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Adaptive Seating: Things to Consider

by Raymond T. Heipp. Ph.D.


SE Today-blog badgeThroughout my travels here in the US, I am constantly being asked questions about adaptive seating. There are so many questions and almost as many assumptions being made about these various types of seating. In the blog written by Andrea Simpson, she speaks of how an SLP can use a “Bitty Bottom” to assist in language activities. She adeptly discusses that as one of the manners in which to include the sensory and movement pieces into speech therapy.

In that idea, she hits upon the key point for any type of sensory feedback or, in this case, adaptive seating, there is no one-size-fits-all! That is the foundation from which I suggest we all operate. I recently was called by a principal who was absolutely frustrated. He had ordered chairs with moving seats for all of his third through fifth grade classrooms. He explained to me that he had read the stories and heard from colleagues as well as the manufacturer how wonderful these seats were for students with attention issues. Yet, after the implementation at the beginning of the school year, he found those classes were the least focused on studies and the hardest to control. We had a great talk and he came to better understand that while those seats may have been working well for some of the students with attention issues, they are not going to work for all students in the same way. Plus, for those students who were not demonstrating any attention issues, those seats became an excellent distraction. I simply gave him this analogy; imagine the seats being fidget spinners. Students who need the spinner and have been properly trained how to use it for their own benefit will use it well. However, it becomes a toy and distraction for all of the students who do not need it.  He understood that immediately.

So, what do recommend to schools? First, I suggest that they analyze specific student needs. You will have some students who need specific types of seating. There is plenty of research out there which supports how some students can actually increase their activity engagement when they are properly supported and comfortable; thereby deceasing environmental factors which limit engagement. If you are looking for specific research, you may want to involve your OT or PT as much of the research comes out of their realm. I remember the first article I used was Rigby et al in 1995 looking for ways to help those with CP and other physical health issues. The one point which is fairly consistent is that adaptive seating can be effective, but it must be geared toward the individual and cannot simply be assigned to everyone.

Special Tomato Extended Small MPSBy knowing the needs of the students, schools can then begin to look at what they have and what they might wish to have available. We will see products like Tumbleforms and Special Tomato seating which have their roots in assisting those with CP as well as being able to be applied to many more individuals. We also see Rifton chairs and other types of chairs which are meant to be a support as well as allow individuals to interact with classroom materials and others. Those are the types of adaptive seating which are recommended for specific individuals through the work of therapists. These are some of the easier decisions to make when it comes to seating.

The more difficult decisions come when the seating enhances focus and attention and does not carry with it ways to analyze exactly what a student might need. For these cases, I recommend a variety of tools for classrooms and therapy rooms to offer choice. Let’s face it, in our inclusive classrooms, students with differing abilities do not want to stand out from their neuro-typical peers. So, we need to think about these classrooms as an ability-friendly way of approaching education.

Those who have heard me speak know that I am a big proponent of using inflatable cushions as a support for a variety of students. It is ironic that Ms. Simpson referred to “Bitty Bottoms” as many realize I love this product and see it as a benefit for students who need it at the middle school and high school levels. These cushions are small, easily customizable, and can be carried in a backpack from location to location. I am always amazed too at the number of classrooms which use CoreDisk cushions with the teacher having one for herself, providing a wonderful model for the students, while sitting more comfortably at the desk.

Exercise balls are another common manner of adaptive seating. Please remember the following guidelines though if they are being used in a classroom. First, have a stand in which the exercise ball can be placed. It helps to limit the rolling that may not be easily controlled by some students. Second, make sure the exercise ball is the appropriate size for the students. If the students cannot place their feet flat on the floor while using the exercise ball, it is too large. Balance plays an essential role in using the exercise ball. Thus, being able to place one’s feet on the floor while sitting on the ball is important to the effects of the ball on learning. Third, make sure that the students have enough of a sense of balance and core strength to maintain a position on the ball. I have heard stories of students sitting down and going right over on to their heads because they did not have enough core strength to use the ball properly.

Specialty types of seating for sensory feedback like Beanbag Chairs and Scallop Seats may be quite appropriate for students too. Those of us who lived through the 1970s have had experience with Beanbag Chairs. The irony is the flexibility within those chairs is perfect for some of our students who need feedback at multiple points throughout the body. Although associated with being a calming and relaxing method of seating, these chairs have also proven themselves to give enough proprioceptive feedback to the body allowing the students to read or review information with limited distractibility. Scallop Seats are great for positioning students, whether on a floor or on a chair. Although some might look at them as a modified booster seat, they are actually an excellent way to add some texture, upper body parameters, and posture support for students.

