Understanding your learners who have troubles with spatial awareness with Lil Deverell and Marnie Roth
When our learners aren't performing the way that we expect them to be able to because their spatial awareness issues are not allowing them to make the decisions that we think that they should be able to make by now, we often internalise it. But what if it's not necessarily us? What if there are things going on underneath the surface of spatial awareness? That's exactly what we get to dive into today, with our guests, Marnie Roth and Lil Deverell.
In this podcast episode:
Background Introduction
Who is Lil Deverell and Marnie Roth?
How they came up with the presentation topic
Lil and Marnie’s key learnings
Taking a step forward
Transcript of the Episode:
Background introduction
Welcome back to the podcast, my friend. I'm so glad that you are here. It is no secret that this time of year is my absolute favorite because we get to not only anticipate the amazing presentations at the symposium itself, but we also get to sit down and have real conversations with the presenters.
You know, it's one thing to go to a conference and have a presenter just give you their information. And a lot of times when you go to a conference in and of itself, it feels like you're sitting down and the person is just talking at you, which can be really boring and especially if you're online that can be just excruciating. And that's not what the symposium does whatsoever.
This symposium is a three day live global experience, where we get to learn from not only the presenter, but also the people that are in the room. And these podcasts episodes really allow us to more so become friends with the people that we're going to be learning from to find out Why did you want to study this and how does this actually impact me? And to get a little bit of behind the scenes in a casual way. So that way we can really understand the full context of what we're learning about. And who we're learning from, because these are our people. If you don't know Lil and you don't know Marnie, that's totally okay. By the end of today. You will so pop in those headphones because it is going to be a good one.
Now, Marnie Roth stumbled upon O and M while studying ortho… I'm gonna say this wrong; Orthoptics. Why can I not say that? Orthoptics, but the keen interest in Low Vision Services. Although she's a mom to four teenage daughters, she is a big kid at heart and so loves working with young people. Marnie has spent many years working as an O and M including working specializing in Acquired Brain Injury children's one on one and group services and early childhood services.
As a Comms, Marnie has supervised many O and M students at guide dogs Victoria over the last six years, and is passionate about seeing future O and Ms being well supported as they launch into being O and M practitioners. Marnie now works as an independent O and M in Melbourne, working in schools and community with a predominantly young client base after launching confidence steps in July of 2022, which is her company, by the way, you guys. Marnie has upskilled to be able to re register as an orthopedist to be able to provide a holistic service to her clients.
Now, Lil, if you were here, a few years ago, little presented at the symposium and she does fantastic work in the world of spatial awareness and orientation and mobility in that she does a lot of research that I personally do not have the patience to even try to attempt to do nor do I have access to people. But her brain just works in such a really cool and fun way. I can't wait for you to meet her if you don't know her already. Lil has an ongoing fascination with things that immobilize us, including spatial dysfunction.
Lil has worked with diverse O and M clients since 1993, taught trainee O and M specialists since 2007, and developed functional vision and O and M outcome measures in the context of bionic vision research. She occasionally sees an O and M client but mainly works in an international co design team at IRA Research developing vision related assistive technology. This is quite a challenge for a tech weary O and M specialists. She has commercialized the Stewart tactile maps test so that O and M specialists can use this great assessment resource to assess a claim It's mental mapping capacity.
She lives in Melbourne, Australia, but enjoys talking with people worldwide in her RO&Ming with Lil podcast. And we're gonna get straight into this episode, but for the links to all of those things that we talked about will be available on the show notes. And at the end of the podcast as well.
Who is Lil Deverell and Marnie Roth
Kassy:
Alright, so hi, Hi! I'm so glad that you guys are here Lil, Marnie. I love the work that you were doing. It's so needed in the world. And I'm just excited to have you both on our podcast today.
Lil and Marnie:
Thanks for having Kassy.
Kassy:
Yeah! So Lil, I know you've been on the podcast before but Marnie, you are new to our community. So can we start with you, Marnie, and have you tell our community a little bit about yourself?
