I have alluded to this in one of my other posts; I have a student with CP, exotropia, and CVI. He also has significant interfering behaviors. According to Mom, he is a totally different kid at home than at school. We have not been able to engage him in communication, learning, or anything at school, because he doesn’t tolerate anything on his tray or in his area. He is unable to use direct select (fingers/hands) due to his CP, so the AT and I have been working on different access methods. It’s frustrating for everyone because he is 8 years old and doesn’t have a communication system in place. As an SLP, this breaks my heart.
I talked with mom, the psychologist working with him, my supervising SLP, and we came up with a plan for me to begin incorporating speech at home rather than attempting carry-over and generalization in the classroom first. By doing this, everyone believes that this will create a motivating environment for this student to communicate and be less frustrated by his inability to get his wants and needs met. Obviously, we still have to work through these barriers at school, but I do believe this will be an effective and authentic experience for him, his mom, and myself.
Not me sobbing when I read this. Wow. This is such a beautiful and inspirational story about how and why we need buy in! Something I have really enjoyed is that as I learn about CVI, I am able to use my TVIs and my O&M peeps to help me advocate as an SLP to also discuss communication skills revolving around CVI. I am recently “relocating” from one area of my school to the Intensive Program, where most students are mutiple disabled, are BLV, and have significant interfering behaviors. On top of that, most of them do not have an established form of communication (verbal or otherwise). Behavior is definitely misunderstood and there needs to be more education around that as well! We can’t do better until we know better, right?
I love this so much! It is absolutely important and necessary for teachers to know we are available and willing to help. Something I’m seeking to do this year is to meet with each of my teachers and just discuss what communication looks like for the students of theirs I have. It will be new for me to do this, but I am hopeful it will work well! Fingers crossed.
I agree, Katherine! We can’t do better until we know better! That’s a perfect statement. I have taken a lot of classes on CVI the past several years and honestly find the more I learn the less I know. I am always learning from my students and adjusting what I think I know as it always changes.
What a great way to adjust instruction! As we know, the classroom setting can have so many unpredictable pieces making it challenging for some of our students.
I have a mostly nonverbal student who was in first grade last year. He is learning to talk but due to having a trach for over 6 years, this has been a process for him and though he’s making great progress we cannot understand him well. He has a talker and in kindergarten used it very well. His first grade classroom was not accessible in many ways and he refused to use it. He worked with the SLP more recently in a separate setting and did very well. I am convinced he is not able to access this tool in the chaotic setting he was in. We are working on a new placement for next year as he cannot function under the current circumstances.
Yes, this is so important. Learning AAC is just like learning a new language. Students have to be immersed in its use, and if there is not 100% buy in from all stakeholders, it won’t be successful. It sounds like he has a great advocate in you!
What I have found most useful and effective in informing and educating the teaching/support staff about a student with CVI is taking the time to provide a detailed, specific presentation on that individual student to the teaching team. These professional development sessions have been provided by me and my team of TVIs during a specific PD day or I have presented before school or during a period or block of time. The teaching teams have found the information shared more personal to the student, with concrete examples of strategies to use based on the CVI characteristics of the student they are supporting. Before doing this, I found when I went in to try to explain to the team, not everyone was there at the same time, they were busy, distracted and often the suggestions were brushed off. For example, I have been told many times that their student knows their schedule so well and they don’t need to have a tactile schedule, or they don’t need to be verbally told who is the educator working with them – one of my biggest concerns is having educators move and work with a student with CVI or any visual impairment without verbally introducing themselves by name!! Anyway, after these specific PD sessions I have been given positive feedback by the teaching/support team where they feel more confident in how to provide programming that is based on the student’s preferences/likes/dislikes, how to present the visual targets and in what types of environments and for how long for a session or time period. I am hoping to use and refer to this thorough document on the “The Learning Environment” to ask deeper questions and gather more information in order to better meet my students at where they are at and to ensure they are motivated and feel connected to the learning and communication systems being presented to them.