There are many more types of adaptive seating out there, so the process of determining what is best can be overwhelming. By starting with a review of the school’s students and a cataloguing of what is already at the school, one can begin to piece together a plan for seating support in all classrooms. Remember that there is no such thing as one-size-fits-all. Speak to your vendors and see who is willing to let you try products before you buy. That way, you get a better sense of what will work along with having a great return on your investment.

As always, if you have any further questions, please feel free to reach out to me at rheipp@schoolhealth.com. We are all in this to help individuals with differing abilities, so I am here for you. We know that everyone has a voice and sometimes that voice is stronger when we do not have the distraction of an uncomfortable seating arrangement!

Of Electrical Blackouts and Sensory Overload

by Raymond T. Heipp. Ph.D.


SE Today-blog badgeThis past August, I was reminded that this was the 15thanniversary of the electrical blackout that affected the East Coast and parts of the Midwest. I can vividly remember what I was doing during those days.  The power went out just as I was beginning a multi-day training for new faculty members coming into my high school. Of course, the first comment someone made was “did you guys forget to pay the bill?” I was tempted to get rid of that rookie for making such a lame joke and showing no real creativity there.

Needless to say, the next few days were interesting. We still had the training but altered where and how it was done. I completely understood that we would have to delay any training on technology or academic online systems but didn’t understand the presenters who could not present without their PowerPoint slides. I think the new faculty came to understand that adjustments can be made no matter what the situation when we did things like having a peripatetic discussion on teaching methodologies one morning around the neighborhood and having our “fancy dinner” change into grilled burgers and salad. There is definitely a lesson to be learned from this as some adjusted easily and others experienced difficulties.

I hope that you do not experience any electrical blackouts throughout this year! My greater concern though focuses on classrooms and buildings which create sensory overload for our students. We must be aware that every human being has sensory needs and triggers as we put together our classrooms and the activities within them. We also are reaching a time where I am seeing more schools adding a “sensory room” for student use.

Sensory rooms are good for all students and not just those with differing abilities.  We need to understand that a good sensory room varies from school-to-school. I have seen schools and institutions which have put in $50,000 Snoezelen Rooms which work very well. But as a former administrator, I recognize that very few of our schools have that type of a budget for sensory. So how does one go about creating a good sensory room? Talk to others who have them and then talk to those who can help you make them a reality. A good sensory room can be designed inexpensively and effectively as long as you know what you are looking to accomplish and are not seeking the quick and cheap way out.

Sensory RoomThere are sensory room kits that have many of the items you might need to create a sensory room. First you need to determine what kind of a room you want. Do you want it simply to be calming or be calming and interactive? When I say interactive, I refer to the fact that the user can actually dictate color schemes and devices to be used as they calm down. A sensory room that gives this control to the user is available for less than $18,500. The items in those kits include things like Bubble Tubes, Fiber Optic Showers, LED Sensory Projectors, and Fiber Optic Star Carpets. All of these can be purchased individually too which makes it easier to manage. Calming Sensory Room kits can be purchased for less than $8000.  The difference with these kits is that the users cannot dictate color schemes or how things will flow within the room. Either way, these items can bring students on the verge of a meltdown to a more calmed demeanor quickly.

I visited the STEPS Academy this summer and watched how they designed their sensory rooms. Each room was a different theme (space and under the sea). There were high tech and low-tech items in the rooms. They did have one of the Fiber Optic Star Carpets and it was fantastic to watch the children come in and just sit right down and decompress. For me, the critical piece to the design of a sensory room is knowing your students and what they like.  STEPS is definitely aware of their students with their themes and assortment of items that stay within the theme while giving sensory input.

We need to carry this awareness into our classrooms too. Classrooms do not need to have Fiber Optics or Bubble Tubes, but they do need to be aware of sensory overload. Too many pictures and items on the walls can be distracting for any student and downright overwhelming for others. Be creative, just not Jackson Pollock as you put your room together. Have meaning and purpose to what is displayed. One can go into just about any Chemistry classroom and see the Periodic Table on the wall. That makes an impact on students and is not overwhelming (unless you don’t like Chemistry!) Also, watch the colors you are using. Keep the colors bright without being too distracting. Large areas of red or orange can become distracting for some students.

