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by Fran LaWare, Teacher, TSBVI and David Wiley, Transition Specialist, TSBVI Deafblind Outreach

More attention is being paid recently to the importance of recreation and leisure skills as a part of special education cirriculum. This particular focus is made clear in the Individual Transition Plan which requires identification of leisure outcomes as well as employment, education and independent living.

Any discussion of recreation and leisure has to begin with the understanding that "leisure skills" implies personal choice making by participants. We all do many things that we would rather not be doing but we do not call them recreation, nor do we call the time spent doing them leisure. Therefore, a prerequisite to teaching leisure skills to young people is paying close attention to what they enjoy, helping them understand that leisure time is a time that they can make choices, and if they are unaccustomed to making choices, providing them with the skills and framework to do so.

MAKING LISTS

Consequently, whether leisure skills are to be taught at home or at school, the first step is always doing a further survey of the child's interests, the family's interests, and the environments that the child/family move in. It's best to sit down and make a list of all the things that your child enjoys doing, remembering to get imput from him/her to the greatest extent possible. Some of these things may seem a little weird like tearing up paper or putting things in purses. Don't make judgements about the value of the activity at this point, just collect the data. To elicit this information from some children you might be able to simply ask for their ideas after explaining what you are doing. With children who are not as skilled in the area of communication you might need to spend time observing your child in a variety of settings to gain some insight to his/her preferences.

After you make a list of the child's interests, the next list to make is what your family and your child's closest friends enjoy doing together. Because many of our leisure activities are done with somebody, it's best to learn some of the things the other people in your child's world like to do.

The third list you will need to make is of the places your child and your family spend most of their time. Skills that you teach should be things that can be done in those environments.

Finally, now that you have your lists, use them and share them with relatives, baby sitters, teachers, friends or anyone who can help your child learn recreation and leisure skills.

IMMEDIATE SKILLS

The first level of leisure skills that your child needs to know are those skills that we might refer to as "immediate skills." These are the skills that your child should use during periods when they have to wait, when they are receiving a minimal amount of supervision, or when other plans fall through: what your mother may have called "things to do on a rainy day." These skills are what every child needs, not only for himself, but so that other family members can take care of their own everyday needs. In most cases, developing these immediate skills is not so much a matter of teaching but of observing and adapting. Remember, leisure skills are those things that your child chooses to do and might not be the things you would expect. We have known kids who take great pleasure in pumping up inner tubes, washing dishes, sorting through candy wrappers they have saved, looking through binoculars, grinding coffee beans and collecting bowling pins. The important common denominator for all of these activities is that the child selects and enjoys the activity. Our job, as adults, then becomes letting them choose and letting them participate in that chosen activity.

While some of the things your child may choose may seem "inappropriate", with some creativity and adaptation, you can turn these activities into meaningful leisure skills. (Editor's note: Tom Powell notes that there is not really that much difference in collecting candy wrappers and collecting stamps or rocks or baseball cards.)

ADAPTING

An older student who still enjoys a push toy might easily be taught to push a carpet sweeper or a shuffle board stick instead. A dust mop proved to be a good substitute for a teenager who is blind and enjoyed exploring the space in a room by banging the ceiling with a stick. She had fun and kept the cobwebs at bay simultaneously. Someone who likes to push buttons might be taught to use a piano, push keys on a typewriter, push the slide changer on a slide projector, or learn to operate a tape recorder. A child who throws things could be taught to load the dryer, play horseshoes or shoot baskets. Kids who enjoy vibration might learn to use an electric toothbrush or operate a foot massager. Someone who loves to spin might enjoy playing on a merry-go-round or learning to dance.

Activities should be those things done by typical people your child's age. Even if the activities your child enjoys are not typical for a child their age, the materials they use can and should be replaced by materials that are chronologically age appropriate. For example:

Activities and Material that are Age Appropriate
Individual likes:For a child:Older adaptation:
to rock rocking horse rocking chair
music a musical stuffed animal tape player with head sets
to put objects into containers nesting eggs tools such as socket wrenches into form fitted tool set

If you are stuck for ideas, start asking friends and family about activities they do that include certain actions or that resemble the behavior your child seems to enjoy so much.

Some children seem to need certain sensory stimulation to calm themselves such as light gazing, being inside tight spaces, putting things on their fingers, hands, head, etc. These behaviors might give direction to you in helping that child to develop some leisure skills. For example, the child might start a collection of lighted objects such as the type found in some of the novelty stores. They could spend time exploring them in their room, taking them off a shelf or out of a box, and putting them back. They could also take a few of these items with them in a back pack or fanny pack if they are going to be in a situation where they are required to wait for periods of time. A child who likes to be in tight places may enjoy a snuggle bag or bean bag chair with pillows or accessing some designated place that could be created within his room for him to crawl inside. Just hanging out can be a legitimate leisure skill if your child chooses it.

EXPLORING

Beside developing "immediate skills" your child needs to be taught a number of new skills that can be used throughout his/her life. Because leisure activities should be done by choice, it is our responsibility to expose children to a variety of options from which they may choose. Many times children surprise us with the activities they enjoy once they are given the opportunity. We should let children sample all activities participated in by friends and family and that can be done in their familiar environments. This exploring should include both group and individual activities. While exploring with your child it's a good idea to note which activities your child shows some interest in doing. Try these activities a few times before giving up on them. Sometimes doing something for the first time can be frightening and overwhelming.

TRAINING

When your child's exploration has identified some activities they seem to enjoy, your next step is to teach the skills they need to participate to the greatest extent possible. This involves gathering materials, learning skills and rules, possibly learning money exchange or budgeting, developing social skills and making choices. The teaching might also involve classmates or brothers and sisters who would like to participate in these activities as well. Your child may never be able to fully participate in all aspects of an activity but any part of the activity they enjoy is worth doing. For example, your child may not be able to play a game of basketball, but she might enjoy throwing out the ball to the other players, retreiving it if it goes out of bounds, making free throws, and interacting with peers in a group activity.

