Week 1: July 1-6

Core Curriculum Unlocking the Foundations of Reading
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  1. What has your involvement with literacy instruction looked like in your role? What factors have limited your involvement in literacy instruction? Are those factors things that can and should be changed? Why or why not?

I have been a TVI for 13 years, but I went to grad school to be an SLP (obviously that didn’t work out), but when I first started in this field, it was in a very small town in Louisiana. The elementary schools needed help with Early literacy interventions. I was given training on the DIBELS and helped launch reading intervention for all students that were below grade level. I believe my education for becoming a Speech path and training for early literacy interventions helped mold my understanding of literacy development. Without that I’m not sure where I would be in this field.

With that said, I have not had limited involvement in literacy instruction. I have probably inserted myself more in the instruction with my students than most!

Also in my role I have mentored several TVI’s in graduate programs and after working with them & listening to these modules it is very clear to me that if TVIs do not have a background in reading interventions or a basic understanding of building literacy skills that the concept of teaching a student with a visual impairment Braille is very difficult. I have seen TVIs, gen ed & sped teachers break down over a child struggling with decoding, fluency & ultimately comprehension as the demand increases! Resources (such as this course) for TVIs is critical for the literacy success of our students.

  1. How did The Eye’s Role in Learning to Read shape or alter your opinion of serving students with Convergence Insufficiency.

I think it helped me better understand the complexity of how CI affects reading. I have had several FVE/LMAs for CI since the OSEP letter and most of them have not qualified as they were reading on or even above grade level, but some did show signs of fatigue and needs within the ECC. The video and information did confirm the services/accommations that have been recommended were correct. CI is not an eye condition to be dismissed, teachers need to understand how that student learns best, what accommodations may be needed for success & students need to be able to advocate for their needs.

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In preparing reading materials for my student, I’ve found that using Bookshare can be helpful in obtaining a novel that my student might be reading for an ELA class. I try to get Braille books whenever possible, but I’ve also had to rely on the audio book when a Braille format has not been possible. While I know that the goal is to provide accessible materials to our students, I’m a little hesitant to always provide audio books as a means of accessing the general education curriculum. By always listening to a book, I feel that my student isn’t getting key reading elements, such as spelling and grammar structure of sentences. What is your stance on providing materials for students? Do you feel that their needs to be a balance to the amount of materials that is either in Braille or audio? This is a question that I grapple with,and I’m still trying to find a balance between the two reading mediums. Thanks.

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Shannon Pruitt, Week 1 Responses

