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Texas School for the Blind & Visually Impaired

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Expanded Core Curriculum for Students with Visual Impairments and Deafblindness

24nmok amanda 022 2008 Mentor Center

Two important education bills impacting students with visual impairments in Texas was passed during the 83rd Legislative session. HB 590 will require that all students with visual impairments, upon initial referral to special education, will be required to have an O&M evaluation by an appropriately certified orientation and mobility specialist. SB 39 has added specific language into Texas law that states that students with visual impairments should receive evaluation and instruction in all areas of the Expanded Core Curriculum (ECC). Children who are blind and who have low vision in Texas will significantly benefit from both of these laws going forward. Texas School for the Blind and Visually Impaired, a center for educational services for all blind and visually impaired  students in Texas, offers a wide range of supporting activities related to these new laws.  Here are some of the ways our school collaborates with local districts to meet these new legal requirements.

Comprehensive Programs

Comprehensive Programs along with the Post Secondary Program provides special focus on the expanded core curriculum for students who attend during the regular school year including:

  • braille and other modes to access the general curriculum
  • orientation and mobility
  • assistive technology
  • career education
  • independent living skills
  • recreation and leisure
  • self-determination
  • sensory efficiency
  • social interaction skills

 

Short-term Programs

Short-Term Programs provide short-term services to visually impaired students who attend their local districts during the school year. Short-Term Programs provide two types of service:

  • School Year Short-Term Programs: range from three to five days in length and offer  intensive, individual, narrowly focused training to academic students who are on or close to grade level in any area specifically related to vision loss, such as adaptive  technology, Braille & Nemeth Code, and tactile math tools in relation to the Expanded Core Curriculum. Close collaboration with independent school districts occurs before and after participation in these programs. Instruction supports the regular curriculum (TEKS) by teaching:

  • Summer Short-Term Programs: provide a wide range of offerings, from elementary to high school, academic to severely multiply-impaired,  in a broad array of content areas such as vocational, functional  application of academic skills, independent living skills, social-emotional  development, and adapted athletics.

Outreach Programs

Outreach Programs provide training for teachers and family members on a full range of topics related to instruction in the Expanded Core Curriculum, including orientation and mobility.  We can support districts in

Curriculum

This outline was originally created by Chrissy Cowan and Carolyn Mason in the form of a powerpoint, which was updated by Jim Durkel and then by Sara Kitchen and Lynne McAlister.  You may also want to view the series of videotapes made by Sara Kitchen and Lynne McAlister related to CVI.

Download a MSWord Version

Definition and Incidence

  • Definition of cortical visual impairment
  • New field of research
  • Fastest growing visual impairment
  • Diagnosis

The Problem with Medical Diagnosis

  • Eye report frequently doesn’t say “CVI”
  • Best information may come from neurological
  • Test like MRI is not necessarily useful in diagnosing CVI

Look for “red flags”

  • Asphyxia-damage depends on severity & duration.  Some causes:  placenta previa, prolapsed cord, delivery complications.
  • Hypoxic Ischemic Encephalopathy-too little oxygen (hypoxia), too little blood flow (ischemia), irritation of the brain (encephalopathy).  Results from asphyxia.  Seizures common.
  • Cerebral Vascular Accident-(stroke) blood capillaries in the brain rupture, damage depends on extent of bleed, more common in full term male infants, mostly affects left side of brain, seizures common.
  • Intraventricular Hemorrhage-occurs in premature infants w/in 1st 48 hours.  Severity grades I-IV.
  • Periventricular Leukomalacia (PVL)-something, such as trauma, occurs and oxygen does not get to the distant areas of brain.  These die and become filled w/ fluid (sometimes called cysts in the brain).  Can cause CP, developmental delays.
  • Infection-viral and bacterial (TORCH)=toxoplasmosis, rubella cytomegalovirus, herpes/HIV.  Also meningitis.

The Brain from Top to Bottom

brain - functional vision sections
Figure 1 Image of the brain including the functional subdivisions of the visual cortex, cerebellum, inferior temporal cortex (ITC), temporal lobe, lateral geniculate nucleus (LGN), frontal lobe, parietal lobe, and occipital lobe. (from  McGill University)

Current Trends in Neuroscience

  • Hardwired: Outdated theories stated that the brain was static and could not be healed once injured.
  • Neuroplasticity: Current beliefs include the brain’s ability to organize and reorganize itself.
  • http://www.youtube.com/watch?v=TCM4UBM8wTM)       

drawing by bhild with cvi
Figure 2. Drawing by an 8 –year-old child with CVI.  The eyes and hair are on the bottom of the drawing and the mouth is at the top.

