the participants to be seatedso with that shortlygood afternoon everyone good afternoon sessions so please take your seatsif the staff can tell the people outside to please come in and take our take your seats we can start doing thethe start of the principality I mean yeahthis afternoon2 keynote speechesuh from whereso we'll start with Dr basa from Malaysiaso Dr basherfrom Malaysia and she's going to talk about uh how to teach uh parentstake care of cock implanted kidsABT how do we get the parents tomotivate the parents to get the kidsdoing what I have to do correct good this ant teachers yeah but mainly parentsparents have to have involvement because if parents don't do the work teachersuh is the president of workability Thailandso he'll be talking to us about fostering community integration and creating meaningful opportunities for youth with disabilities so he'll be our second Keynote today and in between we'll have guests from uh overseas givingpaper presentationuh Dr Jennifer Lynn Reverend Father Peter will be joining us by Zoom Dr John Sherman Miss sen-yung Dr John shervin fromfrom the Philippines Mr Yogen Turned Down is from Vietnamand then consultuh Steve is the vice president of the cock implant community in Thailand so he'll be talking about thebroccoli implants being done here in Thailand so that's our you know our program for this option is quite integrated it's very knowledgeable I think we'll get a mix and match of many things today so hopefully people start coming in so we can start. Symposium after lunch you know they're getting sleepy probablyjuicethough should we wait or should we startme okay all right we'll start our session . our session this afternoon empowering children with hearing loss starts with equipping theprofessionals the support them what are the essential skills and knowledge that Educators and therapists need to help these children we are honored to have Dr basa othman with us today a true leader in professional development as a habilitation manager cocka Asia growth market and former program coordinator the professional certification in auditory verbal therapy Dr Othman has shaped the skills of countless practitioners representation supporting students with hearing loss a guide for teachers on transitioning to school with auditory verbal therapy will provide invaluable insights for everyone working with children. Welcome Dr Basha. we're ready when you are thank you very much Madame chairperson for the introduction a very good afternoonDr. Basha Othman now I'll come everyone sadika uh I'm basa from Malaysia and I'm the habilitation manager for Cochlear Asia growth Market this is my disclaimer. I am a Cochlear employee and my participation is this conference is fully sponsored by Cochlear Limited. Let's begin by asking ourselves why mainstream education entry is a crucial point. Firstly children with hearing loss and their families have the option whether going mainstream or going for special education school or class. Before this recent decade, it's by default that all our children with hearing loss go to special education. That's no longer the case now, but just wearing a device that's wearing cochlear implant automatically means that they will succeed in mainstream. you know the answer mainstream is challenging despite using cochlear implant and these students they need accommodation in teaching and learning they need extra assistance in teaching and learning.One of the biggest challenges is learning to read and  for pre literacy skills to develop children need 20,000 hours of listening as a foundation now if you have a child who only just started listening at 5 years old.  seeks your will they have 20,000 hours estia Foundation basis for literacy skills. it's also reported that many of our children with hearing loss ,the underachieve in mathematical subjects, they frequently fail to pass the grages and therefore they are at risk of lower educational achievement and later unemployment in life. So how can teachers help auditory verbal therapy students. But before that I will not assume that everybody is familiar with auditory verbal therapy, so let me give you a one minute crash course on what avt is. Auditory verbal therapy facilitates optimal acquisition of spoken language through listening. So it is a unique model way of acquiring oral language.it is for young children who are deaf or hard of hearing. it certainly promotes early diagnosis 1 on 1 personalized therapy and the latest audiologic management and the latest technology One Hallmark of auditory verbal therapy is that parents or caregiversneed to access in the therapy process because they are the primary language facilitator is for the child at home and this can happen through guidance coaching and demonstration of their auditory verbal therapists. the goal of EVT is for our child to have the access to a full range of academic, social and career choices, and must be conducted in adherence to the principles of listening, spoken language specialist in auditory verbal therapy. So that is avt. I'm sure you've heard about cochlear implant. just giving you a very quick idea about how the implant works. very differently compared to hearing aid hearing will amplify the sound and we are lucky in the year 2025 the technology of hearing eats are so advanced that it is not just simply meaning cranking up the volume or intensity of the sound, there are a lot of programs that is data logging in hearing aids. However 1 thing that hearing still cannot achieve is the amplification and the clarity of sound especially in the higher frequencies, meaning that  unvoiced positives and fricative sounds these are often cannot be achieved the signal clarity via hearing aids and that is when we need cochlear implant where the indication in Thailand in Malaysia and many other Southeast Asian countries is from severe or worse hearing level cochlear incline is not  similar to hearing aids in the way that it is an electrical stimulation the implant happens in the cochlear and therefore when the cochlear is stimulated by the implant then the signals will be processed by the external sound processor, and this will be processed by the brain because signals that are sent by the implant, goes via the auditory nerve, and goes to the brain.. now let's go back to our students with avt. before they enter our schools this is what happened to them. Hopefully and I know there are cases where babies start to be diagnosed with Device start interventio in Thailand and I'm so happy to hear that but this is an exception not yet to be the norm. let's hope that this will be the norm in about 10 years from now so when these kids are young between 1 to 3 years old sorry between babies to 3 years old they are diagnosed, they are fitted with device or cochlear implant and then they start auditory verbal therapy. I remember my youngest patient came in start intervention \ and a half months old and then as they grow older they go to kindergarten. mainstream kindergarten. they we try we try and we try as therapists to work so hard so that these children will catch up with their listening and spoken language skills, so that they are listening and spoken language skills is at or near each age appropriate. it's not enough for them to just talk but at which level are they talking; that is crucial. because when enter mainstream school at 6 or 7 years old, depending on school they go to we want them to enter school at each appropriate language, or at the very worst , 2 years gap of language age between their peers and their language functioning level. So for teachers often people will ask what is the main thing when you have a child who is mainstream in the classroom Often we talk about seating. yes seating is important look at the access, black, blue green and red. Red is a total no no because it's near the corridor near the window that is noisy we have other classes and children would run and talk and whatever across along the Corridor that will be distracting uh uh that's not where we put our child. Green that's good. why ? that's right at the front. however the child who is sitting in the green spot of peripheal vision of what their friends are doing it will be better if they are having more peripheral or sorry rather visual cues meaning that blue is much better there are still quite at the front and have the students at the front row to help them to get visual cues. Black that is right in front of the teacher's desk, but how many of you teachers when you teach in the classroom you are just sitting like me at the teacher's desk and do not get up at all. Do you do that I think if you do that right from your training days you'll be disqualified from being teacher because you are supposed to get up, and be around the class. so no black is not the spot; you want blue. If you have any other seating arrangement, Circle or round table is a good 1 or have a semicircle or horse shoe formation, that is also a good 1, so that your child will be able to see everyone. as of their visual cue. but that alone is not enough; seating arrangement is not the of the story. Acoustics. how many of you now sitting in this hall you really want to listen to me , but the person next to you or behind you or in front of you are talking and you can't hear me well. don't put up your hand I don't want to offend people in the audience imagine if you wear cochlear implant, and you try to listen to the teacher but find it hard to listen, hard to understand, because there are noises so if possible, whenever possible identify the source of noise, put it far from the child. It can be the fan. I can hear some whirring, not worry. worrying of machine behind me put it behind the child and for Cochlear brand cochlear implant the child can have forward Focus where wherever the child move the head the focus of the listening will be in front noise from the back will be automatically attenuated. don't put noises to the next to our student with avt. you will know who is the noisy a bit naughty, and cheeky student in the classroom. Please put them a bit away from our student with ADT. Look around in the classroom if there are hard shiny surfaces these are the ones that are bad for acoustics. Let's put some soft materials be it curtains, paper posters, cork boards or something soft to absorb the sound waves and reduce vibration. if you are not sure reach out to the audiologist reach out if the child is an 1 user especially for their brand reach out to tune our Thailand country manager from physical accommodation for noise reduction. this is a little bit technical but I need to say this .that we need to understand about signal to noise ratio. Regular classroom anywhere in the world where the children are talking and speaking mainstream classroom, the noise is around 50 to 60 DBL, then when the teachers is talking our regular voices without the mike, when I talk like this which you cannot hear of course, the best is around 70 Del but you cannot do this throughout the day are the device will be abusing your vocal cord. So because usually teachers voices around 65 decibel, classroom noises around 60 Del the difference for the signal for the teacher's voice to reach the child's desk is only +5 that's all the increment teachers voice that arrived at the child's device. that's  enough? no student with normal hearing they need plus 6 decibel; students with hearing loss without mini mic they need about plus 15 to plus 20 decibel. for good signal to noise ratio.But is it realistic to always tell the class be quiet, be quiet, be