Marnie:
I'm an orientation and mobility specialist, I have worked in the field since 1998, or seven, something like that. A long time with a substantial break while I raised my children. I came to O and M via orthoptics. Studied orthotics at Latrobe University, was really interested in the low vision aspect of orthoptics, which is not the kind of the common part of orthotics in Australia. And it was quite hard to break into at that time. So then I learned about O and M and I was like, that's the job for me, I get to be out and about in the weather. Usually, that's a good thing, but not always. And so then I've went on and studied O and M and worked in that industry. Work as an O and M for a long time at various agencies, and then five months ago, decided to start up on my own, went back and re-registered as an orthoptist. So that I've added that back into what I offer to my clients.
Kassy:
So Wow. So you have experience both areas, the scientific, medical, as well as the educational model. How do you feel like that has really created your perspective on how you see things that might be different from other O and M specialists?
Marnie:
I think that gives me a really good to start with. It gives me a really good understanding of the vision system and allowed me to cruise through that aspect of the O and M study, because I knew all the anatomy and the what the functional implications could be. I guess it helps also, for me to bridge the gap between for my clients between that medical hedger eye diagnosis, and, and what that means functionally, because I can read those reports, I know what that mean. I can put it in layman's terms for the clients so that then they can understand what it means in a clinical setting, but then talk to them that help means in a functional setting, because they often don't marry up, you know, what you see in a clinical setting is under ideal lighting conditions and with high contrast, and that's not the real world. So I think having that round really allows me to explore that with clients and help them to understand and have the right questions to ask when they go back. So I want you to do this, I want you to, I don't know what you mean, when you say that to their doctor and be comfortable to say that. So I think that's the main thing that it gives me. To be honest, when I studied orthoptics and finished, I was like, most of what orthoptist do bores the life out of me. And I couldn't imagine doing it with only the low vision component, we get to actually see a benefit that really interested me.
Kassy:
So I just love that. And I was actually going to ask you that question, but you touched on it. Because you have experience in both. You can send your clients to their doctor with a list of like actual questions of like, how does this work in the real world, we see that all the time, where you will get this acuity, and the learner doesn't know what that means. And oftentimes, like the parents don't know what that means. And they don't know what questions to ask. And I've had even like, my own child has very low hearing loss, and putting him in a clinical setting. They're like, Oh, no, he's fine. And I was like, you know, so having a tiny bit of knowledge, I was able to go visit him in his cafeteria and do like a tiny bit of testing and be like, Oh, we're gonna need to, we're gonna need to go back to the doctor and actually ask some questions. So I bet just you having so much knowledge and information really helps to support your clients in that way as well. So that's really cool. Yeah, yes.
Lil:
The other thing I find, Kassy, is it's fantastic when you're working in a team as an O and M specialists to have an orthopedist or two on hand. And if they're dual qualified as an orthoptist in an orientation and mobility specialist, you just get the best of both worlds because they're already, you know, thought through the kinds of questions that we're wanting to ssk and we’re able to draw on the specific information about low vision aids or what's likely to happen to that client's vision in the next year or two years. Am I right in thinking, Marnie, that most orthoptists would find employment with an ophthalmologist supporting that clinical testing and just a handful go out and do community work in functional practice?
Marnie:
Yeah, absolutely. I would say it's probably 95% that work with ophthalmologists. When I finished, unless you've done further study, your honors or a PhD in low vision orthoptics, you just weren't going to get a job. Whereas now there's a few more opportunities. There's more knowledge of how an orthopedist can support someone with low vision to make most use of their functional vision through magnification and lighting. About the time when I do that, it was just there were two jobs in our state of Victoria. And they'll both firmly stuck where they were and there was no way they were getting out so. But now there is a little bit more opportunity. There are a couple of orthoptists, including myself working independently, providing that magnification assessment and being able to make recommendations for how to support someone with their reading goals or as an O and M. It's also for binoculars for reading bus signs or street signs that I find that magnification knowledge really helpful.
