Episode 294: Emily Macklin, Neha Sharma, & Amber Skerry: Supporting Communication for Deafblind Students

This week, we share Chris’s interview with Emily Macklin, Neha Sharma, Amber Skerry, three SLPs working with the deafblind population at Perkins School for the Blind! They share a wealth of information about working with deafblind students, including how sensory impairment influences their incidental learning, the importance of trial and error in teaching language, the different ways deafblind students use AAC, and more!

Before the episode, Rachel shares about a client who uses Read & Write for Chrome. Some school team members felt assistive technology was a “crutch”. until Rachel and the client made a story together using the Read & Write that convinced them was an important tool!

Key ideas this week:

🔑 Deafblindness doesn’t mean completely deaf and blind - it usually involves varying degrees of loss in both senses.

🔑 Teachers of deaf blind children design learning experiences to teach students about things on a deeper, more experiential level, such as teaching about apples by climbing an apple tree, cutting an apple, and planting the seeds.

🔑 You don’t want to be a “fairly godmother” for a deafblind student, where objects appear and disappear as you give them items and take them away. There needs to be a connection for the student between the object, where you get the item, and where you put it when done, e.g. a “finished” bucket.

🔑 Some deafblind students use a ProxTalker midtech device that allows a user to place any photo, symbol, or object on a sound tag card. Users place the sound tag card on any one of the buttons and push to trigger voice output!

Links from this episode:

Project Core - 3D Symbols https://www.project-core.com/3d-symbols/

Tactile Connections: Symbols for Communication https://www.aph.org/product/tactile-connections-symbols-for-communication/

Tactile Symbol Library: https://www.tsbvi.edu/campus-resources/accessibility/tactile-symbols-library

DeafBlind International: https://www.deafblindinternational.org/

Active Learning Space: https://activelearningspace.org/

Guest Email addresses: emily.macklin@perkins.org, amber.skerry@perkins.org, and neha.sharma@perkins.org 

Transcript of the Episode

Please Note: This transcript was generated using speech recognition & AI tools; it may contain some grammatical and/or spelling errors.

00:00:06
Welcome to Talking to Tech. My name is Chris Bugaj, and I'm here with Rachel Madel. What's going on, Rachel?

00:00:11
Hey Chris, I have a story to share.

00:00:12
I love your story.

00:00:14
OK, so I have talked in the past about some of my clients who have been a little hesitant to start using assistive technology tools. Mostly conversations I've had with the family about how or teachers how they don't want the student to become reliant on the assistive technology and they fear that they're not actually learning, you know some fundamental skills because the assistive technology tools coming in and doing things like word prediction and grammar and spelling check and all the things, right. So this one specific student I'm thinking about that was the case and everyone was saying like, oh, we have to teach him how to spell and we have to teach him all these things. And I of course was advocating for how much this tool has helped. You know, the student in my sessions and I've been kind of fighting with the district on implementing specific assistive technology tools that I have been using very successful in my practice.

00:01:15
They think it's going to be a crux, a crutch.

00:01:17
Exactly. We don't want them to to miss this learning opportunity. I think that's like the big kind of idea and the family has been a little bit on the fence and ultimately has trusted me and said, you know, do what you want during your sessions. Like we love, he loves, you know, coming to see you and the sessions are really helpful and you know whatever you think is best. But I could tell, especially like dad has been like a little resistant.

00:01:44
So anyway, we've been doing using Google read and write in our sessions and I'd say probably for about a year and we don't use it every session. But I really like working on writing with this student because he's actually very creative and he has a hard time formulating expressively. So when he's telling a story, kind of get stuck with, you know not always using the right syntax and grammar and it's just like you can tell it's a hard process for him, but he can very much formulate via writing. And so we've been working on telling stories and telling them in writing first and then kind of doing like a not a story retail. I guess it would be a story retail.

00:02:28
But him figuring out what he wants to say via writing and practicing that skill and then sharing expressively the story. And so the other day we and you know we've also been incorporating like reading comprehension and inferential thinking and lots of other things into this. So it's like we'll often times do it some type of summary in writing after we watched a short little video clip of an animated short or we've read a reading passage. He loves Percy Jackson. And so we will sometimes read a chapter of Percy Jackson and summarize it.

00:03:02
And so there's lots of different skills that we've been working on. So the other day for Halloween, we actually did a creative writing assignment. So I was like, oh, let's get like something really fun going because I feel like sometimes, you know, we're working on things that he's interested in but aren't always like super creative. And he's very creative. And so anyway, I did this really fun rating exercise and it was like I started off by just giving him like this prompt.

00:03:32
It's like you got a a train ticket on a spooky train and like the next thing you know and then I'll just stop. And like, he kind of comes in and fills in the rest of the sentence. And then we did something different this time, which was we went back and forth because I realized when I opened it up to just like you could say anything right now, he actually struggled a lot, which I think a lot of our students. This is very common. It's just like, I don't know if if I could say anything.

00:03:58
I don't even know what I could say. You know, having just like open up to anything is possible, especially because this is like a silly, spooky story. It can be anything you want. He kind of struggled. And so I like hopped in and decided every other sentence I would write for him and we would kind of Co create this story back and forth.

00:04:19
Improv. You're doing improv.

00:04:21
Exactly. It was so fun. He was so excited and not only did we create this amazing story, but he what was really cool was that we started working on some dialogue. So I'm also working on kind of social pragmatics with this student and having conversational turns. And you know, all of those skills started kind of coming out in this story.

00:04:43
And I would say, you know, and I would say really crazy things like. And then all of a sudden a baby alligator jumped on my lap and started dancing like just it is crazy as I could get in my own mind. We started like and then he took that ball and he ran with it. And then I said I started doing dialogue back and forth. And it was such a fun exercise.

00:05:04
And the coolest part was to see how far the student has come with the assistive technology. He was highlighting his sentences, hitting the play button to listen to them back. He was going through and using the spell check and grammar check all independently. And it was so great because at the end I said OK, do you think we're finished with our story? And he's like, we're finished.

00:05:28
And he independently goes, he highlights the whole paragraph, he listens to it back, he fixes all the errors. Actually got this on camera. Like I started recording because it was just so beautiful and he just independently created the most beautiful story and so it was just like such a small win afterwards, which was his the most fun part. We actually went into Canva and we created a picture based on this crazy story and we used the AI magic application on Canva because like we were talking about like dancing alligators and flying Guinea pigs and just like the craziest thing and the AI tools actually created images of these things. I reported him into it, 'cause he was a part of the story, and it was just so much fun.

00:06:13
And I sent the video and the story and by the way the story was designated, I would write in red and he would write in black. So I told the family, like the things that are in red are are me, but everything else is him and everything is independent. Like, I didn't help him at all with this. And so I sent the story. I sent the the video of him going through and independently using the tool.

00:06:36
And then afterwards I I also sent and attached the image that we made and I said pull this up for him and see if he can share the story. And so I got a text her mom after our session, she said, Oh my gosh, I can't believe he did this by himself. We watched everything. I asked him about it. He told us the story and the parent had the story to reference, right?

00:06:58
And then I got in a a message this week and it was we actually shared this with his teacher and they want to use it in class. And I said like, Oh my.

00:07:10
Gosh, finally.

00:07:11
Like we've done it. Like, I've convinced him that like, this is something that's so helpful for him. So anyway, I just wanted to share that small win because I just sometimes it takes a second to get people on board. And it was just like such a great activity. He did so well with it and it was kind of combining all the things, like all the things that we've been working on with fun, engaging, you know, activities that he got really excited about and then creating that visual.

00:07:38
He's like using Canva now totally independently and we were using the AI tool. He's like, no, right, like dancing alligator and he was like helping me like type things in so that we can get a more refined, you know, image. So it was just such a great session.

00:07:52
It sounds awesome. I mean, you can see the giant smile on my face. My my cheeks are cramping from this story because you said it. You said the word fun. It's super fun and it shows the that technology can be used and is most likely used to enhance skills not lose skills right.

