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Marc provides instruction at a crosswalk for a client during a guide dog walk. The Golden Retriever stands between the two men awaiting instructions.

Central Bark Episode 34

Orientation and Mobility Immersion Program

In this episode, Theresa sits down with GDB Director of Orientation & Mobility Services, Marc Gillard, to talk about the importance of our Orientation and Immersion Program in helping clients reach their independent travel goals.

Hello everyone, and welcome to Central Bark. I am so excited about today's episode. Our guest is Marc Gillard. He's the director of Orientation and Mobility services at Guide Dogs for the Blinds, and he's going to tell us a little bit about our new orientation and mobility immersion program, about how it works, who it might benefit, and what future plans are. So Marc, welcome.

Marc Gillard: Thanks, Theresa. It's really good to be with you.

Theresa Stern: Well, it's awesome to be with you too. It's kind of funny, for those of you who know Marc and myself, Marc and I have worked together for many years. It's fun to interview you, Marc, and to really talk about this program that I think is really near and dear to both of our hearts. But before we dig into that, let's dig into you a little bit. Tell us a little bit about your background. You have a really interesting background.

Marc Gillard: Yes. Well, I'm proudly Australian by birth, and that's important because I started my career as a guide dog mobility instructor in Melbourne, Australia, way back in the nineties actually. And I was fortunate enough at that time that my employer, Royal Guide Dogs Associations of Australia in Melbourne, in their apprenticeship, they actually gave you the guide dog mobility stuff, but also sent you off to university to get your orientation and mobility degree. So I was fortunate enough in my apprenticeship that I got that in there. So that had me come out as a dual qualified GDMI, guide dog mobility instructor, and an orientation mobility specialist. So I was still pretty young at the time when I came out of there, Theresa, and had a little itchy feet.

Theresa Stern: We're still very young now, Marc.

Marc Gillard: I had a bit of an itch. I wanted to do some travel, and Australia's all far away from everything, basically, the land down under, as they say. So I toured a few of the world's guide dog schools, including the UK, and came over to the United States and went to some East coast schools. And then my final stop on the way back to Australia was at Guide Dogs for the Blind in San Rafael in beautiful California. So that was a very important stop, because they at that time didn't have any duly certified guide dog O&M specialists. And I was looking for work, and I was fortunate that they had a position as a field service manager that they offered me. And I gladly took that and made my way over to the United States and had a wonderful three-year period there doing field work, combining O&M and guide dog mobility instruction, and got to see a lot of the US.

But at that point, I was on a three-year work visa and didn't want to stick around for another three. So I ended up going back to Australia and worked at Guide Dogs Victoria, which had changed names in Melbourne again, and had a few roles in charge of staff training as one of them, and then ended up being the manager of Guide Dog Services. And then a nice complication arose at that point, and I left out a little bit of the story.

Theresa Stern: Yes.

Marc Gillard: I met a wonderful California girl at Guide Dogs. Her name's Christie, and she is now my wife going on 17 years.

Theresa Stern: 17 years. Wow.

Marc Gillard: So yeah, we decided to come back to the United States, and I was fortunate that Guide Dogs for the Blind opened their door back up to me, and joined up again as a guide dog instructor, and then eventually a field service manager for the Bay Area. And then met you, Theresa. And there was a wonderful opportunity to start up our orientation and mobility immersion program in 2016.

Theresa Stern: 2016. Wow. Yes, we did cook it up together. We did.

Marc Gillard: We sure did.

Theresa Stern: But you were definitely the chef. I was the sous' chef in that situation. But why don't you tell everybody what we're talking about, about this orientation, the Mobility Immersion program, and really what the need is that we're meeting with this?

Marc Gillard: Sure. So back then, fortunately as it is now, as I'll explain, the number one reason that people who applied for Guide Dogs for the Blind for a Guide Dog weren't able to qualify was a lack of orientation and mobility skills or opportunity to train to get those skills. So what we're talking about there is that people need to know before they train with a guide dog how to cross a street, how to make a safe determination using traffic sounds, that it's appropriate to enter the intersection. How to analyze an intersection. Is it light control, stop sign control? Is it a T, is it a plus? All those things are part of orientation mobility. And of course, to travel independently without a guide dog, the only way to do that on your own is to use a long or white cane, long white cane. So O&M incorporates that.

