Article
A day in the life of a TVI: Matt Tietjen
What's a typical day in the life of a TVI? Matt Tietjen, a teacher of students with visual impairments who specializes in CVI, shows us.
Teachers of students with visual impairments (TVIs) are integral components of a CVI educational team. They teach kids adapted methods for participating in their school curriculum and in everyday activities. They conduct assessments to determine abilities. They make referrals for additional services. They’re experts at observing classrooms and homing in on where kids need extra support, all through the CVI lens. They also work closely with families, offering strategies to make your home environment more accessible.
Have you ever wondered what happens during a TVI’s busy day? Your child might see their TVI at specific times during the week; however, there’s so much that goes into the job all day and behind the scenes.
A TVI and a leading thinker in the CVI field, Matt Tietjen lives in rural Connecticut with his wife and two sons, but he travels all over the state, working with kids ranging from infancy to 22 years old. Tietjen started out as a special ed teacher, working with a blind student. This inspired him to enroll in master’s coursework at Umass Boston to teach students with visual impairments.
“CVI especially resonated with me because it’s neurological. It’s about the brain. It’s a form of neurodiversity. I just found it so fascinating. It’s one of those things that you can never stop learning about—because every single little thing you learn is going to help support your students better,” he says.
To understand more about what a TVI does, here’s a snapshot of a typical day.
5 a.m. Alarm goes off.
He hits snooze.
5:30 a.m. Wake-up time.
For real this time.
6 a.m.
Walk dogs.
7 a.m.
Help his two kids get ready for school.
8:30 a.m.
Matt’s work day begins.
“I’m in itinerant TVI, meaning that I go from school to school, district to district, in certain regions of the state, working with kids from birth to three all the way through 22-year-olds in transition projects.
On any given day, I might be in somebody’s home, working with a toddler and collaborating with the family, typically with an early intervention specialist or an occupational or physical therapist. My next stop might be a high school where I’m helping a team adapt a chemistry assessment to meet a student’s needs. It’s really pretty varied.”
8:45 a.m. – School visit
Buzz into an elementary school and get his badge.
“I’m here to consult with an elementary-schooler with CVI. I’m observing my student in a math session in his classroom. Everyone gets math worksheets. I look at the sheet: Are there too many problems on a page? Are the letters and numbers squished too close together? Is he making errors that seem related to visual clutter?
Then, my student starts working. In the meantime, I walk around to all the other kids and say hello—just so my student doesn’t feel like he stands out.
I notice that he’s having difficulty with multi-digit addition problems. He’s carrying over the 10s place to the wrong column and then getting the wrong answer. That’s specifically a CVI issue: Clearly, he knows he’s supposed to carry over the 10s column, but he’s just doing it in the wrong spot.
I just observe. I don’t want to call him out in the classroom and make him stand out while students are all working independently. We have a half-hour scheduled after class in a separate space.”
9:30 a.m.
“When class ends, I run off a few copies of his worksheet, take some highlighters, and make some worksheet adaptations.”
9:45 a.m.
“We meet with his paraprofessional in a quieter conference room space. We find that if we blow up the problems and present them one at a time, increasing the spacing between the numbers and the operation signs while highlighting each column with a different color, he has a much easier time lining up those numbers. The color-coding and increased spacing helps so much; he ends up getting the problems right.”
10 a.m.
“Before leaving for my next session, I reconnect with his teacher to discuss those adaptations for the future.”
10:30 a.m.
“I hop in my car to arrive at the home of a toddler with CVI, joining a speech language pathologist who’s doing early intervention. In these sessions, I’m looking for opportunities to really get in there and play with the child.
I’m trying to assess where she’s at visually and from a compensatory strategy standpoint. That means: What other senses does she use to compensate for her vision loss?
For some kids with CVI, their vision leads the way. For others, it’s more auditory and tactile. I find it’s really important not to just focus on vision for kids with CVI, which our field has done a lot in the past, but to really see what’s leading the way for that child and to assess that.
For example, a child feeling on the floor to find their toy because they can’t see it visually, would be a tactile compensatory strategy. A kid who has their Cheerios in the morning on their high chair tray and bangs the tray to get the Cheerios to move up and down to see them, because they can see things better when they move? That’s a visual compensatory strategy.
A TVI home visit
This child notices her toys mostly tactilely, when she bumps into them. So I take my LED, high-power red flashlight and just shine it on a toy and wiggle it. I’m quiet. I want to see if she notices that there’s anything there, by reaching out for that light and encountering her toy. I’m trying to create an environment that encourages her continued use of compensatory strategies like tactile and auditory, while at the same time giving her opportunities to access things visually.
At this home, a cat is also biting my feet—which always happens! It’s funny. The meetings are always pretty informal. I put a lot of thought into home visits. Each school has its own culture, but in general, they’re more similar than families. There’s less structure in a home visit, and the kids are younger. I improvise to follow her lead instead of trying to steer the visit too strongly.
While we’re playing, her mom and the speech pathologist also chime in with what they notice; her mom shares some words that she always responds to. It’s an improv thing where we’re collaborating in real time.