00:08:14
You just said he's he's he's now a better speller. He knows how to use the tools to confirm that he's spelling things correctly. There's confirm that he didn't leave out little words that that what his eyes might be reading might be might be unreliable. So he needs to listen to it as well and then go back and make so that he uses multiple a multi sensory approach to doing his editing to make sure this the story is telling the way it wants it to be. He's making edits like adding adjectives like you said dancing instead of just you know alligators.

00:08:46
All of those are awesome skills that I guess maybe he could have learned some other way. I just would speculate that it'd be a lot harder you know, and a lot less a lot more drudgery than the fun experience that he had that he was excited to share with the rest of his family. So I I hope that this sort of story acts as a catalyst for other educators and other parents out there or other parents who are educating their kids to say lean into the technology, lean in to use it for the powers of good.

00:09:18
Exactly. And you know what's really fun when you're doing some type of creating creative rating assignment is that it can be as, as specific an interest and a passion as possible, right? And it can be anything, which I think is sometimes, like I said, a little bit hard for some students, which is why I kind of jumped in and gave him fun ideas. But he's he loves trains. And so it was like it's a train ticket like where we going we're on a train and which he automatically got so excited about.

00:09:46
And so I think you can pull in a student's specific, you know, passions and interests, and you can incorporate those types of things into what you're doing. Especially, you know, as as SLP is like, we have a lot of creative license. I know that sometimes teachers have to follow specific curriculums, but it doesn't mean that you can't like fuse in fun and engagement and and choice making 'cause I feel like often times it's like this very specific thing that kids are asked to do. And if we just opened it up to be a little bit more creative and give kids a little more choice as to what they're writing about, what they're reading about, what they're doing to demonstrate curricular knowledge, it just think about how much better school would be and how much more fun it would be.

00:10:30
Voice and choice and flexibility is definitely the the name of the game. Let me ask you this, this particular student does not have a visual impairment, right? I mean can see Canva, that's not one of the concerns that that you have about this particular student.

00:10:44
Correct. He's very strong visually.

00:10:47
But I mentioned this multi sensory approach and that kind of leads us into the interview today. The interview today is with Speech Language Pathologist that work for a Perkins School of the Blind and they actually came up to us at ATIA and we were having a conversation and this is one of those that ATIA is right around the corner at the time of this this recording. But a year, almost a year ago now is when we met these particular Speech Language pathologist and said oh you got to come on the podcast. And so we we have and we're going to have the the interview you're about to hear is all about adopting a multi sensory approach to help people who may have some form of visual impairment.

00:11:40
We've.

00:11:42
Been doing this now for a couple of years and it's always super fun time. It's a great experience and so this is a whole what, a whole day together doing a pre conference.

00:11:50
I love our pre conference Chris. It's just like such an amazing group every single year and every single year it's totally different. I feel like it's never the same day twice and just full of tons of fun activities and lots of engaging conversations. And by the end of it, we're all like BFFS and it's so much fun.

00:12:09
So if you're interested in attending, check us out at atia.org, find the Pre conference link, find us & Up and we'll see you there. Welcome to the Talking With Tech podcast. My name is Chris Bugaj and I'm joined with a bunch of people from well, I'm going to let them introduce themselves and say where they work. So Emily, you want to kick us off?

00:12:37
Sure. Hi there. This is Emily Macklin, speech language pathologist at Perkins School for the Blind and the Deaf Blind School.

00:12:44
And I'm Neha Sharma. I'm a Speech and Language Pathologist at Perkins School and also in the Deaf Blind School.

00:12:51
I'm Amber, Scary and the same as everyone else. Speech language pathologist at Perkins Deafblind.

00:12:57
Excellent. So you're all working at Perkins Deafblind. So tell us, what is that? Where is that? Give us the the lowdown on Perkins.

00:13:06
So we are located in Watertown, MA and the Perkins School for the Blind is quite a large campus with different programs and different schools for students with vision impairment. Our school particular is the place for deafblind students and those are students that have a deficit in their hearing and vision and a combination of both. Our school is for students ages 3 to 22 year olds. We have a wide variety of different types of profiles for our students. They all have this dual sensory loss and we are a total communication program, which means we try to use every single type of modality of communicating that we can offer.

00:13:55
So that could look like speaking verbally, but also signing we do tactile signing, we use whole objects to represent concepts and places and people. We use photographs and drawings and tangible or like tactile symbols and then of course augmentative communication as well. Our students are very different from each other so how we approach them and what we work or how we work with them are very different. We have a such a multi sensory approach to our teaching and our language development and that is something that they need especially given their dual sensory loss. What do I mean by dual sensory impairment?

00:14:38
It means a complete or a partial loss of two of more senses, which is typically vision and hearing. One of the big myths that I would like to bust right now is that deaf blindness does not mean completely deaf and completely blind at all times. So our students have varying degrees of loss on each of those senses. We could absolutely have students that are completely deaf and are completely blind. But we right now in our program of almost 55 students, we only have one student that is completely deaf and completely wet.

00:15:16
And then another myth is that, you know, not all students are going to need the same support. So our students are really coming with their own unique profile. So we need to really address their unique needs individually. And like I said, the dual sensory impairment is a huge range and it can, you know, come about from a lot of different ideologies. Congenital acquired.

00:15:40
A lot of our students have Charge syndrome and a lot of our students that come from rubella backgrounds and Usher syndrome, you know, brain injury seizure disorders. So it's really a spectrum of profile for our students and like I said before, it's really, really a big, big range of how they can present.

00:16:01
All right. Well, let me ask you this. So here you are, the three of you, working at Perkins. Let's say a new student comes shows up at Perkins. What does that onboarding look like?

00:16:11
And how do you figure out where to go, what interventions to use? And the reason I ask that is because people listening to this podcast might well, I don't work at Perkins, but I certainly have a student with deaf blindness. So what do I do? You know where do I start?

00:16:29
Before you get started, can I just add one quick thing? I think it's really important to realize that our students have this very limited access to incidental learning that a lot of our students with typical hearing and typical vision have access to. And so that's that learning that happens outside of direct teaching and that is really through observation and kind of taking their whole world and processing it within themselves. So our students really, really require the experiential learning. So that is really hands on, do by function and do by things that are going to be meaningful and functionally for them.

00:17:08
So I just wanted to put that caveat out there.

00:17:11
Well, that's great advice. I mean really to be thinking through from an educator lens, like oh, OK, I know that's sort of just stuff up on the walls might where other people might be able to glance up and see something or ancillary conversations. After a lesson is over, a conversation might be happening where people are digesting it. Those sorts of incidental where it's not planned necessarily. It's just sort of there People with deaf blindness might have less opportunities to learn content from those sorts of experiences.

00:17:41
So we have to be more intentional about what we are intentionally teaching. Was that fair?

00:17:47
Exactly. And there's a huge risk for sensory deprivation, especially when you have this dual sensory impairment. So it's being really intentional of bringing the learning to the student. It's something we're always thinking about because we learn so much from early childhood, just from observing others around us. So if you have less access to that, it's really important to bring that access right to the student that that's something that's a day-to-day strategy that we're using throughout the day.

00:18:16
Emily can I give an example there where I've learned from a teacher of the visually impaired. I was working with a student with the visual impairments once Once Upon a time and he had some residual sight and was using his hands to court, sort of his finger sort of to to move them in front of his eyes, right. And the the teacher, the visually impaired whispers to him in a in a prompt. Remember, other people can see you which fine wave in front of your hands, but just know do it if you want to do it. It's not.

00:18:46
She wasn't saying don't do that. She was just sort of prompting this where anyone else who might be able to see was recognized, Oh, if I'm, you know, doing something with my hands, I might be able to see other people around me reacting to that, right. And so it's just an interesting cue and I feel like that's an example of what you're sort of talking about as as you might have to be a little bit more direct in sort of saying, just remember this is a thing that some other people might not have to think about because it just sort of happens with experiences.

00:19:20
Yeah, absolutely. A few.

00:19:22
Examples that I like to think about when we're talking about like incidental and you know, learning someone with sight would kind of look at a forest and see that there's a bunch of trees there. But someone who's deaf, blind wouldn't just feel one tree. They would have to feel all the trees to understand the concept of a forest. So that's something that, you know, a student who's sighted you, you wouldn't even think. You bring them to the woods all the time and they just see that there's a bunch of trees.