Kassy:
Right. Okay, we're going to take a quick side note. Lil, I do want to introduce you as well. However, we've said the word orthop... Oh, my gosh, I keep saying wrong! Orthoptist. I don't know why I cannot say this. Orthoptists. I say the R… okay. We've said that word a few times. And when we first came on, before we started recording, you had mentioned it and I was like, What is this? What happened to the rest of the word? So can you kind of describe what you do? And then I will put it into, you know, American terms? What like, what would your job description look like?
Marnie:
As an orthoptist? So for my particular part of orthoptics, which is not true of all orthoptics in Australia. But for me as a low vision orthopedist, I help people to understand what vision they have remaining. Often, it's a conversation about what that prognosis might be as well, because they may have heard something in the doctor's office and not really be able to understand it. So helping them understand what that eye condition is, what it means now and what it might mean in the future. And then also looking at what their goals are particularly around reading or near vision tasks.
So might be puzzles or crosswords, it doesn't have to be reading gold, but it might also be reading, you know, university, research material, or reading their child a book at night, whatever their particular reading goal might be. And looking at the different magnification tools, handheld CCTVs, there's lots of different options out there from a number of different providers to find the best fit, also looking at task lighting, which can make a huge difference.
So adding in the right lighting conditions, or changing the position of the desk, or wherever it is that you're reading your child's story before bed, can make a big difference as to how much you can actually read that text. So making recommendations around the magnification and then yeah, writing to funding bodies, if that's part of it, which is usually the case to have that supplied.
Kassy:
And so do you also do the evaluations as well? I take it?
Marnie:
For the vision
Kassy:
Yes.
Marnie:
So well, I'll usually do more functional look at their vision, because I'm looking at their ability to read in the position they want to read. So they have their favorite chair in the lounge room. How do they read there, as opposed to as we've talked about, the clinical setting is very different, they have the ideal condition, with the maximum contrast and that's not the real world. Books aren't crisp white pages with thick black writing. That's not the real world. So assessing their vision in a functional setting. So show me… I go to people's home so show me what you would like to do, and then make little suggestions. So they still want to sit in their favorite chair. But maybe if we turn it around, we'll get rid of the glare and we can add a task light. And it might be easier to achieve the goal they're wanting to achieve.
Kassy:
Thank you. Lil, and I'd love for you to introduce yourself too.
Lil:
Well, I'm Lil and I've been working in the O and M field since… well qualified at the end of 1992. So that's a long time ago now, thirty years. I've enjoyed during that time working a lot with children with multiple disabilities. And this is a situation where I found it so valuable, being able to request a co assessment with an orthoptist. So the person who taught or was initiating the orthoptics program at Latrobe that Marnie did, she was an expert in eccentric viewing and taught us all about eccentric viewing, you know, particularly working with adults and how to increase people's, you know, focus on literacy-based tasks in the clinic and then encouraging us to transfer those skills to looking for cars along the road and that kind of thing.
But when working with kids in special schools who have multiple disabilities, on one occasion, I called an orthopedist in to assess a boy with CHARGE syndrome. And she arrived with a big suitcase full of toys, and I was just fascinated, I sat back and watched the play. And she was using this big suitcase to see which toys the child was drawn to, which ones he piffed, which ones he sat with, the longer. She did lovely things like offer him slices of kiwi fruit on a green plate. And sure enough, he looked, he looked away, he reached and these are signs of course of CVI. And so I learned a lot about how to do functional assessment of low vision in that nonverbal context just by working together with someone.
Another girl I was working with was in a classroom with five kids, all of whom were nonverbal, and had multiple disabilities and this girl love to lie on the hammock in the classroom upside down hanging over the edge and just swinging until the orthoptist came in, and told me she actually couldn't raise her eyelids. And so being upside down, gave her a much bigger field of view of what was happening in the classroom than when she was sitting up right in her wheelchair with her eyelids sort of hanging low, only being able to see her needs in the wheelchair or having to have us present something kind of right under her nose.
And this is where the coming together of that anatomy, physiology and a deep knowledge of the vision conditions, together with our functional observations in more dynamic places. Just such a benefit, having that specialization. And I don't know, Kassy, is that what you know, as low vision rehabilitation with that certification with ACVREP?
