're thinking about career education for little friends, it's not just the fact that they're not working, what's the organization look like? That clean up song at the end of your session. Or some ideas. Developing that routine. Like I said before, if you're going to open up your session by reading a book, if you're going to close your session by singing a song, that's always that song, right, or always that book. Then they have an opportunity to develop and predict what that session is going to look like. They know what they're supposed to do during certain activities because we're using those same activities. We're working on those same skills. Those skills may take a while for us to teach them and learn them and comprehend what we're actually doing. But it gives our students an opportunity to anticipate what their day is going to look like. Who you are. Scott's coming through the door. I hear his voice. I understand his voice. I anticipate what he's going to do because he's done the similar things or the same things every time I've been here. And they have been things that are fun to me, I enjoyed them. I welcome him into my space. If they're not, they're crying. They're walking away from you. They're moving away from you. They're doing things that are not conducive to what you may have in mind for that particular session. I don't want us to lose sight that we're orientation and mobility specialists. That we don't have to function within that static environment. If you have those students who are not moving, if you have those students who have had those limited experiences, that they don't know what's outside that space, that mat, that rug, that blanket that they may be on or that playpen or that play room they're in, we can manipulate them to get there. It may be that you're helping them to roll to get to something. Those are opportunities. Utilizing a wheelchair, utilizing a gait trainer. Utilizing a walker. Utilizing a wheel rifting chair. To help you navigate but give them an opportunity to learn other experiences except for what's being brought to them. They have an opportunity to go to those places and be able to explore those things and take in that information. If you're doing that manipulation piece, talk through that. Prepare them for what you're going to do. We're just not coming in and just grabbing them and yanking them around and doing all this stuff. We're teaching them what my body does. What's this thing that's on the side of me. Why is it there? What can I utilize it for? What's the benefit to it? Can I get my toe to move? Can I get my finger to move and touch something, explore something that I like? If I can get my finger on it, can I get my hand on it now? Here's my final piece, and I just want to say this. And I see it a lot of times with professionals that I go out and observe and I work with. We have to slow down as professionals. I think we come in sometimes with our own perceived notion of what we want to do but we're not thinking about what that child is like that day. Could be sick. Could just not be in the mood. Could not like you, right? But let's slow down. Take an opportunity to learn the child, build that rapport, understand what their likes, their dislikes are. Understand them, how they communicate to you. Because that makes our sessions a lot easier. It makes the progress come a lot quicker. Think about those prerequisite skills. I put these images in here for that reason. You can't get a basketball and just go dunk. Even if you could. Right? You've got to learn how to dribble first before you learn how to shoot. You got to learn how to shoot before you get to that chance of being able to try to dunk the ball. And I know sometimes it seems as O&Ms that that's going to take a long time or, you know, I got to get them walking now. I got to get them moving now. I got to get these now. The skills don't make a whole lot of sense if you don't have those prerequisite skills there first. And I think that's where my focus is. That's a conversation I want to have with you guys. Have you think about that before we get into our comfort zone, to think about what skills are needed prior to getting there and how does that look. What do those activities look like? What do my sessions look like? How do I build on those skills? So now I can move into the skills that I'm a little bit more comfortable with. Okay? That's all I have for you guys today. Thank you for joining me. Hopefully it was beneficial to you and we'll see you again soon. 

>>Kaycee: Thanks so much, Scott. Thanks, everybody for being here today. I'll go ahead and give the closing code in case anybody needs to jump to their next meeting. The code for