Light FiltersThe lighting can also be overwhelming. Many of our classrooms still use florescent bulbs in the ceiling. Consider getting Light Filters to place over them. The best light filter colors tend to be blue, green, and purple. Please be careful though. Just running to the store and getting cheap sheet sets or cloth is not the same as Light Filters. My favorite anecdote comes from a presentation I was giving on making classrooms sensory friendly and discussing Light Filters. I had a teacher stand up and say I was correct (always nice to hear!) She went on to describe how she had bought some material at her local Walmart and covered her lights. During the afternoon of the first day of school, she thought she smelled something burning. She looked up to see one of the pieces of material smoldering from the direct exposure to the lights.

Twisty TwidgetsFinally, as you prepare for your own classes, build in sensory breaks. OTs will share with you that a simple one-minute break can reinvigorate students and allow better attention to take place in ALL students. Consistent sensory breaks can also create a positive learning environment with limited issues from students. For the kinesthetic student, these breaks can actually increase the learning of material.

Sensory overload can occur in anyone, not just students with sensory processing issues or differing abilities. By taking some time to make a classroom sensory friendly, you can add depth to the learning process. A sensory-friendly classroom can also make you feel more relaxed in front of your students.  Sensory rooms and sensory-friendly classrooms are important in today’s academic environments. With anxiety levels being reported as the highest they have ever been in our students, we need to do our part to let them be students and take in the information we share with them.

May this be a year without any electrical blackouts or sensory overloads for you and your students!

Three Must-Have Resources that Explain the Effective Communication Rights of Students with Disabilities

by Robin Ryan and Gabe Ryan


SE Today-blog badgeIt is good to know that the Federal Special Education budget has not been cut.  At this time, it is good to review the joint guidance that has been prepared by the Federal Government in regards to the Rights of Students in regard to effective communication.



Joint Guidance on the Federal Laws


The U.S. Department of Education’s Office for Civil Rights, Office of Special Education and Rehabilitative Services, and the U.S. Department of Justice’s Civil Rights Division have released some joint guidance materials related to students with disabilities and meeting their communication needs

Sifting through varied legal requirements designed to support the learning needs of students with disabilities sometimes leaves educators and parents/guardians puzzled. Having guidance on the intent and explanation of different aspects of the law related to providing services is invaluable to educators and families. This encourages less time spent interpreting what a law ‘might mean’ and more time creating a supportive plan and accomplishing goals, moving toward successful outcomes for students.

The following guidance materials relate to the public schools’ responsibility to ensure students with hearing, vision, or speech disabilities have access to effective communication through appropriate aids and services.


  1. Colleague Letter


    The DOE and DOJ Colleague Letter (in Spanish) is intended for educators. This two-page letter briefly introduces the aspect of effective communication for all students and highlights a Frequently Asked Questions Document. This letter touches on the responsibilities schools have for meeting the communication needs of students and the differing ways the three Federal laws relate – The Individuals with Disabilities Education Act (IDEA), Title II of the Americans with Disabilities Act of 1990 (Title II), and Section 504 of the Rehabilitation Act of 1973 (Section 504).


  2. FAQ


    Frequently Asked Questions on Effective Communication for Students with Hearing, Vision, or Speech Disabilities in Public Elementary and Secondary Schools. This 30-page FAQ document is intended for educators and parents/guardians. The first few pages of the document provide an introduction and detailed description of the three Federal laws. Starting on page six, the Q and A portion consists of twenty questions and their answers with related regulation and/or case references. Question #20 includes a list of additional resources for continued guidance and explanation of the provision of services. The appendices of the document are a supportive extension with a few case studies as well as a section specifically on IDEA- Part B: Communication Needs.


  3. Fact Sheet


    Meeting the Communication Needs of Students with Hearing, Vision, or Speech Disabilities (in Spanish) This two-page fact sheet is intended for parents/guardians, however is really an essential overview for anyone. This document includes six questions with bulleted answers to each one. It is a quick look at what the law requires of a school, who is eligible, what aids and services could be required and where to find more information.


Please share these must-have resources with your colleagues and families today!


As the individual communication needs of your students are determined through the appropriate process, we invite you to explore and find the assistive technology tools within the School Health Special Education website.

Ensure the Best Placement of AEDs in Your School

AED in wall cabinetThe increasing square footage of schools can make determining how many automated external defibrillators (AEDs) and where to strategically place them seem like an overwhelming task. But it is a necessary task to ensure the best response in the event of sudden cardiac arrest (SCA). If you need help determining the best number and placement of AEDs in your school, connect with one of our experts.