  1. My involvement in literacy instruction has mainly consisted of teaching braille symbols and their use to students who already know how to read and access print, as well as to very young students who are learning emergent literacy skills. I also perform assessments to determine reading skills in the context of a Learning Media Assessment (LMA). However, when collecting data for the LMA, I typically use the data to determine if the student is functioning on grade level, how their reading fluency or comprehension might indicate the need for accommodations, and if there is a medium that is clearly more efficient due to fewer errors, faster pace, or student preference. For this reason, my involvement with students who are simultaneously learning to read and learning braille has been limited. Additionally, my involvement in literacy instruction has been limited by my lack of in-depth knowledge related to reading research, as this was not covered in my personnel prep program to become a TVI. Although I had previous knowledge in education as a math teacher, we also did not receive instruction on teaching reading. For students I have taught who already know how to read print, they either have a degenerative condition or have lost their vision unexpectedly, so we often rely on their experience with print. Recently, however, I have been working with students who are English Language Learners. While I am teaching reading via braille, I often also have to teach many “reading” concepts, which has forced me to be more involved from a literacy aspect. The students I work with are often limited by natural caseload distribution and individual student needs. However, I hope to play as active a role as possible as a team member for the student. So, yes, I hope this will change more in the future.
  2. Though it is not necessarily the response I identify most with, which is an entirely different question, I think the response that was most influential to me was Cay Holbrook’s response. I have mainly chosen this response because one of the key ideas is that the teaching of braille and reading should not be separated, as we would not separate the learning of print from reading. Additionally, it seems that if a student is to receive adequate instruction, it will require a team effort and the avoidance of working in silos. Everyone’s expertise is needed for maximum benefit. I think this is ideal but often realistically hard to achieve. Given the list of characteristics needed to teach reading, I feel that in most cases, the TVI does exhibit most of these. However, the one hangup, which Holbrook points out, is that the TVI may not have the needed understanding of “the development of language and literacy in young children.” As Holbrook and the other authors point out, this really requires a fundamental change in personnel prep program requirements for TVIs. I do have some concerns about the implication that TVIs should be teaching parts of the core curriculum. This is because there are already so many areas where a TVI is expected to have experience and where their expertise is really needed that adding more core to their plate may be exhausting and overwhelming. Also, I think it continues to open the TVI to being used in ways that are less beneficial to students and that tend to isolate students more. Clearly, it is an area for much further discussion.
  3. Since the release of the 2017 OSEP memo, I have seen more and more students being referred for special education for eye movement concerns. Because of this, we have been evaluating and determining the needs of these students for some time, so I don’t think it changed my opinion in any way. However, it did reinforce the reasoning behind why a TVI plays an integral role in helping the team understand what might be going on with the student. I really like the explanation of saccades because sometimes that is a hard concept to explain to others. Additionally, I found the information about the different cranial nerves very informative, as I was not familiar with all of these and their impact. I certainly want to learn more about nerves and their impact as I complete my own research and development.
  4. North Carolina was one of the states that previously used criteria other than the definition of “visual impairment including blindness” for eligibility by requiring that there be an indication that the student had to have an acuity of 20/70 or worse. Thus, this qualification was removed from our eligibility requirement. Because of this, I feel well-versed in the details of the memo and its implications. While I understand the memo’s reasoning indicating that states and LEAs cannot add the modifier, it seems that this is the result of changes to the way “visual impairment” has changed over time. As the memo points out, other disability categories such as orthopedic impairment and intellectual disability specifically indicate that to be determined eligible for those categories, there needs to be a “significant” or “severe” impact, while visual impairment does not. However, when this law was most recently updated or revised, some of the conditions we are facing today, such as CVI and convergence insufficiency, were either unknown, just becoming known to medical professionals, or their educational and functional impact was not yet understood. Now that we have a better understanding of these conditions, it is understandable that they should also be included. However, because they can still fall under the guise of visual impairment, I find that this can be confusing for parents and other team members because in many cases (not always, of course), the specially designed instruction is best handled by a team member who is not a TVI. Thus, it seems to me that it is probably time for a revision and revisiting of eligibility categories under IDEA. Either the VI category needs to include a modifier such as “severe,” “significant,” “neurological,” or “oculomotor,” or possibly there needs to be other categories considered, or even just a generalized category like they have previously used in Iowa, such as “a student with a disability.” Regardless, it seems there needs to be a meeting at the table to discuss this.
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Reading Instruction for Students with Visual Impairments: Whose Job is it? (JVIB, 2008, p. 197-209)

Which author’s (Blankenship, Swenson, Farrenkopf, or Holbrook) response is most influential to you? Why?

Before responding to the question, I want to share that literacy and reading instruction has been on the forefront of my mind for some time now. I am finding myself learning as much as possible about Reading and the science behind it. One of the most interesting (and basic) things that I have learned in my reading exploration is that as humans we are not born to inherently read. We need to ‘learn to read’. For me, understanding this basic idea makes it even more important to learn as much as I can about reading and the process behind learning.

With my response I am torn because I felt that all three presented great ideas for reflection.

As a newer TVI (5 years – 3 emergency certified), Blankenship’s response was “Indeed, recent surveys found that the number of teachers of students with visual impairments who responded did not feel that their university programs had prepared them adequately to feel confident in teaching the content areas of the expanded core curriculum”. If individuals are not feeling confident in the basis of what it means to be a TVI, how can we expect them to look beyond what they ‘need to do’ as part of their vision session? Personally, I feel that, due to the emergent needs of certified TVIs, university prep programs are covering the basics, with the hope that people will continue to grow in their knowledge and practice. Honestly, we need more. More instruction beyond the basics. At the end of the day there is only a certain percentage who will look to grow and learn beyond their university program.