Unique Characteristics of CVI

  • Color:  strong reaction/preferential response to a particular color, typically red or yellow.  Color receptors are diffused through brain & almost all children have some color vision.  Need their favorite color as a visual anchor.
  • Movement:  Stimulates the “aware” system, gets the visual system activated.  Movement w/out sound is generally easier to visually process.
    • Movement plus reflective qualities provide an invasive, difficult to ignore effect on the visual system.
    • Child may exhibit better than expected navigational skills.
  • Latency:  delayed response to presentation of object.  Can vary according to time of day, state of alertness, degree of stress, and neurological stability.  Decrease in latency equals increase in visual behavior.
  • Visual Field Preferences: objects are more easily seen in certain parts of the visual field.
    • Especially in periphery, where movement is better detected by the retina.
    • Mixed field preferences:  May use one eye for a field preference, and the other for verification.
  • Complexity:  most interfering of all characteristics. 
    • Target/object-some objects are too complex, and there is no place for child to anchor his vision and so vision shuts down: faces are very complex.
    • Array-what’s behind the object can cause problems even with preferred objects.  This is responsible for the misconception that vision is variable.  Actually, vision is constant, but background interferes with vision functioning.
    • Sensory environment-unable to process with more than one sense at a time; will defer to auditory over vision.   Be careful where you place auditory stimuli.  Limit talking while doing vision work.
  • Abnormal Reaction to Light-Photophobia/Light Gazing/Non-Purposeful Gaze-prominent in early stages.
  • Distance Viewing-As object gets farther away, complexity increases.  Makes child appear nearsighted.
  • Visual Reflexive Responses-absent, intermittent, or delayed blink reflex.  Blink to threat; blink when you touch the bridge of the nose.
  • Visual Novelty-strong response to familiar objects.  Appear to ignore novel items.
  • Visual Motor-look and touch may happen as separate events.

Resolution of Characteristics

  • Best chance for resolution is within first 3 years, but the possibility for resolution continues to exist into adulthood.
  • Characteristics will not resolve without structured intervention
  • Phase I:  Building visual behavior
  • Phase II:  Integrating vision with function
  • Phase III:  Resolution of all CVI characteristics

“For Children with CVI, it is important to determine where they are on the continuum of possible impact of CVI, to identify in this way what they are able to look at or are interested in looking at, and to give them as many opportunities to look as possible by integrating motivating activities and materials into their daily lives.  The goal is to facilitate looking.”  (Page 114, Roman-Lantzy, Cortical Visual Impairment: An Approach to Assessment and Intervention.)

Order of Resolution

  • Early resolution: light gazing, and visual reflexive response of blink to touch
  • Mid-Resolution:  color, latency, visual novelty, visual reflexive response of blink to threat, and movement
  • Later Resolution:  visual fields, visual motor, complexity, and distance vision

(http://www.aph.org/cvi/articles/bbf_1.html)

Introduction to Christine Roman-Lantzy’s Assessment

ORDER HERE: http://www.afb.org/store/product.asp?sku=978-0-89128-829-9&mscssid=5D71MSQKD5CF9PH5CBFVWJT0FU8LCPKC

Assessment Framework

  • Interview
  • Observation
  • Direct evaluation of student

Reliability

The Reliability of the CVI Range: A Functional Vision Assessment for Children with Cortical Visual Impairment, by Sandra Newcomb, Journal of Visual Impairment & Blindness, October 2010, © 2010 AFB.

