In this episode of the OT Schoolhouse Podcast, Kelsey Kornaus delves into the world of visual impairments in students.
From the importance of self-advocacy to the impact of sensory difficulties and the role of assistive technology, this episode discusses the challenges and innovative strategies for supporting students with visual impairments in educational settings.
Listen now to gain valuable insights into assessment techniques, the decision-making process for residential placement, and the benefit of community support.
Listen now to learn the following objectives:
Thanks for tuning in!
Thanks for tuning into the OT Schoolhouse Podcast brought to you by the OT Schoolhouse Collaborative Community for school-based OTPs. In OTS Collab, we use community-powered professional development to learn together and implement strategies together.
Don't forget to subscribe to the show and check out the show notes for every episode at OTSchoolhouse.com
See you in the next episode!
In this episode of the OT Schoolhouse Podcast, Kelsey Kornaus delves into the world of visual impairments in students.
From the importance of self-advocacy to the impact of sensory difficulties and the role of assistive technology, this episode discusses the challenges and innovative strategies for supporting students with visual impairments in educational settings.
Listen now to gain valuable insights into assessment techniques, the decision-making process for residential placement, and the benefit of community support.
Listen now to learn the following objectives:
Thanks for tuning in!
Thanks for tuning into the OT Schoolhouse Podcast brought to you by the OT Schoolhouse Collaborative Community for school-based OTPs. In OTS Collab, we use community-powered professional development to learn together and implement strategies together.
Don't forget to subscribe to the show and check out the show notes for every episode at OTSchoolhouse.com
See you in the next episode!
Jayson Davies
Hey there, fellow OT practitioner and welcome back to the OT schoolhouse podcast your place for practical school based occupational therapy tips, research and professional development. I'm your host Jayson Davies. And today we have a fantastic episode about how school based OT practitioners can support students with a low vision. To help me out with that. Joining me today is the incredibly knowledgeable Kelsey Cornell's, an occupational therapist with a background in optometry and extensive experience working with students with visual impairments, particularly at a school for the blind and visually impaired. Together, Kelsey, and I hope to help you understand the role of occupational therapy practitioners and supporting students with visual impairments and their specific needs, including the use of assistive technology and universal design for learning. And before we get started, I also want to let you in on one little secret, Kelsey recently presented a full training on supporting the sensory needs of students with visual impairments inside our OT schoolhouse collaborative community. So if you enjoy this episode, which I'm sure you will be sure to check out her course inside the collaborative at OTSchoolHouse.com slash collab, we hope to see you there. And with that, I hope you enjoy this enlightening conversation with Kelsey Cronos. As we learn and grow together as a community of therapists enjoy the episode.
Amazing Narrator
Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies. PLAs is officially in session.
Jayson Davies
Kelsey, welcome to the OTs schoolhouse podcast. It is such a pleasure to have you here today. How you doing?
Kelsey Kornaus
I'm doing well. Thank you for having me excited to be joining on the OTs podcast. Yeah, you know, we've done a lot together over the years, it seems like I've known you for so long, you've been part of those costs collaborative a little bit helping out over there with presenting about visual impairments. And I'm excited to bring you on today to again talk about visual impairments and really sharing the role that OT practitioners can can partake in supporting students with visual impairments. It's gonna be a good time, I think it is I'm excited to kind of dive in and talk more about visual impairments and what we what our role is as school based OTs. Absolutely. So, you know, let's kind of start off with a little bit about your background and how you kind of fell into the world of working in the VI space. I did, yeah. So um, my OT journey was definitely that it was a journey. I did not start out pursuing occupational therapy. I actually was pursuing a career as an optometrist. And did my undergrad with a bachelor's in pre optometry was going to do pediatrics and vision therapy. And like that was, that was the plan. So went to grad school to be an optometrist, and quickly realized, like, oh, this just isn't the right fit for me. Like, it wasn't everything that I was hoping for. So I kind of took a pause on that and was figuring out like, what am I going to do next? Like, what what does this look like? Because there was really only plan A and not plan B. So it happened to be at the time that I had a family member who was going through vestibular therapy. And she called me up and she was like, You know what she's like, I think this could be like a really good combination of skills. Like I'm working with an OT, we're doing vestibular therapy, like, here's all the vision pieces, you know, why don't you kind of look into this some more, just like, okay, like, let's do that. So, did some shadowing, talk to and worked with some really great OTs and vestibular therapy world. And I was like, alright, like, OT school, like, that's the new. That's the new goal. Like, let's see where we go from there. So I was very fortunate to get into OT learn more about it. And I went to the University of Indianapolis, where I got my master's in occupational therapy. And really, the, the drive was like, Okay, I'm gonna connect my vision background with occupational therapy, like, I don't know how that's gonna happen. But like, I know, that's, that's my passion. And so after school, you know, you kind of start out get your first job, get, you know, used to everything. And after about a year of working, I got in contact with a company that was looking to place an OT at the School for the Blind in Wisconsin, which is where I'm at, and they were like, you know, we think this would be a good fit, like you've got this fishing background and yeah, I I always knew I as an OTA either wanted to go school based or peds based, and then to have the School for the Blind opportunity, I was like, well, this kind of merges everything together for me. And that was, so it just kind of all happened. I wasn't planning on it, it's kind of how that worked. And so I got into the school for the blind, and just really started to like hone my skills as an OT, working with students with visual impairments, and also learning the school based side of OT. Yeah, simultaneously.
