“Who put salt in the water?” Incidental Learning!

CVI Momifesto2 Comments

Yesterday was Helen Keller’s birthday.  In honor of her extraordinary heart and intellect.  In honor of the brilliant teacher who opened up the world for her.  

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In Helen Keller A Life, author Dorothy Herrmann describes the moment when Helen experiences the ocean for the first time.  Anne Sullivan Macy, Helen’s teacher, explained later that she had anticipated Helen would be overjoyed by the full sensory experience of the pull of the tide and the wetness of the water.

What she did not expect was that Helen would emerge from the waves grimacing and coughing.

When she found her teacher’s hand, she demanded to know who put salt in the water? 

Clearly Helen had not expected that either.

Reading this passage made me laugh out loud.  It also reminded me that even when I try to teach E about the world, I will always have a lot to learn.  I have typical vision.  I experience the world visually, first and foremost.  I will leave out key details.

I keep learning and trying because I am her mom.  It’s challenging.  I forget to describe salient features.  I don’t always notice when she becomes still to listen to a fire truck that is passing because I’m rushing to get to the store.  I sometimes forget to give her a verbal cue before I give her a new object. We have lost so much time in her education.  There are still so many delays.  There is so much to teach.  I feel as though I am just now learning how to reach her. It can be very discouraging.

I find myself wondering how can I expect anyone else to try so hard when she is not even their kid?  Curling up in a fetal position in the closet seems like the only choice.  Then, I remind myself (clearly it’s quite busy in my head) that this is America.  There are laws and systems in place because parents like me – like you –  said “Enough already,” and demanded education for their children with special needs.

We are walking a path that has been paved by the parents before us. It’s a bumpy path with potholes the size of Texas, but, it’s a path nonetheless.  As parents of children with CVI, we have to create our own lane.

What we do for our children, and together for all of our children, will begin a movement to create a system of services for children with CVI when we say “Enough already.”

A key part of “Enough already,” is understanding and explaining the effects of sensory loss because CVI makes it challenging for children to receive visual and auditory information.  Even if your child is making great progress moving from Stage I to II to III in short order, your ability to advocate for access and why it is important remains the same. 

Here is some information you can use when you are discussing how your child with CVI learns.

The website for the National Center on Deaf-Blindness (https://nationaldb.org) contains a wealth of information about the effects of sensory loss and the importance of knowing how to teach children who lack incidental learning.  (Snuck that one in there on you.  If you are reading this post for the first time, please go back and read the earlier posts about incidental learning. It’s my favorite two word phrase! There’s a quiz later. Not really.)

The following is from the page, Developing Concepts with Children Who Are Deaf-Blind, written by Barbara Miles, M. Ed, and Barbara McLetchie, PhD. (https://nationaldb.org/library/page/1939)

Concepts are the ideas that give meaning to our world.

Here are some ideas that make sense from the perspective of the deaf-blind people who had them, but that might seem “odd” to someone with sight and hearing:

  • a boy thought “going home” meant the feel of a bumpy road and a series of turns in the car
  • a boy experiencing snow for the first time thought it was ice cream and asked for chocolate
  • a girl touched a wet leaf and signed “cry” (it felt like tears)
  • a girl thought food came from a mysterious place up high (it was always set down on the table from above)
  • a young man didn’t know, even after many years, that his family’s pet cat ate (he had never seen it or touched it as it ate, and no one had ever told him)

What each of these examples teaches us is how important it is to always be sensitive to and curious about a child’s perceptions of the world.

We need to continually ask, “What idea might she have or be developing about this experience, object, person, or place?”

If we want to help a child develop meaningful concepts, we must be willing to enter into a relationship and seek to understand the child’s concepts.

Children who lack sight and hearing or who have significant impairments in these senses, need to be consciously given continual access to the world and the society around them.

Most importantly, we must take the responsibility of providing experiences that will maximize the child’s opportunities to develop useful and meaningful concepts of the world. 

(“We” meaning the parents, yes, but also, the teachers, therapists, aides, and administrators who plan learning experiences for our children.)

It can be done.  Would there be a National Center on Deaf-Blindness if there had not been an extraordinary girl who became deaf-blind and an extraordinary teacher who made it her life’s mission to teach her?

I look to history to show us how to get where we need to go.