quiet. You can't do that it's not realistic, so remember there is such a thing as remote microphone. Ffor Cochlear brain we have mini mic; for hearing aid users there's some FM system or Roger system. The mini mic will help our student to focus to teachers voice because they will hear the voice directly going into their processor. This will have to reduce their auditory fatigue but teachers need to familiarize yourself with the deviceeither get help from the family, the parents or again reach out to tools in Thailand or anywhere you come from each country will have a popular representative and get help how do I teach myself to familiarize with this minimize. so that wherever you are in the classroom ,your voice will reach the child's processor as if you are talking right next to it.One thing though remember to return the microphone that you use to the child, so that the child can give the microphone to the next teacher that comes into teach. I have had some cases where teachers wear the microphone, because they forget to give back the microphone to the student, whether it to the toilet where it when they go gossiping about their family and our students with implant knows all the secrets. Speak in a natural clear voice at a regular and do these facing the class. One thing that you need to be very very ... where is it is very hard for the child to follow your teaching. Remember the traditional chalk and talk teaching, the teacher faces the chalkboard and talk while writing uhuh that doesn't work with our a AVT student. when the our child does not understand your sentences, you need to repeat or rephrase and you need to do this when other students are commenting or asking or speaking, you need to again repeat or rephrase what the other student is saying to the class, because you have the mini mike but other students do not have it so you need to tell it again so your avt student can hear. hopefully you have the chance when you want to give new instructions then asked the class to be quiet first and then you give instruction. And I've talked about don't give your back facing the class when you are talking because this will be hard for our child to follow. Use what we call gearing up to listen phrases because if you start talking by just giving instructions for example you start talking and you just say, turn to page 55, and by the time the child wants to listen to you the sentence has already ended.So you need to have the gearing up phrases like "now everyone listen up" and you get the attention turn to page 55 so use this gearing up phrases. When child doesn't understand say it in another way. Try not to repeat the same sentence over and over because the child may get a better idea of what you are saying if you rephrase it.Write key information on the board so that the child can what you write and what they hear from you. Consider having a body system; put a friend next to the child who can help with rephrasing or repeating what he said in the class. But choose wisely who is the body; don't choose a child who is the smartest in the class who has the highest IQ in the class because usually very smart students, they are impatient .they cannot deal with a lot of questions and they cannot understand why some people are so it's slow. I remember my best friend in school before would turn to me and said "you are on that question do I've already finished and there were 30 questions" but she was still my best friend, she is still my best friend until today .so don't pick the smartest student in the class; don't pick the a student either because we don't want the weakest student to be the role model for our AVT student. Pick student who is in the middle with a lot of compassion with a lot of understanding of how to interact communicate and Foster friendship with a friend who has hearing loss. And also what teachers can do is orientate your class oriented the other hearing students on how to make listening and communication easier for your AVT students. the things that I've mentioned before about speaking clearly and speaking directly, do the same. teach other students to do the same with their EVT friend. when they want to talk with their EVT friend. ask them to stand closely don't shout from across the room shouting doesn't help them to hear it better. If they want to talk with their AVT friend tell them to get the attention. When they're talking to your avt friend tell them not to run while talking that doesn't help. be still always watch and if they think that every friend looks lost looks confused need help just approach him or her and asked would you like me to help you. T this accommodation but these strategies also help the other hearings students in the mainstream class to have more understanding of how it is to live with students or fellow friends with different abilities. so what's needed for successful mainstreaming.Mainstreaming is not just about the child the teacher and the school; we need the team that worked with the child previously. parents have to be there. the therapist the audiologist If the child had occupational therapist or physical therapist or special education specialistor the Ministry of Education officers all these people need to work together and communicate. I just go straight to The Orange Box; they need to communicate with each other. does the child have undergone... has the child undergone teach appropriate goals throughout the intervention. And if yes is this carried out continuing when the child is in school, includes current level of functioning individualized goals, precise assessment and measurement across all aspects of the development. remember for the whole child management is not just speaking and listening;what about self-help skills, what about daily living activities what psychosocial development This is something that I must stress; for a child to go to mainstream, they need to have age appropriate language. You will hear me repeating this again and again. if it's not at each level at least near age level because for them to access the curriculum in a mainstream setting, via listening, they need each appropriate language. and there needs to be pre and post teaching of Concepts and again I must stress usage of remote microphone when teaching and learning occurs. Just to give you the idea of what is needed. Before this child AVT student enters school ,they need the learning to listen period this 1 so infancy to break in the garden this what happened hopefully when they have enough adequate and good quality of learn to listen period then they can go to kindergarten they enter our schools with the skills to listen to learnif this doesn't happen or this happened poorly or this happened in a very short period because they only started habilitation or intervention at the age of 5, at the age of 6, there isn't enough time for them to learn to listen. what happened when they entered this phase? It's hard or almost impossible for them to use listening to learn because listening did not exist. Let me share you some data from Malaysia. This is an old data because this was when I was still working with University. The nearly 400 children implanted by you the university we found that 60% of these children use oral language. now compare that with education placement, we have 60% here in mainstream? not quite but nearly 60. what happened to the 2% you ask. the 2% in the in Special School cute speech school or integrated in Malaysia integrated School meaning that is special education class within a mainstream school so that when the child in special class improves they can do semi inclusionor full inclusion when the child actually reaches the level that enables them to function in mainstream so they don't have to change School. What this means is that the mode of communication that is for the child very crucial because it will decide where the child will go. The second thing that we learned is that just because the child uses Auto language which doesn't mean that the child will become mainstream school student. It is harder to be mainstream compared to learning to talk. And this brings me to the second data that I want to share. Again from Malaysia when I was still there. With every 1 month delay of cochlear implantation, the odds of our child to be able to speak will be reduced by 2.6%. You time this by 12 to know if we delay cochlear implantation by 12 months for 1 year. what is the decreased probability for this child to talk?Usually you don't delay by 1 month. Some parents say oh we need to look for money funding and all that we don't have that wonderful the Federation and things like that like what you have here in Thailand we don't have such things Malaysia. Sometimes they delay by 1 and a half years, so imagine how much reduction of probability for the child to speak. Now to enter mainstream school is much harder; every one month delay of implantation the odds of going to mainstream School will be reduced by 3.3%. Time this by 12. How much reduction of probability the child will have to go to mainstream School if we delay the implant by a year? Let that sink in for a second.So there is a continuum of how our children with hearing loss communicate. I'm so happy to today to see quite a number of people in our audience who uses sign language.Many of our children with hearing loss will also use sign language and they are or here they are fully visual or mostly visual communicator. If they are fully visual they you signing only; if they are mostly visual it probably will use a lot more sign and some oral language. will they be in mainstream school without interpreter?probably not. They need interpreter in school. how many Bangkok schools have sign language interpreter in mainstream class? None. the same with Malaysia. children who use sign language cannot be in mainstream schools in both Malaysia and also Thailand. I know that. So our children who are more visual, despite using hearing aids, despite using even cochlear implant ,they are here they are not supposed to be in mainstream even with implants currently in plan really good habilitation then they most probably will end up being fully auditory in communication. They're listening and speaking or maybe mostly auditory. Their language level may be not age appropriate but just slightly delayed, about 2 years delay. Then this group can be in mainstream setting. if you try to put this group in mainstream setting, you can and then you will realize after 6 months 1 year what will happen they need to be replaced in special education setting . You are setting the child up for failure.Let's Ponder on several points; let's take as something food for thought. You just had lunch, you had food for your stomach and now food for your brain. and I'm talking from the heart of a habilitation looking after southeast Asia region especially Thailand my nearest neighbor to Malaysia. first one, do we know when our child enters school what has been the history of progress in the listening and spoken language from beginning of the child's intervention to just before the child enter School as a teacher, do we know ? as a teacher do we ask? if we don't you better do now because Dr basha has told you to do so. do you know if the child has any additional diagnosis. sometimes parents do not tell you why? because they are afraid if they come clean and tell everything to you you will be so overwhelmed when you said "look maybe you should just send your child to special education class without even starting to teach the child first".That's why talking to the