How they came up with the presentation topic
Kassy:
I'm not 100% sure. I think the way that you guys do things is just a little bit different. As far as, at this moment in time for the podcast, I can't figure out you know, many of you go in, like how your services are structured. But I'd love to continue that conversation maybe at another time. But for today, because I am very curious. You guys talked about teamwork. And one thing that was really cool. And really very evident was the teamwork in the presentation that you guys are going to be doing at this symposium. And, of course, when Lil involves, it's all about spatial awareness, because you are the go-to every time somebody asks me anything about spatial awareness. I'm like, have you met Lil? Here's her website, go check that stuff out, because she has much more prolific thoughts than I would have ever had without knowing her. Which is so cool. Because I get to know you. And we all do. Everybody at the symposium gets to know you and gets to learn from you guys, and you're all the way across the world and we don't have to go all the way across the world.
So would you like to share a little bit about how you guys came up with the topic that you guys are going to be presenting at the symposium? I know there are two, you know, people in your study and things… How do that evolve? How did that happen?
Lil:
I had the privilege of presenting a keynote to the Swarmer conference last year with Dr. Ian Stewart, who's the neuro psychologist I've been working on thinking about spatial dysfunction with for about 30 years. Well, Ian's getting on a bit now. And he says little we've got to get on and finish this work. I said you're feeling your mortality? Andhe said definitely.
So we continue to assess people together. And we've had this opportunity to go back and assess someone 35 years after Ian's initial spatial assessment in a 15 year old’s school context. And this has been fabulous because what we've realized is there's been absolutely no spatial learning in 35 years. This is a man who's disorientation is just as entrenched now at the age of 50. As it was, back then, when he was 15, and in by all kinds of dire prognosis about what this man's life would become, but he's actually… his mom, I supported him to find his thing, which is playing violin and singing. And I just went to see him performing with his male Welsh choir a few weeks ago, and it's just a privilege to have that. And yet at the same time, he gets lost wherever he goes, he needs to be an accompany traveler.
So when Marnie and I have the opportunity to offer different aspects of and O and M program to a 15 year old, and we're both looking at it from our different O and M perspectives, I'm thinking about spatial function, and Marnie has done lots of work in the school context. And again, why does this guy keep getting lost. So I asked Ian to come and assess him for the first time. And to my astonishment, his tabletop tasks involving block construction, and the Stewart tactile maps were brilliant. So there's nothing wrong with the parts of his brain that interprets spatial information and memorize it. The problem starts when he leaves the front gate. So what's going on? Over to you Marnie.
Marnie:
So I've worked with this young man for quite a few years, probably since he was about nine years old, so six years. And I would have said he has quite poor spatial awareness. I've done the Stewart tactile lines, and got a moderate sort of response that he was not as bad as I expected. As he appeared functionally, he performed quite well on the street tactile maps, but not fabulously, as Lil saw in the more recent assessment. But in a functional capacity, he gets lost all the time. And I questioned whether he actually had the ability to make a mental map, and then be able to problem solve and put together his environment.
I guess, if we go the next step, what's happened is he's gone to a new school this year. So obviously, our school year starts in January. So he's been there for a whole year now. He has a much more welcoming environment for him. There's a lot of diversity in the school in terms of learning needs. And it's a very positive environment for him. It's also quite a structured school in terms of the layout of the buildings, there's one main corridor, and there's ABCDE wings that run off that main corridor.
So and what I've found over the year, is he can mental map and he can mental map very well, when he's in the right mindset. So if he's stressed, he can't find his way out of his classroom. But when he's calm and relaxed, he can engage that mental map. And what I found is the more that he has success in O and M, which is really this year is the first time he's had success in O and M, I would say over his life. He now has some more confidence, which then it's snowballing. And he now knows he can do things. So he's less stressed entering O and M.