Parent Interview/Teacher Interview

  • Information on medical background
  • Eye report
  • What does child like to look at
  • What are your concerns
  • Child’s favorite color
  • When is child most visually alert
  • Does child look directly into faces
  • Does child notice things that move more than things that are stable
  • Does child seem to look “through” rather than at objects

Observation of Vision

  • In living and learning environments
  • Quiet and noisy times
  • Near and distance
  • Familiar and unfamiliar objects
  • Cluttered and simple backgrounds
  • Interest in objects of specific color (color preference)
  • Movement
  • Light gazing
  • Preferential viewing

Direct Evaluation

  • Evaluate range of visual functioning
  • Evaluate presence and degree of individual CVI characteristics
  • May need several sessions to test 

Forms

  • Parent Interview questions are on page 34 of book.
  • Answer Guide to Parent Interview – the page after page 40, appendix 4a.
  • Rating 1– Across CVI Characteristics Method – Figure 5.2, the page after page 56
  • Rating 1 – CVI Scoring Guide – page after page 96, appendix 5a.
  • Rating 2 – Within CVI Characteristic Method/CVI Resolution Chart – Figure 5.6, the page after page 74. 
  • Essential Forms are also at the end of the book, the page after page 185

We invite you to be on our Outreach Program mailing list.

The Outreach Program at TSBVI regularly sponsors conferences and workshops on subjects related to parenting or providing services to young people with visual impairments, deafblindness, and other disabilities.

Outreach also publishes, with the Texas Department of Assistive and Rehabilitative Services, TXSenseAbilities, a quarterly newsletter with timely information on many topics, including articles by family members, strategies for working with young people who are visually impaired or multiply disabled, information about agencies and programs, medical and health information, and classified ads and announcements.

To receive announcements of upcoming workshops and the quarterly newsletter, SenseAbilities, fill out this form in its entirety and return it to TSBVI Outreach.

 

Thank you!

Part 2

When we see our student or child who will be learning primarily through the tactile sense and is chronologically or developmentally young, we often look with an untrained eye at what the child is doing.  We sometimes fail to see the wondrous tactile skills a child already exhibits.  The ability to move any part of the body is a blessing, and is integral to learning, even if the movement is very subtle. 

If someone moves, we must look at how they move.  Will they reach out from their own body even a little bit with the hands, feet, or head?  What do they do with their hands and mouth?  Do they kick or wave their arms?  Are they able to wiggle the torso? What kind of expression does the body communicate that the face may not?  Is it excitement, frustration, security or anxiety?  Any sort of movement can be used to interact with the environment and/or people, and will be an asset to this child's learning.  We must train ourselves to notice and respond to the body and hands of our children as well as offer up our body and hands to validate their movement.  We must also offer environmental factors that will respond to the type of movement the child currently uses.  

During a Power of Touch workshop a small group of parents spent time learning about touch and having opportunities to practice some of the skills Barbara Miles discussed in her article, Talking the Language of the Hands to the Hands.  One of the activities they did during the workshop was to simply observe another child to see what he or she did with his body related to touch.  

Later the parents were invited to simply offer their hands or an object to their child and follow the child's lead in exploring the object tactilely.

Here are some of their comments.


 Activity 3:

Read Tactile Skills for Students with Visual Impairments and think about the tactile skills you observe in your child or student or notice when you offer hands or objects.


Continue to Part 3: Interacting with Others Tactilely / Tactile Communication

Jump to Part 4: Articles and Resources on Touch 

Return to Introduction: Touch and the Development of the Tactile Sense

Return to Part 1: Importance of Touch and Tactile Skills

Part 1

HandsExploreDishSMDuring the first phases of learning, information that is within arms' reach is used to integrate the senses and learn about the self, and then the world.  Reflexive behavior, such as circular movement of the arms, gives sensory information to the skin and joints that something is happening.  The peripheral vision is triggered by the movement, and the child may begin to notice that when the arm is in a certain position, his eyes notice the movement, but when it is touching the mattress, he can no longer notice the movement.  With enough repetition, the child may discover that he can control those movements. 

When a child has little movement, has reduced or absent vision, and/or has fewer opportunities to play in this way due to health issues, this learning is delayed. Still it remains integral to development and cannot be skipped.  The child with sensory and/or motor impairment must have the opportunity to notice what affect his reflexive movement has on the world, to repeat that movement until he understands what connection it has to his body and will, and to begin to build a framework for higher understanding.

Once we have embraced the idea of tactile skills and learning through touch for the child, we must be careful and approach the sensitive hands of a tactile learner just like we would approach the sensitive eyes of a visual learner.  We show, point, and guide the hands, but we never restrict or force them.  Just as we would not move a person's eyes for them, we don't move their hands for them.    Early experiences with touch are very important, so we do not want them to be negative. Sometimes this is unavoidable, especially when a child has gone through lifesaving but unpleasant and perhaps painful medical procedures.  When a child pulls away from touch, the trust of the outside world must be rebuilt slowly and gently. 