team managing the child is important. Do you know what is the child's language and listening levels near the entry to school? Again you know this by talking to the therapist or to the audiologist. School readiness skills like I mentioned before, it's not just about listening it's not just about talking can the child go to the toilet independently, can reach a bite things from the school canteen independently, does the child know how to problem solve, does the child know how to establish friendship and maintain friendship? does the child can can the child play with other children well in the playground? do we know this? do we observe this?This may be a raw point but I asked this question, not just in Thailand but in other countries as well. Here my audience people who are very close to Ministry of Education. am I right? do we talk to people in the Ministry of Health? is there any formal or informal communication cable between m o e and m o h? if there isn't when are we going to start? knowing that it is important for our child to transit from their early Intervention which is mainly under MOH to shcool which is under Ministry of Education. Last question do we know how involved is the child's parents during intervention before the child started school because that is an indication of how much these parents will be involved when the child is in school. From your experience you already know, parents who are involved with the child's academic, help not help them with their home, God forbid ,takes interest about the child's performance and making sure that the child schooling experience is well taken care of these are the students that are more likely to succeed whether they have disabilities or not. you need to find out the history of these parents involvement during intervention because the parental input of languageis the best predictor of the child's language and the child's native outcome. Children who use listening and spoken language at home intensively and using the right avt techniques, they are the 1 who have better language course. Compared to those who use speaking and signing or total communication. Parents who are well coached, well guided during intervention will become active learners will become the primary language facilitators for their child and they will continue to do so when their child enters school age.Parent and child conversation in particular they are taking turns conversation will influence the child's verbal language and cognitive skills. And these skills between 18 and 24 months the more conversational turns happen then will predict their skills 10 years later The effect is long-lasting. Those of you who are young parents who have very very young children or babies, make sure you have a lot of conversational turns. with your young children. so hopefully with the right direction, early intervention the right device the right therapy with the right Knowledge and Skills and I would if it is student goes through school from primary to secondary and then tertiary, hopefully this is they will become. I will show you one of my previous patients I don't call them student because I was a therapist who was 8 years old when I first met him, he was with another therapist before. So from being my patient now he is my colleague at cochlear Malaysia; he is a head engineer at the repair department in cocka Malaysia even though it's COA Malaysia the repair for speech in Malaysia from all over the world and he is the head engineer there. Let's listen to his experience then he went to University and he shared this with this with parents during uh seminar that we held at the University before.I'm sorry I don't get the sound from this video can I get technical help. There is no sound from here. I'll try again .okay. any update Kelvin try again. okay let me try again.  um they don't have a huge problem from study information all about and if she was surprised that disability as you know it's something and then she said that are you calling now ... was surprised and she's really to teach me on Facebook you just need to[Inaudible] teachers that you have a problem who was my patient and now my dear younger brother because we both our both our families considered each other as related now. So let's hope that that inspires you to really assist support and really guide your avt student in your classroom. Thank you for your attention thank you Dr basa uh that was very informative um of me I uh anybody has questions for Dr Basa the longer you yes ohuh hello good afternoon everyone and thank you uh your presentation is very great.  and uh I know especially me I have learned a lot from your presentation so thank you so much. uh I have 2 questions, how often do you assess a child with EVD the learning challenges in the schools or any issues how often do you as students when you talk about assessment we will usually do in in Bhutan like us we do assessment 2 types of this is men 1 is a clinical assessment 1 is functionality assessment. so how how often do you dothe clinical assessment and how often do you do the functionality assessment of the child with EVT. this is 1 question and uh the the second question is the parents. I can't give the families and the teachers are so important uh if you really wanted to see children grow and learn very important is these are the important stakeholders and how often do you actually build the capacity of these stakeholders for the better life of the children. thank you. thank you very much it it's probably the first time I'm interacting with professional from Bhutan so lovely lovely experience today. okay the first 1 is how often the assessment by right if the child is managed by an EV therapist it should be every 6 months at least so the same with what you mentioned. However usually when the child goes to school. their relationship with avt their avt therapist becomes a lot more ... because the child is now under the um responsibility of the school. so schools from where I come from the teachers are not equipped with the terms of time resources or skills to do language investment.  So usually the language assessment will come in when the teachers feel that the child needs to be relocated from mainstream to special ed, so in order to justify the request the teacher will reach out to the therapist and ask for assessment.  So although by right even during school years they need regular assessment in practice, that doesn't happen. Okay the other question is about family involvement parents involvement and how do we force this is this what the question is...  This topic is very close to my heart I spend ... about 5 and a half years of my lifestyle doing this for my doctorate. Um so what I looked at is how therapists and parents relate to each other. What model do they operate on and this is Malaysian parents. Therapist in Malaysia at that time my PhD was between 2005 to 2010 and you can guess what my age is unless I did my PhD when I was 10 years old. Um therapist in Malaysia who work with families who have with children with hearing loss. They know they believe working with families is super important. It's very crucial as long as the keep their mouth shut and just obey whatever the therapist said.  If you have good therapy if the good Knowledge and Skills.  Maybe that's a good thing but still it's not Democratic at all it's very autocrat. But what if you have a therapist God forbid who have very poor skills and knowledge and do not like when parents ask questions or Heaven forbids these disagree with them. You don't like it so it's not really family centered.  They they treat the family as important but as long as they listen to the terapid. So my career Mission and also life mission if you like is to change paradigm.  To change this Paradigm among professionals when they start working with family understand that we as the professionals are trained. How many several years that you are trained 4 years in bachelor's degree probably and then you go on into specialization to be an expert in your speech and language and hearing. and you come and meet the parents who is the expert in their child in their family India strength in their needs.  The family did not study for 4 5 6 7 years to become a parent an expert of a child with hearing loss.  This is not a journey that they have children you can certainly hear my advice goes my voice goes up because when I talk about this I cannot help but be very passionate about it. Parents did not choose to be to be a parent of a child with hearing loss. We choose our profession be kind and considerate especially at the entry point of their Journey during diagnosis many of the teachers here, you've seen the child and the family after so many years of their Journey in hearing loss.we do not know that some parents are still grieving at the fact that this child cannot hear I do not want a child who is deaf. Because for many reasons some parents they have gone through this grieving Journey with the help from their professionals. Because this happens in any country audiologist only see the device and only see the ear. Our ENT only see the pathology of the ear and then put implant and close the head and that's therapies on the do the speech and language and communication. We work in silos we don't talk to each other and the child have this fragments I suppose it help and who helped the parents. Nobody. We need this paradigm shift especially those who meet with the family right at day 1 in the beginning of their Journey the day they get the diagnosis. This is where working with the family starts if you want to talk me to talk about this I can talk about it for 1 month everyday. And it still doesn't end I hope I have answered your question. in my head because I'm a parent and nobody came to me at that time so that was ages ago.  So thank you for bringing that into light and I see a lot of professionals here I was talking to Dr deed. who is help is helping people who are blind in provinces but after he goes who's going to help them further so I think thisseeing professionals wanting to help parents have a sense of relief. So thank you from the bottom of our hearts to all the professionals here who want to make a change thank you so much. So, .Dr basa can you please come down because uh Dr maliwan as something new she wants to give you. Dr money 1 please oh sorry oh sorry there's another question.I hearing ability then ...  So it was taken to a hospital and the doctor said that that the cock clear is broken was broken. If you're interested. You can have cocoa implants I would like to but my family did not want to Up to now my family doesn't accept that so so I use a hearing aid and and also speech therapy now I still use the hearing aids I just want to share my experience uh to the speaker. ... hearing loss uh he went to see uh doctor and the doctor said yeah if you want the cooking plan then it can be done but during that time. Uh the his family also doesn't want to have their surgery and then he decided that he would continue uh with the sign language and right now he's also wearing the hearing aid and he's uhhappy about that okay that just want to share...  