00:19:49
But someone who's deaf, blind you would really have to go and feel all the trees. And another example is someone told me this story once about someone who's deaf, blind, who didn't realize that buildings when you were inside of them had roofs on top until one day they felt the roof and they were like.

00:20:03
Whoa.

00:20:04
I am in a box, so Joseph, just a few examples of things that you might not think about, but for our deaf blind students, we really need to fully teach them in a more hands on kind of way.

00:20:17
Well, these are great examples, which brings us back to the question, Emily. Yeah, I get, I get a student with abilities like this, and I think, well, OK, that those are two examples that I wouldn't have thought of. How do I learn to think about them and what do I do? How do I start?

00:20:33
Absolutely. So First off, Congrats that you have a deaf blind student. You have an opportunity to learn about the world with a completely different perspective. I learned so much from working with our deaf, blind students about the world itself, things I've taken for granted, and perspectives I haven't taken. So buckle up and you'll have a learning opportunity ahead of you.

00:20:54
So, room for growth? We all have. We all have it. I'd start with.

00:20:59
Emily, can I interrupt you for one second? Of course. What's an example? Can you think of an example of like before I started working with deaf blind students this. But now that I've been working with deaf blind students, I've evolved to think like this.

00:21:14
I think the explicit teaching part of it, taking things for granted throughout grad school and our education, we we kind of just think about, you know through natural opportunities. So learn this natural language development, they're going to learn this. They're going to acquire this. But working with really skilled teachers of deaf blind children, I've had awesome experiences learning about what is an apple and what makes an apple an apple. It might be a fruit I eat, or maybe I don't eat by mouth, but peers of mine eat by mouth.

00:21:47
And what does an apple really mean to me? And then learning that actually going to the orchard and climbing up the tree, or if someone's helping you kind of lift and grab an apple down, holding it, coming back to school, cutting it. An apple without being cut feels different than a cut apple. What are those things inside? I never thought about that.

00:22:06
Let's feel around. Those are the seeds that next thing you know, you're in a gardening activity, you're planting seeds. But it's all hands on. And I I think I learned a lot by learning alongside my students about the process that things I've taken for granted, we need to explicitly teach, and we want them to have these these real natural opportunities to learn about our.

00:22:29
World, I feel like I would.

00:22:30
Agree. And I was just going to say, too, that it's breaking down the things that we again take for granted. But breaking it down to all the steps and the thing for me that was huge was their tactile sense is so important. And there's so much that they're taking in from their world through their tactile sense. And it's just one of those things you read about, like Helen Keller.

00:22:55
Like, yeah, sure, she touched everything and that's how she learned. But when you see it in action, it is absolutely, I mean, humbling for us, but also to say wow, this is an area where I can really work and help build off of.

00:23:11
Well, I have to say I feel like these sorts of experiences help you become better therapists and educators for any student right Like and this way everyone learns from all of their different senses and all their different modalities. So provide as many different modalities as possible and making it as practical and experiential as possible makes it stick more and and makes it easier to understand than some sort of abstract picture in a book about what an orchard is, or a little video about an orchard is. You're actually in the orchard, hearing the sound, smelling the smells, crunching the crunchy apple, having it slip out of your hand, and you're squashing it as you're walking on it. You know, all of that sort of thing is is then having taken all that, you get to say, well, let's let's apply this to everybody. Let's just use this, this for everybody.

00:24:05
So again, Emily, I'm stepping all over your Yeah, how do we get started?

00:24:09
So, so first, get ready to learn because you're absolutely going to learn. You're have to take on the role as not just the teacher or the clinician, but also the student because you're going to be learning about their perspective and their world. Where I'd start is relationship building that rapport and trust is absolutely paramount with this population, with pretty much every population but with medical interventions. A lot of our students are medically complex and we have to think about how much medical intervention, surgeries, doctors, they've been kind of poked and prodded through a lot of their childhood. So building a really strong relationship and trust that you're you know, a safe and trusted adult.

00:24:51
You know, a lot of our work is hands on because we're using tactile sign language and very, very close together with the child. So I really would emphasize not rushing that process. Build a trusting, trusting relationship with the student and their family. Get to know what they love. Embed that into everything.

00:25:10
Embed their interests into therapy activities and and academics.

00:25:17
Emily, can I ask here to to me, the way to do that potentially is to ask a lot of questions. You said to get to know them. So really starts with asking questions to get to know them as opposed to what I think some people might do is jump right in and tell me what to do. We need to start doing this. We need to start doing that.

00:25:36
Let's get going. We're wasting time if we don't, right? If no, let's take time to get to know who you are and what what, what drives you and then you can work from there. And then I know that they can trust you. Is that fair?

00:25:46
Observe them. Observe them for a while, kind of in natural opportunities as they arise. Rely heavily on the family because they are really the experts on that child. So you each discipline will have their own lens that they're looking for to treat clinically or the teacher academics. But the family knows their child.

00:26:06
So that's a really important route to take is to ask what they like, what they don't like, when they feel or when they perceive them as being sad and happy. We want to use that to that information to our advantage because we we want to set up safe and fun learning environment and kind of get off on the right foot. It's it's about being really curious and knowing that you don't know everything and being excited to learn it all.

00:26:32
I was going.

00:26:32
To say Chris. Oh, sorry.

00:26:33
Emily, I was just going to say, when you say that you ask questions to get to know a student, I feel like it's a really interesting phrase because asking questions to our deaf blind students can look very different than, you know, at a traditional school. I think that, like you said, Emily, really observing their body language and the things that they maybe keep coming back to tactilely. If you have a bunch of things out on the table or something on A-frame, we'll be talking about that a little bit later. But I think that talking to the teachers, talking to the family about what they like, but really kind of observing and having a shared tactile experience with something, seeing how long they engage, are they laughing? That's kind of like us asking them questions.

00:27:17
Yeah, it's not always in a traditional sense. It's a lot of observation, body language, facial expressions, overall demeanor tell us so much and we can go off that and we can build joint experiences together in this way. So it's really important to think about how maybe typical priorities might look different for a clinician. So if you were getting at something in a for coming from a public school, you might need to kind of change your lens and change your approach because this will be a little bit different. Something I'd say you get a deaf blind student on your caseload.

00:27:53
Something I'd say to be careful with is what we call the Fairy Godmother Syndrome, where things just kind of appear and disappear. And often we have really, really passionate and motivated staff members who just want the best for our students. So if there's any way they can help, they want to help. We want to not over help. And with that we want to look at kind of prompting hierarchy and not over supporting.

00:28:19
And with that very godmother syndrome, we don't want objects to just appear out of nowhere and then disappear out of nowhere. We want really a beginning, middle and end to an opportunity, a learning opportunity. And actually everything is a learning opportunity where things don't just end up on my wheelchair tray out of nowhere. We're talking about what they are. Maybe we retrieve them together when we're done with them, we jointly put them into a finish bucket.

00:28:44
That's really important for the learning. Or else you kind of just learn that I'm passive in my environment and things just come to me when other people decide they come to me. So be really careful of that. And it often comes from really, really positive and good intentions. But we want to set our students up for an A fruitful, autonomous and independent life.

00:29:05
So that's something to be careful about. And then there's some universal there's some universal things that we like to follow, because it might work really well for one peer in a classroom and the rest of the classroom don't necessarily need it. But just getting used to and getting in the habit of saying your full name when you enter a room and when you're greeting someone. Hello, it's Emily Macklin. You might want to add a little context.

00:29:32
It's time for speech class. Something like that. Really helpful, because then you're not singling out. One student kind of needs that reminder of name. I did full name because I happen to have a very common first name within our school building.

00:29:47
But maybe just, Hey, it's Emily, it's time for speech. Something like that. If you get in the habit of doing that with everyone, you're not singling anyone out. And one more thing we do kind of universally is we have tactile symbol name markers, so get in the habit. We all wear ID badges and they have a little tactile symbol attached to that, and that means that's me as a person.

00:30:08
That's just something to get into the habit with everyone. If they're interested in kind of exploring that. This is who I am. It's a tactile way to represent me, and once again, it's not singling any student out as needing that. Nothing wrong with needing it, but we just get in the habit of doing it for everyone.