If even Anne Sullivan Macy forgot about the salt once in awhile, I can continue describing the world to my girl, making her experience books, and teaching her how to communicate through signs and technology

and

reaching out to you on the path we are making together.

 

 

Lego Trees and Last Straws / Incidental Learning, Part Two

CVI Momifesto6 Comments

This post was one of the original posts after CVI Momifesto began in September 2017. 

We are running it again as a lead up to the American Conference on Pediatric Cortical Visual Impairment beginning on Friday, June 29, 2018 at the Children’s Hospital and Medical Center in Omaha.  

Learn all you can about incidental learning.  You may have to teach the folks who work with your children.  Encourage them to learn more.  Your child with CVI does not have visual access to the world.  But, this visual access can improve.  

 

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The following story is the final straw, the very last straw, the one that broke me and the camel’s back.

This is the story that led to my current life of crime, um, advocacy.

lego tree again

When my daughter, E, turned 3, she aged out of early intervention. This was after a thoroughly disheartening couple of years in search of an early interventionist who knew anything about CVI.

I realized it was going to be up to me to find the educational services she needed.

It was quite a learning curve and a huge responsibility. I was already sweating organizing doctor appointments and therapies (sometimes even successfully!), hunting down specialists, researching seizures and reflux, and occasionally, if absent-mindedly, patting my older daughter on the head.

I did not feel successful in anything I was trying to do.  Launching my complicated daughter’s educational career was not something I felt equipped to do.

I was told that our state’s School for the Blind was too far:  I would need to enroll her in our local special needs preschool.  This was a developmental preschool classroom.  The children had a variety of diagnoses. She was the only one with a diagnosis of vision loss. I was informed that the classroom teacher would have consult time with a Teacher of the Visually Impaired.

“Okay,” I thought, “I’ll just take them information about CVI. I can hand this over to the TVI.” Right?  Right.

The classroom was as colorful and welcoming as any preschool classroom should be.  This also means it was way too busy for a child in Phase I or Phase II of CVI. At the time, E was in early Phase II.   I asked for a meeting with the teacher and TVI to get a jump on the accommodations and modifications we would need to develop together.

At the meeting,  I gave the teacher resources I had printed out online.  I began explaining the diagnosis and how we would need to simplify some places in the room if we were going to expect her to develop the use of her vision.

Then the TVI told me about the “one kid like that” she had 20 years ago.

A now familiar feeling of dread was born.

With little to no suggestions coming from our TVI, I suggested putting cloth on some of the toy shelves to create less complexity and clutter.  I asked them to find a space for her with a tri-fold and an uncluttered table so that she could  spend time learning new objects or pictures, without the visual and sound distraction from the classroom and other students.

My requests for modifications simply meant that, like any mother, I wanted her to have visual access to learning materials.  I wanted her to have as much access as she could.  This is more complicated for children with CVI. But, it is possible. Do-able even.

For E to be successful in this classroom, the staff would need to make the effort to understand her vision loss and to help her understand what she was seeing throughout  the school environment.  They needed to know that she could learn to see better and that they had a responsibility to support her in that.

I encouraged the teacher to make the requested modifications, and for the staff to read about CVI.  I watched the TVI drop off a box from the American Printing House for the Blind.

Despite my feeling of dread, I thought, “I’ve got to give this time to play out.”

For a few weeks, when I dropped her off,  I would linger awhile before leaving. Pretty soon I was  getting the “let me do my job” stink-eye from the teacher and had to shuffle back to my car.

One day, near the end of class time, I dropped in a few minutes early to see how she was doing.  Was she interacting with other kids? Were they explaining things to her? Giving her time to process? Encouraging her to touch things?

It was free play time.   All of the kids, E included, were sitting on a brightly colored carpet. Behind them were low, wide bookshelves filled with toys and puzzles.   Kids were reaching for toys, pulling them down, and putting them back.  They rolled cars on the carpet, built block towers, or talked about which action figure was cooler.

Eliza sat with her back to a toy shelf. Smiling. She’s a happy kid. She was sitting next to an aide and listening to the kids playing.   Seeing her smile made me happy too.  She loves to be near other children.  It was great to see her included with them.  It was great that they were giving her a chance to get comfortable there with them.

The aide spied me in the doorway. I could tell she wanted to show me that they were keeping Eliza involved. So, she reached up on one of the shelves, grabbed a large plastic bin of legos and brought it down – crash – into Eliza’s lap.