Jayson Davies
Yeah, that's, that's a unique experience. Because I mean, to be fair, there's just not a lot of school for the blind out there. I mean, states, if you're in a smaller state, you might have one. And if you're in a larger state, they might have them but they're very spread out and right. It's not like every city has one like they do have schools.
Kelsey Kornaus
So and, and typically, it's like, you know, if you're lucky to have a school for the blind in your state, it's going to be, you know, usually located near your capital, or, you know, you're going to be serving students throughout the whole state, you aren't going to have schools in multiple locations within a state.
Jayson Davies
Yeah, yeah, absolutely. So did you were you saying that you actually started with a fieldwork placement and this and then it turned into a job? Or did you just get that as your first job out of OT school,
Kelsey Kornaus
I got it as my second job out of OT school. So the first job I was working with a company doing assisted living and memory care support, and kind of starting there just as that first grant experience, and then after a year of working there, this position at the blind school became available, and they were reaching out in trying to find qualified applicants. Yeah.
Jayson Davies
Wow. That's awesome. Because you already had that background with optometry a little bit and it just kind of worked out. Yeah, I'm sure they appreciated that background when when you came in for your interview, like not only she you know, tea, but she's got some some background and optometry that really works out. So very cool. All right. Well, as you dove into that job, you know, I want to get into the VR. I really do. But I kind of want to ask you, as you're diving into that very first job as in the school for for the blind, kind of what was that first experience? Like? Was it very shocking to you? Was it exactly what you expected? What was it like going into that position?
Kelsey Kornaus
Yeah, I would say I definitely had a thought of what it could be. And then I quickly realized, I have a lot to learn, I have a lot to kind of just experience and wrap my head around. Because initially, you know, I was kind of told like, yep, students with a visual impairment. I'm thinking, okay, low vision blindness, the thing that we that I hadn't considered was just the additional diagnoses are the additional complexities that can go with that for some students. So, you know, not only are they blind and visually impaired, but there might also be a diagnosis of cerebral palsy, or they might have a neurodivergent diagnosis. They might also be, you know, minimal communication skills. And so when you start to look at, you know, how are you bringing information into your body? Well, you might have decreased vision, but then you might also have decreased communication skills and decreased hearing, and just how all of those play into the whole student. And so that part, I don't think I was prepared for it, just the complexities that you work with, for some students. So I had to learn quickly. But thankfully, I had some great support. And, you know, great team members that I worked with to help me learn this new role. Yeah,
Jayson Davies
yeah, definitely. And I know we're going to dive in as we go a little bit further into some of those other attributes that you saw with these students. They were common with some of your students with visual impairments. But let's take a kind of a quick step back, I guess, and, and define a little bit what a visual impairment is, as it relates to schools. As everyone I think out there knows, like we're not diagnosing the school psychologist is not diagnosing. Often there's not an optometrist or an ophthalmologist on campus, this diagnosing that's happening outside, but when it comes to education in the schools, what does it mean when a school identifies a student as having a visual impairment?
Kelsey Kornaus
Yeah, absolutely. So Ida will define a visual impairment. It's an impairment in vision that even with correction adversely affects the child's educational performance. And we want to make sure that we're including both partial sight and blindness. So that's why it's important to know like, is the student considered to low vision? Or completely blind? And so that's where that visual impairment eligibility criteria comes into play.
Jayson Davies
Gotcha. And then, I'm assuming, I mean, you worked in a school for blind, so the student was already been, they already had an IEP identified them as having visual impairment. However, I do want to ask you this question. For those who aren't working in school for blind? How might a school go about identifying a student with visual with a visual impairment? Is it something that an OT is often part of? Is there someone typically specific on the IEP team that might do that? Or what have you experienced? Yeah, so
Kelsey Kornaus
in my experience, you know, if you're wanting to consider a visual impairment Diag, her eligibility criteria, there is a team that's going to get together to help determine that criteria. So typically, the members of that team are going to include a teacher of the visually impaired, and they will perform the functional vision evaluation, they're going to look at medical records, they're going to get information from that optometrist, or ophthalmologist, and they're really going to look at the educational needs, and what's impacting that student. In addition, there's also going to be an Oregon orientation and mobility specialist, the team and they need to evaluate and determine if there's going to be any orientation and mobility needs, either in the home and the school or community environments. So a child can meet criteria for visual impairment, but not necessarily need the orientation and mobility component. So not every student is going to be a white cane user, which is typically where orientation and mobility specialists are going to work with the student, some students might be in a wheelchair, and might, you know, still meet that eligibility criteria for a visual impairment. But as a part of that team, you want to get that full, comprehensive evaluation. And then oftentimes, depending on the size of the team, and what the team is considering that they might bring in, you know, occupational therapy, physical therapy, to evaluate any additional concerns, but that initial team is really looking at, you know, what are the students visual, like visual skills? Where do they fall? And then how is that impacting their educational needs?