If I can just add on to that. Thank you for sharing your journey. And I am so glad that you continue with another mode of communication. Using sign language is just as good as speaking because you do have the community you have the system you have the schools where the choice of your communication will support the sign language and 1 thing that we need to remember that did we manage the management of hearing loss the way that the technology has evolved. It's very different compared to 20 years ago 15 years ago even 5 years ago. What happened when I started working is very different compared to now. I have worked for nearly for 24 years actually, so probably if your story of sudden hearing loss happen in 2025. The journey might have been very different. When this happened 10 years ago or 15 years ago I don't know how long ago your sudden hearing loss happen. The management was quite different. And this again different depending on where we are Bangkok management will be quite different from say...Why I don't know I'm I'm just trying to draw a comparison see with Malaysia. Which is the capital city management will be very different compared to uh Village in Bono. So all this depends where you are when this happens Whether there is a system to manage sometimes it's just a stroke of luck but again I have a lot of respect and a lot of um um admiration for you and the journey that you've gone through. Thank you for sharing.So I like to share my experience.  Oh my experience from my school after I have a implant called clear. Calculate implant I like to to be mainstream that is a waste of opportunity but you still study in the uh special school with the deaf people. be put in the mainstream rather than going to the side language school in order to develop uh and spoken language but he's... Thank you for that I agree and I'd like to also draw the attention if you can remember. Now I'm testing who among you paid attention to my talk just now the Continuum of communication. Whether the child fully visual or the child is fully auditory sometimes we give cock implant. But we give clay implant when the child is already 5 and a half years old. There's only 1 and a half years before the child started school. We want the child to enter mainstream school with language level that is adequate to survive and thrive in mainstream School.  If the child starts implant only starts hearing only start speaking at 5 and a half what do you think will be the child language age at 7 If the child comes to see me this is probably a bragging point I'm sorry. I probably can try to get the child to get at least 2 years of language within 1 and a half yes in calendar . Am I making sense, so it's not just 1 year calendar 1 year progress uh uh we need to speak up. If we are driving any of you remember driving in a manual car we need to go to 6 6 we need to go fast. Then even if as fast as I can do 1 and a half years I can only do probably 2 years of language from zero language. So this child will enter school with language age of 2. Be among friends with language age and hearing of 7 years old. Do we want to put this child with 2 years old of language with 7 years old. Do you think this child will drive survive mainstream education. No. So that depends on principle yes I agree that is what I would fight for but that depends... Thank you very much thank you Richard Dr basa thank you for all your questions. sections is deferred paper speaker of the person today and uh ladies and Gentlemen please tell me you're welcome. paper speaker um... Dr John shervin Dean for the Philippines he's going to uh printed about uh the leveraging technology for Low Vision. We have he likes what um we have... limitation. I'm sorry and life skill developments in resource Limited setting welcome.um good afternoon everyone thank you for joining us today at the ninth National Symposium on special education I'm Dr John Dean um optometrist and founder of JD in gisha care in the Philippines today I will be discussing leveraging technology for Low Vision. Rehabilitation and life skills development in resource limited settings before we delve into the details uh we want to be fully transparent JD visual care has no financial interest in or affiliation with any of the specific app Developers or Brands mentioned in this presentation.these Technologies are highlighted solely based on their General availability their accessibility features and their observed utility in our low vision Rehabilitation practice. Our aim is purely educational and informational. so let's start by acknowledging the immense Global challenge we face over 2.2 billion people worldwide live with some form of vision impairment.  Disturbingly at the least 1 billion of these cases are either preventable or remain unaddressed so that's still a big number.This burden this proportionately affects children in resource limited settings where access to care is scarce.personally we had this experience in the Philippines we visit different provinces and we go places wherein they never had eye exams we had a case wherein uh a person's like 75 80 years old never had an eye exam ever in his life so it's across all ages the impact is profound. We see significant educational delays and limited opportunities for these children. They often experience social isolation reduced Independence and the severe lack of access to traditional specialized services and costly assisted devices by assisted devices I mean the traditional low vision devices the magnifiers and other sort of stuffRecognizing these barriers our study at JD and visual care is focused on ident an accessible solution. Our objective is to demonstrate how readily available and affordable ology can empower children and adolescents with low vision in these challenging environments to give you my experience um whenever we do the low vision assessment we explain the management plan to the the parents the families and then to the point wherein we say this is the best solution um your child needs that expensive uh digital magnifier the the answer will always be it's too expensive. We cannot afford so as a practitioner it it is a burden with that we need to uh need to always carry so we have to find some way. Like you know, to help these people our core approach involves leveraging existing smartphones. And simple do-it-yourself or DIY adaptations for Effective Rehabilitation.And vital life skills development this this approach directly addresses and the challenges specific to Resource constrained areas aiming for interventions that are both scalable and sustainable so smartphones are you know very widely used nowadays uh we had patients been using smartphones but not to a point that they can maximize the feature so that gave us an idea hey that's maximized that. Let's look at how these affordable Technologies translate into action smartphones are Central to our strategy. They are built-in accessibility features like magnification screen readers such as voice over in iOS and Apple and talk back on Android. And high contrast modes are incredibly powerful and often underutilized Beyond built-in features dedicated mobile apps offers specialized functions. If you will go to your app store or uh I don't know, Play Store and search low vision apps or or Vision AIDS you will see lots of these apps but uh for for the interest of presentation I just featured the the 3 of them. Seeing AI by Microsoft excels at reading texts. Identifying objects and describing scenes in real time, essentially giving a voice to the visual world look out by Google offer similar assistance with reading and environmental exploration making daily tasks more accessibleand of course be my eyes connects users to a Global Network of cited volunteers via live video call. For real-time visual assistance, which is invaluable for Unique situations so the technology right now. It is very different from what we had like 5-10 years ago the the challenge right now is for us to maximize the technology these resources to help people and I think that's you know the same across the disciplines that we have today.Beyond sophisticated apps simple DIY adaptations can make a significant... A smartphone itself can be a portable digital magnifier utilizing its camera zoom for close-up viewing of texts or objects now with the integration of AI we can do so much more. Not just with the magnification, and there are lots of things that we can discover high contrast textile markers. Easily made from common materials can be applied to appliances or containers greatly enhancing Independence in daily living and finally simply optimizing lighting strategically using natural light or affordable lamps can dramatically improve visibility various tasks. And in the Philippines we after the assessment um part of the rehabilitation is to help um people with the orientation and Mobility training wherein we teach them skills. How to navigate inside the house, how to uh cook are you seeing these tactile markers um using their other senses to make sure that if it is safe. And they their efficient and effective in working around their places.Our work at JD visual care is an observational case series drawing Upon. Our extensive clinical experiences we focus on a diverse participant group children and adults has been very slow vision ethology. Because of low vision um we say that they are visually appeared but there are different kinds of visual impairment so it's it's always a case-to-case basis. We have to make sure that our solution it's the specific case of of that person. Our trading approach is Hands-On, directly educating both participants and their caregivers. By caregivers, I mean their familie,s uh even the teachers because based on our experience after providing these the assessment after giving the uh they need support on a daily basis. And the people who can provide that would be their families would be the teachers so we have to make sure that the solution the management is is continuous. We emphasize community-based models and collaborative strategies to ensure the sustainability of these interventions our data collection involves careful observational notes qualitative feedback from families. And relevant clinical metrics to track progress.So let's illustrate this with a transformative case. uh Maria a 12 year old female diagnosed with congenital cataract, underwent surgery with iol or intraocular lens implantation so for both eyes with cataracts and then they were the the cataracts were removed and replaced with the artificial limbs. Before our intervention, Maria struggled significantly she was in a special education class unable to catch up with mainstream education. So even with the special education class um the teacher reported that um she's having difficulty identifying letters and numbers and and that's difficult for Maria. You know to have that confidence in the class despite trying eyeglasses for additional hand magnifiers and large print materials. She reported persistent reading difficulties and saw no significant Improvement. Just on a side note, most of the patients that we've handled aside from the visual impairment we you know we always hear that they are having that confidence issues.Thay hear that people are talking about them um there there's this barrier that they face on a daily basis. So as I Care Professionals we we have to always remind ourselves that we're not just treating the eyes. We're helping a whole person. At her initial visit to JD in visual care, Maria had difficulty identifying letters and numbers necessitating the use of Leia shapes so instead of letters and numbers we use the shapes. To make sure that we are we're getting a credible measurement. Her near visual Acuity with updated glasses was about 3.2 M at 30 cm. For reference this is as big as the large print materials for for children's books that's how big it is that's the best she can have. We introduced her to smartphone-based magnification