Then, she reached into the bin and pulled out a small square stack of legos. She grabbed Eliza’s hand and put the legos in it.

“Here Eliza. This is a tree! Feel it? This is a tree.”

Eliza was startled both by the noise and weight of the bin dropped on her lap. To her it was just a loud noise and a physical intrusion. She was startled again by the suddenness of her hand being grabbed. The words made no sense to her.

She pulled her hand away, leaned over and curled up on the floor, overwhelmed by all of this confusing sensory input.  The aide just looked back at me and shrugged.

That sound you just heard was the last straw breaking.

This moment gave me a chilling glimpse of the next 12 or so years in classrooms without teachers and staff who understand CVI.

If there was ever a kid who needed to learn about trees by touching them, E is the kid. If there was ever a kid who needed to go outside and feel the bark and the leaves and have it all explained to her (frequently) to make a lasting cognitive connection, E is the kid.

I suspect she is not the only one.

I wondered how many learning moments would pass right by her because a teacher or an aide didn’t understand that the way they were presenting the material was all wrong – and, quite likely, was pushing her further away, further into herself ?

Their ignorance would create behaviors that made her seem agitated or vacant.

(And, let’s consider this for a moment.

How much could you take if you were surrounded by flashes of light, color, and sounds that had no reference point? 

What if people were always talking to you in words you found hard to understand or too quick to grasp?

What if, every day, you were told to move, yet before you could get your body organized enough to move, someone else’s hands grabbed your hands or your shoulders to steer you?

What if you didn’t have the ability to speak your joys, your frustration, your pain, or your fears? 

What behavioral problems would you have on your report?  How much would you learn?  

My behavior report would be the size of your average copy of War and Peace, highlighted with lots of red exclamation marks, frowny faces, and the occasional cuss word.)

In this moment, I saw a situation that would begin in the ignorance, and, the apathy, of a teacher, an aide, and a TVI.   Their inability to reach her would be documented as E’s lack of cognitive ability and her behavior problems.

It would start there, in preschool, but their ignorance and apathy would follow her every year as a downward spiral of low expectations about my girl’s abilities.

To learn, she needs to have experiences with the real objects.  THE REAL OBJECTS.  THE REAL PLACES.  THE REAL ANIMALS.  THE REAL SENSATIONS. (Within reason, I get that.  We’re not going to run into the polar bear exhibit at the zoo to get the authentic Antarctic experience, or anything.)

THE REAL THING.

This is NOT a tree.

AND, this is NOT rocket science.  lego tree again

It is a problem, my fellow parents.  A real problem for our kids.    This is NOT how our children learn.

And, they can learn.

What can we do about it?  I started telling this story to whomever would listen.  Tell your stories.  Ask for more real experiences in your child’s classroom.  Ask your child’s teacher how she can bring real objects and real experiences into her classroom. (Because your child is not an incidental learner, right?) Ask them if they understand incidental learning.  If they don’t, teach them.  I know a great Blue Bowl story you can tell.

There are some advocacy action items in the works.  CVI Momifesto will fill you in when we have more information.

Thank you for your comments and suggestions.  We are a work in progress and will continue learning as we go.

It is good to know there are other parents out there on a similar path.  And, as we travel this path together, may there be many beautful trees to touch, flowers to smell, apples to taste, and well behaved animals to pet, even the occasional even tempered polar bear. (Because how cool would that be?)

 

 

“Vision Time” is not a thing. Incidental learning is. Part One

CVI Momifesto5 Comments

The Pediatric Cortical Visual Impairment Society will convene for its annual conference at the end of this week at the Children’s Hospital and Medical Center in Omaha, Nebraska.  As we prepare for an educational and lively meeting, we are revisiting some earlier posts.  (http://www.pediatriccvisociety.org/conference/)

Every family with a child with a visual impairment (CVI or ocular) needs to understand incidental learning to be an effective advocate for their child.

This post was published on September 14, 2017.

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Okay, my fellow parents of gorgeous children who happen to have CVI.

Here’s the deal.

We have to speak a common language for advocacy.  We have to know some fundamental things about the effect vision loss has on learning to affect change in our early intervention programs and our school systems.  We have to talk the talk.

In most cases, we have to teach the talk.

Will it be easy?  No, but what else do you have to do?