Jayson Davies
Gotcha. And correct me if I'm wrong, but that would typically happen at the local Lea the local school, correct, right?
Kelsey Kornaus
Yes. So your local district within your state is going to do that initial evaluation. Oftentimes, if a school team needs additional support, they can contact the state's outreach team, which is often associated with your schools for the blind schools for the deaf. And then those team members can also help facilitate those services, because it's really about making sure the student has access to services to be as independent as possible.
Jayson Davies
Yeah. And, you know, just like other types of services and other types of eligibilities, you know, schools don't have all the resources to support all the students. And that's where the School for the Blind really comes into play, kind of going down that route, then would it be, I guess, that team could make that initial referral to potentially refer that student to the school for for the blind, however, it might occur later, potentially, they might try out the local Lea first, and then determine if they need to move on to school for the blind. But I kind of want to understand that process just a little bit, that you've probably experienced from being at the school for the blind, like, what does that referral process look like when a school when a student has been referred to a school for blind from an alley from a their local Lea, I guess?
Kelsey Kornaus
Yeah, correct. So oftentimes, you know, a student will be in their what I refer to as their home district, right? They've started out in their home districts, they've gotten services. And then usually, it seems to be like around middle school, is when you can see that a student might need additional supports or some really individualized opportunities and learning a bat is really well provided at the school for the blind. And so typically, what would happen is families would come they would tour, you know, they've started those conversations, maybe those le A's have connected a family with their State School for the Blind. And then if a family would like to Do we typically call that a trial placement, like, okay, um, you know, spend an amount of time in the school setting. And what's unique is you have to remember, it's also typically a residential setting. So students are coming from all over the state. So you also want to make sure like they're comfortable being away from home, that they're, you know, able to support themselves with assistance where needed. And so typically, students would do a trial placement, and then the team at the blind school would come together, kind of do like, just an IT not an evaluation, but just kind of assess the skills like where's the student at, you know, here's what's working well, for them in this environment, here's what, you know, some additional supports or accommodations that we can recommend. And then really based on, like both schools coming together, so the local Lea team comes together, the School for the Blind comes together, and just with the families in the student have that conversation about, you know, what do we think is the best placement, you know, for a student? And where can they get the services and supports that they need to continue on academically. So most of the students I worked with, we typically see them like middle school through high school. But that's not to say there isn't support for, you know, your younger students as well, those three year olds, four year olds and five year
Jayson Davies
olds. Yeah. And, you know, LEA is local districts, they, it's not like, they want to send out students to the school for a blind, I mean, they, they want to help the student and they want to try and keep the student in the least restrictive environment, which is that homeschool and, and give them the support that they that they need there. And so I can imagine you're trying to get through elementary school, and maybe they're working on teaching the student Braille with a vision teacher working on orientation, mobility, but at some point, for some students, it just becomes maybe a little too much. And they need that extra support. Yes.
Kelsey Kornaus
And then what I know from a lot of my students and having spoken with them, like there's a sense of community, there they come and they are with other students who have had similar experiences similar opportunities as them and they're like, Okay, I didn't have this in my, you know, I didn't have this community or this network. And I will say, with social media, there is a much larger community now. Yeah, and, you know, that's been beneficial for some students, but there's just this sense of, like, I'm with other students who understand what I do on a daily basis, and not have to explain it or not have to, you know, like, why do you need this support? And why do you, you know, do this or this, but, um, so I will say like, those middle school students are like, it's really great to, to have that community.
Jayson Davies
That's awesome. That's awesome. Yeah, it's so interesting, when you think about like, the least restrictive environment, and how just things have evolved over the years. And you think about trying to keep students with their typically developing peers, as Ida wants us to do. But then there is that sense of community, when students do have that alternative type of placement where they can go be with like minded, like abled peers that have shared those experiences? And it's hard to find that, that happy medium, right, like, where do we give them that opportunity to experience both experiences with peers, typically, typically developing peers, as well as their peers that have similar lives that they have? So it's hard. Yeah.
Kelsey Kornaus
And then I, you know, I'm sure for families, it's a huge decision to say, Okay, I'm gonna send my son or daughter to a residential setting five days out of seven. And, you know, also consider transportation because we had students that would come on charter buses, some would fly, depending on the distance. And so like, it's a big, you know, I'm sure it's a big decision for a lot of families and students.