The time we all spend enjoying ourselves is a very important part of our lives, we can help ensure that our children have a richer life by honoring their choices, developing their interests, exploring new activities and teaching them the leisure skills that they need. You might also find that teaching a child to play is a treat for you as well.

Editor's Note: If you are a parent who feels lost when you try to teach your child a new game or activity, ask your school to help. See that the goals on his/her IEP include skills that will facilitate the development of a variety of recreation and leisure options for your child. School personnel need to solicit ideas and information from parents, friends, and family when they try to identify the areas of interest and the types of environments the child will likely access. The more independent an individual is in entertaining him/herself the better their chances are for functioning well within their immediate family and in adult living situations. Participating in recreational activities is often a natural way to make connections in the community. Having activities that you enjoy and opportunities to choose to do these activities regularly makes you a happier, healthier individual.

Originally printed in the April 1991, P.S. NEWS!!! pusblished by Texas Deafblind Outreach, Texas School for the Blind and Visually Impaired.

 

by Millie Smith and Stacy Shafer

Student's Name: Catherine
Date of Assessment: 3/5/95

Name(s) of Assessor(s): M. Smith, P. Castro (mother), N. Jones

Assessment Period
School day starts at: 8:15 a.m
School Day ends at: 3:30 p.m.

Nonschool environments:
Place: Home From: 4:00 p.m. To: 8:30 p.m.
Place:           From:                   To:

The total assessment period should be at least one school day. Assessment of the student in nonschool environments on the same day would be extremely helpful.

Recording Schedule

Indicate the length of the interval between recordings in Part II. Intervals should be no shorter than one minute and no longer than 15 minutes. The intervals should be consistent throughout the assessment period. Part II information will be recorded every 15 minutes.

Part I

Provide the information called for in the grids for the 24 hours preceding the beginning of the assessment and throughout the assessment period. Under "Comment" indicate any significant factor that comes to mind and be sure to note when the recorded information is a departure from the student's typical routine. If there are significant departures or if the student is ill on the day of assessment, postpone the assessment.

Note: This is an informal teacher-made assessment based on the Carolina Record of Individual Behavior (CRIB), by R. J. Simeonsson et al. and the Project ABLE Manual: Analyzing Behavior State and Learning Environments Profile by B. Guy et al.

Food and Liquid Information

Each time the student eats something, drinks something, or is tube fed, enter the following information on the grid:
(the table has five columns titled Type, Start Time, Stop Time, Amount, and Comment)

Food and Liquid Information
TypeTime StartTime StopAmountComment
Ensure. 8:20 8:40 16 oz  
Water. 8:40 8:45 6 oz  
Ensure 12:30 1:20 16 oz.  
Water 1:10 1:15 6 oz.  
Ensure 4:30 4:50 16 oz.  
Water 4:50 5:00 6 oz.  
Ensure 8:00 8:20 16 oz.  
Water. 8:20 8:25 6 oz  

Medication Information

Each time the student takes a prescription or over the counter medication enter the following information on the grid:

Medication Information
TypeTimeAmountComment
Tegretol Suspension 8:20 a.m. 200 mg  
Dimetap Elixir 8:20 a.m. 10 cc for congestion
Dimetap Elixir 12:30 p.m. 10 cc  
Tegretol Suspension 4:30 p.m. 200 mg  
Dimetap Elixir 4:30 p.m. 10 cc  

Seizure Information

Each time a seizure occurs, enter the following information on the grid:

Medication Information
Start Time Stop TimeDescriptionComment
       
    none observed  
       
       
       

Sleep Information

Each time the student sleeps for more than five minutes, enter the following information on the grid. If the student's sleep is interrupted for longer than three minutes, enter a stop time and begin a new sleep episode on the next line:

Sleep Information
Start TimeStop TimeLocationComments
9:00 p.m. 12:00 p.m. Bedroom Cried to request in bed change in position
12:15 p.m. 3:20 p.m. " "
3:28 p.m. 6:15 p.m.. " Playing quietly in bed when checked at 6:15

Part II - Instructions

Time: Record the clock time for every third interval recorded. This will help show the continuity of the assessment.

State: Record the state at the moment of observation, not the prevalent state for the entire interval.

Position: Indicate the position the student is in at the moment of observation (e.g., sitting, side-lying, prone, supine, standing).

Specific External Stimuli Available: Describe the specific external stimuli available to the student at the moment of observation (e.g., music, vibrator, swing, water, food, Little Room, mobile). If no material is available, enter a zero.

Ambient Conditions: Describe the characteristics of the surrounding (e.g., room temperature, noise level, conspicuous smells, lighting) for the first state recorded and whenever conditions change. When no change occurs, put ditto marks in the column.

Social Conditions: Record the name of the person interacting with the student at the moment of observation. The person must be talking to the student, touching the student, and/or co-actively manipulating an object with the student. The passive presence of another person should not be recorded. If no person is interacting with the student, enter zero.

Key to Part II Assessment

State Key: _ = Seizure; S = Sleep; D = Drowsiness; QA = Quiet Awake; AA = Active Awake; FA = Fussy Awake; MA = Mild Agitation; UA = Uncontrollable Agitation.