In the last few minutes before I leave, we talk about what I observed, what to try next time, and we schedule the next visit. In this case, the child and I developed a routine with her favorite ball that involved nonverbal turn-taking and the student tapping my hand each time she wanted me to bounce the ball. It was really a nonverbal conversation between us, and her mom is going to try to continue that pattern of interaction throughout the week and see how she responds to it.”
11:45 a.m.
“I get into my car and voice dictate some case notes, since I can’t get to my computer right away. I use voice-to-text dictation, a long-running monologue without identifying information, using my Notes app. I don’t want to forget anything before I see my next student. My notes usually involve functional vision information and compensatory strategies: What did I notice her seeing? What compensatory skills did we use to make things easier?
My agency has a system where we file and record all case notes, which I’ll do from my computer later, along with sharing any follow-up information with the family that we might have discussed. When it comes time for an older student’s annual IEP review meeting, I’ll take all my case notes, all observations, any direct assessment that we’ve done with the student throughout the year, and compile it into a functional vision report that details how the student’s using their vision, what helps them, what makes it harder, what compensatory strategies are helpful, recommendations for making things accessible, and recommendations for accommodations.”
12:30 p.m.
“I eat lunch in my car. I’ve got someplace to be!”
1 p.m.
“I’m scheduled to do a functional vision and a learning media assessment at an elementary school for a third-grader. An eye report from a doctor will tell you acuity, visual fields, contrast, things like that. It’s not going to tell you how a kid uses their vision in day-to-day life, how they access activities, and what visual adaptations help them. That’s my job.
Observing a student with CVI in the classroom
My student is in his afternoon classroom meeting. I observe where he’s sitting and sit on the outskirts, trying to blend in with a good vantage point. I see how he’s behaving, what his attention is like, and where he’s looking as compared with other students.
Is he following with his eyes? Or are his eyes drifting and wandering to seemingly random things?
I also notice if he engages in self-regulating behaviors like flapping his hands or rocking. This indicates to me that he’s trying to achieve sensory regulation because the environment is too overstimulating. Sometimes, my students flap their hands in front of their eyes. This is because there’s so much unpredictability going on. The flapping gives them a predictable visual input, while they tune out the unpredictable. Other times, visuals aren’t accessible for students with CVI in their classroom meetings due to distance. Or there’s too much complexity, too many kids wiggling, too much stuff to sort through visually, too many materials on the wall. It’s a visually and auditorily overwhelming setting.
Sometimes, teams will report that a CVI student is misbehaving during those times, not paying attention or biting and poking peers. I look at: What’s really going on here?
After the afternoon classroom meeting, kids go to their tables for independent word-matching work. My student is helped by a paraprofessional. I join them. I don’t talk too much at first; I observe. I’m analyzing if my student is paying attention despite visual clutter; whether the para needs to prompt him to stay on task; whether he’s refusing to do the work.
He starts to get off task, so I make some quick adaptations right at the moment. We try folding his worksheet so only one question shows at a time. The first step is observation; the second step is observation with some interjection, if appropriate. As I make suggestions, I also jot down ideas for things I want to assess directly with my student.
CVI assessment activities
Right after their independent work, my student and I spend a half-hour together with his paraprofessional in a conference room. I conduct some CVI functional vision assessment activities. I often do a two-dimensional image assessment with students with CVI, where I show them different types of images and ask them what they see, and I’m assessing their visual recognition abilities. I use pictures of different visual scenes at different levels of complexity, and I see if he can find certain things in the scene. I also show two pictures of a visual scene and see if he can tell the one thing that’s different about those two pictures, which evaluates overall visual processing ability.
This student was having difficulty decoding CVC words: consonant, vowel, consonant. He kept missing the middle letter because it was squished between two other letters. That’s a common pattern; the more clutter in the middle of a word, the more some of my students miss it.
I start typing CVC words similar to the ones he missed. I try making the middle vowel a different color, which helps. I’m always following the student’s lead: really listening and trying to learn how each student perceives and interacts with the world.”
“I leave school and have a minute to reflect. Each time I see a different student, it’s like I’m diving into a new world, with a different set of interests, cultures, ways of communicating, and with its own internal world.
2:30 p.m.
It’s so rewarding to learn about those internal worlds as best I can and then try to enter their world and meet them where they are. Sometimes, we’re so focused on getting students to enter our world and follow our agenda that we forget their own world is just as important and worthy of experiencing. And it’s really special when they let you in. These days, rather than approaching an interaction with a student with my own agenda, I try to start by following their lead and seeing where it takes us. Often, the final destination is more interesting and creative than anything I could have pre-planned.”
3:30 p.m.
Time to go home to type up case notes.
5 p.m.
“My 9-year-old son’s saying, ‘Dad, when are you going to be done?’ I log off and we play basketball in the driveway. Then, I drive my older son to karate.”
7 p.m.
“My wife and I clean up after dinner. I like to listen to music—especially REM, my favorite band. I also love the really socially conscious lyrics of Kendrick Lamar.”
8 p.m.
“After dinner, I’m winding down with a book. Right now, I’m reading a lot of Buddhist thought and philosophy. I’m teaching a class for UMass Boston on collaboration, so I’ve been reading a lot of books on the philosophy and science of collaboration—which is a departure from watching my favorite team, the New York Mets, in the playoffs. But they’re out of the playoffs now!”