Jayson Davies
Yeah, yeah. I, I would not want to have to go through that. And if I ever do like it, it will be such a big decision. And it's not just for schools for the blind to like any residential placement. Correct, right. Yeah. All right. Well, let's continue on earlier, you mentioned some secondary potential diagnoses or other conditions that students may have in addition to the low vision. Did you see themes were there common themes, whether it be in research or just in practice that you have started to see while working with students with visual impairments? What did you see on their IEPs? But also just while working with them?
Kelsey Kornaus
Yeah, so I mean, typically on an IEP or a student to be having an eligibility criteria, you're going to see somewhere along the lines that visual impairment, diagnosis or criteria. But in addition to that, I mean, there are students that have a medical diagnoses, whether that's cerebral palsy, there also might have that autism diagnosis or eligibility criteria in there as well. And then you can also have students with the visual impairment and hard of hearing. So sometimes you have like that dual deaf and hard of hearing with a visual impairment as well. And so it's really unique, like, you know, every student is going to be needing some very specific adaptations or requirements. And so it just takes like, you really just have to kind of do your digging in your homework and get to know the student. And just because the student has a visual impairment, like it's it's one visual impairment, it's going to impact them differently.
Jayson Davies
Yeah, yeah, definitely. I know, one of the reasons that you and I first started connecting and working together a little bit is because of the sensory aspect. And when we think of students with visual impairments, and also students who have hearing difficulties, like those are two very important senses that we rely on a lot in life. And so I kind of want to get into the weeds and talking about sensory with you a little bit. And we can start more broad and talk about maybe just the the difficulty with the sense of vision, and how that just impacts maybe other sensory systems a little bit. Yeah, absolutely.
Kelsey Kornaus
So I mean, we know as OTs, our sensory system is always working, right, there's always input coming in and output. And when we're working with a student with a visual impairment, research tells us that like they, that student is going to perceive sensory information differently, like their sensory system is already built and established differently, then, like a typically developing peer. And so when we, like, we want to consider all of those components. And so oftentimes, it will be, like a student with a visual impairment will tend to rely more on their hearing and their sense of touch. But at the same time, those same systems can be over responsive or under responsive. And then, depending on if it is a dual, like sensory impairment, now, what does that look like? And so in any evaluation or assessment, like it's so important to, to do that sensory assessment, that evaluation piece, and really try to understand all of those components and what that looks like. Yeah,
Jayson Davies
we know that, obviously, vision and the vestibular systems are so linked really close or so closely linked? Have you made any connections with those two systems in general, either via again, research or your own practice? Yeah,
Kelsey Kornaus
so what, what we tend to see, and research will back this up as well. But like, typically, a student with a visual impairment will prefer increased vestibular input. So oftentimes, you will see certain sensory traits that present themselves for these students, and so rocking back and forth to get that increased vestibular input, spinning in circles to get that increased vestibular input. There's just this like, crave for vestibular movement. And it comes very naturally for these students, you know, they're going to self regulate the way that works best for them. And so you tend to see those common sensory traits for a student with a visual impairment. Gotcha.
Jayson Davies
And then you also kind of mentioned, the tactile system, if I recall correctly, are there some, I guess, patterns that you might see among your students when it comes to the tactile system? Or is it just that they really need to rely on it more, um, it can be
Kelsey Kornaus
bold, there's so some students can really rely on their tactile system for information and input. And then it can be that the flip the flip side of that, where students are like very tactfully defensive, because it's a higher input system. Yeah. And so, I mean, I've seen it both ways where students can be seeking that tactile input, and then at the same time, when you're asking them to use their hands together, or you're asking them to try something new with their hands, that defensiveness or that hesitation, can be really strong as well, because what I don't know is how strongly that information is coming into their body. You know, and they can't always tell me but they can show me so we you know, we always know that that behavior you Communication. And especially for the students that have an additional communication need, like, it's very important to just be aware and be a good observer and see, you know, look to see what your students are showing you.
Jayson Davies
Yeah, I mean, I can think of many of my students that when I would work on some tactile based interventions, and you try to occlude that vision, and you know, they freak out, like, these are students who rely on their vision a lot. And, you know, granted, I know that the students with low vision, you know, they've, over the years they have been become accustomed to not being able to visually see, but I can still imagine, right, like, you ask them to put their hand on something, and they don't know what it is. Yeah, like, whether it be slime, sand or whatever, there's gonna be some hesitation every single time not yes, when you occlude their vision, because, yeah,
Kelsey Kornaus
yeah, absolutely. And it's also really important that when we're supporting a student's tactile exploration, that we're using hand under hand technique. And what that allows, is, so like, my hand is the OT with guide the student's hand. And then it's my hand, typically interacting with whichever sensory support or item that we're using, and then it allows the student to take their hand away, if they're feeling uncomfortable. And then typically, they'll come back and they'll be like, Oh, okay, like, let's see what's going on, like, and I'll always ask a student, like, Can my hands help your hands? And I'll kind of wait to see like, okay, yep, they're interested, like, I can give them some additional assistance. So hand under hand, very important technique to use with a student with a visual impairment. And the difference being that is if we go to hand over hand, the student have now lost that autonomy, they've lost that sense of control. And so we're now forcing them to do something that they may or may not want to participate in. So that's definitely one of those key aspects for, for any OT, like switching to that hand under hand technique. Yeah.