TimeActivityStatePosition Spec. Ext. Stimuli Avai.lAmbient ConditionsSocial Conditions
8:15 Arrival QA Seated 0 Outdoors cold, windy, noisy chairlift in bus Greeted by TA  Linda
8:30 Breakfast D Supine 0 Normal temperature and lighting 0
8:45 Tooth-brushing MA Seated Toothbrush, toothpaste, water, towel Noisy bathroom,very bright lighting Hand-over-hand   manipulation; L
9:00 Hair Drying QA Seated Hairdryer, mousse, brush Normal temperature and lighting Talking; Linda
9:15 Hair Brushing QA Seated Hairdryer, mousse, brush Normal temperature and lighting Talking; Linda
9:30 Drama Class AA Seated Papier mache material Dark stage area, echoes Surrounded by peers
10:00 Changing AA Supine Cold wipes, talcum  powder Normal temperature  and lighting Patting, talking; Linda
10:15 Mail Delivery AA Rolling  prone stander Variety visual & auditory stimuli avail. Many changes; different noise levels Interaction with 6 different adults
        Remainder of day not shown    

Part III - Summary

Typical duration of alert states: 15 to 20 minutes

(Note: If the student is typically alert less than one minute, a different type of biobehavioral assessment will be necessary. Consider assessing one activity at 30 second intervals. The purpose of this assessment would be to try to determine what influences cause state changes and to provide modifications associated with changes to more alert states.)

Positions during alert states: Seated, standing (in prone stander)

Specific external stimuli available during alert states: Movement; tactual materials (e.g., paper, hairbrush); auditory, especially human voice

Ambient conditions during alert states: Normal lighting, temperature, low noise level

Social conditions during alert states: Talking and touching

Less than alert states typically occurred when: There was no social interaction

Agitated states typically occurred when: There was too much noise or strong smells and just before feeding

If you have concerns about food and liquid intake or medications, talk with parents and other team members about getting more information.

Do you have concerns about food and liquid intake being adequate for maintenance of alert states:

___X__ Yes  ______ No

Do you have concerns about medication and/or medication schedules facilitating alert states at optimum programming times:

___X___Yes   _____  No

Busy medium business setting or small metropolitan areas

The first time you complete this exercise use your monocular.  If you have a bioptic, try this exercise a second time to compare the difference.

Exercise2Unlike most residential areas, where there are few traffic lights and generally light vehicle and pedestrian traffic, medium business settings and small metropolitan areas make greater demands on all drivers.  After you feel confident in distance scanning in residential areas, take a drive in a busier setting where there may be multiple lanes of traffic, a variety of traffic lights, one-way streets, and many cars and pedestrians moving into traffic.  Once again as you ride along, let the driver know what you spot and when using the distance scanning technique. As you are traveling, look ahead as far as possible and comment on these things:

  • Stops signs, traffic signs, traffic lights and other warning lights
  • Pedestrians approaching the street to cross
  • Vehicles approaching from the opposite direction
  • Vehicles traveling beside and in front of you on a multi-lane road
  • Vehicles turning into the street from other streets or driveways
  • Things that must be maneuvered around like delivery trucks and vans parked on the street
  • Hazards, animals or objects in the street

Considering your observations, answer these questions:

  • How was this experience different from driving in a quiet residential area for you?
  • What things that were difficult for you to spot?
  • What did you find confusing or surprising about the roadways, pedestrian traffic, or vehicle traffic?
  • Did you see any potential collision “traps”?  If so, what would have been your “out”?
  • What things did you specifically need to use your monocular or bioptic to see?
  • Did the weather, light or other uncontrollable conditions impact your performance?
  • What skills do you most need to work on related to driving with low vision?

Developed by TSBVI Outreach Programs based on materials provided by Chuck Huss, COMS, Driver Rehabilitation Specialist with the West Virginia Bioptic Driving Program

Return to:

Bioptic Driving: Passenger-in-car Skills

Exercise 1

Exercise 3

by Millie Smith, Education Specialist and Stacy Shafer, Early Childhood Specialist, TSBVI Outreach

Biobehavioral states are levels of arousal ranging from asleep to agitated. Students with profound disabilities may not respond to the stimulation and interactions around them because they have difficulty establishing and maintaining alert arousal states. They, like any other student, are available for learning only when they are alert. The primary task of teachers serving this population is to become skillful at using environmental management to create conditions that facilitate establishment and maintenance of alert states. Once students are alert, appropriate learning materials and social interactions must then be provided in order for learning to occur.

Many external as well as internal factors influence arousal states. All significant factors must be considered in determining the best way to facilitate alert states with any given student. For that reason, biobehavioral state assessment is crucial before interventions occur. Under no circumstances should it be assumed that a student is nonresponsive under all conditions before biobehavioral assessment and subsequent intervention has been provided.

Two of the most well known biobehavioral assessments that have come from the research and literature developed during the last twenty-five years are the Carolina Record of Individual Behavior (CRIB) and the Analyzing Behavior State and Learning Environments Profile (ABLE). Each of these tools has strengths, but cost and accessibility limit their use for some teachers. The informal, teacher-made assessment tool which follows this article attempts to assist teachers in their efforts to identify factors influencing their students' arousal states. Teachers are encouraged to change this tool as needed to meet the unique needs of an individual student. Teachers are also encouraged to read the resource material listed and to take advantage of training opportunities related to these tools as they arise.

The success of this type of assessment is highly dependent upon the sharing of information. Parents and staff members who will be recording states and other information should plan the assessment together. All assessors must agree on the characteristics of each state for the student they are assessing. Using a video tape of the student to practice recognition of states before the actual assessment takes place is very helpful.

Resources

Guess, D., Mulligan-Ault, M., Roberts, S., Struth, J., Siegal-Causey, E., Thompson, B., Bronicki,
G.J., & Guy, G. (1988). Implications of biobehavioral states for the education and treatment of students with the most handicapping conditions. JASH, 13 (3), 163-174.

Guy, B., Ault, M., & Guess, D. (1993). Project ABLE manual: Analyzing behavior state and learning environments profile. Lawrence: University of Kansas Department of Special Education.