The American Heart Association recommends AEDs be accessible within three minutes of an SCA emergency. Every minute of delayed defibrillation equates to a 10% decrease in the chance of survival of the victim.When an AED is applied prior to the arrival of an ambulance, the victim’s chance of survival increases nearly fivefold.2

It’s important to consider the following when equipping your school with AEDs.

  • Placement – AEDs should be placed within 3 minutes of anywhere within the facility. That means a responder has 1.5 minutes to get to the device and 1.5 minutes to get back to the victim when walking at a brisk pace. On average an individual walking at a pace of 4 miles per hour will walk 152 steps in 1 minute.That’s 228 steps to the device and 228 steps back. Determine your 1-minute radius and center an AED around that.

    TIP: Consider obstacles in the pathways to AEDs. For instance; hallways with security doorways, multiple floors, furniture.



  • Visibility – Make sure AEDs are easily located within your school by placing wall signs above the AED to direct responders to the location. Wall signs are sold separately from AEDs and budgets should allow for proper AED signage. A well-marked path to an AED can make the difference in the survival of a victim when minutes count.

    TIP: Place a wall sign at the end of a hallway or at an entrance to direct responders to the location of an AED.



  • Accessibility – Make sure the AED(s) is easily accessible to responders. Wall cabinets designed to hold AEDs are often alarmed and improve accessibility while deterring theft. The Americans with Disability Act (ADA) guidelines state the height to reach the handle of an AED should be no more than 48 inches high.



  • Location – Consider locations throughout the school that are easily accessible. Consider places of congregation and high-traffic or high-risk areas. For example, at the end of hallways, near the cafeteria, auditorium, office and gymnasium. Schools with multiple levels should place AEDs on each level to ensure the quickest response time.

    TIP: Provide AEDs at school sponsored sporting events by placing the AED in an easy to transport carry case.  



  • Program Management – Implementing an AED program management solution will ensure your AED(s) are rescue ready and compliant. Program management solutions make it easy to track the expiration of pads and batteries as well as CPR certification for trained responders.


Sudden cardiac arrest (SCA) strikes anyone at anytime and anywhere. Making sure your school and staff are trained to respond makes all the difference for the survival of an SCA victim.

AED on student deskThe ZOLL AED Plus® with Real CPR Help®, provides rescuers the confidence to deliver high-quality CPR when it matters most. In addition, long-life consumables, 5-year pads and batteries, increases readiness and decreases frequency of maintenance.

 

 

 

 

 

1Link MS, Atkins DL, Passman RS, Halperin HR, Samson RA, White RD, Cudnik MT, Berg MD, Kudenchuk PJ, Kerber RE. Part 6: electrical therapies: automated external defibrillators, defibrillation, cardioversion, and pacing: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122:S706–S719.

2Weisfeldt ML, et al. J Am Coll Cardiol. 2010;55(16):1713–20.

3”The Average Steps per Minute for Different Exercises”.Verywellfithttps://www.verywellfit.com/pedometer-step-equivalents-for-exercises-and-activities-3435742

Asthma Peaks in September

By: Sally Schoessler, MSEd, BSN, RN -- Director of Education, Allergy & Asthma Network


September – the temperatures start to drop, there’s a crispness in the air and the hallways of our schools are once again filled with activity. Children have returned to school with boxes of tissues, new binders and freshly sharpened pencils.

Asthma Peaks in SeptemberOne in 10 children in our schools will also bring their asthma back to school. Asthma is a huge issue in America’s schools and is the number one reason for school absences – it is responsible for more than 13.8 million missed school days. And there is a proven phenomenon that occurs every year – the September Asthma Peak.

The third week of September has been identified as the peak time for asthma flares among children and youth. Hospitalizations and visits to the emergency room due to asthma tend to spike during this time.

So what’s so special about September and asthma?

In summer, most families are more relaxed about their Asthma Action Plans and asthma controller medications, but when school restarts, there is renewed stress around family schedules and expectations for the new school year - not to mention the pressure of academics, sports and social aspects of school that can include bullying. The student enters a new classroom (or classrooms) with different children in a relatively small space, increasing the risk for infections.

Our environment changes with the fall season. Outside, the weather gets chillier and ragweed and mold pollens return. Inside, we’re in closer quarters with others and we tend to keep the windows and doors closed as the weather gets cooler and cooler.