Jayson Davies
Visual Impairment working with students with visual impairment or not the hand under is so important. And kind of what I where my mind was going. As you're speaking, there was the safety net to that offers the student, especially if you're doing some sort of tactile activity, right, your hand being the first hand to touch the slime, as opposed to their hand, being the first hand assistant slime, so they feel safe knowing that you're not asking them to touch anything that you yourself are not putting your hand on as well, your hands gonna be touching whatever it is, before their hand might be touching it. So yeah, a little bit of that safety as well. And
Kelsey Kornaus
then just describing like, what I'm feeling. So is it slimy? Is it rough? Is it smooth, like giving them those descriptors, because that's also part of early Braille skills? is learning difference in textures and using those hands together? Gotcha. Yeah.
Jayson Davies
All right. Well, I want to ask you a question about assessments. I know now you are working at a more traditional school based occupational therapy position, even though you had several years with the VI program. So I want to ask you a little bit about the difference in your assessments, how might your assessments be a little bit different when you're working in that VI setting, or maybe they're exactly the same. But what does an assessment look like when you're actually whether it be a try, or whatever it might be, or you're using additional or different tools.
Kelsey Kornaus
So really, it's going to be quite the same as it would be for traditional school based OTs. We want to look at that top down approach, we want to do that comprehensive occupational profile, because we're going to learn a lot of information about the student observations for me were the most helpful those skilled observations in the classroom in those different settings. And for me, like I need to see a student in multiple academic settings. So like how they interact in daily living skills versus how they're going to act in science class, and what's it like to be in the lunch room, which can be very overwhelming for a lot of students, and then also relying on those teacher and caregiver questionnaires to get some of that additional information. And that also helps me determine like, you know, what, what are we seeing what are the concerns for an evaluation, making sure that we're not missing a key piece of information. And then always, for me doing that sensory assessment as well. So that can be the sensory profile to or the sensory processing measure to it's just, if we're going to use those standardized assessments. We're now using them and on standardized method because they're To my knowledge very is not yet that like standard sensory assessment for a student with a visual impairment. But it still gives really valuable information. And that's information that I want to be able to share with the team. Yeah. So that when we are looking at programming and accommodations and modifications, we have that information.
Jayson Davies
Yeah, I want to ask you this, because it is very common right to use the SP or the SPM. Although that is going to be completed by a teacher and or a parent and or an aide, and they both include a lot of vision questions. So, you know, we also kind of have to be a little mindful, right? And would you cross out vision questions? Would you preface the Completer? Whoever is completing that form, like, Hey, don't worry about these questions? Or would you just kind of leave it as is and go with it? Or?
Kelsey Kornaus
Yeah, it's really interesting, because it's gonna depend on who's scoring it? Yeah. I mean, who is administering it? And then it also depends on like, does that student have some vision? Sure. Are they completely blind, so like, you kind of have to tease out that piece a little bit as well. I think for me, like, I always just requested that they fill it out to the best of their ability to like, fill out all those sections. And then when it does get to that vision area, like, I'll look to see what's been filled out or not filled out, and kind of go from there. Because, you know, we know that vision is one of those primary senses. So when we're looking at these assessment tools, like it's often very much intertwined with other areas. And so, for me, and this was just in my practice, like, I'm gonna get as much information as I can, but I don't want to skew someone's interpretation. Like, I don't want to say don't fill it out, or like, don't do it. Because maybe there's something there that is helpful. Like, to me data is data, like all data is helpful information.
Jayson Davies
Yeah. Yeah, one way or the other, it's going to help that is true. I was just, I was just thinking about, like, if you're giving that to, especially if it's like a parent, I could see them some there are probably some parents out there that would almost be offended, potentially, by some of the questions that are asked on there. And that's, I don't know if you've ever experienced anything like that. Or if you've ever had a parent addressed that at all, like I personally
Kelsey Kornaus
have not had that experience. And I think for a lot of these families, by the time I would see their student, they're so used to filling out these assessments, like, kind of been doing it for a long time at this point. But they wouldn't be uncommon for me, it would be great to hear a parent question, you know, like, Hey, by the way, we know, my student has a visual impairment, like, Is this really necessary for me to complete? Or, you know, it wouldn't surprise me that if there are families out there that would question that, and you make a good point. Like, I guess I hadn't really thought about it that way.