Activity 2:  

Please download and read Talking the Language of the Hands to the Hands written by Barbara Miles.


Continue to Part 2: Awareness of Existing Tactile Skills

Jump to Part 3: Interacting with Others Tactilely / Tactile Communication

Jump to Part 4: Articles and Resources on Touch 

Return to Introduction: Touch and the Development of the Tactile Sense

This is a very short tutorial on touch and the development of the tactile sense in children with visual impairments and deafblindness.  We hope that it will help you understand the importance of touch for these children and develop better skills in tactile interaction.  

Introduction

For an individual with visual impairment, blindness or deafblindness touch is a critical sense for connecting and understanding the world.  As parents and educators it is important that we understand and develop this crucial sense.  The first step is to become skilled observers of how the child or student uses his whole body to gain tactile information.GigiBabySm


The development of touch and the tactile sense in a child with visual impairments or deafblindness can be impacted in both positive and negative ways.  The gentle touch of a parent can do much to calm and reassure a child who is frightened or overly stimulated.  Touch connects human beings in a way nothing else does. However, when a child is born with a visual impairment or deafblindness he or she is often exposed to aversive tactile sensations.  Sometimes as a result of many hospital stays or experiencing a world where things happen without the advanced warning that typically developing infants and toddlers gain from sight and hearing. Some children also experience delays in being able to integrate or tolerate certain types of touch.  Touch can be painful or distracting. This may result in resistance or aversion to many types of touch or tactile sensations.

TaniaTouchFor most children with visual impairments and deafblindness touch is key to all learning.  If there is residual vision and/or hearing, touch supports these distance senses.  If there is very little or no vision and/or hearing, touch is the primary sense for learning.  Children with visual impairments and deafblindness may naturally developed extraordinary tactile skills.  They are likely to use not only their hands, but tongue, lips, teeth, feet, legs and any other parts of their body as a way to gain tactile information about the world around them.  It is important that we allow them access to this information by not restraining them from this exploration. 

It is also important that we help them to develop confidence to explore tactilely, since this will be key to understanding much about the physical world.  Reaching out into the unknown can be frightening. We can support the child's willingness to use hands and fingers, toes and feet to explore if we can become a trusted companion and share the experience with them.  We need to provide them with a great variety of textures and tactile experiences.

There is so much to know and so much to learn about how all humans use their sense of touch.  We hope this information will give parents and educators information to help them have better tactile interactions with their child or student.  Interactions that will help the child improve his or her sense of touch to support learning. We also hope this information helps both parents and educators become aware of the importance of developing tactile skills and provides resources for use in both home and school settings. 


Activity 1

Read Touch: A Critical Sense for Individuals with Visual Impairments

Think about the toys your child plays with and touches.  What are the tactile characteristics of these things?  What do you think he or she likes or dislikes about how these feels?


Continue to Part 1: Importance of Touch and Tactile Skills

Jump to Part 2: Awareness of Existing Tactile Skills

Jump to Part 3: Interacting with Others Tactilely / Tactile Communication

Jump to Part 4: Articles and Resources on Touch 

 

Part 3

When we begin to communicate, none of our communication is intentional.  Others respond to our needs, which help us learn that our behavior can affect the behavior of others.  Whatever behavior gains the greatest response will be the behavior that is repeated.  When our behavior is responded to consistently, patterns begin to form.  The child becomes aware that people are dependable, which increases his emotional security.

DadDaughterCroppedBefore we ever begin to expect our children to imitate us or understand our communication, we anticipate their basic needs, such as sustenance, rest, and cleanliness based on their behavior.  We also spend a great deal of time teaching them how we learn about others by imitating them.  We imitate subtle facial expressions and label them long before the child can understand language.  A lower lip out may be responded to by an adult doing the same thing while asking, "What is wrong?"