That is so great to hear, the positive impact and the receptive of the classroom teachers, based on your ongoing support and teamwork. I was nodding my head as I was reading your post, as I also feel that it’s so important to walk into the classroom of a teacher and show that we are there to support them as well as the student and to work together, not to add more work for the teacher! Building that trust and learning attitude, that we are here together for the support goes a long way in providing the compensatory skills and resources that our students need. Thank you!
Definitely lots of barriers, as I have struggled with keeping more up to date information with the parents of a few of my CVI students and it’s been tricky – language barrier, the emotional load of the family at home, time restraints, information overload for the parents. I find that some parents use the school setting as respite and it’s very understandable, but it also makes it very difficult if I am not able to have open communications with them regarding what compensatory skills work best for their child in a very familiar setting, their child’s likes/dislikes, favourite toys and motivators. It’s a journey and building that relationship takes time and patience for all involved.
Think about the classroom adaptations you’ve used for students with CVI. Which have been most effective, and which seem underused or misapplied? Are there tools or approaches you wish were used more often?
My CVI students have such a wide range of visual and cognitive skills that I cannot say one adaptation has been better than others. My mantra to all classrooms is data. I even give them the data rubric to record how changes are working. I want to know how the change recommended has helped that student. In the changing landscape of CVI one approach with the most success and the hardest buy -in is clutter. For many elementary school classrooms, the teacher has spent hours/years creating a bright visually complex classroom that she is proud of. Trying to get her to understand how the last 5years of time and money to brighten her classroom are not working for one of her 30 students is a hard sell. Helping her collect data on one small change in that cluttered room helps to open the teacher to other changes that would have been refused if all presented at once.
I try to present one compliment on something they are doing right and along with one small change and data collecting to see if that change is working. Once that student has had successes in the kindergarten room, the first grade teacher is more apt to follow those changes and add a few more.
I have found the middle school teachers are the most eager to get rid of clutter. They are also the most eager to discuss in teams ways all of them can make the curriculum more accessible.
High school has been the most difficult. They have end of the year exams. If the student cannot rise to the challenge, they want them placed in the other programs.
Each of my CVI students have different cognitive skills. I have 2 that read on grade level and need very little modifications..Just get rid of clutter on the worksheet page and verbally explain the pictures they cannot process on said page…I have another that is multiply-handicapped. I have been working with the SLP and OT on creating an AAC system that the child can use with eye gaze. Creating pictures that have salient features and finding what color contrast works best has been an ongoing project for 3 years now. My hope is that we will have a system the child can use when she graduates at home with the family that is very onboard with the process.
I agree. I taught for 40 years before becoming a TVI. We have to remember that while this is OUR student, it is only 1 of 25 or 30 for that teacher. While we will have this student for maybe 12 full years, they will have this child for 1..So they are not as invested as we are. Meeting them where they are and trying for one change and then two is the only way to get success.
I do a PD at the beginning of the year for my region. I offer it after school and during school. Some teachers don’t like to leave their room while others don’t like to do work after hours…So it provides a learn opportunity for both kinds of teachers. I use the simulation glasses and they are powerful.
I have also found that embedding myself into the classroom provides me the opportunity to made adaptations and provide feedback to the classroom staff in “real time” as opposed to addressing the needs during their prep time. Overlapping with other related services providers also provides me those opportunities.
As an itinerant “outsider” working in the school setting - I am contracted to each district via an educational agency - I am not in any one building/district long enough sometimes to be a well-known staff person to other staff and/or students. However, because I am not necessarily bound by district regulations, I am sometimes able to help “bridge the gap” between home and school instruction by providing some services at home and then collaborating with additional team members working with the student at school. I do find that in providing services at home, I can not only observe potential needs/concerns at home, but relay those to the school team to help assuage parent’s concerns and tie in some tried-and-true educational supports to connect home and school services.