It’s important for the school’s healthcare team – led by the school nurse – to come together to promote asthma management all year long, but especially in September. With the student at the center of care, the parents and family, the medical home and the school team can be strategic in minimizing asthma flares. First and foremost, talk with your student to see how they are feeling and if they know how to access their asthma medications as needed during the school day and after-school activities.

Back to SchoolEvery student with asthma should have an Asthma Action Plan, which should be updated annually. This plan directs the care of a student with respiratory issues and provides guidance from the medical provider. Another vitally important point is to stress the importance of hand washing. Good hand hygiene is key to stopping the spread of germs and illnesses at school.

As students settle into a new school routine, encourage healthy habits to get the school year off to a great start!

Shop Allergy and Asthma products on SchoolHealth.com! You'll find essential products to help keep your students healthy this year.

Fighting Germs in Schools Helps Stop the Spread of Illness and Reduce Absenteeism

Good hand hygiene helps keep germs at bay and is a critical part of preventing colds, the flu, and infections from spreading. Most of the country has just come through one of the worst flu seasons in recent history. Schools were hit especially hard and many schools faced days-long closures as they tried to stop the flu from spreading or find enough healthy staff for classrooms.

While handwashing with soap and water remains the gold standard for hand hygiene, it’s not always realistic as students move between classrooms, buildings, busses, and navigate the demands of a busy school day. And, when a student is sent to the restroom to wash their hands, how do we know that they’re washing with soap and water for the prescribed length of time – or if they’re washing at all?

Sanitizers to the rescue! School Health recommends an all-inclusive approach to fighting the spread of germs in your school. A complete solution includes using alcohol-based hand sanitizers and surface disinfectants that are scientifically formulated for no trade-off protection, in addition to handwashing, as an important part of cleanliness and well-being.

PURELL® products are universally recognized and trusted to provide fast and effective protection from germs.1In one study, schools that combined hand-hygiene education with PURELL products reduced teacher absenteeism by 10 percent.2Student absenteeism was reduced by 51 percent when PURELL hand hygiene products were used in conjunction with a curriculum to teach kids about good hand hygiene.3

Placing the right products in key locations helps teachers and staff remind students to practice good hand hygiene during the day, which helps stop germs and illness from spreading. Hand hygiene is the single most important way to prevent the spread of infection, but it’s just half of the solution. You can significantly improve results when you also prevent recontamination by disinfecting the surfaces people touch.

School Health recommends using a combination of hand sanitizers, surface disinfectants, and wipes. Placing these products in easily accessible, high traffic areas will help to combat germy conditions and keep kids healthy. Some placement suggestions include:

  • The entrance to the school

  • The entrance to the gym and locker rooms

  • Outside of the restroom

  • Near the water fountain

  • Outside of classrooms, offices, and the teacher’s lounge

  • In food preparation areas and cafeterias


To learn more about solutions for a clean and healthy classroom, Request a Consultation with one of our experts. You can even learn how to get FREE dispensers with your purchase!

Increasing The Odds For Survival with Real CPR Help

Zoll AEDCPR Saves Lives.That’s why more than 30 states now require students to receive CPR training before they graduate from high school. Many of these states also require that students be trained to use an automated external defibrillator (AED).

CPR + AED = even more lives saved.

The evidence is indisputable: high-quality CPR is the primary component in influencing survival from cardiac arrest.1 Not every patient will need a defibrillating shock, but every patient will need CPR to increase the flow of oxygenated blood to the heart and brain.

Even for seasoned health care professionals, it’s hard to know if you are pushing hard enough and fast enough to meet current AHA Guidelines for compression rate and depth. With ZOLL’s proprietary Real CPR Help technology, you know. It provides audio and visual feedback that guides rescuers to deliver high-quality CPR. ZOLL introduced Real CPR Help® in 2002, and it is standard on every AED and professional defibrillator ZOLL sells.

Superior Support in a Rescue, 100% of the Time!

The ZOLL AED Plus®defibrillator with Real CPR Help provides integrated, real-time CPR feedback to help rescuers save a life. Only half of all sudden cardiac arrest victims will need a shock, while 100% will need high-quality CPR. Real CPR Help guides you every step of the way, telling you—and showing you—whether you need to “Push Harder” or whether you’re providing “Good Compressions.”

Not all heart rhythms are “shockable,” but high-quality CPR can potentially convert a non-shockable rhythm into one that is shockable. Even if this isn’t possible, CPR will keep blood circulating until emergency services arrives.