Because he used to know I was coming. And he would avoid going to school on the days that he knew I was coming. So then we had a period of time where we didn't tell him I was coming. The school knew I was coming, his parents knew I was coming. But we didn't actually tell him until he arrived at school so he couldn't refuse to go. Because O and M was so stressful for him because he really found it's so so challenging.
And what this year has shown is that in the right environment, when he's calm, and the environments a little more structured, he actually is able to demonstrate what he can demonstrate on a tabletop task that he has good mapping skills, he can now put into play. Not all the time, if a child says have a go at him or something at recess, and then I show up next during his next class, we have to really work to get him calm before we start, because otherwise, he'll walk out and he'll turn the wrong direction, his frustration goes up. And then he feels like he can't achieve anything. So it's really about having that. Helping him to understand and see for himself. If I can self regulate and be nice and calm. And before I set off, I'm going to have success. So rather than storming off, which can be his go to when he is frustrated about something. It's a teenage boy after all, that's probably pretty normal, that he can't himself so he doesn't end up exacerbating. He's getting lost.
Lil and Marnie’s key learnings
Kassy:
Wow. Okay, first of all, thank you so much for sharing all of that information. A few years ago, when Lil present it at the symposium, one of the big things that was my big aha moment, from that presentation on spatial awareness that I had never really thought about, you guys are kind of bringing it up again, is, we have this idea that spatial awareness is fixable in everybody. And if we don't see improvement, it's our fault as the O and M specialist. And then we internalize that and we get stressed. And I call it the cycle of burnout. When we start to internalize the lack of results that we expected to see, because who sets the goals, it's us, like, we're setting the goals. We're the ones working towards it as our profession.
Of course, our clients and learners are working towards it as their life. But when it does happen, we can internalize that and it was Lil who first brought up this idea of like, maybe it's them, you know, like dating analogy, like, it's not you, it's me, like, maybe it's not me, maybe, maybe it is them. And that spatial awareness isn't something that I should expect from everybody.
But what I'm also hearing is, you know, there's a difference between static spatial awareness, sitting, being able to do something on the maps and then dynamic, as in moving around the environment. What you're bringing up, Marnie is something that I've never considered before, which is the idea of trauma and stress on that system. So have you guys found that trauma and stress have like an effect in the brain? Can you briefly, because I don't want to step over into what you guys are actually going to teach us in the symposium, you can briefly like, share the correlation there that you guys have found?
Lil:
One of my key learnings from working at guard dogs Victoria, over 30 years has been around acquired brain injury. Because that organization has built particular strength in working with adult clients who have acquired brain injury from because they've gone to rehab hospital across the road. And there's been a lot of collaboration and Ian Stuart has worked between the two as a neuro psychologist.
One of my key learnings in that space has been around fatigue and attention. So whereas I might work with a 60 year old with age related macular degeneration, who gets visual fatigue, from struggling to see and work out in the community and make best sense of available low vision. If I work with someone who's had a stroke or a head injury, and I'm going out and working with them, in even the same environments, there will be an abrupt cut off to their attention. And we call it the neuro yawn.
When you see the neuro yawn, no further communication will be entered into. You just wrap up the session, get out of there and start fresh another day because that client with acquired brain injury, like they just have had enough. It's not a slow developing fatigue, just this abrupt cuddle. It's very similar to what we see in someone who has a trauma response. So all it needs to be as a sound trigger or a memory and bang, that person's suddenly becomes dysfunctional. It's not that they gradually get tired.
And when they suddenly become dysfunctional, it can happen is that fight, flight or freeze. And you know, as a kid in school, I certainly heard about the flight and fight. I didn't know so much about the freeze and the other one that I've learned about since is actually born. So in order to cope with this untenable situation, some people just need to latch on to someone who can make the decisions for them. And that's what we see a lot with this young man.
Can I take your arm? I need sighted guide. So he has cultivated his own dependent behaviors and taught everyone else that that's what they can expect of him. As well as a thing, you know, the fight flight and freeze behaviors as well. Oh, that's interesting. Where's the trauma? Because I'm thinking Vietnam veterans. And I certainly know guide dog mobility instructors who work with returned vets and use the dog as that softening safe space for people dealing with PTSD.