Jayson Davies
Yeah. Yeah. I mean, you never know. I mean, everyone, everyone reads things and looks into things differently. But I was just, I don't know, always think about the quote, unquote, worst case scenario, potentially, I could see someone being offended by questions related to vision when their student is is completely blind, potentially, or whatever it might be. I know, on the SPM. I don't think taking out the vision questions would impact other factors. However, with the sensory profile, each question gets scored in multiple ways. It's not just in relationship to the vision system, but also the school factors and a few other areas. So if they're not filling that piece out, or that piece isn't completed, it could impact some of the other areas. Granted, we already talked about how you're no longer using it in a standardized way. Anyways, but but still, it could impact some of the other scores. And just to know, yeah, and I
Kelsey Kornaus
know, for me, like, I tend to prefer the sensory processing measure, just because I can kind of tease out those areas and not have to rely fully on, like if the vision piece isn't there, or, or things like that, but either is going to give you valuable information. And it's going to help the team during those IEP meetings.
Jayson Davies
Yeah, yeah, I will. I'll say this really quickly. I preferred the sensory profile early on in my career, because I felt like it was so much more comprehensive, like so many more questions, you could really go back and tease out things. But as my observation skills increased, then I started to prefer the SPM. It gave me enough that I could then use my observations to kind of fill in some of the blanks. So just kind of my thoughts on that. But good point. Yeah. All right. Anything else you want to talk about in relationship to sensory before we can move on?
Kelsey Kornaus
I think we've covered a good amount at the moment.
Jayson Davies
Yeah, yeah, definitely. I think that's a very good start, and I Again, you know, this is an introduction to working with students with visual impairments. This is definitely not the end all be all, there's always more to learn. And if this is catching your ear, if you're listening today in this kitchen, you're here, set up a Google Scholar alert for vision impairment and sensory and you know, you might, you might be surprised, and you might learn some new information every time a new article comes out. So that is one way to keep the learning going. Let's move on to another very important topic in the area of visual impairment. And that's assistive technology. But what's been your experience with assistive technology while working with students who are blind or visually impaired?
Kelsey Kornaus
Great question. So I was very fortunate to work with assistive technology specialists, teachers of the visually impaired that were doing that additional piece as well. And what we know for students with visual impairment is that assistive technology really opens up opportunities for them, and especially academically, provides tools and supports that they can use in their, in their daily lives. And what is also really great about that is, you know, for most students, just, you know, having their smartphone in their pocket, you know, that provides so much assistive technology, and opportunities for them. So, you know, I get really used to listening to voiceover super common, like VoiceOver is on every computer, every output device, and then, but also like, allowing them access to more of like, their curriculum, and, you know, using, you know, whether, whether it is that laptop with additional supports put on it, or that Chromebook, assistive technology really is a beneficial piece for a lot of students with a visual impairment.
Jayson Davies
Gotcha. And so what role did you play in assistive technology? Were you evaluating? Were you hoping to implement? Were you doing all the above? What was your role? Yeah, so
Kelsey Kornaus
for me, I definitely fell under the piece of helping to implement. And so going into that assistive technology class, so our students were fortunate to like, have that as part of their school day and part of their schedule, but going in and like helping with a typing program, going in and helping students learn to access their smartphone going in, and then helping those students use that as a technology in the classroom setting. And so there was, there was a time where I was kind of pushing into the math class. And every student would have a different form of assistive technology. And, you know, even a brailler is considered that assistive technology piece to me, because it's another form of output and support. And so, like, we might have some students on a brailler, some students using their laptops, another student is going to use like both of those combined. And so just really making sure that like, once a student grasp the foundational skills of whatever their assistive technology is, and then helping them to implement that across those school environments.
Jayson Davies
Yeah, absolutely. And that's great that you had the opportunity to help to implement that in the fact that they have their own like, specific class dedicated to assistive technology, which is, I mean, heck, every high schooler could use a class like that, I think. Just go ahead. Yeah,
Kelsey Kornaus
well, and I will say like, it's dependent too on like the school because I've been talking to other OTs that are in those residential school settings. And, you know, not not every program can have a designated Assistive Technology instructor or someone to like, have those supports daily for students. And so, again, it was just a really great team working together.
Jayson Davies
That's awesome. I want to ask you about the team and the differences of the team. But first, I want to while we're on assistive technology, I want to ask you a question. This might challenge you a little bit. And that is based upon your experiences in that classroom, that environment that is really set up for students with VI M, with visual impairments to succeed. What piece of equipment do you feel like could be implemented on every school campus as a piece of universal design for learning for students that would help both students visual impaired students as well as just all students on campus? Is there something that you feel like that would be so awesome if every single third grade classroom in America had
Kelsey Kornaus
right that is a great question and that really does like kind of stretch my thinking a bit. And so what I would say for that piece is really helping honor su against requests, when they're asking for, like lighting is a really easy one, that's a universal design. Like, for a student with a visual impairment, they might need task lighting, they might need the overhead lights to be shut off. And then just allow for more natural lighting to come through the windows. So that can be like a really easy universal design that is easy to implement, you know, in a school setting, and also just having the opportunity for high contrast colors. So if a student with low vision is having having difficulty seeing the items around them, like something simple, like a black backdrop with bright colors on top, so whether that's orange or yellow, or red, so I think really like an easy universal design would just be access to high contrast colors, and then having the lighting opportunities or change in lighting.