How effective do you find cross-setting collaboration (between home and school) in building compensatory access? What practices support authentic carryover and what barriers still exist?
I have experienced wonderful results in building cross-setting collaboration between home and school in building compensatory access. The particular students I am referring to is a 2nd grade student which a collaborative team. We utilize a daily log that travels with the student to each related service and includes input from the classroom and special education teacher as well. Each week, two sets of adapted materials are created. One to utilize in school and one to be sent home including manipulatives. Materials are also uploaded to an iPad which travels back and forth from home to school. It is also important to mention her home work area was very similar to her school work area which included black mat, slantboard and Invisiboard.
Each day a detailed account of activities and accommodations was included in her daily log. Each weekday she was asked to complete a task with a particular accommodation. For example if a story was presented auditorally, she was asked to practice this same compensatory skill as home. If additional problems were practiced with manipulative, she was asked to do the same at home.
As the other students in the classroom also had “homework” to complete, we found authentic carryover for the student. We created a weekly homework sheet for her as well but the daily log created a better opportunity to add details to what was being asked to be completed.
In this case, the only barrier was obtaining permission for the student to take the iPad home as the others in class only used them within their school day. This was accomplished through collaboration of the principal and the IT department.
I find that providing the teaching staff and related service providers a short handout summarizing the student’s visual needs, manifestations, simple stragtegies, preferred items/songs/colors, preferred environment setting (i.e. reduced visual clutter, high constrast, etc.) has helped because it is a guide that they can refer to when they are planning activities/lessons. This information sheet is updated throughout the school year as the student’s needs and preferences changes as well. I have also found it very helpful to record some of my sessions to provide the teaching staff/related service providers a visual to see how some of the stragegies and adaptations are used.
I think one of the misunderstandings that I have consistently experienced over the years of being a TVI is that the student is being “lazy” or “acting out” because the staff does not understand the nuances of CVI related behaviors. I think schools focus alot of their professional development trainings on informing the teaching staff on managing behaviors, speech related topics, curriclum, etc. However, I have never seen a professional development training on the topic of CVI even when many of the students in the school are students with CVI.
I love that the dailly logs were used with each related service provider as well as in the home setting! I really liked that all service providers can see what skills are being worked on and also incorporate it into their settings.
The ongoing 3 year projecting of creating/adjusting an AAC system really speaks to me. I have also been working closely with a few SLPs for the past few years to make adjustments to AAC devices for several of my students to ensure that it best fits their visual needs as it changes. I think I realized in year 2 that this will be an ongoing journey with the SLP as long as the students remain on my caseload. It does bring me joy to learn about various assistive tech devices that are not usually in the realm of vision.
Communication and collaboration between home and school is an absolute must for the gaining of full potential learning in students. Video modeling ( recording the student performing tasks throughout the day)has a huge impact on the carryover of skills from school to home and vice versa, for both the student and primary caregivers. A daily task sheet recording a few significant tasks the student has accomplished can be sent home. Using a communication app (one that records messages, pictures, and video)that is private is also very useful and can be done quite easily in real time through the use of a phone. Some barriers that still exist are time restraints, the time of day ( accomplishing skills late in the day when fatigue may be present), and the skills learned at school do not always generalize at home and may need additional adaptations and/or training to be effective. I had one student who had a great deal of primary-care turnover, creating more of a challenge in keeping caregivers informed.
Loved your insight of meeting classroom staff where they are and not overwhelming them with a lot of new requirements to an already full-packed day. Looking at routine-based interventions makes sense. I would add the value of observation as well. I feel that sometimes when I work with support staff, they do not always see the difference between an accomplished task at an independent level and prompted dependency. I have had support staff tell me "That they feel like they are not doing their job when they are ‘just watching’ the student. When this does happen, it can be the perfect opportunity to teach/model the value of observation, its benefits to understanding a specific student, and meet staff where they are.