Rainforth, B. (1982). Biobehavioral state and orienting: Implications for education of profoundly retarded students. TASH Journal, Volume 6, Winter, 33-37.

Simeonsson, R.J., Huntington, G.S., Short, R. J., & Ware, W. B. (1988). The Carolina record of individual behavior (CRIB): Characteristics of handicapped infants and children. Chapel Hill: Frank Porter Graham Child Development Center, University of North Carolina at Chapel Hill.

Editors note: If you have questions regarding the forms that follow contact Millie Smith at (512) 206-9271 or write to her at TSBVI Outreach, 1100 W. 45th Street, Austin, TX 78756, Attention: Millie Smith. The actual forms may be found in Teaching Students with Visual and Multiple Impairments (1996). Austin, TX: Texas School for the Blind & Visually Impaired, Austin, TX.


Assessment of Biobehavioral States and Analysis of Related Influences

by Millie Smith and Stacy Shafer

Student's Name: Catherine              Date of Assessment: 3/5/95

Name(s) of Assessor(s): M. Smith, P. Castro (mother), N. Jones

Assessment Period

School day starts at: 8:15 a.m
School Day ends at: 3:30 p.m.

Nonschool environments:
Place: Home From: 4:00 p.m. To: 8:30 p.m.
Place:           From:                  To:

The total assessment period should be at least one school day. Assessment of the student in nonschool environments on the same day would be extremely helpful.

Recording Schedule

Indicate the length of the interval between recordings in Part II. Intervals should be no shorter than one minute and no longer than 15 minutes. The intervals should be consistent throughout the assessment period. Part II information will be recorded every 15 minutes.

Part I

Provide the information called for in the grids for the 24 hours preceding the beginning of the assessment and throughout the assessment period. Under "Comment" indicate any significant factor that comes to mind and be sure to note when the recorded information is a departure from the student's typical routine. If there are significant departures or if the student is ill on the day of assessment, postpone the assessment.

Note: This is an informal teacher-made assessment based on the Carolina Record of Individual Behavior (CRIB), by R. J. Simeonsson et al. and the Project ABLE Manual: Analyzing Behavior State and Learning Environments Profile by B. Guy et al.

Food and Liquid Information

Each time the student eats something, drinks something, or is tube fed, enter the following information on the grid:
(the grid has five columns titled Type, Start Time, Stop Time, Amount, and Comment)

TypeTime StartTime StopAmountComment
Ensure. 8:20 8:40 16 oz  
Water. 8:40 8:45 6 oz  
Ensure 12:30 1:20 16 oz.  
Water 1:10 1:15 6 oz.  
Ensure 4:30 4:50 16 oz.  
Water 4:50 5:00 6 oz.  
Ensure 8:00 8:20 16 oz.  
Water. 8:20 8:25 6 oz  

Medication Information

Each time the student takes a prescription or over the counter medication enter the following information on the grid:

TypeTimeAmountComment
Tegretol Suspension 8:20 a.m. 200 mg  
Dimetap Elixir 8:20 a.m. 10 cc for congestion
Dimetap Elixir 12:30 p.m. 10 cc  
Tegretol Suspension 4:30 p.m. 200 mg  
Dimetap Elixir 4:30 p.m. 10 cc  

Seizure Information

Each time a seizure occurs, enter the following information on the grid:

Start Time Stop TimeDescriptionComment
       
    none observed  
       
       
       

Sleep Information

Each time the student sleeps for more than five minutes, enter the following information on the grid. If the student's sleep is interrupted for longer than three minutes, enter a stop time and begin a new sleep episode on the next line:

Start TimeStop TimeLocationComments
9:00 p.m. 12:00 p.m. Bedroom Cried to request in bed change in position
12:15 p.m. 3:20 p.m. " "
3:28 p.m. 6:15 p.m.. " Playing quietly in bed when checked at 6:15

Part II - Instructions

Time: Record the clock time for every third interval recorded. This will help show the continuity of the assessment.

State: Record the state at the moment of observation, not the prevalent state for the entire interval.

Position: Indicate the position the student is in at the moment of observation (e.g., sitting, side-lying, prone, supine, standing).

Specific External Stimuli Available: Describe the specific external stimuli available to the student at the moment of observation (e.g., music, vibrator, swing, water, food, Little Room, mobile). If no material is available, enter a zero.

Ambient Conditions: Describe the characteristics of the surrounding (e.g., room temperature, noise level, conspicuous smells, lighting) for the first state recorded and whenever conditions change. When no change occurs, put ditto marks in the column.

Social Conditions: Record the name of the person interacting with the student at the moment of observation. The person must be talking to the student, touching the student, and/or co-actively manipulating an object with the student. The passive presence of another person should not be recorded. If no person is interacting with the student, enter zero.

Key to Part II Assessment

State Key: _ = Seizure; S = Sleep; D = Drowsiness; QA = Quiet Awake;
AA = Active Awake; FA = Fussy Awake; MA = Mild Agitation;
UA = Uncontrollable Agitation.

TimeActivityStatePosition Spec. Ext. Stimuli Avai.lAmbient ConditionsSocial Conditions
8:15 Arrival QA Seated 0 Outdoors cold, windy, noisy chairlift in bus Greeted by TA  Linda
8:30 Breakfast D Supine 0 Normal temperature and lighting 0
8:45 Tooth-brushing MA Seated Toothbrush, toothpaste, water, towel Noisy bathroom,very bright lighting Hand-over-hand   manipulation; L
9:00 Hair Drying QA Seated Hairdryer, mousse, brush Normal temperature and lighting Talking; Linda
9:15 Hair Brushing QA Seated Hairdryer, mousse, brush Normal temperature and lighting Talking; Linda
9:30 Drama Class AA Seated Papier mache material Dark stage area, echoes Surrounded by peers
10:00 Changing AA Supine Cold wipes, talcum  powder Normal temperature  and lighting Patting, talking; Linda
10:15 Mail Delivery AA Rolling  prone stander Variety visual & auditory stimuli avail. Many changes; different noise levels Interaction with 6 different adults
        Remainder of day not shown    

Part III - Summary

Typical duration of alert states: 15 to 20 minutes

(Note: If the student is typically alert less than one minute, a different type of biobehavioral assessment will be necessary. Consider assessing one activity at 30 second intervals. The purpose of this assessment would be to try to determine what influences cause state changes and to provide modifications associated with changes to more alert states.)