um specifically the visor app at that initial assessment here near visual Acuity with the visor app was 1.0 cm at 30 cm so that's equivalent to a regular size text the the printouts that we have in our in our handles right now so that's how big it is. So initially it is good, it looks significant really nice however we have to consider that Maria say with other person with visual impairment will use their vision of daily basis they will be fatigued there will be environmental issues elements that we have to anticipate. So what we did is um, we provided a 4-week plan. So every week the parent would have to work together with us. Series of exercises with Maria introducing her with different visual targets to make sure that the vision is being stimulated so aside from the tool. We make sure that there's this approach which will help her um build the skills for it.Just 1 month after implementing the visor app and integrating it into her daily. We observe transformative results her near visual Acuity with a visor app significantly improved from 1.0 to 0.8 m. So for reference we started with the target as big as a large print material for children. Very big. Right? And then after 1 month, she started identifying as small as those telephone directories nowadays, we don't have them anymor,e we have the smart folks beyond the numbers the qualitative impact was profound clinicians observed a significant Improvement in her near vision. And she became more confident in recognizing letters and numbers performing significantly better than her last visit. Uh we also asked the teacher about her interaction with the classmates. So we're happy to hear that she became more confident. This led to enhanced Independence. Maria started catching up with class discussions was more confident interacting with peers. Her goal of being included in mainstream education became more realistic. So 1 month is not enough it's not enough it it it's a continuous process. So we have to make sure that we are there to support um uh the people who need our help. So in conclusion, our study highlights that affordable technology offers highly promising and scalable approach for Low Vision Rehabilitation and life skills development particularly in resource limited settings. We offer key uh 3 key recommendations for impact. First for the Educators and practitioners to integrate these accessible Technologies into your practice and curriculum for the organizations and policy makers invest in Awareness campaigns accessible digital literacy programs to support broader adoption. And of course, for Community engagement Foster strong local Partnerships. I think this is 1 of the key ingredients, really and training initiatives for sustainable impactEmpowering individuals with low vision to unlock their full potential is a shared responsibility leading to more inclusive features.Thank you for your attention and we are committed to fostering Clarity and comfort for those with low vision welcome any questions you may have thank you once again.. Thank you Dr Dean um just uh please don't stop with your passion keep going on. A lot of kids need you, please continue with your passion. Thank you so very much. Our next speaker is uh Mr. Nguyen Trong Dan from the National Institute of Education Sciences in Vietnam, let's give him a round of applaus,e thank you very much.Just a moment please. All good, a bit of an IT glitch, sorry everyone. good afternoon everyone yes uh my name is I'm working under the National Center for special education in Vietnam. Uh under the Ministry of Education and Training. So uh I'm parents, so you are also parents and will be parents future so my research is on the skills of the parent in Vietnam. So in my opinion I think that if we improve the balance skill in interacting with the children with autism so the children with autism will develop so that's my research um and I'm very honored to be here to is then 1 of our research during 3 years. uh with the and research content the methodology and writings. So the amount of our research is my current state and invention skill quality and with ASD through 3 to 6 years who are diagnosed with ISD and for the sample and the population so you can see on the slide that we we do the research on total 280 parents. and high city. So you can see that we do some uh methodology that like we have the ... assessment, we do the survey form and we we will have the observation for the parents who have children with I actually in in Vietnam. So for example the statistics of the parents who do the questionnaire provided by the providing in the city and um is very important that uh most of the parents in Vietnam. When we do the research they have the intervention for the children at home like them for at the 85% of the parent determine that they do the intervention for the children at home in the activities ,and they get the children to go to the Early Intervention Center is very important so mostly the children with autism in Vietnam. are in the Wind now uh but uh some factors affect the effectiveness of the intervention of the hands for example the balance in the v method they don't have enough methodology to to teach and to intervene their children at home Um they have some, they don't know uh what is the specific security of the children for example, the language the behaviors and some of the the diagnose although this other for example they don't have the economics call distance. Apparently to work all day so they don't have time to teach the children at home. So on our surveys and our... We focus on the fact, so you can see on the slid,e and there are some main group a skill that the parent need to have when they have the children with autism for example they need to focus on the child. They need to adjust the communication. They need to create the opportunity to to have more connection with their children at all the time. And they need to teach the new skill quality and and they said the skill for all the activities in the whole day.So that's 5 group of skill that we do the research on the pattern. For example when we do the still buy on we focus on the child's skill, so for um the post-season also the position that the parent uh often use for example they they see face to face to the children and the the the ice level and and the object they take out of the children. So most of the baron is the position very very good in Vietnam. So uh so other people will sit behind the children to bribe Provide support or see at the same level of the children And uh the parent often any test the interaction between their children for example they will let the children play first and then... They follow the chair and lead and in the involvement with the children but uh but you can see here most of the parent of often questioning and giving instruction to the children even they the children don't understand what... they answer and the question. Um sometimes the the parent will imitate the body facial like passion and the body movement of the children body language and to get the connection between the parent and the children so uh the children will have more developments. Um the band will um inWe will make more retro and body language for the children and may I use the facial expression more and more and the toner The Voice. will be used in the chat and interaction with the children. They um, about the position that they um put the toys, they will um select the toy within the children Ed ricks. And teaching new skill for example the parent will often comment on what the children are doing joying in The Children Play and guiding the children play. Yes and I also found that most of the band will participate in the trainings of the teacher and all the ... and In Vietnam, we also have a very good support of the community community live Vietnam autism Network live Community for my full parent of special need a blue light. So the support of the community has the parent to have more skill and skill to to live with the children. So on on discussion so how can we develop the parent right now not only the policy but also the community. The committee needs to be involved intending the skill for the parents. So that's all my my reseaches. So uh if you have any question related to my resource all the parents still related to the chair then with autism I can answer all the question to you thank you very much for listening. thank you very much Mr uh William from Vietnam and um our participants so do you have any question for the session no question I'm sorry because we have no time no more time like that... Okay and I would like to say thank you very much, Dr Union from Vietnam, and are right now. everybody, could you please uh and QR code to if uh evaluate uh our event and um give her some feedback for 10 minutes. Thank you very much.Everyone this is really very important uh please scan the QR code and give us your evaluation it will help us to do the next uh Symposium thank you very much.  [Thai Spoken]hi everyone I hope you've had your break. before we go to this next speaker I want you to see this video. all of you listen to Dr basha talking as a a teacher teaching kids how to use their cochlear implant and helping parents but this video is is the other version of how a parent and what he's done to help his child with a cochlear implant. Can we please show the video? thank you. hello my name is will now I used to a cochlear implants I uh have that since 3 years old and I start the first side and the left side and later on I the second implant later  in 3:00 at 3 years old and uh we bring him to a health checkup and at Rhema Hospital uh we realize that my son has a hearing impairment. And that time we are shocked I and my wife tried to find more information as much as possible at the time 15 years ago it has a very limited information about quickly Cochlear Implant and finally we found that the best way is to do the operation and at that time we consult with doctor and the doctor also check about his physical condition His um mental condition and also uh do assessment and at that time. My son is only 3 years and umSo his language development is delay comparing to other children.So as fast as he start to hear he can't do a lot his language skill. My mom and my dad really helped me and supported me. You bring me to the Center to learn to pronounce the word, and he helped correct me when I not speak clear and he helped to guide me how to pronounce it. More properly after I hear after I speak more I began to relationship with my friend Joy them in many activities I play football with my pray and go out and buy things hang out with others I hear many things and bring me me attention to other things and I really appreciate my support for my mom and my dad and if I'm thinking about this situation and I think because if I am I'm very glad that uh I'm very glad and happy with the result I'm glad that my son be able to um leave his life and in the beginning I see that uh it's not easy and could we also say that 1 of the success um point for my life is be able to get the driving license and I also be able to drive a car with a license and as a parent you need to support your child of the cock implant and hearing is very important for your children when they gain their hearing skill they will be able to continue in his lifefluently and I learned about the cooking, I learned about bakery, and I hear the things that moving around in the kitchen and you know here the sound when I do cooking it's um make me more enjoy and I enjoy uh cooking