AHAHAHAHAHAHAHAHAHAHAHAHA!

(Sorry, I’ll wait while we all catch our breaths from hysterical laughter or choke on a spit-take.  I’ll wait while you get a towel.  Bonus:  Now the floor is clean!)

Knowing how to parent a child with severe vision loss did not come naturally to me.  I have typical vision.  My daughter was the first blind person I had ever met.  At 6 months, when we got the diagnosis of CVI, we were told she was legally blind.  We did not know anything about CVI.

What I remember about the first couple of years:

  • She never looked at me or anything I tried to show her.
  • Her head hung down all the time.  (I thought this was because of the diagnosis of Cerebral Palsy which we also got on around the time she got her diagnosis of CVI.  At Christmas time.  Ho. Ho. Ho.)
  • She never slept for more than 3 consecutive hours.  (So when people at the grocery store commented on how serene she looked  while asleep in the baby carrier on my chest, it was all I could do NOT to scream – “She is not asleep!  She never sleeps!  Her head just hangs down!  All the time! Why won’t she sleep?  I’m dying inside! Argh!”   To be fair, I was severely sleep deprived.  This is against the Geneva Convention, by the way.  People have been charged for war crimes for less.     Just sayin’.)
  • I was never more than an arm’s length away, yet I felt as though I was a million miles away from her. (Nothing made me feel more useless than sitting on a blanket next to my infant daughter, trying to get her attention, while she stared blankly at the light coming through the window behind me.  I asked her therapists over and over again, “Is she in there?” Typing this reminds of how low and sad I felt in those days.  Did I mention that the child NEVER let me sleep?)

There was so much I did not understand.  There was so much to learn.  Over the years, I sought out some fantastic teachers of the visually impaired (Annie Hughes, TVI and Director of VIPS-Indiana is my personal hero.) and Dr. Roman-Lantzy in an attempt to educate myself about vision loss and CVI.

What I learned from them made perfect sense, but had not occurred to me before.  I was struggling.  I wasn’t sleeping.  My older daughter was a toddler.  Nothing made sense at that time.  Basic hygiene was a luxury.  Forget living day-to-day, we were living minute-to-minute.  The transition into the “new normal” of being a family with a child with multiple disabilities was (and is) chaotic and messy.

Maybe sharing some of the fundamentals will help another mother of another child with CVI get a handle on the situation a little earlier, a little easier.

Maybe developing a common language will help us all go into our IFSP meetings and our IEP meetings with an action plan and the information to back it up.

Here’s where we need to start.

INCIDENTAL LEARNING

Incidental learning is the learning that just happens for a typically sighted person.  From the time you open your eyes in the morning to the time you close your eyes at night, you are constantly taking in information about your environment without even trying.

Incidental learning is the information you receive with your eyes without realizing it.

Children with Cortical Visual Impairment are not incidental learners.

Here’s how it was explained to me.

Blue bowlMiss Annie’s Blue Bowl Story
Blindness or significant vision loss has a number of impacts upon a young child’s development.

One of these is the child’s lack of access to incidental learning.
Vision is the “great integrator” of sensory input. No one plans incidental learning, but it goes on every minute that a sighted child is awake. To illustrate this, I often tell parents the “Blue Bowl Story.”
Two babies are in high chairs at one end of the kitchen. One has normal vision, and one is blind. The dad comes into the kitchen and says to his wife, “Hey Honey, where is the blue bowl? I have rented a movie and want to make some popcorn.” The mom replies, “It’s on top of the refrigerator.” So, the dad walks to the refrigerator, he stretches his arm up and reaches on top, he grabs the bowl which is blue, and he walks to the microwave to make the popcorn.
In those few seconds, the child with vision has just had four “incidental” lessons;

1) The word/label “refrigerator” was connected with the object

2) The child is starting to get an idea about the concept of “on top”

3) The child is beginning to understand that even though this bowl is much bigger than his cereal bowl, it is still called a bowl.   It must be the “scooped out/can hold things” aspect that makes it a bowl.

4) The child has a blue ball, and this is a blue bowl, so identifying that color as blue has just been reinforced

What did the child without vision get?
He/she heard the same words, but they weren’t connected to any meaning. Sometimes this is called “empty language.” This story illustrates how important it is for children who are blind or have low vision to have real experiences with real objects, so the language they hear isn’t “empty language,” but is tied to meaning.

