Future Reflections         Summer 2010

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An Interview with Brett Page

From the Editor: It is always exciting to meet professionals who are deeply committed to their work and who are eager to explore innovative approaches. One such professional is Brett Page, school psychologist at the Ohio State School for the Blind. In this interview he talks about his work with blind children who have additional disabilities and his efforts to build bridges between professional communities.

Deborah Kent Stein: How did you become involved in work with blind children who have additional disabilities?

Brett Page: I began my career in the field when I was hired as the first school psychologist at the Kentucky School for the Blind in Louisville. After two years at KSB, I continued working with students who were visually impaired or blind as a school psychologist in the Columbus, Ohio, school system. I transitioned to my current position at the Ohio State School for the Blind in 2005. Throughout my career I have served students with multiple disabilities, including those with severe vision impairments or blindness. At OSSB my daily work frequently involves providing assessment, intervention, and counseling services for students with multiple disabilities who attend our school. I also periodically travel throughout the state to provide consultative assessment services.

DKS: Did any personal experiences shape the way you think about blindness and the abilities of blind children?

BP: I was very close to my maternal grandfather when I was growing up. He was a successful engineer who lost his sight gradually due to an injury. He was a great role model for me. He never let his vision impairment stop him from completing large or small tasks. I guess I felt the work I'm doing was meant to be. He was very proud when he heard I decided to take my first job at the Kentucky School for the Blind. I enjoy taking on new challenges every day, just like my grandfather did.

DKS: A lot of educators and other professionals believe there is a high rate of autism among blind children. What are your thoughts about that?

BP: Many students with severe vision impairments or blindness have significant social interaction, communication, behavioral, sensory integration, and cognitive processing issues. Is it true autism? It's hard to know for sure. Whatever you want to call it, it is important to address the unique needs of each specific student. The framework of autism has opened me up to assessment and intervention methods that I believe make significant differences for these students. The autism community--professionals in the autism field, those actually diagnosed with an autism spectrum disorder, and parents of kids on the autism spectrum--have come up with some terrific methods for working with diverse learners. I think we need to accept that an increasing number of children with severe vision impairments or blindness have additional significant disabilities that may include autism. Professionals working in our field must think in fresh ways in order to address the developmental needs of these students effectively.

DKS: How much communication exists today between the autism community and the blindness community?

BP: Traditionally they've been pretty separate. A lot of the tools and methods that have been developed to teach kids on the autism spectrum are highly visual. Historically the thinking is that people with autism are visual learners. For instance, some common intervention methods include use of picture schedules, picture stories, and picture cards for vocabulary. The concepts behind these methods need to be adjusted for use with students who are visually impaired or blind. In 2007, I helped organize the world's first conference focusing on the topic of autism and sensory impairments. "Sensory impairments" included blindness, deafness, and deafblindness. It was a highly successful conference that involved much collaboration between the Ohio Center for Autism and Low Incidence (OCALI), the Ohio State School for the Blind, the Ohio School for the Deaf, and the Ohio Center for Deaf-Blind Education. The conference was held in Columbus. It brought in some of the leading people working with children identified as having various sensory impairments and autism. It got everyone thinking in fresh ways about the issues.

DKS: Tell me about the work you're doing to develop nonvisual materials for your students.

BP: Right now I'm working to modify a series of books created by Michelle Garcia-Winner, an internationally respected speech and language therapist who works with children with autism. Garcia-Winner's books help kids who have problems with what we call social thinking skills. Social thinking skills involve such skills as perspective-taking and being able to think about a variety of potential solutions for solving various life problems effectively. Many students with vision impairments or blindness exhibit challenges with these skills.

To teach these skills to younger children, Garcia-Winner has developed a comic book-based series in which the lead character, Superflex, takes on thirteen villains called the Unthinkables. In the stories the Unthinkables attempt to get into the brains of children and get them to make bad social decisions. For instance, one of the Unthinkables is called Rockbrain. Rockbrain tries to get children stuck on their own thoughts so that they ignore other people's feelings and actions. Superflex is the superhero who gives the children in the stories flexible thinking strategies to defeat Unthinkables such as Rockbrain. The overall concept taught to the kids is that Superflex lives within each of us. We can apply flexible thinking strategies to situations in which our own cast of Unthinkables attempts to influence us to make bad decisions when we are solving social problems. Garcia-Winner has also used her social thinking concepts to create a book for teenagers and young adults called Socially Curious and Curiously Social.
I have received permission from Ms. Garcia-Winner to work with the American Printing House for the Blind (APH) to make her series of social thinking books accessible to students with severe vision impairments or blindness. The project will take several years to complete. It will involve transcribing the Superflex comic books into Braille and will include tactile graphics and hands-on props for the various Unthinkable characters. It will also call for the creation of nonvisual alternatives for Garcia-Winner's intervention strategies and activities that are highly visual in nature. I am currently using Garcia-Winner's curriculum with groups of elementary and middle-school students at OSSB to address their social thinking skill challenges and develop ideas for the APH project.

DKS: Can you give an example of some of your adaptations to Garcia-Winner's social thinking books?