While some children with visual impairment may use facial expressions to communicate, others use mostly their hands and bodies.  We must learn to respond to, imitate, and label that which they express in another way.  When a child begins to breath more quickly, but can't see someone else, we may respond by breathing more quickly while in physical contact.  We may know that means the child is excited, or anxious, and may label the emotion that way.  This way the child knows that you are talking about the same thing and begins to know labels for his own emotions.  More subtle hand and body movements may not have a specific label, but they can still be explored through imitation.  The child must be imitated a great deal before he will become interested in imitating another's behavior. 

 

References: Remarkable Conversations (Miles), Entering the Social World (McFarland), etc.


Activity 4:

Play a tactile interaction game with your child or student using fingers, hands, feet or legs.  Begin by imitating something he or she does.  After a time slightly change your movement and see what happens.  Did your child enjoy the change or imitate you?  If not, did he or she let you return to playing in the previous way?


Continue to Part 4: Articles and Resources on Touch 

Return to Introduction: Touch and the Development of the Tactile Sense

Return to Part 1: Importance of Touch and Tactile Skills

Return to Part 2: Awareness of Existing Tactile Skills

For Credit Indicates content that is available for ACVREP or SBEC credit.
You must register for each event prior to submitting the Delayed Viewing Request in order to obtain continuing education credit.

Index

 STAAR ALT 2For Credit

 STAAR Administration TrainingFor Credit

 Mentor Series: Strategies for Helping a Protégé Conduct an FVE and LMAFor Credit

 Learning Media Assessment & Assistive Technology Assessments for Students with MIVIFor Credit

 Learning Media Assessment & Assistive Technology Assessments for Students with MIVI: Part 2For Credit


STAAR ALT 2

Original webcast date: 2/21/2018
Description: This webinar will include an overview of STAAR-Alt. There will be thorough explanations of how to implement allowable accommodations. The session will end with an opportunity to answer any questions you may have.

 Register to receive ACVREP or SBEC credit.For Credit

Downloads: Transcript (txt) Audio (mp3) Handout (pdf)

STAAR Administration Training

Original webcast date: 11/14/2017
Description: This webinar will include an overview of STAAR, specifically STAAR End of Course requirements. There will be thorough explanations of how to implement allowable accommodations. The session will end with an opportunity to answer any questions you may have.

 Register to receive ACVREP or SBEC credit.For Credit

Downloads: Transcript (txt) Audio (mp3) Handout (pdf)

Mentor Series: Strategies for Helping a Protégé Conduct an FVE and LMA

Original webcast date: 01/19/2016
Description: Conducting a Functional Vision Evaluation and Learning Media Assessment may be very intuitive to you because you have had years of experience, but these evaluations are daunting to the novice teacher. During this webinar we will share ideas for using the eye report as a road map, assembling a kit, observation skills, evaluation templates, and writing reports.

Mentor Series: Strategies for Helping a Protégé Conduct an FVE and LMA

 Register to receive ACVREP or SBEC credit.For Credit

Downloads: Audio (mp3) Handout (pdf) Transcript (txt)

Learning Media Assessment & Assistive Technology Assessments for Students with MIVI: Overview

Original webcast date: 09/19/2016
Description: Assessment of students with multiple impairments in the areas of learning media and assistive technology can be problematic. Typical approaches may not afford information that is useful in designing effective learning strategies.  In this webinar series, we will review existing instruments that are designed for the child with visual and multiple impairments.  Included is information about the design of each instrument, the skill areas it considers and a step-by-step explanation of the assessment process it employs.  Assessment tools that will be reviewed may include: Sensory Learning Kit, Functional Schemes, Every Move Counts, Communication Matrix, Infused Skills / Basic Skills Assessment, Robbie Blaha's Calendar Assessment, and Philip Schweigert's Tangible Symbols assessment.   Additional dates include: 1/13/17 and 5/15/17.

Learning Media Assessment & Assistive Technology Assessments for Students with MIVI: Overview

 Register to receive ACVREP or SBEC credit.For Credit

Downloads: Handout (pdf) Transcript (txt) Audio (mp3)

Learning Media Assessment & Assistive Technology Assessments for Students with MIVI: Part 2

Original webcast date: 1/23/2017
Description: Assessment of students with multiple impairments in the areas of learning media and assistive technology can be problematic. Typical approaches may not afford information that is useful in designing effective learning strategies. In this webinar series, we will review existing instruments that are designed for the child with visual and multiple impairments. Assessment tools that will be reviewed may include: Sensory Learning Kit, Functional Schemes, Every Move Counts, Communication Matrix, Infused Skills / Basic Skills Assessment, Robbie Blaha's Calendar Assessment, and Philip Schweigert's Tangible Symbols assessment.