Positions during alert states: Seated, standing (in prone stander)

Specific external stimuli available during alert states: Movement; tactual materials (e.g., paper, hairbrush); auditory, especially human voice

Ambient conditions during alert states: Normal lighting, temperature, low noise level

Social conditions during alert states: Talking and touching

Less than alert states typically occurred when: There was no social interaction

Agitated states typically occurred when: There was too much noise or strong smells and just before feeding

If you have concerns about food and liquid intake or medications, talk with parents and other team members about getting more information.

Do you have concerns about food and liquid intake being adequate for maintenance of alert states:

___X__ Yes  ______ No

Do you have concerns about medication and/or medication schedules facilitating alert states at optimum programming times:

___X___Yes   _____  No

Quiet residential area

The first time you complete this exercise use your monocular.  If you have a bioptic, try this exercise a second time to compare the difference.

Quiet residential street as seen from the driver's seat.Residential driving is often considered easier and safer because of the slow speeds.  However, they can provide as many or more challenges to safety.  Many more cars, people, animals and objects can suddenly appear in your path. There are four-way stops, yield signs, school crossings. Drive through a quiet residential area and as you use your monocular or bioptic comment on what you see to include:

  • Stops signs and other traffic signs
  • Pedestrians near or in the street
  • Vehicles approaching from the opposite direction
  • Vehicles turning into the street from other streets or driveways
  • Hazards, animals or objects in the street

Considering your observations, answer these questions:

  • What did looking farther down the road allow you to do?
  • What things were difficult for you to spot?
  • What things surprised you while you were scanning at a distance?
  • Did you see any potential collision “traps”?  If so, what would have been your “out”?
  • Did you feel comfortable using your monocular or bioptic during this exercise?  If not what skills do you think you need to practice?
  • Did the weather, amount of light or other uncontrollable conditions impact your performance?
  • What skills do you most need to work on related to driving with low vision?

Developed by TSBVI Outreach Programs based on materials provided by Chuck Huss, COMS, Driver Rehabilitation Specialist with the West Virginia Bioptic Driving Program, 2015.

Return to:

Bioptic Driving: Passenger-in-car Skills

Exercise 2

Exercise 3

 

by Millie Smith and Stacy Shafer

Student's Name: Catherine
Date of Assessment: 3/5/95

Name(s) of Assessor(s): M. Smith, P. Castro (mother), N. Jones

Assessment Period
School day starts at: 8:15 a.m
School Day ends at: 3:30 p.m.

Nonschool environments:
Place: Home From: 4:00 p.m. To: 8:30 p.m.
Place:           From:                   To:

The total assessment period should be at least one school day. Assessment of the student in nonschool environments on the same day would be extremely helpful.

Recording Schedule

Indicate the length of the interval between recordings in Part II. Intervals should be no shorter than one minute and no longer than 15 minutes. The intervals should be consistent throughout the assessment period. Part II information will be recorded every 15 minutes.

Part I

Provide the information called for in the grids for the 24 hours preceding the beginning of the assessment and throughout the assessment period. Under "Comment" indicate any significant factor that comes to mind and be sure to note when the recorded information is a departure from the student's typical routine. If there are significant departures or if the student is ill on the day of assessment, postpone the assessment.

Note: This is an informal teacher-made assessment based on the Carolina Record of Individual Behavior (CRIB), by R. J. Simeonsson et al. and the Project ABLE Manual: Analyzing Behavior State and Learning Environments Profile by B. Guy et al.

Food and Liquid Information

Each time the student eats something, drinks something, or is tube fed, enter the following information on the grid:
(the table has five columns titled Type, Start Time, Stop Time, Amount, and Comment)

Food and Liquid Information
TypeTime StartTime StopAmountComment
Ensure. 8:20 8:40 16 oz  
Water. 8:40 8:45 6 oz  
Ensure 12:30 1:20 16 oz.  
Water 1:10 1:15 6 oz.  
Ensure 4:30 4:50 16 oz.  
Water 4:50 5:00 6 oz.  
Ensure 8:00 8:20 16 oz.  
Water. 8:20 8:25 6 oz  

Medication Information

Each time the student takes a prescription or over the counter medication enter the following information on the grid:

Medication Information
TypeTimeAmountComment
Tegretol Suspension 8:20 a.m. 200 mg  
Dimetap Elixir 8:20 a.m. 10 cc for congestion
Dimetap Elixir 12:30 p.m. 10 cc  
Tegretol Suspension 4:30 p.m. 200 mg  
Dimetap Elixir 4:30 p.m. 10 cc  

Seizure Information

Each time a seizure occurs, enter the following information on the grid:

Medication Information
Start Time Stop TimeDescriptionComment
       
    none observed  
       
       
       

Sleep Information

Each time the student sleeps for more than five minutes, enter the following information on the grid. If the student's sleep is interrupted for longer than three minutes, enter a stop time and begin a new sleep episode on the next line:

Sleep Information
Start TimeStop TimeLocationComments
9:00 p.m. 12:00 p.m. Bedroom Cried to request in bed change in position
12:15 p.m. 3:20 p.m. " "
3:28 p.m. 6:15 p.m.. " Playing quietly in bed when checked at 6:15

Part II - Instructions

Time: Record the clock time for every third interval recorded. This will help show the continuity of the assessment.