with my friends and I also love to eat a lot of food.The thing that we all parents who have kids who are in cock that want to happen so Steve's son is a good example is once you have the Cochlear Implant  your name is very difficult. Steve is the vice president of the Cochlear Implant  Association Thailand uh and uh I am connected with this because of my son but the work that Steve and the association is doing to advocate for children with hearing loss to get a cock implant for them to go to normal schools for them to have a very normal life is the work of our uh Association so let's give a hand to Steve he can start his presentation thank you.how the process you know here first thing I have to tell the translator behind uh could you be translate my English to be the English. Because of my English is not influence I have to thank you to the Foundation to give out the opportunity invoice our association Commission. Experience to everyone uh I'm I'm I'm will not talking all the debt will follow all uh because of you can see all the detail in in the books already. But I I going to tell you what Association we did we are doing and what is our association uh vision uh. In the future, and what we are doing in the future uh talking about uh 20 years ago uh-huh since my son uh was born uh born and during that time there's a we are just realized that the thigh men not uh subsidi for the operation for the core yoohoo so 20 years ago. my son uh doing the cock clearing pan on the first size at that time the court is 1.2 million B 1.2 but so after we did the operate for my son I just talked with my wife hey so this kind of thing is a for the social with they are not cover all the Thai people or the children so what they are doing how how they operate. So that time we are just and my wife just talking with the ministry uh Governor. That uh start from the all the global Governor people who who have the dept born so they better Italy and so finally the ministry and the minister. They agree approved for all the governor during that time that they can reimburse 85% But after that again I just tell my wife that I told my wife it is unfair also how is normal people who work with like a low low slightly they cannot effort for like a 1.2 million baht. So after that I decide to operate my son on the second size because of we need to pushing who post more the governor or the prime minister at that time and I don't want the people to gossip me that uh we are pushing for my son. So after we operate on the second size we are just like lighting the letter to the Prime Minister and the pushing all the ministry in public health. uh-huh We fighting for almost like a 12 year until last 2 year we can get the proper law they approved all the people everyone that who dept born they can do the operation 1 side fee of charge this is what our association doing. But after we we realize that uh many children they did the Cochlear Implant the problem is coming to us uh not not uh how to say we just realized the problem is not only the how to how to operate how to do the cockpit and but the problem is The transition after the call clear implant to the normal school to the to the school get the get the children to the school. Most of the parents they don't have like the idea they don't know the mindset of the balance that that thought that after the children doing the Cochlear Implant and then they can put the children to the normal school immediately they thought that the student can speak immediately. But in fact is no because of just like uh the children after the operate they just like a baby just born they just hearing they just uh listening so they need the time to transition study how to speak study how to read study how to write first. Before get to the normal school. So we try to push everything even the to go to talking with the uh this is the governor of Bangkok home Metro. Our association go to meeting with them that's hey we know there are many many school the families who under the Bangkok metal present already check the always check the children that doing the calculating timeso we just talk with them hey can you do uh like a project of the for the cocking pain children until that the Lord May uh Mr chat right now. He uh he commit to us and doing the project that the reject uh zero reject for the Cochlear Implant of uh of the primary school Under the Bangkok rate of return uh Also uh we we are try to uh make our our own project under under the how to say under the support from uh debt Foundation Dr Mallika that we open our AVT not AVT the speed Therapy Center. In our association offer to all the children or uh just doing the Cochlear Implant and need to study to to speak so they can come to our association every Saturday free of charge. This kind of thing that uh we our association we have we can we we can support right now. But a problem another problem that after we talked with the uh depth Foundation that right now in Thailand we don't have much for the speech therapy. So we have to set up the avt center and the uh all the people to know all the teacher specialized teacher how to know uh to know how to uh the teach Cochlear Implant children. This is the project for the future and yesterday that's we went to the hospital so I had to talk with them. Because of what she like uh hospital they going to be start from uh they are going to be start support check I had the first project for like a center and also talk with uh. We are try to uh not only how to say... uh Try to ask all the pilots of the children who did the Cochlear Implant come to learn also this is uh the the thing that uh our association uh we're going to do in the future. So that's all I will Association we are doing. Thank you. Thank you very much Steve thank you. contact this okay uh from China via Zoom Dr tatone are you in Zoom right now can we see you yes. Yes I will. Oh great so how are you good thank you yeah I will share my slide now. Can you see me my my my slide yes yes you can see your slide in here as well audio is very thank you.Okay thank you so my name is I am dat 30 and add content University. Sorry that I can join the meeting website because uh today is my outpatient clinic is 5 BC to travel to Bangkok. Anyway uh What uh is it my partner to to be speaking. For this conference uh my title today is from ing to learning from the uh educational outcomes in their children both Cochlear Implant. So we know that uh the hearing loss is uh By common problem up from the data from the BHO. uh They found that uh over 1.5 billion people worldwide is have some degree of having impairment. And in Thailand we also have a study uh this uh significant study is conducted by for professor ... not only in Bangkok but but in the rural area also. She found that population have that's already near say neural and file that in the rural area the the incident is increasing 2356 and so uh in this study Professor say that the the real different environments in Thailand should be around 2.5 to 5% operation is that if like surprising time and uh from the previous uh presenter we we already know about the operating implant uh the cockran time is the uh surgically implant electronic device. That uh that the 13th insert into the inner ear to let the the deaf patient looking at again but it is not all necessary is not all. We need to do the rehabilitation after the surgery. It is the what we have try to do in previous 10 years ago. Is the we try to have a great day we call this regret the co-creating primary disease of Thailand. It is the National Database that collect data in the University Hospital that performed the Cochlear Implant surgery and collect data from past 10 years we have in this we can see we have the the database around 500. uh patient in District uh For the outcome that we have a published in 2021. We found that this is the surgical Improvement we found that the hearing level technically improve and we also found that the speech mailing level is also improved also. That uh that is the surgical outcome. We don't know about after the surgery. What is the learning outcome of the patient.So as we already have the registry. So we try to use uh existing ... to collect the data about the academic performance of this patient. So so the objective of this this study is to find the outcome of the learning of the pages we collect the participant from for University contact University. And we got for 47 participants that uh that uh agree to participate in in the data collection.This is the age group of the patient that agree to pass the pair most of the patient is in the early year from 6-12 And the next half is from 12-18 and more than 18. And the female and male is quite far 50 and 47. This is what we found from the that that current uh GPA. Most of the patient have the GPS around 3 to 4. Some of them have the GPA from 2 to 3 and only a small portion allow 20% have the GPA that is not not quite good. When we as as the we also file file that most of the patient is quite good at learning. So we try to use that that GPA to during knowing the vacation Model 25 for from the 77 patient if they have some of the significant factor that that affect the GPA. We found that only the 1 Factor that at the communication method that that is the significant factor for to be uh better learn learner for the fact getting a intelligent level .. score for method it's called for training Guardian a number of families member .. member type of school and this time of is not significant but uh I would like to say that this is the eliminate the data from from only less than 100 patient. So uh it may be significant if we contact the larger study populationSo uh what if can can what we can conclude from this study is... uh This is uh just a preliminary data that you saw that uh the patient in in our registry is put in at learning and found also file that is uh communication working language communication is the factor that it contribute to improved public academic performance. Okay that is out of my presentation. Thank you.Thank you Dr pathan. uh For your outstanding presentation. Thank you very much. no um Our next speaker today is uh Dr Jennifer from uh the Philippines. Welcome to the state.point out today you got a very interesting experience. uh At 1:00 you got to got to see Dr Basa as a a specialist how she's teaching a Cochlear Implant tp kids then you got to see the real thing which these presentation how his child is with the cock leaving a totally normal life. And then to end it we have Dr pathan talking about cock plans are you getting from the medical you getting from the parent view getting from a specialist view so it's complete package today. So I think we were very lucky today now don't you agree Dr maliwan should I call you Dr Mallika.Okay. Okay we're ready Dr Jen. Good afternoon everyone. I'm a faculty member at the essential University College of Optometry in the Philippines and I'm hereto present an ongoing collaborative case study with Dr Seline feeble Conte entitled. Apologetic in developmental case study of a child with autism understanding developmental challenges and interventions. According to World Health Organization autism spectrum disorders are a diverse group of conditions. They are characterized by some degree of difficulty with social interactions and communication. And about 1 in 100 children has autism. In the Philippines according to Autism Society Philippines also 1 in 100 Filipino childrens are on the autism spectrum. It's translates approximately 1.2 million Filipinos as