00:30:24
You find Emily, that that's the strategy, or really any of you that that's the strategy you use for preventing the fairy godmother syndrome as well, meaning we prevent, we present things in multiple modalities. So there's a tactile way of saying this is coming up maybe like a tell me if I'm way off here like some sort of rope with beads and this bead means we're coming 1st and this next bead we're coming, this thing's coming next and this last bead means and each bead is a different shape like something like that. Is that what you're sort of meaning as providing a multi sensory approach. So they're hearing that this thing is coming. They're seeing something maybe, and they're feeling it.

00:31:05
And you're again, why not do that for any kid?

00:31:08
Yeah, I think so. And a lot of that will be tied right into a strong calendar or a schedule system. Amber is excellent at talking through that. Amber, do you want to take take those away?

00:31:17
I was just going to say that, yeah, I think you're, you know, right on the money, Chris, something that we do that I would consider starting with your student right when they start at your school, as well as creating a calendar system for them. And like Neha was saying, all of our students are really individualized and you have to create individualized plans for each of them. And some of our students might do better with whole objects, some photos, some partial objects. So creating the calendar system based on where their understanding of communication is. If they're really at the beginning of communication, you would create a whole object based on something that they experienced.

00:32:00
What's the best is if it's an actual piece of the activity. So for an example, if they go to gym class and they always do a certain sport, like maybe baseball, having a baseball be the object that represents that class. And then you set up, set up a schedule for them. Again depending on the students, sometimes they are able to understand a schedule that has their whole day laid out. Other students, you show them the the object of the activity they're going to right before the activity, they bring it to the activity and then they bring it back to class and put it in a finished box.

00:32:36
Very concrete. We are going here, we are literally bringing it to that place. So you can pair the object with the activity, and then we're putting in the finished and on to the next full object representing the next activity.

00:32:49
Can I ask you a clarifying question there? So something that I'm sort of hearing is that you are pairing an object with the activity. Is it pairing one object or is it pairing multiple? So for instance, scenario 1, I'm teaching you about baseball and we're going to talk about verbs like hitting and running and playing and and that what baseball is. And so here's this baseball.

00:33:11
And so I give it to you and feel it and feel how that's like round right and how it's hard and you might use vocabulary like that. Is it? Then we go play baseball. Or is it? Here's a baseball.

00:33:24
And then this is another thing that's part of baseball. Here's a bat. Feel the bat and touch the bat and see how long it is and see how it's hard like the baseball. And then here's a third thing that is also associated with baseball. It's this glove and it's softer and it goes on your hand, right?

00:33:39
And look, squeeze it, you know, and the ball goes inside and you do some sort of experience like that or so. Is it tying it to one thing or is it tying to multiple things? Or is it as most things? It depends. What?

00:33:52
What do you think?

00:33:53
That's a great question. I do think it depends on the student. Definitely you want to make sure that you stick with the same object to represent the same, kind of like class. But once you're in that class, I would definitely, you know, do the whole experience, show them a bunch of different objects like you were saying. If you wanted to teach them the term hit.

00:34:12
Then use a different object from the one that represented the class or the game, like a baseball. And now baseball can represent the word hit. And you know, maybe running, you use a piece of a cleat. And then what we love to do is make sure that a lot of those kind of terms are generalized. So if you're going to show them running for track, you know what I mean?

00:34:31
Time to run, bring that cleat back and start running with them after they touch the cleat. But again, it really depends on the students. Some of our students are so concrete that they really need the exact object that they're going to do in that class to understand that that's the class they're going to. You're talking about like a great level of much higher level language that would be amazing to get to. Are a lot of our students at that level with partial object representation right now?

00:34:58
No, but that is the big idea.

00:35:02
Yeah, I would imagine they get to that by showing them those words and.

00:35:05
Teaching them those.

00:35:06
Words, right? They're as opposed to just someday they'll get there without having those experiences. We have to do that intentionally.

00:35:12
And having.

00:35:13
Those real experiences with those exact objects. So that natural functional practice of actually with a bat, holding it, learning about it. We talked about how it's wood and it feels smooth. And then with the baseball that I've been familiar with, I've been exploring, I feel the, I feel the smooth leather, then we're going to together hit the baseball, and then we're practicing the movement. So in that way, we're embedding some movement and some tactile sense once again, which might be a strength.

00:35:41
And it's that real functional practice with these objects, which are often the most meaningful kind of symbolic form for the students who are just learning to perhaps experience the world outside of them.

00:35:54
Again, I was just going to say the the overarching theme I'm hearing is that we're really trying to take something that's abstract and make it as concrete as possible. And in order to do that, you have to touch all the things you have to experience the movement. Because again, that sense of doing and that kinesthetic sense for them is going to be huge in learning actions that they can't see or that they can't hear happen. And so how do we get them to learn that? Well, they have to do it and we have to kind of make that concrete sort of experience for them.

00:36:27
One other interesting tid that when we're talking about this, like higher level language but using objects or partial objects symbols, the Tactile Connections toolkit has these interesting backings that have different shaped and colored. They're different colors, but they also have different shaped tops and that different shape represents different part of speech. So if you do have a student who is really building their vocabulary and you want to show them these are all verbs, these are all people, you would use the different shaped top backing. I'm kind of jumping ahead of myself because we haven't even really talked about like moving from objects to partial object symbols yet. But you know, the backing is kind of what you mount the object or the partial object on.

00:37:08
So using different shaped backings can help the student with that higher level language distinguish. Oh, this is a verb I'm running right now. Oh, this is a person, You know what I mean?

00:37:17
OK, I feel like we're going to come back to that because it sounds like there was a lot to to that. Like it sounds like there's already a group of people tell me if I'm wrong here that have sort of said, if you're teaching baseball, use a baseball as opposed to a bat or a MIT or having to come up with it on your own. And there's some guidelines here about what you, or at least the place you can go to kind of have a universal experience. Like. Again, deaf blindness has been around for a while and people have been teaching it for a while.

00:37:46
So I'm sure people have learned teaching kids with deaf blindness for a while. So they've learned some tips and tricks and maybe there's some resources people can go to to say, I'm not sure how to teach this. Oh, well, here, go here. It's going to have where it's going to have these objects that you start with or like you said, Amber, partial objects that you evolved to. Is that fair?

00:38:07
Yeah.

00:38:08
And so Emily, let me there's other one other thing that you were saying and I want to drive all the way back to, which is you are introducing yourself and you're saying, hi, my name is Emily Macklin. You say that each time it's time for speech, giving context of who you are. And then you said you have some sort of tactile object on your name badge. How do you, what does that tactile object look like? Are you talking about like a Braille symbol for Emily?

00:38:31
Or are you talking about this random swirl that goes for Emily, Or is it alphanumeric Emily? What? What is that tactile thing that you put on your name badge when you introduce yourself each time?

00:38:45
That's a good question. So this could be something that's completely random. I would recommend it be something that reminds the person of you. So if you wear a specific bracelet or ring every day, those are excellent things as you're kind of connecting with the hands that the student will likely encounter. If you have very long nails or something's kind of distinct about how your hands feel, those are excellent markers.

00:39:12
For me, I wear an Apple Watch every day with these silicone bands, so while I do change the color in the season, my tactile symbol will always be the same. It's a piece of the watch band because that is something that is every single day, always on my wrist, always in the same place. It's predictable about me and for my students, I'm the only one only staff member that that is their symbol. So it's paired with my name sign, it's paired with my V verbally saying my name, and it's my watch. Other people have a bit of a more a unique symbol, so that could go for someone else who happens to wear silicone Apple Watch, but that is my name symbol, so no one else on their staff would use that symbol.

00:39:54
And if they do wear Apple Watches, it would be distinguished in some way because it's important they know the people. Differently.

00:40:01
Let's go around the horn. Neha. What? What's your symbol? I feel like this is like me talking to Prince.

00:40:05
And like this is my symbol for for Prince.

00:40:08
Right, right. I actually have. I always wear a hair, hair elastic, this kind. Not a big scrunchie or anything, but it's this one and a beaded bracelet that I have on my arm. So those are my my markers.