State: Record the state at the moment of observation, not the prevalent state for the entire interval.

Position: Indicate the position the student is in at the moment of observation (e.g., sitting, side-lying, prone, supine, standing).

Specific External Stimuli Available: Describe the specific external stimuli available to the student at the moment of observation (e.g., music, vibrator, swing, water, food, Little Room, mobile). If no material is available, enter a zero.

Ambient Conditions: Describe the characteristics of the surrounding (e.g., room temperature, noise level, conspicuous smells, lighting) for the first state recorded and whenever conditions change. When no change occurs, put ditto marks in the column.

Social Conditions: Record the name of the person interacting with the student at the moment of observation. The person must be talking to the student, touching the student, and/or co-actively manipulating an object with the student. The passive presence of another person should not be recorded. If no person is interacting with the student, enter zero.

Key to Part II Assessment

State Key: _ = Seizure; S = Sleep; D = Drowsiness; QA = Quiet Awake; AA = Active Awake; FA = Fussy Awake; MA = Mild Agitation; UA = Uncontrollable Agitation.

TimeActivityStatePosition Spec. Ext. Stimuli Avai.lAmbient ConditionsSocial Conditions
8:15 Arrival QA Seated 0 Outdoors cold, windy, noisy chairlift in bus Greeted by TA  Linda
8:30 Breakfast D Supine 0 Normal temperature and lighting 0
8:45 Tooth-brushing MA Seated Toothbrush, toothpaste, water, towel Noisy bathroom,very bright lighting Hand-over-hand   manipulation; L
9:00 Hair Drying QA Seated Hairdryer, mousse, brush Normal temperature and lighting Talking; Linda
9:15 Hair Brushing QA Seated Hairdryer, mousse, brush Normal temperature and lighting Talking; Linda
9:30 Drama Class AA Seated Papier mache material Dark stage area, echoes Surrounded by peers
10:00 Changing AA Supine Cold wipes, talcum  powder Normal temperature  and lighting Patting, talking; Linda
10:15 Mail Delivery AA Rolling  prone stander Variety visual & auditory stimuli avail. Many changes; different noise levels Interaction with 6 different adults
        Remainder of day not shown    

Part III - Summary

Typical duration of alert states: 15 to 20 minutes

(Note: If the student is typically alert less than one minute, a different type of biobehavioral assessment will be necessary. Consider assessing one activity at 30 second intervals. The purpose of this assessment would be to try to determine what influences cause state changes and to provide modifications associated with changes to more alert states.)

Positions during alert states: Seated, standing (in prone stander)

Specific external stimuli available during alert states: Movement; tactual materials (e.g., paper, hairbrush); auditory, especially human voice

Ambient conditions during alert states: Normal lighting, temperature, low noise level

Social conditions during alert states: Talking and touching

Less than alert states typically occurred when: There was no social interaction

Agitated states typically occurred when: There was too much noise or strong smells and just before feeding

If you have concerns about food and liquid intake or medications, talk with parents and other team members about getting more information.

Do you have concerns about food and liquid intake being adequate for maintenance of alert states:

___X__ Yes  ______ No

Do you have concerns about medication and/or medication schedules facilitating alert states at optimum programming times:

___X___Yes   _____  No

A baby plays with toys on a tray.“According to some researchers, vision is usually involved in 90% of the learning that takes place in early development” (Ferrell, 1996, p 89).

Do you know an infant or a child who appears to have difficulty seeing the world around him?  Have you noticed any unusual visual behaviors or difficulty in one of your students or patients?  Take a minute and find out how you can help put them in touch with agencies that may be of service.  Let’s help children maximize their education by maximizing their VISION!

The Statewide Leadership Services for Blind and Visually Impaired has created these brochures to share with parents, teachers, doctors, day care providers and others to make them more aware of the signs associated with vision impairment and where to go for resources and support related to intervention.

Download the Eye Find Brochure in English - PDF  DOCX

Warning Signs 

Atypical Visual Behaviors that might indicate the need for an examination and or assessment:

  • Moving closer to an object for viewing
  • Tilting of the head to view objects or face
  • Squinting
  • Sensitivity to light
  • Excessive rubbing of eyes
  • Excessive tearing
  • Consistent eye turn (amblyopia)
  • Rapid eye movements (Nystagmus)

Vision is not just in the structure of the eye.  These medical conditions might indicate the need for an assessment by a teacher of     students with visual impairments.

  • Prematurity (i.e. ROP)
  • Syndromes: (i.e. Down, Charge)
  • Stroke
  • Anoxia (oxygen deprivation)
  • Glaucoma
  • Cataracts
  • Albinism
  • Optic Nerve Hypoplasia
  • Cerebral Palsy 

Typical Visual Behaviors:

Birth

  • Focus on objects 8-10 inches away
  • Eyes have difficulty working together

3 months

  • Tracks moving objects
  • Eyes are beginning to work together
  • Beginning of a directed reach

6 months

  • Turns head to see objects
  • Accurate reach (depth perception)
  • Good color vision/favorite color
  • Sees at greater distances
  • Picks up dropped toys

12 months

  •  Shows interest in pictures
  • Points and gestures
  • Places shapes in board
  •  Judges distances
  •  Recognizes own face in mirror.

18 months

  • Recognizes familiar objects
  • Scribbles with crayons or pens
  • Shows interest in exploring

(AOA.org) 

by Millie Smith and Stacy Shafer

Biobehavioral states are levels of arousal ranging from asleep to agitated. Students with profound disabilities may not respond to the stimulation and interactions around them because they have difficulty establishing and maintaining alert arousal states. They, like any other student, are available for learning only when they are alert. The primary task of teachers serving this population is to become skillful at using environmental management and specific sensory input to create conditions that facilitate establishment and maintenance of alert states. Once students are alert, appropriate learning materials and social interactions must then be provided in order for learning to occur.