So that being the number one barrier, we did some research, and as you know, Theresa, the community back then and still now, unfortunately, it is just not cutting it in terms of people being able to access services for various reasons. So guide dogs for the blind thought, okay, if we can't improve this situation, it could have long-term effects for people wanting to get a guide dog or just people who want to travel independently and regain their independence. And of course, long-term guide Dogs for the Blind because we need qualified applicants. So the decision was made to actually design a program that incorporated the aspects of orientation mobility, which are needed firstly to work with a guide dog. So all those things that I just talked about with street crossings and intersections, but on top of that, things that are largely non-tactile in nature. So what I mean by that, is with a cane, you've got the cane tip, which is in touch with the ground, and the client is moving that from side to side to detect obstacles and elevation changes.

But with a guide dog, you're not using a cane at the same time. So what do you use to actually stay oriented? You're using largely auditory information, so sounds and things, smells and scents, direction of the sun. So thermal information, cross breezes, and also cognitive skills like time and distance estimation abilities. So basically walking along the sidewalk and knowing how far you have traveled relative to the time taken to do so. So they're non-tactile skills, which are very important to learn in preparation for a guide dog and all guide dog users who are listening to this know full well that those skills are just crucial to working with a guide dog. So we put this course together, you and I, Theresa, and one of the key parts of it was that at that point, guide Dogs didn't have an orientation mobility services department. We had O&M specialists that were in other roles, but we didn't have a standalone O&M department.

So we decided to form a connection with a local Bay Area agency serving the blind and visually impaired. And that was the San Francisco Lighthouse for the Blind. So we decided to train up, I think about five of their O&M specialists to teach these skills that I've just identified to people who wanted a guide dog. And the course length was five days. We had five days in order to do it. And the reason for that was because the Lighthouse were good enough to release their instructors for five days. So that dictated the length of the program.

So with their help, we created this curriculum and we ran our first pilot program there that year in 2016. And if I remember correctly, we put through 15 people through that pilot, and it was a huge success. And we also discovered that it wasn't just first time applicants. That is people who've never had a guide dog before that could benefit. We had some of our alumni graduates who heard about this. And in fact, the first person to actually try the program was a colleague of ours in outreach. I'll mention her name, that's Jane Flower who came in and she had obviously a lot of experience traveling with a guide dog, but she benefited enormously by refreshing her orientation and mobility skills.

Theresa Stern: Absolutely.

Marc Gillard: That's another, population.

Theresa Stern: I think we also realized how important that was just with our, Aa guide dogs, we really want to make a promise for a lifetime of service. And people's needs change and people's vision change, as a lot of people who get guide dogs from us have retinal deterioration issues with their eyesight, and so they're losing vision and may need to relearn all this stuff over again. So that was one of the really, I think, great surprises, I guess is what I would say in that program, is discovering, "Oh wow, this could actually serve so many more people than we had originally considered."

Marc Gillard: No doubt. And one of the things you taught me, Theresa, I love this, is that 'Build it and they will come.' And that's what we did. We built this program and we didn't know really who we were going to get beyond our initial goal. So you're absolutely right on that one. Yeah.

Theresa Stern: Yeah. Very cool. So tell me, that's how it all started with a five-day program. And I know that we have expanded, we were working with other agencies, and now we're doing in-home as well, but on campus, at our Guide Dog campus. So tell us a little bit about how the program is working now.

Marc Gillard: Yes. It goes without saying that all of us were affected by the Pandemic, right?

Theresa Stern: Yes.