If a shock is required, CPR must begin immediately after the shock is delivered. The heart struggles as it tries to restore to a normal rhythm. Without CPR, a shock alone may be ineffective. Whether the victim requires a shock—or not—the AED Plus will support you 100% of the time.

Focused on CPR Quality

High-quality CPR improves survival from cardiac arrest, and rescuers need to “maximize the quality of CPR” to save more lives.1,2

High quality means providing compressions at the proper depth and rate, making sure not to lean on the chest, and keeping interruptions to an absolute minimum. In its 2015 Guidelines, the American Heart Associationidentifies five critical components required to provide high-quality CPR:

  • Compression rate of 100–120 per minute

  • Compression depth of 2–2.4 inches (5–6 centimeters)

  • Avoid leaning on the chest to allow for full recoil after each compression

  • Minimize pauses in compressions (chest compression fraction > 60%)

  • Avoid excessive ventilation (2 breaths/30 compressions without advanced airway; 10 breaths/minute with advanced airway)


Rescuers at every experience level need assistance when delivering CPR. The Real CPR Help technology on ZOLL’s AEDs and professional defibrillators assists lay rescuers and health care professionals alike in delivering high-quality CPR to meet the guideline recommended rate and depth.

How Real CPR Help Works

Using accelerometer technology, a sensor inside ZOLL’s CPR electrodes captures the rate and depth of each compression. Once the electrodes are placed on the patient, the person providing CPR presses on the clearly marked hand placement indicator that covers the sensor. The information captured is sent to the defibrillator, where it is immediately processed and provided in real time to the rescuer.

This real-time feedback is a critical component in reaching high-quality CPR. With audio and visual prompts to push harder, rescuers can immediately adjust their CPR as needed to reach the most effective rate and depth of compressions.

Chances of Survival More than Doubled

Studies in Arizona and California prove that high-quality CPR saves lives and that Real CPR Help can improve CPR quality.3,4 A large study of EMS providers in Arizona showed that the odds of survival increased 2.7 times with ZOLL’s industry-exclusive Real CPR Help and scenario-based training.3 And survival to discharge and good neurological outcomes doubled after the implementation of a “resuscitation bundle” at the University of California San Diego Medical Center that included Real CPR Help and specialized training.4

In a sudden cardiac arrest emergency, the victim’s best chance for survival is immediate CPR and a rescuer with an AED. Many people may not realize how critical effective CPR is in determining a victim’s outcome. ZOLL’s Real CPR Help guides rescuers at every experience level with real-time feedback to give them the confidence that they are providing potentially life-saving, high-quality CPR.

1Meaney PA, et al. Circulation. 2013 Jul 23;128(4):417–35.
2Neumar RW, et al. Circulation. 2015;132(suppl 2):S315–S367.
3Bobrow B, et al. Annals of Emergency Medicine. July 2013:62(1):47-56.31.
4Davis DP, et al. Resuscitation. 2015 Jul;92:63-9

Tips for Coordinating Spot Vision Screening Q & A

Spot Vision ScreenerWe received many questions during our Tips for Coordinating Spot Vision Screening webinar. As a resource for you, we have compiled the most frequently-asked questions and have provided them here with their answers.

If you have a question about the Spot Vision Screener and don't see an answer here, be sure to request a consultation with one of our vision screening experts!

Q: Do you still need to do a visual acuity test?
A: The Welch Allyn Spot Vision Screener uses a completely objective screening methodology to screen for 6 potential vision issues including amblyopic risk factors, common refractive errors, and strabismus. Visual Acuity testing is subjective but can identify visual problems unrelated to refractive error. Both screening methods have their benefits and limitations; therefore, the most thorough exam occurs when both instrument-based vision screening and visual acuity are used.

Q: Can I convert the results to a visual acuity score (20/20, 20/40)?
A: No. The Spot Vision Screener results will indicate “All Measurements in Range” or “Complete Eye Exam Recommended.” The device also lists the condition(s) found and the measurements of each eye. Welch Allyn does not recommend converting the results to a visual acuity score. If your state requires a visual acuity score we recommend using age appropriate tests and following state vision screening guidelines.

Q: How does it measure stereopticity?
A: It doesn’t. The Spot Vision screener is completely “objective” in that it requires no response. Whereas stereopsis is “subjective” (requiring a response from the subject).  That would be a different test. If your state requires a Stereopsis screening we recommend using age appropriate tests and following state vision screening guidelines.