Jayson Davies
Yeah, yeah. See, I mean, they're not they're not difficult. They're, they're relatively simple things that can be implemented, it does take some training and you know, giving people that knowledge, but relatively simple thing.
Kelsey Kornaus
Yes. And like other simple accommodations that work well, for a lot of students is just letting them, you know, wear a ball cap in class and letting them have their kids up, which now that I've switched into that more traditional school based setting, like all day long, I hear teachers say like, oh, take your hoods off, take your hats off, like don't wear those. And then coming from a vision background, I'm like, Well, that was just really common. Like, it was really common to see a kid go down the hallway with their hood on and their hat on, because like that is an accommodation for them. Or it can be it can be one of them. Yeah. So it's just been interesting to hear or like, see the differences between the settings. And honestly, like a student is going to know what works best for them. And oftentimes, it's just giving them the space to tell you and to self advocate like, Hey, Miss coffee, like I came in your room today? And can we shut the lights off? And? Or like, this is bothering me today? Like, can we adjust it? And like yes, we can. And that self advocacy piece is so important for students to learn early and in us. And I think if we're not careful, like it kind of comes across as, like a complaint almost for some adults. And so just being mindful, like the student knows what's best for them. And you can help support that.
Jayson Davies
Yeah, you know, I think that goes back to Gosh, I'm forgetting the name. Right. But but the quote that I think many of us have heard before about education, right? Students do well, when they can, like, exactly. And then they know what they know what works for them. And so we need to give them that that space, that ability and that awareness to you know, have that mindset to take opportunities to try things that work well for them and to share that and express that with people that are in their education system. So yeah, love that. All right, you know, we have so much that we can go over. And I think we're going to kind of start to wrap up with this question. It's a two part question. And kind of getting out a little bit of the differences between what you might see at a typical school, and then are your homeschool versus a school for the blind. And you've mentioned several of these people already, but I kind of want to give you the opportunity to kind of go at it with this one question. And we'll start with thinking about a homeschool. Most commonly what services what specialists are available to students with visual impairments. In a typical district, I know it changes from district to district, but what are some of the more common services you might see at a at a home district?
Kelsey Kornaus
Yeah, so typically, and also legally, we want to keep in mind that like students are allowed access to specialists. And so most oftentimes, like you're going to see in, in that home district, like they're going to have access to a special education teacher, they're going to have access to an OT PT, a speech and language pathologist. And then you know, if the team determines that it's necessary, you know, then access to a teacher of the visually impaired and orientation and mobility specialist and, and those two specialists know their jobs incredibly well. Like I love working with a teacher of the visually impaired. It's just like kind of working with another OT colleague, they are just very specialized, like in that visual impairment piece. Very knowledgeable. So if you're in a district, and you know a student has a visual impairment like be be searching out and connecting with that teacher, the visually impaired, especially as an OT Because oftentimes, in a district that student is going to see that TBI maybe once a week um You know if they're lucky and that TBI is going to be traveling to multiple locations, and then same thing with an orientation and mobility specialist, so not every student with a visual impairment is going to require an orientation and mobility specialist. However, like they're another key member of the team, and so you're going to want to connect with them, you're gonna want to talk with them. Because where you come in as the school based OT is being able to help kind of like facilitate what the students learning with those specialists and helping them embed that into their school environment. And then, what what could be different is if the student ends up in that residential setting, or at a school for the blind is, at least in my experience, like those services for TBI and Owen M, are occurring at a more frequent rate, because they're being housed in the same building. So, you know, instead of those specialists traveling to the school or multiple schools, and trying to split their time, like, at least in my experience, like the TBI is, and the UNM specialists are typically designated like to that school. And so then also, like, students get a chance to work in a group setting more. So I mean, typically, I'm gonna say there's maybe one or two kids that might have a visual impairment, and then, you know, in a district or, like, you know, there'll be split grade levels or different schools. And so, again, it allows for that, like, peer interaction and that peer support. So really, I mean, those key team members that I would hope would be on everyone's team, you know, would be the TVI. And the Owen M specialist, for sure. And if that's not the case, like it's your job to help advocate for the student as well, because it could just be that your team isn't familiar, or it could be that they don't really work with a lot of students with a visual impairment, you know, in their district. So making sure like, I will often say to families, like I would like to help advocate for your student, and like, could we reach out to these specialists?