Marc Gillard: But most of the pandemic was bad, but some of it actually helped out various organizations. So back in 2020, when things were at their worst, we actually did investigate in-home training because we couldn't use our residents. And one of our past O&M specialists, Angela Smith, who is still connected to us as an on-call O&M, she piloted in-home training with O&M, and it was a big success, and we've kept that. But also in that year, we were just starting to get people back in the residence in very small numbers at our California and our Oregon campus. So we decided to try two clients. I had one, and Angela had one doing residential OMI, orientation and mobility immersion. And that, too, was a success. And the supportive environment of our residents team with our nurses and our housekeepers and our RAs and our kitchen staff, it all went together to create a real team environment for people. And we've really expanded on that. So fast-forward a little bit.

Theresa Stern: Yes?

Marc Gillard: What happened is we started to be able to get other instructors besides Angela to come to Guide Dogs. And interestingly, they were from the Lighthouse. And the reason they were from the Lighthouse is because the Lighthouse facility didn't reopen until quite a few years into the pandemic or the aftermath of the pandemic. So they were great. They came to our campus and we were able to increase our class sizes and continue to evolve the program. So what happened though, is as we got more people through, we started to recognize something really, really important. And we found out that it's not just O&M skills that people are lacking. Out there in the communities, if they aren't able to get an O&M, there's a high likelihood that they can't get other things related to blind rehabilitation services or allied health. So as an example, independent living skills. So knowing how to cook, clean, arrange things in your home, that sort of stuff. Very important to developing independence. Assistive technology.

Theresa Stern: That's huge.

Marc Gillard: These days, there's some huge benefits of, say, using an iPhone to access navigational apps to aid independent travel. But if you don't know how to use your iPhone, how are you going to do that?

Theresa Stern: That's right. Yeah.

Marc Gillard: Other services too, like independent living skills I mentioned, but also low vision. So a lot of our clients do have remaining vision, but they have never had a glare assessment. Something as simple as having the correct tints on some shields, UV shields, to block out some of that annoying glare and can help them both comfort wise and in terms of their functional vision and to assist with independent travel. The other part of it is what I've just said, allied health. So what do I mean by that? Well, we found out that about a quarter of all our orientation and mobility immersion students, we were referring to an audiologist after their program.

We thought that, you know what? There could be something going on with the hearing. They might be struggling to align with traffic, or they might not be hearing the traffic that's, or there might be some communication issues between them and their instructor, or they could be turning their head from to one side to try and use the ear maybe that's better on one side. And that's affecting their alignment with their long cane and causing veering in the block or in a crossing. So yeah, we recognize that. And we also recognize things like physical issues. So people coming in that might have some aches and pains, but maybe some things that were impacting their travel. So as an example, maybe their shoulders or neck was out of position and they were dipping down to the left or something with their shoulder. And in the absence of any supportive vision, that was causing them to veer it crossing.

Theresa Stern: Yes.

Marc Gillard: So these are just some of the things we found. So what we've done is we've evolved this program now to be what's called an interdisciplinary mobility service. So we've recognized that it's no point just providing orientation, mobility if someone hopes to get a guide dog and there's other stuff going on that could be barriers.

Theresa Stern: Right. That's right.

Marc Gillard: What's the point, for example, training someone with O&M skills if they can't hear properly to make a street crossing?

Theresa Stern: That's right.

Marc Gillard: And the likelihood that they go back to their home areas and hook up with an audiologist, it's probably low to none.

Theresa Stern: Yes.

Marc Gillard: So Guide Dogs for the Blind made the decision, let's create this team in our residential facility here in San Rafael. So we now have an audiologist who comes along on a Sunday and actually offers free hearing screenings for our O&M clients.

Theresa Stern: Amazing. Wow.

Marc Gillard: And this is an opt-in service. People can say yay or nay, but the majority say, "Yes, please."

Theresa Stern: Of course.