So the really interesting thing in the conversation with this young man's mom is she says, Oh, there's capital T trauma. And then there's small t trauma and small t trauma she says is death by 1000 cuts. It’s those, when you're congenitally blind, it's when there's explosive behavior around you that might have frightening consequences in one instance, and make you feel really unsafe. And you learn that any explosive noise or behavior that happens around you might have those consequences and you start to freeze or fight, or run away or hang on to someone who feels safe. This has been astonishing to me, because it's shifted my thinking about trauma informed practice, I've heard a lot about trauma informed practice in relation to people escaping domestic violence, or experiencing big one off traumas, but I've never really thought seriously about what it's like to be congenitally blind and repeatedly in situations that are socially frightening.
Kassy:
Yeah, that reminds me, I've been reading the book, The Body Keeps the Score. Have you read that? And as I'm reading it, I had it as a library download, like on the app, right free library book that I just downloaded to my Kindle. And I actually had so many highlights that I didn't want to give up that I bought the book. And I've been rereading it. And every time like I bought it, you know, for myself, my own reading my own personal development, it's been one of the most life changing professional development books that I've ever read, because there's so much trauma that goes into being a person with a visual impairment that I had not even thought of until I started reading this book. And I was like, oh, that's, that'd be what my students go through. Oh, that's, that happens a lot. And you're right, it's these teeny, tiny micro aggressions against our sense of safety and against our sense of self. That really, as you said, it's death by 1000 paper cuts, it really just erodes. And I also wonder if that's where learned helplessness comes from, there's just so many of those instances, and maybe it's a fawn response or freeze response. And then people start to like, take over and compensate for that. So this conversation is just really interesting.
Lil:
These perceptions were perhaps inspired or reinforced by this young man's psychologist. Manny, do you want to say,
Marnie:
Yeah, absolutely. In the early days of working with him, I found it very frustrating. I hadn't worked with someone who exhibited consistent behavior. He would get quite aggressive. He would throw his cane. He would undo his cane in my direction, knowing that it was coming towards my head, you know. There was a lot of… He would swear at me, you know. It was this real… he really hated O and M. He doesn't like me. We've come to a good place now many years later, through understanding his psychologist has been an invaluable support to me. Because there would be times that I would show up, and we wouldn't actually do any O and M. I'd try and negotiate with him, try and get him to do a little bit. But since I learned that when he was in that state, there was no point I was adding to his trauma by trying to make him do it.
So his psychologists was incredible, and provided me a lot of information about trauma informed practice, said to me, I want you to think about him as someone who's had significant trauma in his life. Because I hadn't had that conversation with his family, I was not aware of any particular trauma in his life. But the information that psychologists gave me totally changed how I looked at the situation, it was a complete turnaround. And I felt terrible for how I'd been engaging with him, because I was engaging with him as a belligerent teenager who wouldn't participate, when in actual fact, that was not at all what was going on. And understanding that trauma has really shifted how I interact with him and how I engage with him. And we have a much more positive relationship now because I understand where he's coming from. And I can see when he's heightened, and rather than adding to that by saying, come on, come on, we just, you know, just do 10 minutes, because that was what we aim for. Rather than doing that. Let's just sit down, have a chat. Let's see if I can get him to calm.
And now he's at a point where he can self identify, and, and I can say to him, how do you think things are gonna go if you set off while you're feeling like this? Oh, I'll probably get lost. Yeah, okay. So why don't we take a breath, let's sit still. See if we can take some deep calming breaths and get you to a place where you feel like you can engage that part of your brain. He's one of the most intelligent people I know. He's like off the charts intelligent. So being able to talk to him about that. It's like, you have this part of your brain that works really, really well. But when you're like this, it's not working. So we need to get yourself calm, so that you can engage that part of your brain because I can't do it for you. Unlike something you can do. So he's got some awareness around it now. And I think that's come from me understanding what was going on and being able to approach him in a way that works for him. So it's not something I knew a lot about, trauma informed practice and a psychologist was such a great help in understanding that.