00:40:21
Gotcha and Amber.

00:40:23
Well, it's interesting. I used to have this mountain ring that I would always wear in my thumb. As you can see, I don't have it on my thumb right now, but I've seen my students now starting to feel my engagement ring, which is rectangular. A lot of people have engagement rings, but I just got engaged pretty recently. So it's interesting that my students looking for my thumb and then they go and feel my ring and now they're starting to just go to my engagement ring to see who I am.

00:40:48
This what you're talking about here feels like really a lot of fun. Meaning like picking out your avatar for Zoom or for, you know, any sort of service that you're signing up for and you get to decide what image you want or what avatar you want to use. It's sort of sort of What do I want to use to represent who I am and help kids learn who I am?

00:41:09
That's sounds fun. I was just going to say another really interesting thing too is that, you know you can pick what you want your tactile marker to be, but sometimes it's all so great to have your student kind of explore and like if you notice they're always gravitating to something about you, then that can be it because that's meaningful for them. Similarly, in the deaf community and the deaf blind community, everybody has a name sign. So rather than signing your whole name with all the letters every single time, it's usually the initial letter or some other sign like glasses depending on that person. So that when you're introducing yourself, you have your tactile marker, you have your name sign and that name sign is always given by someone in the community.

00:41:54
So that's really kind of a nice connection to that community that that person has enough of a built up trust and relationship with you that they say, you know what, I'm going to give you this name sign so that now we have this connection and always introduce yourself, self name sign, verbal, your tactile marker. It's again that total communication. It's everything all at once at the same time.

00:42:18
This feels to me like a grandmother thinking they're going to be called Mimi or something. And the child says you're you're not, you know what I mean? And it's like, OK, I guess I'm not on now, right? Because you might think it's going to be one thing, but it's really following the child's lead to become something else.

00:42:35
And we we offer all the modes too, but it's really up to them what they're kind of honing in on. So that's our job as a staff is to kind of provide all these options and what works for them, what's easiest accessible, that that's what they're going to go with. Neha and I once shared a student who, while we get, had our tactile markers, we had our name signs with hello, it's time for speech. But what she was really interested in was filling your shoes for that day. So we had all of our things ready.

00:43:05
That's kind of our standard start. But what she wanted, she was very curious on what shoes you're wearing. So she'd feel where you are. She'd go towards the ground. She would feel your shoelaces or if you didn't have shoes, that was very interesting to her.

00:43:16
She was flexible if you were wearing different shoes that day, but she kind of knew people by the types of shoes they usually wore, and that was her method and her style. So what we are is available for following your lead, but it's it's our job to creatively think of of other ways that we can present so that a student can identify. Like actually this mode really works for me. This is how I'm going to identify you. Or we want to just empower them to find what works for them.

00:43:43
OK, so if I let let me see, see if this is the time to move on to the next thing, Amber, that you were sort of referencing. So we have these full objects to help represent concepts. We do very experiential learning, but then we don't stop there. We evolve to saying, OK, this is what a baseball is, but then here's another representation of a baseball that like, maybe text, maybe Braille, depending on the kid, right? So tell me, tell me more.

00:44:10
Where do we go from there?

00:44:11
Yeah. So you start with the baseball and then as you are seeing that they're maybe they don't have to fully feel the whole baseball anymore. Maybe they're touching the baseball and now they they know you can kind of get a sense of when it's time to start moving down to a partial object symbol and you really want to take like a piece of the skin of the baseball. And what's an interesting idea is having it like pre cut but still on the baseball and together with the student taking that off of the baseball and putting it together onto stacking so they can really see this was coming straight from you know, the skin of the baseball was coming right off of the baseball and they need the same thing. And then kind of continuing your calendar system but now using just that piece of the baseball would be how you start moving from whole object to partial object.

00:45:01
Or you could cut the baseball in half and then slowly move to just the skin of the baseball, depending on how concrete they need their symbols to be. So kind of slowly over time moving from that whole object to smaller objects. And yeah, you're right. As their language develops, maybe they'll become a real user and learn the word baseball. And then that can be they can have a real schedule system.

00:45:22
When you say maybe, would it be fair to say the expectation is they will and will teach them how to become a Braille user? Is that fair?

00:45:30
That's a great question. Well, you know, I I don't know. It really depends on our students. We've had some students that have come to preschool starting with whole objects and then by now they're talking and they use photo schedules or they use line drawing schedules. I have one of my students who is completely blind, who started at objects and now she is using Braille.

00:45:52
So it also depends on, you know, it's totally different for every student I would say.

00:45:58
The other thing too is, I think you know, while we're moving along the whole objects, because we have to think of when they go out into the community, how practical is it for them to carry a whole bucket of objects and symbols to talk to whoever they want to engage with? And so that's the reasoning for moving to smaller, more concise sort of representations of their whole objects. And as we do that, we're also signing, we're teaching them sign, we're trying to see what visual access they have for pictures and photos because eventually they could go to maybe a device like an an iPad or a photo book or something like that. So even though we're doing that, it's everything else is paired at the same time just to see, you know, how functional can we make this eventually for them?

00:46:45
OK, well, you brought us there, so let's talk about that for a second, 'cause we where I was in my brain was just teaching concepts, not necessarily communication. So, like in the baseball scenario that we've been using, I don't even know how we got to baseball, but let's right? Like, like you probably.

00:47:01
Because we're from Massachusetts and we've got the Red Sox, so you know.

00:47:07
The Green Monster, right? So what does a communication system look like? Because we wouldn't necessarily be like, oh, you need baseball or hit on your communication device. I mean, yes, eventually or yes, we want a part of a system to have hit. I was just going to say what does it look like to have a communication system in when you're working with somebody who is completely deaf and completely blind?

00:47:40
Yeah, I have the student at our program who's completely deaf, completely blind. This is a really interesting student because tactile. We use tactile sign language to communicate to her. She has a few signs that she knows, but her initiation is low in general. And then she hasn't picked up on signs as much.

00:47:59
She doesn't. I totally love, you know, interacting with other people. She's kind of an independent person, which is amazing for her. But it's difficult because she didn't pick up on tactile sign as much as we would have thought. So what I did for her is I created kind of a wants and needs board that has partial object symbols that she is now starting to exchange and give to people to say I need help, to say I want more because she hadn't picked up on like signs for more some deaf blind students, you teach them sign language, you'd actually sign to them and then they would be able to sign in the air back to you.

00:48:36
But for this particular student, she wasn't picking up on sign language. So we started introducing partial object symbols that could mean more have more commutative functions, and she carries those with her in a leather bag along with her schedule throughout her day.

00:48:52
Amber OK, so tell me if this is fair. So she wasn't picking up on sign language, tactile sign language. It means you're she's, she's feeling you while you do the sign, right? She's feeling your hands while you're doing the sign. So how do you know that tomorrow wasn't the day she's going to pick up on it?

00:49:09
Like how did you decide this is the OR is it you're still doing both? We're going to use this and continue along with tactile sign cause. Exactly. Maybe that's how she learns it.

00:49:19
Exactly. Yeah, you got it. So we we've never stopped doing tactile sign language. We still tactically signed her all the time throughout her day, but she wasn't expressing sign, even with prompting. So that's when I was thinking, OK, we need another kind of system to help in addition to, you know, us continuing to sign with her.

00:49:40
But now she needs a way to communicate with us because she wasn't expressively signing. She's also, I'm older, around 20 now. So it was getting to the point where like, OK, she's 20 years old, she's still not tactically or signing to us. It's time for something else in addition to us assigning to.

00:49:59
Her A big part of working with the deaf blind population that I've found is trial and error. With that being said, being consistent and giving things a real long enough try to see if that is a mode that's going to continue to support the student. We're consistently communicating with multiple modes, but it also changes over time. So sometimes something does work and sometimes it doesn't. You need to hit the drawing board and brainstorm again and do some feature matching and see if anything's out there.