an optometrist um I know how important to understand how to deal with different types of patients with and conditions and um autism is 1 of them.Assessing them with the primary goal of improving their quality of life. And enhancing their cooperation during assessment and evaluation. To get the most accurate result possible and to provide them with the best proper management.It also promotes inclusivity and equitability because everyone has the right to quality I Healthcare. The case study that I'm about to present comprehensive assessment change his name with autism to identify not only developmental the delays but also how visual behavior affects overall learning and interaction.For the patient's profile or CVS a 4-year-old and 4 month both meal residing in Venezuela City Philippines.He underwent his first comprehensive I envisioned examination due to concerns 3 his grandmother. It's gone by the reported that the child has always watches very near the television and has 4 eye contact.He was born on April 1513 on full-term via cesarean section with no started complication. The patient is primarily cared for by his grandmother after his parents separated said when he was 1 year old. And his grandmother lacks details on maternal health practices during pregnancy for the early developmental concerns the grandmotherreported that she observed significant speech delays no thing that he was not the patient is not talking by the age of 2. Despite the initial denial by his parents the grandmother insisted on consulting education regarding the patient unusual behaviors.in May 2017 the patient was diagnosed with autism. Speed delay and communication disorder by a behavioral pediatrician. He's currently enrolled in a special education school in an apple Learning Center. reflecting his need for the Lord educational support according to his grandmother the patient exhibits 4 eye contact. Prefer solitary play and is drawn to repetitive movements. His communication is limited although he has shown improvement with speech therapy verbalizing more since his enrollment in educational programs.During his visit in the clinic. It is very um evident that the patient exhibits significant difficulty making eye contact often staring at certain objects or patterns instead of engaging with people. Upon conducting tests that needs illumination the patient exhibits sensitivity to light. His pushing or rubbing his eyes and shows fascination with lights and shadows indicating possible sensory integration challenges.The patient also demonstrates restrictive and repetitive behavior such as fixed on moving objects you're engaging in repetitive motions This behavior is reflexes need for your team predictability which is typical in autism spectrum disorder.These are some of the actual response of the patient during the assessment. um He becomes upset with slight changes in routine or he makes little or inconsistent eye contact. ... shares enjoyment by pointing out or show showing things and the others. For the assessment results we use The Shining Oak assessment tool which is standard adopted for Filipino children.To assess growth and developmental Milestones which comes from civilian Asia Institute. Which consists of or assess 5 domains which is the motor cognitive language self-help and socialization skills. For the motor skills evaluation the patient demonstrated significant limitations in motor skills achieving only 2 out of 16 essential tasks. Such  as working in a balance beam jumping um forward 10 times without falling.It's results in performance rating of 12.5% and this indicates a critical need for targeted interventions to enhance his growth and fine motor ability. For the cognitive skills assessment 22 cognitive skills which consists of picking up specified number of objects requested copying triangle let's just work requested. The patient show difficulties in in structured thinking and task completion. This cognitive abilities require nurturing through tailored educational strategies and cognitive gains. For the language skills performancethe patients scored only 1 out of 14 in language skills it consists of caring out a series of 3 directions telling a familiar story without close. It represents 7.14% so this is a substantial deficit intensive speech therapy for focusing on vocabulary expansion and sentence structure enhancement to facilitate effective communicationFor self-help skills treating the patient managed 4 out of 20 test. Such as buttoning and unbuttoning um his clothing um combing his hairSo it it is a greeting to a performance rating of 17.39% and and this suggests a reliance on caregivers for daily activities and emphasizes the importance of teaching self-care self-care routinesFor the socialization skills review the patients achieved the score of 2 of 9 in socialization skills such as contributing to adult conversations. Differently to 22% so this indicates the struggles of the patients with peer interaction highlighting the need for social skills training in cooperative and based context. For the intervention plan for child with autism.Our primary goal is of course to identify the primary problem so the primary issue identified by the patient. Significant is the significant line language skills deficit impacting his ability to communicate effectively.So this challenge necessities are focused approach to facilitate language development in everyday context.For a long-term developmental goals which focus on a long-term process. To achieve so it is to help the patient achieve optimal developmental milestones. across 5 areas which is again the cognitive motor language self-help and socialization. And each area will be targeted through tailored interventions aiming for each appropriate capabilities.For the short term objectives it focuses on immediate achievement the goal. So it focuses it will be focusing on enhancing the patient's language with supplementary strategies for cognitive motor self-help and social skills.So this is um to set tangible measurable objectives that will facilitate tracking progress effectively. Over at the timeline.For the language skills top goals so it includes enabling the patient to follow.  Follow directions demonstrate understanding of complex sentences and engage in conversation using each appropriate vocabulary active this will focus on naturalistic teaching reinforced learning in context.For the cognitive and self-help skills strategies targeted strategies will involve structured for cognitive acquisition and routines that encourage self-help independent So this includes enhancing decision making and providing opportunities for share tasks with verbal and visual cues.for the socialization developmental development plans. So cooperative to improve the patient's ability to engage with peers. Active this will include turn taking games and group tasks designed to Foster communication and social awareness. So this is the um the example of the upcoming Optimum activities that will be given to the that was given to the the patient. So we're just waiting for the hopefully during the follow-up check up um we will see Improvement for the to the patient. So um thank you for ... for the committee of the International Symposium on special education For giving us the opportunity to present our paper. Someone do it University Bangkok Thailand and again [Thai Spoken] Thank you very much Dr Jennifer and I really appreciate hearing meDr Jennifer thank you so much and I really appreciate you accommodating us by switching timings I know you were prepared yet thank you again a big round of applause for Dr Jennifer please.Our next presenter. Our next presenter is Father Reverend Father Peter Bora CRI I hope I uh pronounce that correctly father... it has 3 languages that we use. I will you speak in Thai. Speaking Thai because data type audience and we speaking in English and uh but I'll be presenting tomorrow as well so place to stay tuned and also we have the sign language interpreter.nothing to so I mean I'm my my team is also bringing the best regard Catholic. I'll be talking about my lessons learned from the death Catholic Pastor programming Titan the plowing somber what if ... Over 2,000 years ago Jesus healed a death man a death man by his own means and said Father which means be open.  According to the Catholic Church teachings affirmed that from the moment of conception human life comprises body so and and passing for human dignity.The the death pastoral ministry under the Catholic bishop Conference of Thailand joins in I had an answer the quality of life and uh for the death individuals opening minds of hearts and standing.... through sign language interpretation and inclusive pastoral approaches. ... for to enable test people to understand the teachings. Okay next up answer and this ... So the ministry we can in 2008 at Our Lady Fatima Church in the bank account in response to the individual seeking access to sacrament of the matrimony and faith information in the Thai language. And we use Ty sign language to train them.And after that we use uh we have developed and used more Thai language in the mass on Sundays. All prayers and hymns led by death members and income...And I saw this study about the other Duty a Bible study catches some classes and I saw monthly will be called ecclesial Community gatherings.As a result deaf Catholics now take active leadership roles in liturgy collaborating with and also in cultural death ways.  Even serve as mentors and advisors to younger deaf participants. So these efforts to build greater confidence and stronger faith and a culture of mutual uh uh in carespan and also exemplary leadership among dept members. The key learning point is that sign language is essential not optional so empowerment replies a real opportunities for uh deaf people to actually to take action.interpreters may serve as the breaches but deaf voices must lead and also inclusion must be intentional and committed.  So you can see that the our ongoing challenges include a limited number of closure proficient in I'm able to train satisi language interpreters.Also talking about the national coverage as well. And also we need more the funding and institutional supports.  looking at the future so we have to train the closure and also lay leaders in order to understand and in close to stop it placement of the death accessible.  but outside you mean the physically uh deaf people have access uh have the access to any social services but what about in inside them they don't have access to the internal or faith-based service. That's why we try to expand our coverage throughout the country. And also we build a clinical and Global partnership across the across the world.So recently I have good news that we have the Catholic Network in uh in mainland China as joining our Global Network as well.Because the uh deaf people in China had no access to this kind of information loudest I will start to have to Global access information.So all this is to lead to the uh uh holistic and inclusiveness so everybody... good for our personal uh social Community developments. In order to enhance the uh deaf people to exercise their full capacity. Staying together in the society with a dignity and without fears. Who are at present here today. for this is not only only about the intellectual exchanges but also it's about the mentality and also the to call emotion and emotion and a Sentimental exchanges as well. Be happy.Thank you very much. I was very informative presentation thank you so much.Before we go to our final uh presentation today. I wanted to tell you a little bit about our our keynote speaker. We often hear about importance of inclusion what does it truly look like in practice how can we move forward.How can we create more supportive and inclusive communities that Empower youth and with the disabilities to strive... to explore the vital question we are honored to welcome Dr Sachin so I see president of workability Thailand. Dr. sutin dedication to fostering Community integration and creating meaningful opportunities for youth with disabilities is truly inspiring Please join me in welcoming Dr Sachin to present on live transitioning process in special education.today I would like to present about a live transitioning process in special education.I am a chairman of the workability Thailand. Work ability Thailand is the a group of people a group of person to help person with disabilities to get an employment in Thailand. I'm vice president of sport Association for person with disability Thailand and president volleyball sport for the discipline of Thailand sitting volleyball. and executive manager of Jaifa Farm in Loburi.  