Kassy:
Yeah I can imagine. And, you know, it kind of makes me think a few things. And that, A, as teachers, we talked earlier about how we set the goals. But really, I've also been in situations with students with low vision, who didn't want to use a cane and our relationship was very rocky at first, you know, or, I've had a student with multiple impairments, who was younger, who would just like refuse to work. And I always felt like shame in a way, on the days where the most that I got him to do was to sit in a wheelchair, like office wheelchair, and I wheeled him around the building. And that was the most that was happening. And sometimes it could just be like, I wore the wrong kind of shoes, he wanted me to wear a different kind of shoe that day.
However, the behavior manifests, it manifests. But it's probably along the same lines, of course, you wanted your learner to reach for their goals. That's what we're there for. And there is like this level of pressure that we have to report on this, and sitting down to say, Hey, today, let's just have a conversation and get to calm and you have that information to help him self identify, is going to change his life.
Lil:
Kassy, there's a lovely threshold concept in medical education for doctors called active inaction. And we actually uphold that when we move from semi solo to solo. And there's always a tension when you've taught a client to do a route, and then you shift to solo because they've shown they can do it semi solo with you're looking. How you should ethically… How should I spend my time, I'm accountable to my employer for how I spend my time isn't actually good use of my time professionally, to drop off a client at the beginning of a route, and then not follow them for the next hour and a half. But make them at the other end. And I would argue that it's absolutely essential for some clients to not watch and to not engage.
Maybe I have busy work to do, maybe I scoot around and you know, get yourself a nice beverage at the endpoint so that I'm there when I arrive. But it's a profound act of trust on my part, that the client can do this. And to be able to say, genuinely, I did not watch you and you did it is really, really important for the client. On the other hand, if I have my suspicions that dodgy things might happen, I will willingly do a sneaky solo. I won't profess to have not watched, I will simply ask questions that are guided by my observations, but that don't disclose that I've watched that invite the client to tell me where there's something unusual happened and whether we need to do some supplementary work before I sign off on that program.
So it brings us back to all kinds of questions around active inaction. And when it comes to making good use of our time as O and M specialists, we can easily feel that we have to be terribly busy whenever we're with a client. But I found that the opposite is really important. It's the time that you spend debriefing or getting ready to go out at the kitchen table. And when someone has a meltdown and they’re chucking their cane around and what's that it's the time that you spend not talking, not answering those questions. Pick up my cane for me, pick up me cane for me. No. And you wait, and you wait, and you wait.
Because it can actually be a power and a refusal on my part to get sucked into reinforcing learned helplessness and breaking that pattern. And it's tough love. And I have to make judgements along the way there about whether this is where tough love is needed. Not by being assertive or aggressive or overbearing, just by shutting up and waiting, or whether I had to believe need to be more kind in order to support someone who's in that trauma informed place. And I’m not instinctively a particularly kind person, so it's probably better that I just shut up and wait. I suspect Marnie is a little bit kinder than me. And so she finds active ways to engage while waiting for the client to be ready to get going again.
Taking a step forward
Kassy:
Yeah, I think you just hit the nail on the head down what my next question was going to be, you know, like, once we have this information, what do we do with it. So, that just really tied everything, our whole conversation into a nice little bow, I'd love to end the majority of our conversation on that note and leave the floor up to you guys. I'm so excited for your presentation coming up at the symposium. I think it's going to help to skyrocket really our O and Ms teaching skills and our ability to decipher you know what's really going on behind underneath the surface. But if you guys have any last words of wisdom as to how our community whether they join us at this symposium or not, we love them either way, how they can take a step forward into becoming better O and M specialist, what would you share?