Q: Does the result screen delineate between near and distance results?
A: Spot Vision Screener can detect measurements for Myopia (near-sighted) and Hyperopia (far-sighted) which are what a near or distance vision test looks for. In addition, Spot detects 3 amblyopic risk factors (Hyperopia, Strabisus (Gaze) and Anisometropia (unequal refractive power) as well as Astigmatism (blurred vision) and Anisocoria (unequal pupil size). 

Q: Can you screen children who are wearing glasses?
A: Yes, but it will take the glasses into consideration. Spot has criteria settings and if they are not referred then they met the criteria settings already established within the devices.

Q: Any suggestions on screening students who wear glasses?
A: Screening with glasses can be tricky, you can screen through single Rx Lens (no bifocals) with Spot. To screen students with glasses, push the glasses up the nose and drop the chin. This helps move the glare off the lens for a better capture. The thicker the lens, the more challenging it can be to screen through; this is also the case if the lenses have scratches on them. It is easiest to screen children wearing glasses in a dark room that minimizes reflections off the lenses.

Q: How accurate are the results? Sometimes if I screen the child two or three times I get both pass and refer.
A: It’s best to go with the first result while the eyes are in a natural relaxed state whereas continually screening the same patient can result in accommodation, thus skewing the results. 

Q: Why do I get different results for the same student if I have trouble screening and try again?
A: Accommodation is the ability for the human eye to improve vision when provided time to focus on an object.This is most widely discussed with amblyopic risk screening on children under age 6 but can still occur with subjects over 6 years of age. This also may occur when a child is just below or above the criteria threshold for their age, thus prompting multiple results. As with the previous question, the best practice is to go with the first result. 

Q: What is the recommended age for use?
A: Refer to the Welch Allyn statement regarding use of Spot Vision Screener in school-aged children.

Q: How reliable is this tool when screening children with developmental disabilities that have difficulty focusing on the machine?
A: Spot Vision Screener is an effective tool for screening children with developmental disabilities. Remember, Spot does not replace a comprehensive eye exam and children with disabilities may also need to see an eye doctor. Spot has an extremely high capture rate even with Autistic or developmentally delayed children. It’s vision optics system and design results in a high capture rate and the non-invasive screening distance of 3.3 feet helps allow the child to be comfortable without feeling like you’re invading their space. 

Q: How do you load student data for screening?
A: There are three options available for loading student data for screening into the device.  

  1. INSTANT SCREENING - Screen and then follow the prompts to enter the student’s information including name, ID, date of birth, gender, etc. 

  2. SELECT FROM THE QUEUE - Preload a list of students by utilizing the import/export function which allows you to create a spreadsheet and load the data into the device by using a USB.

  3. PRE-ENTER STUDENT DATA - Follow the prompts to enter the student’s information including name, ID, date of birth, gender, etc., then proceed to the screening portion.


Q: Is financial assistance available to purchase a Spot?
A: 
You might reach out to a local Lions Club or other local charitable organization, like Prevent Blindness, for assistance; they have helped with the purchase of equipment. Some schools have utilized their Medicaid reimbursement funds to purchase the Spot Vision Screener. Others have utilized the banner space at the bottom of the results page to raise funds by promoting local services and/or optometrists.

School Health Services Give Children a Bright Future

Shared with permission from the Healthy Schools Campaign.


Mary Ellen Barkman, the Medicaid Coordinator for Pinellas County Schools, the eighth largest school district in Florida, is passionate about their vision screening program. “We’re saving children’s lives,” she says.


Spot Vision ScreenerFor instance, last year, there was a new student in the district, a recent immigrant from Egypt who spoke only Arabic. Her teacher struggled to reach her and felt that beyond the language issue, the girl must have some cognitive problems. As part of her special education evaluation, she was tested with one of the district’s new Spot Vision Screeners. This quick screen showed that she had a serious muscle problem that caused triple vision. After she received the specialized prism glasses she needed and hearing aids for her hearing loss, she was at grade level within a year. “Without those screenings she may not have been able to reach her fullest potential,” Barkman says. “With help, children can have such a bright future.”