Marc Gillard: And she can do a hearing screening in our residence and actually produce an audiogram. And an audiogram is a pictorial representation of someone's hearing, both the left ear and the right ear, and gives us a picture of what's going on at the different frequencies of hearing. So we have low frequencies, mid-frequencies, high frequencies, and we can get an understanding with the client and the audiologist, all sitting down talking together in that interdisciplinary way of what's going on and how that manifests potentially in orientation and mobility travel. So that's the audiologist. We also have a connection now to a sports medicine professional who is employed by a company called Briotix, which is an industrial sports medicine company. And Briotix have been working with guide dogs for ages, but they've been seeing our staff. Exactly. And they're great. They're really great.

Theresa Stern: They're doing amazing work. Yeah.

Marc Gillard: But I thought, and so did you, Theresa, well, why just our staff? Why not have them available to our O&M clients?

Theresa Stern: Exactly.

Marc Gillard: So that's also started. And so as an example there, just say someone is having a bit of a problem there with their alignment. They might be one of those folks I mentioned that the shoulder's out of symmetry, they might dip down to the left or something, or their head's turned a bit to the right and it's influencing their line, plus their comfort.

So what can happen now is that they can have, within our, I'll go on and talk about our class models in a second. Suffice to say we have a two-week version of the program.

Theresa Stern: Nice.

Marc Gillard: Which is exciting.

Theresa Stern: Yes.

Marc Gillard: So within the two weeks, they can get a first up consultation of 45 minutes in week one to actually sit down and talk to the sports medicine professional just about their bodies and their background, what's going on, and she can maybe give some exercises, some stretches, things like that, that can improve things. And then she'll see them again for another consultation in week two, just to check on things and also develop a plan that they can go home with to keep things moving along and strength and things like that.

But even better, this is the exciting part, which is the true interdisciplinary nature of it. The sports medicine professional, by the way, her name is Leah Hurst, and she can actually join in an O&M lesson with the O&M specialist.

Theresa Stern: See what's going on.

Marc Gillard: On, see what's going on. So she could see someone maybe veering down the hallway with their cane and stop mid-lesson and get someone to maybe do a stretch on the wall with their shoulder or the deltoid muscle or something like that, stretch it out. And it's really amazing that when they go back to using the cane straight after, sometimes you see an absolute improvement.

Theresa Stern: That's amazing.

Marc Gillard: Immediate improvement in their body mechanics and their straight line walking ability.

Theresa Stern: Wow.

Marc Gillard: So we're also doing that. And the other services, too, that we've been able to provide independent living skills training, assistive technology training and low vision clinic access. And how we provide those is real interesting. It's like a cooperation with another agency.

Theresa Stern: It's great.

Marc Gillard: Just like we did with the Lighthouse, this agency's up in Santa Rosa. It's called the Earle Baum Center. And we can transport our clients up there during their two-week program, and they can maybe have a day up there and get those services within their programs, which is terrific. And then the last service, which I think might even be the most important, is psychosocial support.

Theresa Stern: It's huge.

Marc Gillard: So we have Dr. Jason Doris here, our psychosocial support specialist.

Theresa Stern: Yes. We had a great episode with him on Central Bark not too many weeks ago.

Marc Gillard: Yep. Shout out to Jason.

Theresa Stern: Yes.

Marc Gillard: And so any of all my clients can actually connect with Jason and they can talk about things that might be a little more unique to an orientation mobility student who might be new to blindness. And that is, they could be adjusting to sight loss, they could be going through all the emotions associated with that, their relationships, their vocation, their recreation. So Jason can talk to them all about that, and that can really help them through the process of adjustment and developing independence. So there is our model, Theresa.

Theresa Stern: I love the model. Yes. Yeah.

So Marc, tell me a little bit about the team that you work with to really roll out this orientation mobility immersion program.

Marc Gillard: Yeah. Well, in order to provide on campus programs, I mentioned the Lighthouse helping us out. And Earle Baum, too, had an instructor come down and help us. But the most important development is that Guide Dogs for the Blind have hired full-time O&M specialists to be part of the team on campus. And they can then go into the residents regularly to have campus-based classes. And our senior O&M program specialist, her name is Stephanie Zabitz. Probably known to many of our alumni out there, because Stephanie had a long career before she came into the O&M Immersion as a guide Dog mobility instructor. In fact, she reached the level of master instructor. And she then, along the way, got her certified O&M specialist qualification through San Francisco State University. So with those two on the campus, were able, as I said, to really develop the program with our own staff.

