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Amy Osvold, MSW, has worked at NDVS/SB for 15 years as a Vision Rehabilitation Specialist. She has worked primarily with adults but has done some work with middle and high school students, mostly focusing on Daily Living Skills. Amy recently received her Master of Social Work degree from Florida State University. With a new degree, Amy will be providing new services to adults and students. Learn more about how she can help you or your loved one with vision loss by reading on.

What is your new role at NDVS/SB? 
My role at NDVS/SB has not really changed as much as it has expanded. I am very passionate about mental health and vision loss. It is an area that I do not believe has been addressed as much as it needs to be. 

The Adjustment to Vision Loss services I can provide to adults, middle school, and high school students include talking through issues that arise because of vision loss, mentoring, social skills, and support groups. 

As a person who has had vision loss for 41 of my 45 years, I have gone through all the stages of life visually impaired. I remember first losing my vision, being on large amounts of steroids, and not being able to control my emotions. I remember trying to “fit in” with my sighted middle school classmates. I remember being told I would never drive as a teenager and then being terrified of starting college. In all these events, I was alone. I was the only one of my immediate or extended family and classmates with vision loss. In fact, I did not meet another person with vision loss until I was 18. This is why I believe it is so important that the emotional side of vision loss be addressed and, if needed, acted on. Furthermore, I believe there is true power in knowing others with vision loss in different stages of their journey. 

My goal for the upcoming year is to help connect students with vision loss on an ongoing basis. Time students spend at NDVS/SB is invaluable because they have opportunities beyond the classroom. Connections with peers who are experiencing the same difficulties is something that cannot be replicated anywhere else. I want to continue these connections through calls, Zoom, and other means throughout this next year. 

What sorts of services do you offer students/clients and their families?
During middle school and high school weeks, I help with social skills groups. I am located in Minot, so I conduct these groups primarily through video conferencing. However, if I am needed at the school, I do go and stay for the week. 

I can provide Adjustment to Vision Loss, social skills, mentoring, advocacy, and self-esteem-building. Although these are the areas I worked on this past year, that does not mean that these are the only services I can provide. If you have a need, contact me so we can talk through solutions!

For parents and family members, I can work with you on Adjustment to Vision Loss Parent/Family/Spouse/Support Person Support. This may include helping you find resources, navigating social services, local therapy services, or grants.

I do not provide mental health diagnosis or mental health therapy. My services are strictly related to vision loss. If a student needs a diagnosis or therapy, I can connect you with local therapists and work with them to understand the unique needs of students with vision loss and their support persons.

What are some warning signs that your child may be having mental health issues? 
Parents, family, friends, and teachers, ask yourself these questions:

Is there any change in moods or behaviors? For example, does your child suddenly not like to do things that they once enjoyed? Are they more irritable than usual? Are they self-isolating? Are their emotions fluctuating more than usual? Are they doing any forms of self-harm such as picking at skin, cutting skin, hitting themselves, eye pressing or eye poking (new or worsening)? Are they acting out at home or school (yelling, crying, hitting, biting others)? Are they expressing more negative self-talk (name calling, personal criticism, etc.)? Are their changes in their sleep habits (not seeping or sleeping more)? Are they complaining of headaches, stomachaches, or other aches?  

The temptation to consult “Dr. Google” might be great, but it is better to notice/document behaviors, changes in behaviors, and the situations prior to and post behavior, and take them to a professional.

As aways, if you think there might be risk of self-harm, harm to another, or suicidal ideation, contact the Suicide Hotline at 988 or seek emergency services such as 911. 

What should families do if they observe those warning signs in their child?
First, noticing and documenting will be the best guard against someone slipping through the cracks. Second, ask others if they have noticed the same or similar behaviors. (If possible, emergent situations should be dealt with quickly). Third, speak to a professional. This could be a school counselor, their family doctor, or a therapist. 

Again, any situations that involve self-harm, threats to others, or suicidal ideation should be addressed immediately.

What can families do to support mental health?
First, it is important to recognize how you feel stress, anxiousness, or sadness. Some things I work on with students and clients is identifying their body symptoms. Some may include:

*Butterflies/lump in stomach or general stomachache
*Tightness in chest
*Tightening muscles such as in hands or shoulders
*Rapid heartbeat
*Clenching jaws
*Increasing in rocking, eye pressing, or eye-poking (are they/you self-stimulating as a coping mechanism)

Everyone displays different signs. Just because it is not listed, does not mean it is not it is not a sign of stress, anxiousness, or sadness.