00:50:33
Work with the whole team, kind of come together to find where the communication strengths are, how to build upon them, and where areas of need are, and nothing is really that static. So we want to stay predictable and consistent for our students, but a year or two years also could look pretty different. So when we think about language development, going from a whole object to a partial object, eventually perhaps to a tangible symbols if they can be on the smaller side using those backings like Amber was talking about. So even if the student isn't quite academically learning about the difference between a noun and an adjective, there is some both visual and tactual difference with those symbol backings. That's just giving them that little extra information, just like you'd see perhaps on a high tech system that uses green to represent verbs.

00:51:22
Not necessarily meaning that's that's the explicit goal of intervention. It's just information that's there. It's a little color cue if they're accessing with vision, and if they're not, they feel the same. However, the top, it's either scalloped or it's triangular. It's that little cue.

00:51:39
And then we want to meet the student where they're at. So if we're at a tactile symbol, so going from that whole object to the partial object to the tactile or tangible symbol, they're they're synonymous. We want to think about for those core words to to bridge with the perhaps really fringe or unique vocabulary word that's very important to our students. So light up toys are really, really popular for our for our population especially things with movement and lots of bright lights we have a lot of fans of. So something like pairing a a bit arbitrary symbol for want with a tangible symbol for my light up globe that perhaps you went through the whole symbol transition from the whole spinner to just the sphere, That's the most fun part of it.

00:52:27
Maybe what they really like is the button that turns it on and off. We have excellent engineers on campus that are able to kind of deconstruct toys in a way to keep their function that the student really resonates with or that from our observation we view them resonating with mounting that. And then you're pairing it with that symbol of want light up spinner and just giving that exposure and eventually you might see them expressively saying what they want, what they don't want. We're embedding those opportunities kind of throughout the day. But it could really look different from, I don't want to say month to month because we we give things a real long chance.

00:53:03
The consistency change does not usually happen fast. We want to give things a real chance, but also be comfortable hitting a brainstorm table, figuring out what's working and what's not, and thinking forward thinking, thinking about next steps because there's growth to be had.

00:53:20
Yeah, I'd love to add that, you know, Naya talks a lot about total communication and the fact that we model so many different modes of communication for our students to help in their understanding of language and communication. But also we accept any mode that they communicate using. So whether they're communicating with their body language, we're saying, I see you're upset or I see you're so happy right now. Whether they're using objects, whether they're using speech, whether it's sign language, whether it's AAC. I think that, you know, kind of our theme today has been total communication and how individualized everything is here.

00:53:57
And I just wanted to mention that it's hard to talk about AAC and the deaf blind population because there are so many different communication methods, communication devices that you see even just at our program. So like you were saying, Emily, feature matching is really important. And if you want to go into maybe one of your examples, Emily, of how you kind of, you know, found out what system would be the best for one of your students, it's again, it's just going to be one student out of so many who have so many different kinds of devices. But.

00:54:30
Is it a good good time for that Chris, or did you? I was just thinking, just thinking about language expansion. So for a student example of mine, he was using tactile symbols really, really beautifully. So we ended up getting a trial of a proc stalker in and we put the little chips that come with the proc stalker tangible symbols over those chips with really strong adhesive tape. Next thing you know, I'm putting out sentence strips kind of like I want.

00:55:03
And then he was making his choice, his leisure time choice. So that's what he was working on is make that choice making. I was pairing that with kind of a sentence starter. I want blank. So I saw over time he was tactually kind of exploring each page.

00:55:19
He's looking through it. He does access with a little bit of vision, but he's kind of feeling all the symbols. He's he's flipping the pages in the Prox Talker carrying bag of all of his symbols, looking through and eventually he he stopped tactually scanning. He started visually scanning. So he's I'm just noticing him stop touching every page he's looking.

00:55:39
Then he grabs the symbol, puts it on the Prox talker. Once he became so automatic visually looking, I I hit the drawing board and I said let's try something with a photo, a real photo of his tangible symbols. Let's just see how that would go. Because I do think the tactile support and how different each symbol felt was supporting him learning. But I was kind of curious because he he was tricking me a little.

00:56:05
I was like, I think there's some more vision happening right now where I think he's using his sense of vision more than he was. So he got kind of used to his symbols. He knew where they were. They were predictable. I tried a we got a trial going of a Nova chat device with a key guard, and I just put, I made the first overlay of, you know, iPad and walk, which were his favorite symbols.

00:56:32
He's a mover and a shaker and oh man, does he love an iPad game. So I put those on the front and I used that symbol immediately. He was like iPad. Yes. Go for a walk.

00:56:42
Yes. Using those symbols. And then I used that symbol placement to bridge for want and go because he had been exposed to it for so long that then he was saying go lock, want iPad. And then I expanded it. I put all of his toys in there and that happened actually over just less than a week.

00:56:59
He took to it like that. And I do think that those strategic steps that were put into place kind of going slow but following his lead and now he has a complete, he has a complete vocabulary in his device. I I think those steps, taking a tiny step back to make a huge leap forward went a really long way because he was really able to grasp what we're getting at. I think a lot of language around him is lost because of his dual sensory impairment. So bringing it to him made a really big difference.

00:57:33
And then he actually doesn't access with with much hearing. So he does have a little bit of hearing just like vision, but not so much. So I wanted to make sure that yes, this is a voice output device, but I wasn't as sure if voice output was the most important part of the feature matching. How do I know he knows he's activated the system? Because he's expecting a response to kind of open up some social opportunities with peers, with other staff, new people in the community.

00:58:01
So then it's then the feature matching becomes what systems can have visual effects and haptic effects and looking into what exists, what doesn't exist. The Nova chat ended up being a nice fit for him with the Bluetooth volume all the way up. It does have some vibrate, we have everything expand as he clicks it with an outline. He knows exactly when it's been activated and when he needs to try again, and also using his residual hearing. So kind of multimodal way at that, but sometimes it's not as clear cut, Sometimes we're talking to local engineers.

00:58:37
There's a lot of engineering students. I'd recommend to reach out to local universities and colleges near you, engineering students and robotics clubs, They often need projects and that's a really good way to introduce them to the field. Maybe adding light as voice output comes if they're deaf and they, you want, you know, a vibration or a light activating. It's a way to be creative and give them more access to what others may incidentally have had access to.

00:59:07
Awesome, awesome. Amber, you had mentioned A-frame of some sort. What did you mean by that? Oh yeah.

00:59:14
So that's a great question. Before we go into that, I just wanted to give you one more example of one of my students who kept you know he was making choices from whole objects and I was trying to move to see if we could move to an image level. And I was pairing the object with the image right in front of it to see if he was able to understand I'm you can just touch the image. I don't need to take the whole object. The image and the object are the same and it was too far a step.

00:59:44
And actually Neha was the one who told me to try plexiglass. I don't know if other people know of this, but putting the object behind plexiglass showed him that he didn't need to fully grab and take the object. He could point to the object and I would give it to him. So it was almost starting to bridge the 3D to the 2D and now he's finding the images of his toys on his high tech iPad device by himself. And that was just a smaller but I I would not have thought of plexiglass just putting a sheet of plexiglass in it.

01:00:14
Maybe in a week he figured it out. So just another really cool little tidbit. So going to the frames, I was talking about something called active learning. I don't know if a lot of people have heard of active learning, but it's an approach that was created by Doctor Lilly Nielsen. We talked a little bit about, you know, our students becoming prompt, dependent, becoming passive.

01:00:39
They have a lot of stuff done to them in their lives and because of that they can become passive, become tactically defensive. They think maybe just people will bring them things, but we want to make sure that we're teaching them to be active learners and participants in their world and that they have a world around them, First things first and that second things second. They can reach out and interact with that world. So one way that we do that is by having active learning frames and different objects hanging from those frames. And we position it in a way that the student could maybe accidentally bump into it and then start to realize, oh, there's something there and slowly start reaching out and exploring that object.

01:01:20
And you can put objects on there that's like a big cup and a smaller cup and maybe they see that One Cup can go in and they're kind of starting to build those foundational basic concepts of in and out. And really as our job in that is to not be doing anything and to be observing, we want to be teaching them that they can actively participate in their worlds independently. And if we kind of start joining in then that's, you know, defeating the purpose a little bit. We don't, you know, we're trying to help them to become active learners and not realize that they don't have to rely on adults intervention, do you know what I mean? So we use that a lot for our earlier developing students.