Marnie:
I think my big takeaway from working with this student, I was working with him when I was at guide dogs, I was given his case as a really experienced O and M. And what I learned over that process was that I was lacking the experience that I needed. And I think probably most O and Ms are in that I didn't understand how trauma was directly impacting his spatial awareness and his ability to navigate his world. And the more he struggled to navigate, it was like it added to the trauma with every attempt he made, and got it wrong. And he's a high achieving students, so to not do well at something is devastating to him. So he's not used to it. And it's, I think it adds to his trauma. So I think the takeaway is really that, you know, there's, I guess we all know, we're always learning, but to go out and research trauma informed practice to understand how trauma might present, because it had never occurred to me that this child had trauma in their life, and the impact that all of our students have have that having to do things differently, having people questioned them having to justify what they're doing, is adding to trauma.
Kassy:
That's great, thank you.
Lil:
I take a step back on learning amazing things about trauma and see the immediate application in this context of apparent spatial dysfunction that we feel quietly confident will be able to unravel so that this young man will be a very capable traveler as an adult. I step back though, and think about this wearing my ACVREP subject matter expert committee had. We've had the privilege in the last few years of revisiting the body of knowledge that gets taught in O and M professional programs. This situation highlights for me how important it is to not just draw on the wisdom that we've had since the 1940s. And setting up our profession, with a fabulous focus on mobility skills, blind mobility skills, and right strategies that we can teach the people who are capable of mental mapping, it's time to come back to that body of knowledge and make sure that we include new learning about how spatial learning and spatial dysfunction works, and how we need to be responding to clients in working out the cause of their spatial dysfunction and what to do about it. And I think that the new learning more broadly across our allied health and medical professions and teaching about trauma informed practice is profoundly important. And we need to be teaching that into our University on in programs. Because it's such a game changer. It really is.
Kassy:
I agree. Well, thank you both so much for being here. I absolutely cannot wait to share this information with everybody. Lil we will put your STUART maps and your website on the show notes. Marnie, is there anything you want us to put on the show notes here?
Marnie:
You can link to my website. Yeah, it's pretty basic, because I don't think clients find me that way. But yeah, by all means, link to my website. Yeah, www.confidencesteps.com.au.
Kassy:
I love it. And little Are you still at lildeverell.net.
Lil:
That's right. Yep. For my RO&M website, researching orientation and mobility.
Marnie:
I just add, I don't know if it fits into the podcast somewhere. But I think the way I look at spatial function with my clients has been guided by working with Lil being in the same office and having that understanding that not everyone has good spatial function. And it doesn't rest with me as the O and M. So I think that has been really pivotal in how I approached this young man. And I had probably put him into that category of, even though his STUART tactile lines, when I'd assessed him had something, I was still thinking, you know, he might just be one of those people. And I had confidence that that's okay to say some people can't mental map, and they will be a company traveler. And we aim for the the most independent, but I think having worked in the office with little allowed me to feel like, yeah, that's the thing. It's not my job as the O and M to fix it, because I can't, it's how their brain works.
Kassy:
Yes. You just like, you put it all in one sentence. The relieve that I felt when I realized it's not necessarily nice, sometimes it's me, sometimes it's not. And what we need to do is dig deeper, and look at the levels underneath the surface to really tease it out. Because there's so many different things to look at. And now we're also including, you know, trauma as well, which is this is the first conversation that I've had about trauma informed O and M you know, or services of that nature.
So I really appreciate you both doing this research, sharing your knowledge with us going above and beyond and really, you know, bridging the gap over the oceans to help orientation and mobility as a profession get so much better because we can be so regionalised and then that creates just like small… everyone did, like small perspective or brains. And you guys really helped to elevate us up to that penthouse level where we could see just a lot further and know that we have access to other people all around the world. This is absolutely invaluable. Our community, our relationships with you guys, I absolutely could not do it without you. It is the joy of my life and I'm so appreciative of you.
Lil:
Thanks, Kassy.
Marnie:
Thank you.
I hope you enjoyed that. Talking with Lil and Marnie is such a joy. And I'm glad that we get to have this conversation with you as well. If you want to get in touch with Marnie, you can find her at confidentsteps.com.au and if you want to get in touch with Lil you can find her at lildeverell.net. And there'll be all the links or publications and her podcast. And of course, they will be at the symposium presenting as well.