Second, creating a self-care plan is one of the best ways to help yourself or your child through stressful situations. When I work with students and adults on self-care plans, we are working on finding activities that take various amounts of time and effort. A self-care plan might look like this:

When I feel stressed, anxious, or sad, I can do these activities:

1 Minute Activities:
A.    Breathing – This can be just deep-breathing in and out five or ten times. One way to help yourself complete a whole cycle would be to have a bracelet or keychain with five or ten beads. You can hold the first bead while breathing and then move on to the next. You know you are done when there are no beads left. 
B.    Flash Tightening – Tightening and loosening muscles all together from head-to-toe then release and repeat five times.

5 Minute Activities:
A.    Gratitude Journaling – This could be just stating out loud one thing that you are grateful for or finding an accessible way of keeping track of these items such as with braille, the Notes App, or a digital recorder. The nice thing about keeping track of them is that you can go back and review them as frequently as you want. This is also a great activity for families to do together.
B.    Progressive Muscle Tensing – This is tightening muscles starting with your toes and moving all of the way to your head. Holding all of the muscles tight for five or ten seconds and then releasing them one at a time from the head to the toes. When tensing muscles, think of a word you want to push into your body such as “peace.” When releasing, think of a word you want to push out such as “negativity.” If you have any areas of your body that cause pain when you tense them, skip those areas.

10 – 20 Minute Activities:
A.    Listening to a short motivational, spiritual, or inspirational audio reading such as a Bible verse or a short story in a book like Chicken Soup for the Soul
B.    Listening to music and singing or dancing along.

Other ideas:
*Exercise of any kind
*Creating a list of people you could call
*Giving back – Doing things for others that make you feel good such as a chore or volunteer experience
*Interacting with pets

The important thing about the self-care plan is that it includes things that are realistic for you/your child and things you/your child enjoys. 

What are some resources that you recommend for clients, parents, and families?
The book Self-Esteem and Adjusting with Blindness by Dean and Naomi Tuttle. Although this is an older book, it is really a good one and the only one I have found to specifically address the mental health aspects of vision loss. 

The Hadley Institute does a podcast called “Insights and Soundbites” that addresses mental health issues. I have found it to be very informative. www.hadley.edu

The American Foundation of the Blind (AFB) has great studies on issues associated with vision loss such as employment. Although they do not directly address mental health, they do address issues that I term as “the intersection of life and vision loss.” This intersection can often be an attributing factor to mental health issues. An example of this intersection would be moving from high school to college. It can be a frightening and nerve-wracking time for any student. It becomes more complicated when the student also has a vision loss. https://afb.org/

Join consumer groups, such as the North Dakota Association of the Blind (www.ndab.org) and their national affiliate the American Council of the Blind (www.acb.org). Peer support is invaluable! Knowing that you are not the only one going through this vision loss journey and experiencing difficulties can be very freeing and less isolating. 

Any other advice for clients, parents, and families? 
One of the hardest things I think people with vision loss face is the idea that their adjustment to vision loss is a destination and not a journey. When you experience vision loss, you go through the typical stages of grief. However, with vision loss, acceptance is often a life-long process. This means that while you may accept some assistance in the beginning from devices such as discrete magnifiers, using outwardly identifying items such as canes might be more difficult. Or you work through your vision loss at one point only to have new life experiences or situations arise that set you back a bit. Part of what I do is help people realize that their vision loss is a part of them, but it does not define them. Second, for most people, vision loss is a gradual process. Their vision may stabilize for a period of time and then they have another loss. It is completely normal to go through the stages of grief again. 

You may not experience them the same way, but it is important to give grace and recognize that you are experiencing a loss. Feeling anger, fear, or sadness is not unhealthy. It is a response to the loss. I tell clients that feeling those emotions is normal. What is important is what you DO with those emotions. 

For example, do you not want to do something because you do not like the activity or are you afraid that you CAN’T learn it or are AFRAID of doing it? Those are two entirely different things.

Finally, it is important to recognize that it is not just the individual with vision loss that goes through the stages of grief. Parents, siblings, extended family, friends, spouses, and other support individuals go through those stages as well. Oftentimes, these individuals feel an overwhelming guilt, sadness, lack of control, or inability to help. This leads them to suffer in silence. 

The most important thing to remember is that there is help for the individual and those around them. Unfortunately, not many medical professionals ask you or your child about their adjustment. The solution comes down to one word… ASK for help, support, and anything else you or your child needs! Take you and your child’s power back! At NDVS/SB, our passion is assisting individuals with vision loss and their support persons to live a brighter, more independent life. We are passionate about what we do and who we serve. There is no wrong door. Ask our staff for help. If we are not the right person, we will find that person. 

Contact Amy by calling 701-857-7635 or 701-340-9226 or email abrunner@nd.gov

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