Learning Media Assessment & Assistive Technology Assessments for Students with MIVI: Part 2

 Register to receive ACVREP or SBEC credit.For Credit

Downloads: Handout (pdf) Transcript (txt) Audio (mp3)

 Recreation and leisure skills are important to a rich and satisfying life.  These include things like individual and team sports, reading, music, art, sewing and many other things.  Finding satisfying ways to spend free time can be difficult for many of us.  Most any activity can be modified for individuals with visual impairments to be able to take part in them.  


For Credit Indicates content that is available for ACVREP or SBEC credit.
You must register for each event prior to submitting the Delayed Viewing Request in order to obtain continuing education credit.

Index

Physical Education: Inclusion for Students with Visual ImpairmentsFor Credit

Yoga for Children with Visual and Multiple Impairments: IntroFor Credit

Yoga Webinar Series: December 2016For Credit

Yoga Webinar Series: February 2017For Credit

Using Play and Recreation for Concept Development from Preschool to Graduation and Beyond


Physical Education: Inclusion for Students with Visual Impairments

Original webcast date: 10/25/2018
Description: Students with blindness or visual impairment are sometimes excluded from activities of physical education in the mistaken belief these activities are unsafe or inaccessible for them. This webinar will provide information and suggestions for adapting a variety of sports commonly found in general education so that BVI students experience full and meaningful participation.

 Register to receive ACVREP or SBEC credit.For Credit

Downloads: Transcript (txt) Audio (mp3) Handouts (zip)

Yoga for Children with Visual and Multiple Impairments: Intro

Original webcast date: 9/29/2016
Description: Learn about TSBVI's new publication, "Yoga for Children with Visual and Multiple Impairments".  This series of webinars hosted by Kassandra Heil will provide participants with an overview of the book and feature strategies for working with students who are visually impaired as well as students with visual and multiple impairments, including deafblindness.  Learn about the benefits for students including bodily and spatial awareness, recreation and leisure, and stress management.  Additional dates for this series includes 12/8/16 and 2/23/17.

Yoga for Children with Visual and Multiple Impairments: Intro

 Register to receive ACVREP or SBEC credit.For Credit

Downloads: Handout (pdf) Transcript (txt) Audio (mp3)

Yoga Webinar Series: December 2016

Original webcast date: 12/08/2016
Description: In this Part 2 of a three part series, focus will be on teaching yoga to children with multiple disabilities. Participants will be given a yoga sequence appropriate for children with varying disabilities including Autism, motor impairments, speech impairments, and dual sensory losses. Strategies for incorporating motor skills, social skills, language skills, and self-determination skills will be discussed.

Yoga Webinar Series: December 2016

 Register to receive ACVREP or SBEC credit.For Credit

Downloads: Transcript (txt) Audio (mp3) Handout (pdf)

Yoga Webinar Series: February 2017

Original webcast date: 02/23/2017
Description: In this final webinar of the three part series, we will present strategies to support the academic learning of students with visual impairments. Participants will be given a sequence appropriate for middle-- high school academic students with visual impairments. Participants will gain an understanding of how to include yoga in to the school environment and how to garner support from other staff members.

Yoga Webinar Series: February 2017

 Register to receive ACVREP or SBEC credit.For Credit

Downloads: Transcript (txt) Audio (mp3) Handout (pdf)

Using Play and Recreation for Concept Development from Preschool to Graduation and Beyond

Original webcast date: 06/17/2016
Description: Mickey Damelio, Assistant Instructor, Center for Education Research and Policy Studies, Florida State University, Tallahassee, Florida explores the Recreation and Leisure component of the Expanded Core Curriculum. He discusses keeping everything integrated as we plan for instruction, and the importance of not losing sight of social skill instruction, or O&M, etc. Mickey talks about specific games and activities that students might enjoy, and ways to work with school staff and families to ensure that our students are getting healthy access to opportunities for recreation and leisure.

Using Play and Recreation for Concept Development from Preschool to Graduation and Beyond
Downloads: Transcript (txt) Audio (mp3)