I wholeheartedly agree with Farrenkopf that ‘everyone has a role to play in teaching children who are visually impaired to read’. I also agree with many of the limitations she lists, which prevent ‘best practice’. Beyond the budgetary concerns, there remains the larger issue of having certified teachers of the visually impaired. Even with offering emergency certification, districts and agencies continue to struggle to fill positions. I guess I question how to attract more qualified people to the field.

Finally, regarding Holbrook’s response, I particularly appreciated her list of characteristics needed for a person teaching reading to a child with a visual impairment. What stands out the most from these characteristics is ‘Ability to Teach’. Not everyone who enters this field truly has the ‘ability to teach’. Thinking back to my earlier comment on attracting individuals to become TVIs, there needs to be greater consideration when accepting people into university preparation programs. Perhaps even the consideration of ‘why do you want to teach individuals who have a visual impairment’.

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You are fortunate to have had the opportunity to learn about the process of reading. I would be surprised if there are many other TVIs who had the training you were able to achieve. I feel that with your additional training and knowledge you are providing great support for your students and their teams.

I particularly like how you say that you inserted yourself more in instruction with your students than most. Based on your response, you seem to embody many of the characteristics that Holbrook calls for in her response.

Your comment surrounding visual fatigue in students with convergence insufficiency was also noted. I feel that we need to offer more support for students who deal with visual fatigue. Visual fatigue can be difficult to explain to district administrators and teachers. Teaching students self-advocacy techniques and alterative methods of access so that they can ‘handle’ times of visual fatigue is very important to consider.

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What struck me most about your response was the reference to Holbrook’s quote, 'the TVI may not have the needed understanding of the development of language and literacy in young children.” For me, this is a key concern. Without having this base understanding I feel that we cannot truly support a young child learning how to read. Unfortunately, silos exist in this field. This is especially true in an intinerant setting. We may only get to see a student one or two times per week. Even for kids who receive daily vision support there are always other concepts or ideas that need to be addressed or pre-taught.
Reading instruction is an area where we, as TVIs, need to advocate for learning/understanding more.

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I agree with your concerns related to listening or using auditory inputs. I had a very very bright student, who didn’t like the feel of braille, so she was allowed to use text to speech for most of her access (prior to when she was on my caseload). By the time this student was in high school she was able to formulate wonderful and insightful thoughts and ideas. Unfortunately, she was not able to share her thoughts and ideas appropriately when asked to do so in print (using word processing software). She had terrible spelling, sentence structure,and mechanics. This was a result of always listening to words and not ‘reading’ them. While this may have been acceptable at the K-12 level, the team questioned the use in a secondary education setting.
We need to be more aware of where our student’s skills need to be once they are out of the protection of the K-12 environment. Having access and the ability to use auditory means is great but it should not be the whole.

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Reading Instruction for Students with Visual Impairments: Whose Job is it? (JVIB, 2008, p. 197-209)

  1. What has your involvement with literacy instruction looked like in your role? What factors have limited your involvement in literacy instruction? Are those factors things that can and should be changed? Why or why not?

My involvement in literacy instruction has been varied. In my current role, the vast majority of my caseload encompasses students with significant disabilities in addition to vision. Additionally, most frequently these students have CVI. I have a very small portion of my caseload that are learning literacy in traditional manners. Further, I have no braille students on my caseload. All of the other remaining students I serve vary on the low vision spectrum.

Given this, my involvement in literacy instruction has been mostly through collaboration with the different classroom teachers. The amount of collaboration varies from teaching team to teaching team. Additionally, my level of collaboration also varies on the student. I have one student who is going into 2nd grade with low vision, but then I have two soon to be 7th graders with varying eye movement needs. For my soon to be 2nd grader, I am more involved than the 7th graders. This collaboration also involves varying AT.

Some of the limiting factors for me include staff not knowing my role and/or what I can provide to the team. I often need to take a considerable amount of time educating staff on my role… all while we are trying to provide a solid educational experience. This, however, is something that will be improved with time. Staff in my district have had poor prior experiences with various vision professionals. I am entering my 3rd year in my current position and it can only go up from here!