01:02:05
As long as I believe you're under the age of 4 developmentally, is that correct? Then this approach would.

01:02:11
Be developmentally, developmentally up to 48 months?

01:02:15
48 months. Thank you. Yeah, so as long as your students developmentally below 48 months then it would be appropriate for them. And a two year old knows a lot of stuff, so.

01:02:30
Let me ask you this. Let me go back to when you were talking about having the background images or the background textures be different and giving some more sort of residual. What's the right word context, residual context to what you're talking about? Something that a connection I was making was to the 3D symbols from from project core. Have you?

01:02:55
Have you because the those 3D symbols that are printed have different ridges around the outside. Do you use that and is that something similar? Is that a is like, yeah, Chris, that's it or no, no, no, no, Chris, that's totally different. What's?

01:03:07
I think that's, I think that's an excellent resource when we're talking about resources for people to take from this podcast and like to continue their learning. We've liked by American Printing House for the Blind by APH, the Tactile Connections Kit. We've been using those backings a little bit more. The project core, what's great about that is right online you they have the instructions to go right ahead and 3D print all the symbols, take the brainstorm out. You can have a universal kind of tactile language between two students.

01:03:36
How excellent for them to kind of be able to share that. We we do like to keep the caveat in mind that language development is going to be so individualized for each student. So kind of for those really preferred nouns, those favorite, favorite things, we're way more likely to do something just based on exactly how the students interacting with it. Really observing, you know if the push button is more what they like or the actual globe that vibrates and has those light that on the same light up spinner. For two different students we may use a different piece.

01:04:07
But for those bridge words that are kind of bringing the access to the language development, I would absolutely recommend checking out Project Core. The the feel of the symbols will be the same. We we've liked the flat backings for putting something on, but what I have liked is taking out the brainstorm and kind of just able to get some language right away in when you have especially less time resources. We have our whole day dedicated to deaf blind students, so I do understand that that is not the case that everyone's in and the importance is bringing them symbolic communication and exposure. Texas School for the Blind and Visually Impaired also has a Dictionary of their tactile symbol library, so that's free and accessible online where you can see all the symbols they are using.

01:05:05
We've been working on kind of cataloging some of ours, but they're they're ahead of the game on kind of having a whole dictionary logged. And along with the APH Tactile Connections Kit, they have a whole book of ideas that can represent all these different concepts. Because you don't always have to start from scratch. You want to keep the individualization in mind, especially for those those fringe concepts. And you know the really salient things that they love every day.

01:05:31
But the but want or like doesn't necessarily have to be as concrete because there's really no way to make it too concrete. So finding things that are already out there will make your life easier and also kind of get rid of the barrier of not knowing where to start because there's a lot of places to start. So those are some resources I would check out right off the bat.

01:05:51
And the other thing too is you can always get materials from those resources and then as you get to know your student, you can try to customize that individual symbol, like, you know, the go symbol is that green arrow. But like Emily said, it really does feel the same in terms of texture of all the other symbols because they're just 3D printed. But you know, maybe you add like fake grass on the go and you just glue it right on top. A hot glue gun goes a long way guys. And.

01:06:19
Then remember to go touch the grass outside if that's your you know what I mean, right?

01:06:24
But you can customize the already made symbols if you feel like the texture needs to be a little bit more prominent.

01:06:31
In a similar yet different way, a lot of what we do also is switches feel the same if you're not accessing with vision. Some will be smaller, some will be a little a little bit larger in their face size. But where we have some students who are two step scanners and they know that one of their switch functions is to scan and one's to select, but their select has a bumpy texture, so it feels different and is visually different. They're accessing with a bit of vision. We're of course we're using different color switch faces.

01:07:00
Maybe one's small, one's large, but don't be afraid to add some texture. Could also draw some visual attention by adding some crunchy mylar to the front. If you're kind of bringing attention over to the switch, be creative there. There's not a right or wrong, there's just following the child's lead and interest and bridging that with what you know about what's available with assistive tech and, you know, merging that with the student and what they know and love.

01:07:25
Well something I certainly heard you all sort of mention is like Amber you were telling the story of the plexiglass and how Neha helped you kind of think think of something you hadn't thought of before. And then Emily you were talking about reaching out to the students at Harvard to get the OR whoever. I'm joking but you said reach out to other disciplines to like people working in maker spaces and crafty people who like The Who sort of understand what glue will stick on what surfaces. Do you know what I mean? Who have experienced there?

01:07:53
You you build out your your network in that way. That seems like great advice for parents as well. Meaning there's other people out there that have kids that have deaf blindness and are learning with these sensory impairments or it's sensory. Let me let me change that. These sensory abilities that are different than other people so are sensory disabilities.

01:08:16
So are disabilities that are related to sensory. So how can you help? Or how can we help parents find each other?

01:08:28
Really good place to start is with the students team. We are fortunate that we're immersed in that every day. But the interdisciplinary team is huge. You've got classroom teachers, OTPT speech, audiology, you know, the teacher of the visually impaired, the teacher of the deaf and hard of hearing, the assistive tech person, the social work, you know, the psychologist. It takes the whole village, so they in each discipline has specific resources that people can access for their specific discipline.

01:09:00
So we work really closely with O, TS and PTS and the O and Ms. and the orientation, mobility, everybody we work together. But and so you can really get students specific information from those disciplines. But sort of globally, you know there's the National Commission for Deaf Blindness which is a great resource for connecting families kind of across the nation. But then they also help find supports within their States and then every state or I think major city, Boston has one but Massachusetts also has 1A deaf blind or in deaf community resource for them to go to reach out to help find outside sources or you know we're fortunate at Perkins to have a program here.

01:09:46
But Perkins also has specialist that can go into the public schools to help support students that fit our profile that are out in the mainstream and inclusive classrooms and then of course you know talking to whoever their you know support system is friends in the same classrooms. But yeah there's definitely the National Commission for Deaf Blindness and then Massachusetts has also deaf blindness and blind the Commission for blind as well. And parents can get a lot of support for from these companies at home it within their community and at school which is great because often times in school we're we're not allowed cloud are able to go into the communities and help bridge that gap a little bit. But these programs out there really do offer that support.

01:10:36
Another thing to our school, we happen to have a large number of our student population with CHARGE syndrome. So you know with the CHARGE Syndrome community, there's a yearly conference, the time of our recording right now, it happens to be right now. We have a number of staff and students attending and it's a really nice way for across the whole country different families with the child or a student who has Charge Syndrome to connect. I think with a lot of these rare syndromes to find a Facebook page, look to connect with other resources and just to add to the listening how was was starting the deaf. Blind International has really nice resources that are outside of just what America has to offer, which is a lot.

01:11:22
But also there's European connections in Australia connections. So with the incidents being low and these are still being more rare cases compared to other populations, it is important to kind of rely on each other and see what other people have learned, found to work found to be successful and build that community. It's really important because I I know it could feel isolating for a lot of the families we work with. So supporting them bridging those those gaps and that they're not the only one.

01:11:51
Is is really beneficial. I think some some things that are helpful for families too. A lot of my families are looking for like activities to deal with their with their children. So I think you know, thinking about that active learning approach. If there's something that if their student is below that 48 months developmentally, then having active learning frames and materials at home is something that parents can set up for their children and keep them engaged in learning and then also switch adapted toys.

01:12:21
We didn't really go into like cause and effect and stuff like that. But I have a lot of students who are using switches, whether they're environmental switches, one on the door that means go one next to their communication book that means I want or whether they're at kind of like the beginning levels of switch learning and using a switch for cause and effect. Switch adapted toys are something that I feel like are great for parents to have at home. There's, you know, makers making change and a few other resources about how to even switch adapter your own toys online. So I think that's also something that, you know, a lot of our parents are saying like what can I do at home to kind of continue helping and definitely reach out to the team.

01:12:58
But those are a few things that could be helpful.

01:13:02
Awesome. What did we miss? What didn't we talk about that everybody should know?