And speaking of that, one other thing, and I've got to credit you on this, Teresa, because you were instrumental about this one, GDB launched in January of 2022, I think it was. Yes. So one thing that Guide Dogs of the Blind recognize is we need to develop our own orientation mobility instructor staff. And one way to do that, it's been decided that each year guide Dogs for the Blind are going to provide financial assistance or an eligible to eligible guide dog mobility instructors to go off to university and get their orientation and mobility certifications or degrees, depends where they go. And we're going to fully support that, including their internship, and then they're going to return to GDB, Guide Dogs for the blind, and actually apply that and work in the O&M immersion, as well as bring that orientation mobility expertise to their jobs as Guide Dog Mobility instructors.So that's just wonderful.

Theresa Stern: That's great.

Marc Gillard: Great support by Guide Dogs. And I'm proud to say we haven't mentioned Oregon too much here, and I think there's a good time to do it. Our first two recipients of that O&M educational funding, two guide dog instructors up at the Oregon campus who are currently going through their education at Portland State University and will come out roundabout September next year with graduate certificates in orientation and mobility. So that's just really exciting looking forward.

Theresa Stern: I love it. It really sets us up for the future. I think that's just fantastic.

Now, I think for those of you listening out there in Central Bark land, you may say, yeah, this all totally makes sense, but what you need to know is this is a really unique program, and we're hoping that other organizations and agencies will follow suit. Because we can serve a lot of folks, but we can't meet the need just ourselves. So I just feel so honored to be a part of really setting, I think, the standard for treating really the whole person, not just the vision impairment, because somebody is a lot more than just their vision impairment. So their vision impairment affects the entire world of a person who's visually impaired. And so having access to the services is really, really rare and unique and it shouldn't be. So thank you, Marc, for really guiding the way on this concept.

Marc Gillard: Well, thanks, Theresa. Yeah, I'm very proud to be a part of it and very proud of Guide Dogs for the Blind as being the first US or North American Guide Dog School to offer this model. And I think also it's unique amongst agency servicing the blind. I mean, some of them do have some of these other services, but I haven't heard of one, apart from the Veterans Administration that have audiology attached to it or physical support-

Theresa Stern: Physical therapy.

Marc Gillard: Sports medicine professionals. So we are in uncharted waters and leading the way. I mentioned also the model. Real quick just to close that one. We started off with the five-day program at the agencies, which we continued at Guide Dogs, but when we were trying to combine these services, you could imagine with everything I've said, they take time, and we don't want to water down the orientation mobility component. That's still the primary reason people are coming in.

Theresa Stern: Absolutely.

Marc Gillard: So we expanded the length of the program to two weeks so we could fit in some of these other services at the same time as preserving the O&M content. So we now have a one week, a two week, and an in-home model as well.

Theresa Stern: Wow, that's great. We can meet all kinds of different people where they're at with those different models of service. I think that's fantastic. Fantastic.

Marc Gillard: Exactly.

Theresa Stern: So if somebody's listening and thinking, "Hey, this sounds really cool for me," or "I have a friend or a family member who might benefit from this service," can you tell us a little bit about what the qualifications are and how you apply and what to consider?

Marc Gillard: Sure can. The first thing is that Guide Dogs are just one potential provider of orientation mobility. And while we're real proud of the program, it's still important if someone does have access to local orientation mobility services, that they explore that option first. Because a couple of reasons. Number one, it might be faster in terms of getting services, or number two, it could be provided in home, which for many people is a bit easier. But I say that because I think it's just the professional thing to say. But obviously, a lot of our people might've tried that and they might've got a response like, "I'm sorry, our waiting list is 12 months long," or "Sure, we can serve you. We could give you five hours in a year."

Theresa Stern: In a year.

Marc Gillard: But I think it's still important to check that out first.