BP: Okay, here's one we've used at the school with kids in third to sixth grade. They had to work in teams. We gave them foam blocks and each team had to build a structure in five minutes. Every child on the team had to add two blocks to the structure. Sighted teachers also participated and some of them were placed under sleepshades. When we looked back at what happened, we saw how much the kids and teachers with sight took over. The students and teachers who were blind were often encouraged to place blocks at the beginning and afterward sat passively behind the other students. That exercise provided students and staff with an authentic experience for discussing such concepts as perspective taking, assertiveness, cooperation, inclusion, teamwork, and problem solving. Such hands-on experiences are exactly what our students need in order truly to make sense of and remember Ms. Garcia-Winner's social thinking skill concepts.

DKS: Talk about some of the things you're doing to give kids those opportunities.

BP: For the past five years we've been working with a program called SAVE, which stands for Strategies Against Violence Everywhere. Approximately thirty kids from the school are currently involved, from seventh grade through high school. The SAVE program teaches the students conflict resolution skills that they implement through creative arts experiences. The primary project is the creation of a video portraying how to implement conflict resolution strategies in dealing with real-life problems. Through the video, the students look at the conflict and apply thinking skills, coming up with alternative ways it could have been handled. Some of the kids in the program will be mentors to our elementary-school kids. The idea is to work toward becoming a peaceful community.

Art is another facet of the SAVE program. Recently kids made a mural around the theme "My Peace-Filled Place." Now we're planning to use this concept to make a quilted mural. The process of making the quilt is peaceful in itself. The quilt will communicate how students and staff are connected and mutually responsible for creating a peace-filled school community.
We also take the seventh- and eighth-graders each year to an adventure camp for a day in May. The students are given the choice of completing a high ropes course or doing hands-on activities in a wilderness setting. Both options teach and reinforce perspective taking, assertiveness, cooperation, inclusion, teamwork, and problem-solving skills. Adventure camp is a great teaching tool and confidence-builder as the students transition to high school. Every student who participates finds the experience to be highly meaningful.

DKS: Let's go back to the relationship between the blindness and autism communities. Tell me more about some of the collaboration that's starting to take place.

BP: An intervention planning system that's being used now by many professionals in the autism field is called the Ziggurat Model. A ziggurat is a five-tiered temple built by the ancient Assyrians and Babylonians. The five tiers of the temple were step-like levels diminishing in size, from a large foundation to a much smaller top level. The Ziggurat Model gives us a way to address all of a person's needs in a step-by-step format organized into five levels. When you think about a student, you need to look systematically. You need to identify his/her strengths and needs at each level in order to design effective interventions.

DKS: What do the levels consist of?

BP: The foundation consists of understanding the child's biological needs and sensory differences. It includes medical issues and processing challenges such as tactile defensiveness and auditory sensitivity. The next level looks at what we're doing to encourage a student to develop skills and reinforce those skills as they emerge. This includes such things as providing specific rewards only when the child exhibits specific targeted social behaviors.

The third level is tactile, auditory, and, when appropriate, visual environmental support. What kind of environmental supports can create a consistent and predictable environment? What supports can help the student get beyond rigidity in dealing with change? We need to create an understandable learning environment, building in supports to help the child learn effectively. Level Four is concerned with task demands. We need to understand the child's developmental level in order to provide learning tasks that are neither too easy nor too overwhelming. Level Five consists of prioritized skills for the individual, determined by the student's intervention team.

The Ziggurat Model encourages the educational team to look at the whole child and leads to a more meaningful understanding of what we're teaching. It's a way to help the child make sense of the world as you teach. Instead of starting out with teaching, you lead up to it. Instead of listing deficits the team identifies the student's developmental strengths and builds intervention ideas from there. It is a strengths-based model that gives the team a way to understand each child systematically, not to miss anything.

As I've said, this approach comes from the autism community. I feel it's a very worthwhile investment for our kids. It can be hard to understand our students when they come in with complex issues and the team needs a framework. I have worked with the authors who developed this system and there is sharing in both directions. They have incorporated a lot of our ideas. After listening to us, they've made some changes in what is on the Ziggurat. They have added auditory and tactile supports in Level Three. A lot of the things that help blind and visually impaired students are also helpful to sighted kids with autism.

DKS: What do you see as the future of work between the blindness and autism communities? Do you feel that the climate is right for other collaborative efforts?

BP: We haven't really bridged the gap, but at least we're interacting more. Overall, the autism community still doesn't get us. They tend to see blindness as a very separate issue, and we end up getting lost. There is a lot of great research going on. A lot of teaching strategies are being developed that we can tap into for students with severe vision impairments or blindness, but there needs to be serious thought about how to implement those strategies in nonvisual ways.

Actually this is a great time for professionals in the blindness and autism fields to connect. The Internet makes communication easier and more available than ever before. Professionals can build online communities for sharing ideas and developing best practices. Information sharing is still in its infancy. With time and commitment it can evolve in ways we probably haven't even imagined.

Right now we need people in the blindness and autism communities to reach out to each other. We have to find people who don't accept the status quo, who are willing to push the envelope of thinking. We need to get our ideas out to others around the country and overseas and to learn from what they're doing, too. Someone in Brazil or China may have discovered something valuable and we need to know about it. This is all about our kids. It's about wanting the best opportunities for all of them.

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