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In refrence to your point about “releasing the role,” I think this is a limitation that exists and is likely something that will exist until staff know and understand our role(s). I am the TVI and AT Specialist in my district. I replaced a series of people who did not advocate for the students and did not collaborate in an effective manner. So many bridges were burned. Over the past 2 years, I have been reviving the belief that someone in my position 1) knows what they’re talking about; and 2) will actively collaboarte with staff. I completely understand the struggle when it comes to “releasing the role of follow through.” I find that I often need to teach the staff (have them play the role of the student) so they understand where I am coming from.

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I have struggled with services for students who have convergence insufficiency. Based on my training, I do not feel that I should be the one “driving the bus” for these students. While I am on board to do FVA/LMA for these students and provide recommendation for accommodations; I do not feel that I have the training in various reading strategies, OT strategies, etc. that provide these students more benefit. I often feel that many of the accommodations and things that I suggest are things that could be discovered and thought of from other team members, such as th reading specialist, the intervention specialist, the OT, etc. I do not feel that I need to be the sole person providing support or even specially designed instruction.

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How did The Eye’s Role in Learning to Read shape or alter your opinion of serving students with Convergence Insufficiency?

The learning module by Dorinda Rife really hit home with me, especially the discussion about convergence insufficiency and whether or not that falls within our scope of providing direct instruction as a TVI. Like another cohort member noted, I have come across a local optometrist that has had a heavy hand in identifying and referring students with convergence insufficiency. While I do not have any issue with the identification, as it is a real thing and as the author explained, affects reading efficiency, speed and overall comprehension, and should be addressed, the difficulty I have is with explaining to parents, and sometimes teachers and administrators that putting the student on an IEP, with a qualifier of “Visual Impairment”, is not always the best/right course of action for many reasons.

  1. While I hate the excuse that I “don’t have the time”, the reality is right now that when you have a case load that is already at it’s max with student’s displaying more significant, long term needs, lack of qualified TVI’s in the area to meet the growing and changing needs, and a coverage area that is so big that you often spend at least half your day in the car, you have to prioritize!
  2. A student with convergence insufficiency is often prescribed vision therapy as a treatment plan. Way too often, I have to explain that I am not a “vision therapist”. Thus far, vision therapy is considered a medical treatment done under the supervision of an eye doctor. While I do not provide “vision therapy”, I am more then happy to provide consultation services to assist with the implementation of accommodations and basic education of the disorder to help the student, family and school staff understand the struggles the student may be experiencing. The accommodations in itself can be addressed with a 504, with the assumption that with treatment from the eye doctor, reinforcement of training at home, and accommodations at school, the deficit can be corrected. It is important to note the importance of TVI’s part in educating the family and teachers about the disorder, so they may better assist and understand the student’s needs. Dorinda Rife shared her personal experiences as a struggling reader in regards to the social and emotional toll it had on her. I see that with the students that I have worked with as well. He’s “not motivated”, “avoids work”, “distracting to other students”, “off task”, are common phrases I hear from teachers. My thought is, I would be too if I was not able to follow along with what the class was doing, and constantly fell behind! It’s important for teacher’s to understand the potential root cause of the behaviors and to provide support and encouragement.
  3. While it doesn’t always come together this perfectly, ideally, a student who has followed the Dr.'s treatment plan (though expensive), who has had family involvement and support (encouraged follow through with at-home treatment exercises), and who have received support from the school (additional reading instruction at a slower pace, encouragement to use accommodations and tools to access content), have shown significant process to the point that consultative services from the TVI can be discontinued.

While each student’s plan is individual, with these student’s I have often remained as consult, perhaps providing more direct contact or frequent email check-ins in the beginning and tapering off as the team and student adapt, keeping my “door open” (encouraging them to reach out to me) when any questions of concerns arise. This works for me personally, as many of the students attend schools that I am visiting on a regular basis, so I can work quick check-ins into the schedule.