Thanks to Annie Hughes, TVI and Director of Visually Impaired Preschool Services-Indiana

Being able to say, with confidence, “My child in not an incidental learner,” can be the start of an effective conversation with your educational team.

Stay tuned for more information and resources about incidental learning.

Stone Walls and New Starts

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Thank you to Ian Christy, Illustrator Extraordinaire, Designer,  & Cool Rockin’ Dad for the fantastic illustration in this post!

Imagine you were walking down the hallway of an elementary school.  As you walked, you saw brief glimpses through the slender window in each classroom door.  In one class, a teacher stands writing at a whiteboard, her students taking notes.  In another classroom, children gather on a rug for story time.

In the last classroom on the left, you see a similar scene.  Students sitting at their desks, raising their hands, doing their classwork.  You notice that one little girl’s desk is surrounded by a single layer of limestone bricks.

The next day, you walk down the hallway again to see the usual business of learning.  Some children are walking around their room going from station to station.  One class watches the teacher do a science experiment at the front of the class.

In the last classroom, however, you see the little girl’s desk is now surrounded by bricks stacked about 2 feet high.  She is sitting quietly. No one seems to notice them. The teacher stands at the front of the class continuing the lesson.  The students continue raising their hands.

You become concerned.  You return every day.  Every day you look into the last classroom on the left. Every day, the wall of blocks  gets taller and taller.  Every day, the little girl sits quietly, growing more isolated than the day before.  Every day, the classroom moves on around her.  You begin to feel anxious for the little girl.

She is being walled in, cut off from her teacher, her peers, her classroom, but no one seems to notice.  You stand at the window day after day and watch as she disappears behind cold, hard stone.  ian access

You knock on the door and ask the teacher why the little girl is being walled in.  She looks at you as though you have lost your mind.  She cannot see the wall.

You run to the principal’s office to tell him that the little girl is being enclosed in a kid sized stone tower.  The principal goes to look for himself.  He doesn’t see the wall either.

Every day the wall gets higher.

You demand a meeting with the principal, the teacher, and anyone else who works with this little girl.

You show them pictures of stone walls.  You bring them research about limestone.  You find articles from education experts who have studied children behind stone walls for decades, and, who have concluded  (surprise!)  that stone walls make learning very difficult.

Children cannot learn when they are cut off from everyone else.  Stone walls = bad for learning.

The team considers your presentation.  They reluctantly admit that – maybe – they noticed the wall from time to time.  An aide admits she tripped over a brick once but didn’t want to make a fuss about it.

Someone suggests that the stone wall may not be the little’s girl’s only problem.

“Sure,” you reply, “ she may have other issues, BUT, that STONE WALL IS NOT HELPING.”

The educational team takes another couple of weeks to develop a learning plan for the little girl.

Every day, the wall gets higher.

At another meeting, the team tells you that a teacher who works with “stone wall children” will take the little girl out of the stone wall to another room for 30 minutes a week.

“But, she’s sitting behind the wall for every other minute of the school day!”

Then, Rod Serling comes out of nowhere, pats you on the head, mumbles something about how even The Twilight Zone wasn’t this surreal and disappears.

This seems ridiculous, right?  Or, sadly, mind numblingly familiar?

I have spent sooooo much time trying to explain to people that my kid does not have easy access to the world with her visual system.

I have walked by “Library Time” (my personal pet peeve for children with vision loss in a traditional school setting) where I’ve seen children with CVI sitting passively at tables in the back of the library while the librarian reads a book the size of a magazine to the children grouped at the front.

I have found “art projects” in my daughter’s backpack that were clearly colored in by the well meaning aide who finished it while Eliza was self-stimming in the back of the room.  (I know this because I went to art time one day and found everyone – Eliza’s aide included- sitting at the table coloring, except my girl, who was laying on the floor, rocking. I cannot make this stuff up.)

How are these examples any more ridiculous than watching in panic as a child is enclosed in stone, a situation that no one else seems to find problematic?

They aren’t.

To my fellow CVI families,

2018 is a new start. 

There will be opportunities for us as a community to work together to raise awareness about Cortical Visual Impairment and to demand that our children be educated in a manner in which they can learn.

In this year and every year that follows, we must demand access and expertise.  

Stay tuned

and

Happy New Year!