and this is a professor Dr hiloi Okawa a chairman of job coach network in Japan he is my teacher got the training program about Job coach about transition in Japan. My teacher Dr Hiroshi graduate from America 30 years ago about a support  back to Japan and setting up system in Japan and successful and he helped Thailand he went to Malaysia about 10 years ago to set up a Job Corps Network in Malaysia in China in Mongolia in Thailand. I got retired from Lobburi School. When they graduate from my school how to make them get an employment person with this really especially for intellectual disability and autism, when he graduated from my school. This is the model work in Lobburi Panyanukul. in the center uh special education school we have 4 steps a carrier awareness a second step is Carrier expiration and it says that with career preparation and carry estimation and we have career escalation with the a Medical Institution to help our student and we have special education center in Thailand for every provinces uh vocational college or Vocational School to the place where our student to work to get trainings from vocational Colleges and Welfare facilities. and employment offices. And home and parents want a job. so they will get a job when they finish my school. Home Care from family and community and Medical Institution services: early intervention in special education center. and special education School teaching and learning as follows: career awareness awareness exploration career preparation the last is the career estimation welfare for Ministry of Social Development and human security and uh number 6 is employment support from Ministry of Labor and the last 1 Number 7 internship in workplaces around my school and today how to make them uh stay with the future life happyily. get to work get some job sorry it's not clear It is not clear so sorry. this is a a model set many years ago about how to to make them get an employment when they finish school . uh from the left to right, career awareness careerexpiration careerpreparation and career aspiration.and this is 3 areas of transition emphasis for student with disability. start from the left post secondary education. and the center transition usually refer to movement from special education in high school to employment to Independent Living. and how can student be actively involved in determining their futuer. from the left, student elected transition plan and then transition to adulthood  in the above parents and family. occupational of physical Therapies speech and language therapist and under special education teacher general education teacher and healthy Medical Specialists and CTE. a transition or career education start many years ago that's for those individual for 14 years our older an idea is love of the American law e 1997 added a significant components to the IEP know as the ITP individual transition plan these transition plan address the needs of the student is he or she transitions into the community from the school City.an idea 2004 stated that transition needs should be considered beginning no later than the first IEP in effect when the child is 16 that should be updated annually this IEP must include number one  a list of appropriate measurable secondary goals that have been developed based upon age appropriate transition assessment related to training, education employment and where appropriate Independent living skills. number 2 at least after transition services including costs of study needed to assist the child in reaching goals. a statement that the child has been informed a fit of rice transferring at the age of maturity. my first impression of my of my work at the School intellectual disability become my strong motivation to help person with disability to get employment in the community why are they staying home when finished school they can work in the community, I think. so the detail of transition from school to work or Career Education education: number 1 One Step the first step about funding from G 1 to G 6 was not  begins at the elementary level and is intended to make student aware of the existence of paid or unpaid, get money or not get money and workers and how students will fit into the work oriented Society in the future. career awareness aspect of human development is occurring during the elementary years. Second Step the second step is to career expiration how to explore how to find a job. the second stage emphasized at the middle school Midland School high level is intended to help students explore their interests in abilities in relation to lifestyle in  a few patients. students should learn and examine their own unique abilities and needs be experts to many hands on experience and be given the opportunity to engage in several Community Based experiences. and the third step in High School is a period career decision making and skills acquisition student should be able to identify as a specific interest and aptitudes and the type of lifestyle that we meet this characteristic. The last step career transmission is the transition of the students into post secondary training in community living and working adjustment environments the student should be able to engage in satisfying vocational family and Civic volunteer work activities as well at gain paid employment. Many student we need continuing education and follow up services at this time. This is uh a transition unit a transition Shop for the school. which I worked there to work there to practice there. uh this is the photo of panda transition unit transitions internship in Japan which I visited . there is no transitions in thailand. there so the school should be a transition Center themselves before the student graduate from their school.working for the readiness model I was in charge of probably for intellect on disability so I make a reading is a Readiness model to make them ready to get to work the nasc training system after 2 years of training some student got a job but many were impossible to find a job. or fail to adjust themselves to real work places at the employment.The first step of supported employment in Thailand: the first practice of supported employment, young men with intellectual disability in order was successfully employed in MK restaurants near the school.  The second part supported employment was institutional right in the US in 1986 by The Rehabilitation Act amended of 1986 A definition of supported employment okay you can read this from a paper in your hand.Important terms in the definition of supported employment: the first thing is started people. individual with the most significant disabilities. a second one is competitive employment integrated work setting. and the last one  intensive initial support So visit and also extended services supported in supported employment transformed the focus of vocation Rehabilitation. The left in the left assessment and training before employment we call share the workshop in the right 1 training and continuous support as real work site we say competitive work. Traditional vocational rehabilitation: assessment training and job placement leave them best traditional vocational Rehabilitation.A problem in traditional Vocational Rehabilitation strategie: the difficulties in applying work tasks, work environments, pressure co-workers, to many factors and different between them; that's the problem that's the difficulty. From preparation before employment to support after employment: working support by job coaches, assessment training job placement and assistant for retention.A case study: Somchai is 27 years old moderate intellectual disability moderate in audism long years in shelter Workshop the expect expect to work in ordinary companies not in childhood condition. and uh the role of job coach like a bridge from person with disability and employer co-worker job Crossing in the center like a bridge. How can we work as a bridge between person with disability and employers? This is the photo that's the Box the box as a work and football like a person with disability How to make them get to the Box? to make them get a job? so job coach is like this man to produce good work environment job coaches should work closely and what do they do they want they have they have to know job duties for person with disability how to work requirement, physical environments of work site, co-workers understanding of disabilities, interpersonal relationships with co-workers, and work hours and work regulations. this job help them. and the job code how to help person with disability: how to support person with disability the yellow 1 before employment for the first 4 step and the Pink one is have to get a job the first step in assessment the person with disability then finding a workplaces and then assessment of workplace environment and job matching a good job matching to make them get a real job . and number 5 intensive support at the workplace coordination and employment agreement support fading and follow up for the last step u. type A type B and this job coach in Japan . For type A job coach to help person with disability in other organization.B and type B is a job in the company.  Municipals like local district offices sorry for speaking Thai. about Job coach in Thailand workability Thailand and Department of skill development. Ministry of Labour set up 5 days program curriculum  and give training program to teachers in special education School. Staff of Association of Association for the mentally Thailand, Staff of Bangkok Metropolitan I give them a program a training program about a job coach and the next step for workability Thailand for HR  for the person in the companies the job coach for the company so they can help person with disability in the company. this is job coach situation in Thailand. thank you for your attention.thank you very much Dr Sujin. Dr Maliwan would you please give a token of appreciation to Dr Sajin. Could you come to the Center? thank you very much.okay so we have reached the end of our first day Thank you so much everyone especially at deaf Community here you stayed right from the morning till the last thank you so very much  I take this opportunity to say thank you to everyone for today everybody did such a good job right from the beginning till the end so let's say goodbye and see you tomorrow Foreign delegates will meet at the lobby at 5:30. okay everyone thank you bye bye see you tomorrow