Many external as well as internal factors influence arousal states. All significant factors must be considered in determining the best way to facilitate alert states with any given student. For that reason, biobehavioral state assessment is crucial before interventions occur. Under no circumstances should it be assumed that a student is non-responsive under all conditions before biobehavioral assessment and subsequent intervention has been provided.

Two of the most well known biobehavioral assessments that have come from the research and literature developed during the last twenty-five years are the Carolina Record of Individual Behavior (CRIB) and the Analyzing Behavior State and Learning Environments Profile (ABLE). Each of these tools has strengths, but cost and accessibility limit the use of each for some teachers. The informal, teacher-made assessment tool offered in this article attempts to assist teachers in their efforts to identify factors influencing their students' arousal states. Teachers are encouraged to change this tool as needed to meet the unique needs of an individual student. Teachers are also encouraged to read the resource material listed and to take advantage of training opportunities as they arise.

The success of this type of assessment is highly dependent upon the sharing of information. Parents and staff members who will be recording states and other information should plan the assessment together. All assessors must agree on the characteristics of each state for the student they are assessing. Using a video tape of the student to practice recognition of states before the actual assessment takes place is very helpful.

Example Form: Assessment of Biobehavioral States and Analysis of Related Influences

Resources

Guess, D., Mulligan-Ault, M., Roberts, S., Struth, J., Siegal-Causey, E., Thompson, B., Bronicki, G.J., & Guy, G. (1988). Implications of biobehavioral states for the education and treatment of students with the most handicapping conditions. JASH, 13 (3), 163-174.

Guy,B., Ault, M., & Guess, D. (1993). Project ABLE manual: Analyzing behavior state and learning environments profile. Lawrence: University of Kansas Department of Special Education.

Rainforth, B. (1982). Biobehavioral state and orienting: Implications for education profoundly retarded students. TASH Journal, volume 6, Winter, 33-37.

Simeonsson, R.J., Huntington, G.S., Short, R.J., & Ware, W.B. (1988). The Carolina record of individual behavior (CRIB): Characteristics of handicapped infants and children. Chapel Hill: Frank Porter Graham Child Development Center, University of North Carolina at Chapel Hill.

General

  • Your VI teacher (TVI) should give you a copy of the Functional Vision Evaluation and Learning Media Assessment with detailed information about how your particular student uses his/her vision
  • Students with low vision should be encouraged to use their eyes to the maximum. Vision is not diminished by use.
  • Allow the student to adjust his/her work to a position that he/she is most comfortable with
  • Do not use large print materials when regular print will suffice
  • Whenever an assignment refers to a picture (as in math workbooks) allow the student to look at the picture in a regular print book. The large print process distorts pictures

Reading the Chalkboard/Whiteboard

  • Seat student near the board (within 3 to 5 feet) and in a central location, but within a group of students
  • Verbalize as you write on board
  • If possible, provide a copy of what you have written on the board to the student
  • Have another student with good handwriting copy off the board (carbon or NCR paper can be used and the original can be given to the student with a visual impairment)
  • Allow student to use a telescope supplied by the TVI (if this is done the student will probably need to be seated back away from the board to increase his/her visual field)
  • A clean board makes a better contrast and is easier to read
  • Avoid using red, orange, or yellow markers as these are difficult to see

Projector Screen/Video

  • Seat student close to the screen
  • Provide student with your overhead projector sheet or master copy so he or she can read and/or copy from it
  • Use a dark (preferably black) Vis-à-vis pen on the overhead sheet
  • Discuss movies thoroughly afterwards to make sure the student understands major concepts presented
  • A darkened room provides more contrast
  • Move the projector closer to the screen to produce a smaller, more distinct image
  • Make a good photo copy of your master
  • Do not use red ink
  • Please be sure that your tests are completely legible. Ask the student to read parts of the test to you privately to be sure he or she can see all parts of the test
  • Give the student a little extra time if needed
  • Avoid handing the student a paper and saying, “Do the best you can”. This only cheats the student out of the continuity of your lesson and can be frustrating
  • Use an app, such as JoinMe, to connect the teacher’s computer screen and/or interactive white board with the student’s iPad

Illumination

  • Light intensity can be regulated by adjusting distance from the window or light source
  • Artificial lights should be used whenever brightness levels become low in any part of the room.
  • Avoid glares on working surfaces (a piece of dark colored paper taped to the entire desk surface diminishes glare off the desk)
  • A student with albinism will be sensitive to the light and will sometimes require an adjustment period of about 10 minutes when he or she comes in from being in the sun

Seating

  • Avoid having students work in their own shadows or facing the light
  • Students may need to change their seats whenever they desire more or less light

Contrast

  • Dry erase boards used with dark markers offer better contrast
  • Soft lead pencils and felt-tipped pens with black ink are recommended for use on unglazed light and tinted paper
  • Good contrast and white space between lines of print offer the best viewing comfort for lengthy reading assignments
  • Avoid using red/orange/yellow on interactive boards

Tests

  • Tests should be dark and clear
  • If there is a time element, please remember that a person with a visual impairment will frequently be a slower reader than a person with normal sight of the same intelligence. His or her eyes may tire much faster, so tests in the afternoon can be particularly difficult to read
  • On timed drills allow at least double the time for a student with a visual impairment. Ideally they should be untimed
  • If the student is comfortable performing orally, tests could be given orally by another person who fills in the blanks. Please be careful here, as some people are not auditory performers, and it is a misconception that all blind and low vision students can perform better auditorally.