01:13:07
I can't emphasize enough how quickly you should type into a Google search activelearningspace.org and learn about the active learning approach. It's really a game changer, and I think it's really important for it to be more widely spread because seeing the gains our students make when we bring things to them and kind of encourage them to come out of their own internal shell and explore outwardly makes such a difference. For for communication, for language development, for interaction in their world. So that's active learningspace.org. It's such an excellent resource.

01:13:41
There's activities on that website, there's webinars to learn from. This approach is something that I'd love to see talked about at more conferences and presentations, because we've see it every day making such a difference for so many of our students, becoming more autonomous communicators and living independent lives.

01:14:02
Yeah.

01:14:02
I think also the other thing I was going to say too is I know we're all research based and evidence based practice and all of that is so important. But number one, you're super lucky if you have a deaf blind student on your caseload 2. There is very little research out there and that can be frustrating and we just want to assure you that you have such a as a speech path, you have such a foundation for knowing the trajectory of development and language development and all of that. So don't be afraid to look at research out there that might be for students that have multi sensory impairments or that are MDV right. You might want to look at some of the research out there for students that aren't specifically categorized as deaf blind, but they do have more maybe cognitive differences that you could look at.

01:14:54
So don't be afraid that there's no deaf blind research out there. Don't be afraid to try new things, but also be really creative and critical in your thinking for when you're trying to figure out how to best approach a student.

01:15:09
Amber, are you going to add something?

01:15:11
I was just going to repeat like predictability and routine and you know, sticking to that calendar system can be so important for our students who are deaf bind, you know, making sure that they know kind of what's coming next. I think something fun that we didn't really talk about are story boxes or experience stories and using whole objects to tell a story with a student or a song boxes. We have like the wheels on the bus box, you know, with that Emily made with the windshield wipers and actually has real windshield wipers in it. And we sing wheels on the bus and we play with all these fun things. And it's nice to kind of include objects and you know, if you want to do like a fun activity, those are really great ways to have a student engaged.

01:15:54
And then proactive movement is another topic that we didn't talk about, but it's also really interesting and it's kind of like you and the student are moving together and then it's hopefully leading to the student kind of anticipating that movement. And so you're doing a movement and you stop and then you see if the student will begin that movement again. That's another kind of deaf blind teaching principle. That's really it was interesting for me to learn once starting here.

01:16:24
If we only had 100.

01:16:26
Dollars, right?

01:16:30
But this is a lot of great resources that you shared for people to ideas. And then when they want to go deeper, they can go to our show notes where we'll have all the links that everything you've mentioned. Where do people reach out to you?

01:16:44
You can reach out to us by e-mail, so all of our emails will be pretty clear cut with our first and last names. So my name being Emily Macklin, Macklin, so it'd be Emily. Macklin at perkins.org and that'll follow suit for kind of the rest of the team. So amber.scary@perkins.org, SKERRY and Neha which is spelled NE ha.sharmasharma@perkins.org. I think that's the best way and we'd love to connect with with others in the community.

01:17:20
Excellent. Do you have time for one last question?

01:17:23
Absolutely.

01:17:24
So the way I like to end the interviews is to ask you as curious people that got into this field and continue to be curious, what is something that's in your space right now that you're curious about what sort of information you're questing after or something that has got you going. You know what this is what I I'm searching Instagram or you know what? What's what's got you curious?

01:17:51
That's a great question.

01:17:52
I know there's like this big expectant pause.

01:17:56
I feel like I learn like new things every day from working here and from my students. I feel like I don't. This is even going back to grad school, like deaf finest was really not talked about at all. So I came into this position knowing close to nothing except what I could look up on my own. So I come across things that I didn't even know that I should be asking about and then learning about them, if that makes sense.

01:18:21
I'm going to a conference next week. That's the Deaf Blind International Conference. So I'm really curious to see how people in other countries work with deaf, blind individuals. I think that that's going to be really interesting, especially people from countries who might not have as much as we have. You know, luckily being at Perkins, the the resources are endless.

01:18:39
But you know, getting creative when you don't have those kind of resources or, you know, iPads are so accessible here, but in Argentina they cost so much more. So what apps do you use when you can't have an iPad? You know what I mean?

01:18:54
Awesome, awesome. You know some something you touched on there, Amber? I just want to mention it real quick is that I know that this particular podcast has many students that listen because maybe either they're curious themselves or because it's been assigned and there's sometimes a a feeling. I know. I certainly had it when I was a student.

01:19:10
Like, I made it. Yeah. But really it's. Yeah, you made it. Now you have a job and the learning really continues.

01:19:17
And Amber, your story that really emphasizes that, right. Like I got a job and yeah, my grad school helped a little. I mean, my schooling up. But now it's really the learning continues on on my own, right? And that's why I like to end with this question.

01:19:33
Yeah. And I think for me, a lot of it is not necessarily things that I'm more curious about now, but more how to kind of take what I've experienced and kind of move to the next step. So for me, I can't do what I need to do if I don't talk to the PT about seating positioning, if I don't talk to the OT about their sensory profile or their fine motor skills because they might not be able to isolate a finger. So I'm not even going to go down a direct selection sort of method. And so for me, my the hill I'm going to die on is how are we all working together and so.

01:20:11
It's easy for us to maintain our silos because we are the communication specialists and this is what we do. But realizing that we I can't do what I need to do unless I know and have input from everybody on the team and you know working in a school, we're so fortunate to have all those professionals right there all day, every day. And so working with the classroom teacher because you know they have these students all day. They have multiple hours and back-to-back with them. We have a couple half hour sessions a week and then we bring them back.

01:20:43
So really looking how can I improve, you know my practice with the students, but by making sure I really consider all angles of that child and all the specialists involved and you know how can we actually change our service delivery. That is something that I'm really looking to see more inclusive opportunities, more Co treats. We have a vocational department here that is so robust. And so how can I go into the vocational department and help support students so that they are ready for their adult life? You know, just examples like that.

01:21:15
So less for me to learn for myself, but learn as a whole team is going to be kind of my direction going forward.

01:21:24
For me, kind of a brainstorm process that I've gotten so much stuck.

01:21:30
But.

01:21:31
In for a while is keeping the really tactile, so the whole object users and the ones who need larger they're often less portable objects. Also, symbolizing really large things such as like a trampoline is is pretty tricky. So finding more ways to make concrete representations and if you're unable just pair, pair, pair and give a lot of repeated opportunities. But with the larger less portable systems making sure they still have access, full language access and kind of meeting robust language access with their needs of where they're at and their sensory profile. So being a real critical thinker strategically, if you're able to making things a little smaller, if it's accessible and then opening more doors for for even more.

01:22:21
And then what's a really great carrying case where they still have access when they're in on the move. We've tried different things like a Rolly suitcase or a backpack, but you want them to have access to language in transit too. So is it kind of a flip book that they wear crossbody and you know it it get get kind of tricky and there's not a ton out there. So also as we're reaching out to other professionals in the field, this is something that we think about a lot because what we want our students to do is not just use these symbols in a contrived speech therapy session. We want them using them in the community, in their classrooms all day, every day.

01:22:56
So anyway we can continue to streamline, improve accessibility is a really good step in the right direction and absolutely a win. So even beyond the school setting, where we have a little bit less control of what the home setting or the community opportunities may look like, the best we can do is set them up for success, have a streamlined system where they're, they're ready to show off their skills outside of school as well. So that's just something that is a tricky but not impossible task. And it's something that we consistently think about and are excited for people to reach out to us or things that have worked for them. Or, oh, I'm in a similar kind of kind of place on this, and here's what I've tried and we're happy to kind of share about that too.

01:23:42
OK. Let me see if I can summarize all that. So Emily, I heard you say sort of robust language system that works in every environment. And I heard Neha say and the way you get that is you work with everybody and you listen to everybody and you pull the whole team together to figure out how you're going to do that. And Amber, you say we do that across the world.

01:24:03
We're going to do that in, in cultures that is not just the one we're living in, but you're going to go learn how other places are doing it and share back the information we've learned so it spreads across the globe. Sounds good to me. Let's do that. Thank you so much for taking your time, for being on the Talking with Tech podcast. And we really look forward to continuing this relationship with you and learning from you and sharing information on our website and for all the great stuff yet to come.

01:24:28
So thank you.

Thank you so much it's a pleasure.