Jayson Davies
Yeah, and a lot of time, an individual district and individual Lea won't have those service providers on staff, because it is so infrequent that they have students with visual impairments. And oftentimes, once they, once they identify students having a visual impairment, either A, they might contract with what we call in California SELPA, or the county or the state to bring in some of those services. Or they might go the route of a residential placement. Those are kind of two different options. Right? Correct. What about vision therapist? I know that has been something that has come up in my own practice, and others have reached out to me asking like, what is the role of a vision therapist? How does OT and vision therapy overlap or not overlap? What's been your experience?
Kelsey Kornaus
Yeah, that's such a great question. Because they actually had TB eyes and Oh, nm specialists come to me and asked me that exact question. Like, what is, you know, vision therapy versus vision rehab, you know, what's OTs role? What does that look like? And I want to be very respectful to vision therapists and optometrists that have done the education to provide those services. And because I've worked as the vision therapist previously, so like, for me, it's really important to give credit where credit is due. And so I will say this, like a, for me, a vision therapist is working in conjunction with a most oftentimes a developmental optometrist. They have specific trainings, specific resources, that intervention is weakly it's intense. There's home programming, it is very specific. Okay. So, vision therapy, to me has has its place under under Optometry. Okay. I want to be respectful of that. Yeah, that is not to say that an OT cannot support vision rehabilitation. So that's where this kind of changes a little bit. And so I do believe and fully support OTs role in vision rehab, and then also working with a student's visual system, especially in the schools like as it relates to academics. And so yes, we as school based OTs can support vision, we can support tracking, we can support, you know, vision, and eyes teaming together through different intervention strategies. And so to me, like vision therapy, and and vision rehab are very distinct. Yeah. And so is like working with visual impairments. So you could say, based on ideas definition that a student qualifies with a visual impairment because they have convergence insufficiency. You know, that's also a possibility. Yeah. But then like, we also have to keep in mind the place of vision impairment as it relates to low vision and blindness.
Jayson Davies
Yeah, yeah, absolutely. Thank you for thank you for explaining that a little bit. Because it's something that that comes up in IPS more frequently, it seems like, especially if you're in more urban suburban areas, I think. And I've never had a bad experience with the vision therapist, I just honestly didn't know what their role was necessarily compared to what my role was. And I know, I was doing a lot more in the classroom type of things, a lot of accommodations correct. And it seemed like they were doing a lot more pull out working on, like, really understanding the eye movements. And I don't know that there was as much emphasis on education that maybe I was putting on, like, the education seemed like they're doing a lot more exercises, as opposed to that would help in all aspects, not just education. So practice, yeah. Okay. All righty. Well, before we wrap up here, I want to give you the opportunity to share just maybe one tip for occupational therapy practitioners that let's just let's just kind of say maybe they recently had a student that was placed on their caseload or they evaluated a student and vision impairment. Just the overarching advice for for occupational therapy practitioners out there. Yeah, I
Kelsey Kornaus
mean, this is broad. It is broad, but I will say like, as school based OTs, like you have the skill set, you have the training, you have the knowledge, it can be intimidating at first. But I really want to empower you to know that you have the skill set, you know, you you are keen observers, you are really great at the task analysis, you know how to provide that just right challenge for students. So you have the ability, and then when you have questions like reach out to your team members, like reach out to the teachers of the visually impaired, reach out to your orientation and mobility specialists. And I mean, feel free to reach out to me, I'm happy to help.
Jayson Davies
Sounds great. Well, thank you so much, Kelsey, for coming on and sharing so much information related to supporting students with visual impairments as an occupational therapy practitioner, it's been very helpful. I know a lot of us will never have the opportunity to work in a school for the visually impaired. But we never know when we might come across a student with visual impairment on their IEP in our local district. And so it's always helpful. We don't need to know everything, but we need to know enough to be dangerous in an IEP a little bit and to provide some services. So thank you so much, we really appreciate your time and look forward to keeping in touch.
Kelsey Kornaus
Thank you so much.
Jayson Davies
And that's going to wrap up episode number 142. Thank you so much for tuning in to this very, very special episode. It's not often that we get to talk about working with students with low vision. But I know there's several of you that work in schools for for those who are visually impaired or blind. And even if you don't, there's a very high likelihood that you will have one, two, or maybe a handful of students with visual impairments at your public school. So I really hope this helps you. And if you are looking for all the resources that Kelsey didn't mention today, be sure to head on over to OTSchoolHouse.com slash episode 142 to find all of those resources, and to potentially even connect with Kelsey. Kelsey is such a wonderful person, as both a friend as well as an occupational therapy practitioner, and I'm so happy she was able to come on and share this knowledge with everyone today. And again, she does have a course now on the OT school house collaborative network. And you can go learn more about that over at OTSchoolHouse.com slash collab. As I said earlier, we would love for you to be our newest member inside the OT school house collaborative. So thanks again for listening and I hope to see you in the OT schoolhouse collaborative. Until next time.
Amazing Narrator
Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OT schoolhouse.com Until next time, class is dismissed.