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You make an excellent point. I feel that sometimes, as a whole, the school district might do what is easiest for the child. That may be because the child likes it, meaning using audio for everything, and the student can still learn, and complete the work. While that may be true, what is easy, may not always be best for the child. By always using audio to access print information, then the child is losing out on valuable skills, such as spelling, decoding,and sentence structure. Not having these skills can then make it very difficult to them have to articulate thoughts in the written form.

I’ve been working with a student now for the past four years. When I first became his TVI, he was not using Braille as efficiently as he is now using it with me. When I first started working with him, he struggled to write down his thoughts. He was so used to having someone write for him. I had to work hard to get him to write in braille,and then read back in Braille what he has written. With the use of Assistive Technology devices, like using his iPhone to assist with spelling, he is now using a Braille Sense to write out his assignments. Knowing how to read, not only helps to access the print information,but also allows the student to express thoughts and feelings in a written form. Reading and writing go hand and hand. We can’t have one without the other.

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  1. How does the OSERS 2017 memorandum contribute to your understanding of eligibility for students with visual impairments, including blindness? Evaluate the implications of removing modifiers from state level definitions of visual impairment, including blindness.

I am excited for the opportunity to participate in this cohort because unlike other professionals here, I am not a TVI. My background experience as an intervention specialist includes collaboration with TVIs and, what I learned from the readings, using the role-release model that I experienced when I was teaching my students. However, now I am working at my state educational agency, so I took particular interest in the OSERS memo in which I am familiar.

I want to continue growing in my specific knowledge of visual impairments as I serve the low incidence and sensory disability population in my current role. I have referred to this memo in my work before, but my understanding was deepened by watching ‘The Eyes Role in Learning to Read’ and understanding the conditions, eye movement challenges, sensory vs. motor nerves, muscle and neurological disorders impacting eye movements, to really deepen the meaning of ANY impairment in vision (regardless of significant or severity), included in the OSERS memo.

I have advised many times regarding the two-prong model of eligibility under the IDEA disability categories, and it makes sense to me that since any impairment in vision is considered eligible, you must not only look at certain conditions before looking at the adverse effect on education. I am not familiar that my state has ever provided examples before, but I do know that we have guided around having both a visual impairment (even with correction) AND an adverse impact on education.

Obviously, the implications to not including a modifier mean that more students can be eligible for services under the definitions, and it cannot be limited to certain conditions (muscular conditions, neurological conditions). Dorinda Rife brought up a good point that there can be confusion regarding the responsibilities and training to work with students eligible for services. I agree with the documentation of needs in the Learning Media Assessment, but do agree that without modifiers, there does need to be more explicit understanding of all the roles working together to meet a student’s needs. I do like that not including modifiers does reiterate the fact that total vision is the visual stimulus, eye, nerves and brain all working together.

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As you mentioned, how might one identify a student with convergence insufficiency? While we may identify that a student is struggling in reading, it would not be up to the teacher to diagnose. The most you can do is make a referral if concerns arise. I would guess that to some extent, difficulties may show up during a school-based vision screening. At that time, I would expect that a referral would be made to have the child formally assessed by an eye care professional who would diagnose them. From that point, it would be up to the family, then the school to reach out to the Teacher of the Visually Impaired to perform a FVA/LMA to determine if vision services needed and to what extent.
On the other hand, if the child passes the school based vision screening, but still displays significant difficulties with reading, to the extent that multifactored assessment is needed to determine needs, I would would hope that an eye report would be an essential piece of the assessment to rule out vision as cause.

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Thank you for sharing this experience. I am a former IS (and have never been a TVI) and I did work closely with my TVIs. I can relate to what you are saying, as I did not fully understand the role of the TVI on my team. I also taught students with complex and multiple disabilities, many with CVI as well. However, throughout my experience with the TVI’s, I have learned so much and grown in my knowledge of working with the population of students I served.

I wanted to encourage you that your time spent educating staff is valuable! Once I was trained in strategies and the use of materials, I was able to open up so many more experiences and opportunities for my students that they would have missed out on without the knowledge my TVI’s shared with me. It also gave me a lot more options to work with the students and engage them in new ways throughout my regular lessons.