The district’s investment in spot screeners is the result of careful analysis of the district’s needs. Several years ago, school health services managers reported to Barkman that there was an issue with the district’s protocol for vision screenings. They were inefficient and time consuming, and they simply didn’t work for students who couldn’t talk or who had trouble sitting still or following instructions—often the very students who needed accurate screenings the most. The district researched many options and settled on Spot Vision Screeners, which work by taking a picture of the child’s eye and using it to screen for visual acuity, muscle imbalance and tumors. In fact, in the first year of using the screeners, the district identified a serious tumor in a student that had been missed by his primary care doctor. The machine creates a printout for parents that explains any follow-up services their child needs, and the district has formed partnerships with a vision van, local optometrists and the Lion’s Club to provide services for children who need follow-up services after screenings. And because the screeners are so easy to use, the district’s vision teams can make much more efficient use of their nurses to follow up with students who fail the screenings, rather than having to do the screenings themselves.


Barkman and the Pinellas County Schools team have woven together many different funding streams to build this unique program including Medicaid funding for the actual Spot Vision Screeners. Most of the funding comes from effective maximization of Medicaid billable services, such as Physical and Occupational Therapy, Speech Therapy, Nursing, Social Work, Psychology and Transportation and Administrative Claiming. Half of the reimbursement dollars are given to her program to spend on priorities they identify. The other half goes to operating to offset salary costs of billing providers. Because of this, Barkman works hard with her practitioners to make sure they are billing for all eligible services and maximizing Administrative Claiming reimbursement. They even developed their own electronic documentation system to make this easier. Over five years, the district has increased Medicaid revenue by $1.7 million to increase resources for students.


What’s next for Pinellas County? One priority is developing a micro-credentialing system for the one-on-one assistants who work with children with multiple challenges, to give them skills for physically transferring the children, feeding, seizure monitoring, CPR and social supports. Medicaid will support an increase in their salary after achieving the credential, which will allow them to be Medicaid-claimable health assistants. This invests Medicaid dollars directly into something that meets the needs of some of the district’s most vulnerable students.


“The key is out of the box thinking,” Barkman says, “and the box has gotten smaller.” She continues to look for ways to leverage whatever funding is available. “It’s such a blessing to be able to help a child reach their fullest potential. It’s important that people understand how important the Medicaid dollars are to that,” Barkman says.

Rochester News Station Interviews Gates Chili CSD & Mobilize Rescue Systems about Life-Saving Technology

Fox Rochester's Ashley Doerzbacher interviewed Superintendent Kim Ward and the Mobilize Rescue team about the #Mobilize1Million campaign and the use of the Mobilize Rescue System at the Gates Chili Central School District.

You can watch the interviews here (Be sure to scroll down to watch all five segments.)

Mob1mil_2Mobilize Rescue Systems offer the only interactive trauma and first aid system capable of helping untrained bystanders assess, manage, and monitor a spectrum of medical emergencies.

Each Mobilize product includes access to the Mobilize Rescue app, which provides users with just-in-time instructions to assess and manage life-threatening emergencies. Bystanders can follow simple steps in the Mobilize Rescue app, and have the knowledge and ability to provide care anywhere they go.

The interactive app is designed by experienced medical providers to place the highest accepted standards of emergency medical care in the hands of the everyday person. The app takes the guess work out of providing care - the untrained rescuer can determine the problem, locate the proper equipment and be taught to use it properly with interactive, just-in-time training.

Here are some notable quotes from the interview. These quotes highlight the benefits provided by Mobilize Rescue Systems during an emergency situation.

"I just feel like we're more equipped to handle any situation. It's a different world out there, and we need to be prepared. It's not something we like to think about, we hope we never have to use it, but helping our staff, even students, anyone who walks in the building knows what (the Mobilize Rescue Systems) are, knows where they're found next to our AEDs. They at least know they are equipped to respond and help save lives. We talk about innocent bystanders, these units allow you to be active in trying to save lives, in trying to stabilize victims until the emergency staff can arrive." - Superintendent Kim Ward, Gates Chili Central School District

"The technology for first aid has just changed so dramatically, with AEDs and everything else, and (the Mobilize Rescue System) is an addition to that." - Doug Emblidge, FOX Rochester

"It's so hard to predict how you will react in times of crisis, or during an emergency. That's why this is so important." - Jennifer Johnson, FOX Rochester

"It's also good to know, when we send our kids off to school, you trust that they're in good hands and you feel a little bit more confident that they've got (the Mobilize Rescue) technology there." - Alexis Arnold, FOX Rochester

"Safety comes first... I think it's important for people to feel a comfort, and to have hope that they can help until emergency responders can arrive on the scene." - Superintendent Kim Ward, Gates Chili Central School District

Learn more about the #Mobilize1Million campaign, and how you can sponsor and empower your school, workplace, community, or family to save lives.