Physical Education/Recess

  • Check with TVI to see if there are any restrictions of activity or on visual fields
  • Ball Sports: practice catching, kicking, and batting with students to check whether or not he/she can see the ball in time to catch, kick, or bat
  • Use audible goals and/or balls (available from TVI) or use a radio as a goal locator (as in basketball)

Orientation and Mobility

  • Allow student to explore your room during the first week and whenever you make any major changes
  • Show student where his or her desk is, where materials are located, papers turned in, etc.  
  • Point out the restrooms, water fountains, library, office, cafeteria, gym, and bus stops
  • Contact a certified O&M specialist for detailed information

Presented at the AER 2002 International Conference
July 17 – 21, 2002
Toronto, Ontario, Canada
By
Duncan McGregor, Ed.D. & Carol Farrenkopf, Ed.D.

Download an RTF version (39k)

Strategies

  • Experiential learning (literacy instruction rooted in experiences)
  • Link new experiences with those already learned
  • Use concrete objects whenever possible
  • Learn by doing
  • Unify experiences
  • Pair real objects with representational forms (pictures, miniatures)
  • Pair real objects with symbolic forms (print, braille)
  • Read aloud to and with the student
  • Pretend reading by the student
  • Pretend writing by the student
  • Use repeated readings to build fluency and confidence
  • Integrate instruction of the mechanics of reading and writing (how to turn the pages, identifying the cover of a book, finding the page number, locating the print/braille text, learning how to put the paper in a braille writer, learning how to hold a marker/crayon/pencil, the act of writing/brailling)

Building the Foundation for Literacy

  • Time: Print/braille instruction every day, 1 – 2 hours per day, direct instruction as well as integrated instruction at other times of the day
  • Consistency: Same teaching schedule (avoid cancellations), same teacher of the visually impaired, same teaching style, same expectations
  • Exposure: Braille/print labels throughout the student’s school environment (label as much as you can), especially in the classroom
  • Accessibility: Braille/print books in the classroom and school library
  • Application: Opportunities to apply braille/print reading and writing skills throughout the day, in various environments (gym, office, washrooms, library)

Two Types of Books You Can Create

  1. Concept Books (e.g., letters, numbers, words, shapes, size, position, colours, classification/categories).
  2. Story Books
    1. Mass-produced books that can be adapted (simple, easy-to-read, large type, clear pictures)
    2. Photocopy of already-made books (e.g., Sunshine Series)
    3. Made-up stories (by you, the student, other children, parents)

 

Creating a Braille/Print Book

Materials:

  • Two sturdy book covers (e.g., heavy construction paper, artists’ board, “real” braille book covers, file folders, cardboard)
  • Binding (usually 1 inch binding is a good size… it’s easier to turn pages with larger binding); binder rings, twist-ties, pipe-cleaners, string, and floral wiring also work well.
  • Braille paper (to make the pages in the book)… usually 4 – 5 pages in the book is a good number to start off with for a young child
  • Crayons/coloured markers/black marker to colour pages
  • Glue stick and/or hot glue gun
  • Tape
  • Concrete, familiar items to put in the book that are related to the topic of the book
  • Scissors
  • Braille writer/slate and stylus
  • Braille labeling sheets or Dymotape
  • Photocopied and enlarged pages of a story (if making this type of book)

Creating a Book FOR a Student

Method:

  • Determine an appropriate topic for the book
  • If creating a letter book, base the book on a letter the student already knows or is learning (start with the first letter of the child’s name)
  • If creating a number book, keep the number of items on a page within the capabilities of the child (by gr. 1, most children know how to count to 30)
  • If creating a shape book, consider making the cover and the pages of the book the shape of the topic (e.g., circular-shaped book about circles)
  • If creating a positional book, carefully consider the placement of items on the page so as not to confuse the student.
  • Indicate the page number in braille and in print on each page of the book
  • Include some sort of object on the cover that indicates what the book is about so the student can identify the book independently
  • Include a print and braille title on the cover of the book
  • Braille the text on the bottom of the page so text can be changed easily (if need be); it also allows more space for items to be put on the page
  • If the book is an enlarged photocopy of a book, colour in only one or two identifying parts of the pictures—too much colour may cause confusion; colour only what is most important (raised lines and textures may also help the student focus attention to the most important parts of the story)
  • Use strong fasteners (e.g., glue, tape, pipe cleaners) to keep the objects from falling out of the book. Placing objects in plastic bags that can be opened/unzipped is also a good idea.
  • Use large binding materials because all of the objects inside the book will make it an extra thick book
  • Initially, read the book together. Allow the student to guess at the content and pretend to read what it says
  • Encourage proper position of the book, fingers over the braille, scanning of the pages, and turning only one page at a time
  • Make reading the book as fun as possible!

Creating a Book WITH a Student

Method:

  • Have all of the book-making materials with you (binding, covers with pre-cut binding holes, braille paper with holes, glue, objects, etc.)
  • Allow the student to direct the creation of the book
  • Bring a bag or box of all the materials you think the student may want to include in his/her book—include a wide variety of items so the student may choose some items over others

OR

  • Place items that can be used in the book in the student’s classroom/work area so that he/she can “discover” them accidentally
  • Allow the student to be creative with his/her stories and the placement of objects in the books
  • If the student is creating a story based on a storybook that has already been made, review the original story first and then use that book as a model for the new one the student is creating
  • With the teacher’s assistance, the student may braille the text at the bottom of the page
  • Think about including another child in the book-making experience
  • Encourage the child to read (or pretend to read) the book aloud—encourage smooth line tracking while the child reads the line of braille)

Some Final Suggestions

  • Include the books in the classroom/school library
  • Encourage the child to share his/her book with classmates
  • Allow the child to take the book home to share with friends/family
  • Start a book club
  • Have lots of fun!