Theresa Stern: Absolutely Know what your opportunities are that are around you first, what your resources are. That totally makes sense.

Marc Gillard: That's right. So however, if someone's done that and they're facing barriers, they might even be ineligible for services. There are different reasons people can't get services. For example, in some states, if you don't have a vocational rehabilitation goal, so you want to get into the workforce or stay in the workforce, then you may not be able to get O&M if there's only that what we call vocational rehabilitation department that's available to you. So once again, Guide Dogs, we're not looking at that in terms of someone's vocational goals. So that could be a reason to contact us. So if you make the decision to apply, there are a few ways to do it. We have our wonderful admissions team that are here for our Guide Dog applicants and all services now, including Canine Buddy and our O&M of course. So you would either put in an online application guidedogs.com, and you can apply to the O&M immersion on the website itself. Or, if you want to call admissions, of course you can still do that. So they're going to process that application as they would normally do for a guide dog, for example.

It's important though that people recognize what this program is, and that is, it's a very intense immersive program, obviously the name O&M immersion. So going for five days or 10 instructional days, you are looking at working solidly each of those days. So you could be looking at maybe doing, say, three, four hours of O&M each day for maybe a grand total of 20 for the week and maybe more over two weeks. Right?

Theresa Stern: Right, right.

Marc Gillard: So-

Theresa Stern: It's intense.

Marc Gillard: It's intense. So as our guide dog application does, we ask people to get a physician's report. So we make sure that they're physically capable of doing well, succeeding in a program like that. We're also looking at people in terms of their mental health. And I mentioned Dr. Jason before. It's really important that people are in an emotional state, that they're ready to come in and train and learn long cane, and to be in a residential setting and to be around peers who also have visual impairment.

So there needs to be a level of adjustment. They're going to be comfortable and able to learn. So that's another really important part of it that we are looking for. If someone needs an eye report to prove legal blindness, we do ask for one of those as well. And I say if, because sometimes a guide dog applicant, they might already have that. They've been through that with Guide Dogs before, but the first timer, we need that. And it's not only proof of legal blindness, there are some exceptions, but it's also very important for an orientation mobility specialist to have that information if someone does have residual vision, because we can do things like a glare assessment, we can maximize the use of residual vision. That's what we believe at Guide Dogs for the Blind, that we actually look at that carefully and try and maximize its efficiency. So as for an eye report as well.

And then really from that basis, we have our admissions review committee and our immersion review committee. We have two committees, but we're looking at someone as to, do we think we can serve them and they can come through the program, be successful. And it's pretty rare that we actually say no to anyone, really. We're here to help focus as many of them as we can. And then people are given a decision about their acceptance into the program, and then we look to place them in an O&M class. So that's the application process.

Theresa Stern: And just like the other services at Guide Dogs for the Blind, there's no charge for the service. Correct?

Marc Gillard: Absolutely no charge. And one exciting thing we've added is that everyone now who comes through the program, we really assess them for which can is the most appropriate.

Theresa Stern: There's so many different ones. When I was a kid, there was a couple. Now there's all kinds of different tips and lengths and weights-

Marc Gillard: Materials.

And why I mentioned that is because you get to try out in a program variety of different canes and cane tips and lengths. And when you decide upon one as a client with your O&M specialist, of course, helping you decide, guide dogs will pay for that cane.

Theresa Stern: That's great.

Marc Gillard: And will actually get it sent out to you. So you get to have a cane provided, which is really great.

Theresa Stern: Awesome. Yeah. And it's the perfect personalized cane for you, which is pretty awesome. Yeah, I love it. I love it.

Well, very good. Again, I want to thank you, Marc. I want to thank you for coming and chatting with us today on Central Bark, but also just for all the amazing work that you've done over the years for all of us who are visually impaired. Thanks for sticking in there and really innovating and making sure that we get what we need. So just big, big, huge thanks to you, Marc.

Marc Gillard: You're very kind Teresa. Thank you so much.

Theresa Stern: For more information about Guide Dogs for the Blind, please visit guidedogs.com.

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