Typically, a lot of my students had visual impairments, along with other disabilities. I used to dedicate a section of my classroom to focus on vision activities with children, so I could learn more about them, and implement things that my TVI had shown me. I would also learn from the TVI things to teach the other adults in my room to aid in understanding an individual student’s vision, including things like wait time, visual field preference, color preference, high contrast symbols, hand over hand prompting, etc.

So, my message to you is thank you for being persistent with the teachers and I hope that you can continue to build these connections with the children’s team!

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Thank you for sharing this information. I find it very interesting because I work at my state educational agency. I am looking forward to looking through this guidance that you shared from North Dakota.

We also talk about the two prong approach to eligibility in our state, and the focus is on the adverse impact to education and need for special education. We also direct people to the functional vision assessment and learning media assessment to gather information.

I have received a lot of questions regarding vision therapy and I understand this comes with the convergence insufficiency being included (and any visual impairment) in the definition for eligibility. However, vision therapy may be required for an individual to receive FAPE under IDEA, so those are IEP team decisions based on the data they have for the individual child.

For example: Z.J. v. Board of Educ. of the City of Chicago: Because a seventh-grader with infacility, convergence insufficiency, and oculomotor dysfunction would benefit educationally from vision therapy, a District Court held that an Illinois district’s failure to provide such services denied the student FAPE. It awarded the parents $6,340 in reimbursement for the costs of an independent developmental vision assessment and 36 weeks of vision therapy.

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  1. What has your involvement with literacy instruction looked like in your role? What factors have limited your involvement in literacy instruction? Are those factors things that can and should be changed? Why or why not?

My involvement with literacy instruction most often looks like supporting the regular classroom teacher in their role by providing them with feedback on accommodations and adaptations that can help make the curriculum more accessible to my student. This most often looks like providing resources for large print or digital materials and assistive technology instruction for the student. I have had students that I taught braille who were also learning to read print. When these students are young, I am able to embed some of the braille learning within the regular print curriculum; however, I have found this to be more difficult as the students progress through school. I become the “braille teacher,” and the regular classroom teacher is the “reading teacher.” One of the main factors for this is that I don’t have a strong background of teaching kids how to read print. I am not educated in the dynamics of the print curriculum, phonics, etc. I learn what I can from the classroom teacher and embed that into my braille lessons as I am able. This can be changed by providing more TVI’s with reading instruction education.

  1. Which author’s (Blankenship, Swenson, Farrenkopf, or Holbrook) response is most influential to you? Why?

I identify most with Holbrook’s response because she discusses about how there is no right answer of who should teach reading to a student with a visual impairment. She states how it “takes a village” of people with a lot of dynamic qualities. Ideally, there would be one person to teach reading-the TVI; however this is not the case in today’s world due the lack of preparation for new teachers about reading instruction for young learners. She suggests that the solution to the problem lies in changing teacher prep programs, and I agree with this approach.

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Sometimes I think that people who interact with a student with visual impairments are so concerned about their loss of vision that they don’t ‘want to make things worse for them’. Yet by not having the same high expectations for the student with VI they are actually doing them a great disservice.
Thank you for sharing about your student. It is great that you helped him to find a way to share his thoughts and ideas using an appropriate method.

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It is interesting that you bring up english as a second language learners. I have also had more of these students on my caseload and find myself teaching more “reading concepts.” While I feel like I have a basic knowledge of how to teach reading after being in the teaching field for over 10 years, I do not have much experience with ELL students and best practices. This is another area that I believe universities need to focus on more prep for new teachers.

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Having been recruited into the field of VI 5 years ago, after spending 18 years as a Teacher of Students with Multiple Handicaps, I got my certification in a 2 year program/cohort. While I had a wealth of knowledge from my previous job experience that I could fairly easily incorporate into the role of TVI, I agree that the preparation programs are just touching concepts vs. really preparing us, so I would like to see improvements made to the curriculum. I have found that the field of vision is so very vast that you can not possibly fit it all into a 2 year program understandably, but find that some of the important pieces were missing as I look back. One important area was how to teach braille! I was top of the class in learning braille, but learning the variety of methods, strategies and resources was skipped over.