7. West Virginia’s same day Bioptic Training On Foot and In Car Passenger

Chuck, Ashley, Dan at West Virginia Division of Driver Rehabilitation Services

During my visit to West Virginia, I was fortunate to have the opportunity to participate and observe one of the students enrolled in the WV bioptic driver’s training program participating in an on-foot, then active passenger in-car training exercise taught and reinforced by former instructor, Chuck Huss, COMS, Driver Rehabilitation Specialist. I wholeheartedly believe we need this in Australia. I’ve been a bioptic driver since 2016 where beyond the role of the eye assessment professional there is no training such as this; and getting to do this in practice gave me knowledge to techniques/ issues I had read about and taught myself. This was an opportunity to be taught systematically and learn progressively that has given me new insights to driving that I can’t wait to apply when I get back home to Australia.

 

Training in the proper and appropriate use of bioptics is introduced in detail on Monday of Week 2 of the West Virginia Bioptic Driving Program. This is because at least 95% - 97%of the bioptic driving is done using the carrier lens and the student needs to learn when and how to use it after they have been exposed to driving. Remember, novice (never been licensed ) candidates have been told their whole life they will never drive so they may never been exposed by parents/ others/ school that one day they might do this and to pay attention to what happening in typical driving settings or down the road so to speak . This training follows the same ‘concurrent’ teaching model as the rest of the program: i.e., classroom instruction, then hands-on with on-foot, outdoor parking lot lesson, followed by passenger in car and then behind the wheel instruction (all within the same day, M-Fri, 6 weeks of instruction minimum).

 

Details of this program can be accessed at this link for the following documents:

https://www.biopticdriversaus.com/papers

 

·       Step-by-Step Guide to Reinforcing Pre-Driver Readiness Skills with Novice Bioptic Driving Candidates

·       Basic Bioptic Usage Exercise (instructions on how to do exercise)

·       Functional vision Awareness Lesson (supporting document teacher and student holds during the lesson and refers to the page relevant to the bioptic power they are using x2.2, x3x, x4)

 

Bioptic on-foot training

 

The morning activity teaches the client how to appropriately use their usual vision (through the glasses or called carrier lens) and then the bioptic for visual assistance in the driving task. Clients start by standing 10 yards from four parked cars, two faced front end two faced back end, do the exercises stated and step back each time 10 yards, repeat some and add others until they get to 100 yard. At each stop the instructor notes the actual distance through the carrier lens and apparent distance through the bioptic. The apparent distance depends on the power of the bioptic lens and documented in the above mentioned document for 2x, 3x, 4x. Some of the matters covered include the following which Chuck or I and others would be happy to discuss should you make contact. There is only so much I can include in a blog and other documentation on the Bioptic Drivers Australia website talks to these.

 

·       Visual gaze through the carrier lenses

·       Difference in image size and linear distance

·       Telescopic field(s) of view

·       Ring/rectangular scotoma

·       Fixation time

·       Forward and backward head tilt

·       Vertical displacement

·       Jack-in-the-box effect

·       Apparent movement of objects/forms in opposite direction to head movement while fixating through telescopic unit

·       Reference point maintenance through carrier lens(s) and telescopic unit(s)

·       Momentary reduction in visual resolution with quick movement or scan of telescopic unit or as a result of vehicle or road vibration or road re-surfacing

·       Common distant spotting angles (10-20 degrees from central fixation) 

·       Awareness vs. identification vs. sure acuities  

·       Chromatic aberration

·       Weight of the bioptic lens system

·       Appearance

·       Image quality

·       Cost of the device

·       Maintenance and insurability

 

By lesson’s end, students often comment that they have a better idea of how they compare with normally sighted persons in terms of:

·       What objects, forms or activity they can detect and identify under magnified vs. unmagnified conditions

·       Different linear distances  

·       Under variable natural lighting and weather conditions. 

 

Students also find themselves capable of using their respective bioptic lens system as an effective vertical spotting device on “stationary viewing activities”:

·       After only 1-2 hours training

·       Sets the stage for continued bioptic reinforcement under dynamic on-road conditions: first as a passenger-in-car; then while driving.

 

Where a client needs more training, assistance can be provided by an Orientation and Mobility Specialist to train and assess the following on foot followed by in car passenger and the student can apply behind the wheel. A checklist available that describes these and what needs to be looked for in each category:

 

·       Receive, retain, and follow route instructions.

·       Travel a designated path or route (and respective reverse and alternate routes) in a variety of environmental settiings.

·       Detect, identify, and react in time to critical objects or critical present in various travel environments.

·       Detect, analyze, and cross intersections (stop sign and traffic light controlled).

 

The on-foot bioptic training assists with visual function awareness for both acuity and field: for example, with functional visual acuity abilities: awareness acuity, Identification acuity, and sure acuity. And functional visual field abilities such as: static visual field, dynamic visual field, and preferred visual field. Exercises are described in the documents at the above link. These skills are reinforced through in-car passenger and behind the wheel instruction.

 

 

Bioptic in-car passenger training

 

Taking the skills learnt in the morning, the student/client then has the immediate opportunity to reinforce the basic bioptic usage skills learned in-car as a front right seat active passenger-in-car after lunch.The instructor drives and the client sits in the passenger seat where the instructor asks the client questions on what they see. The session starts with spotting large objects such as tell me when there is a vehicle in front and whether it’s a truck/car and spotting other large objects. This is followed by medium viewing such road signs and then smaller objects or forms such as tell me what that regulatory sign says e.g., lane merging, hidden side road right/left stop sign etc. This is generally a couple of hours and can be done with two (2) students at a time swapping back and front seat, so they get to observe another student.

 

Here are some videos of my observations of Chuck’s instructions throughout that training session. You will notice this session is on a highway and he reinforces bioptic skills usage. For example, telling the student start in their carrier lens then slow dip their head and slowly rise again and repeat several times on one object followed by others first larger and then to practice doing the ‘spotting’ faster until the student can quickly and accurately ‘spot’ the target. e.g., back of a car/ truck, signage on a bridge ahead or side of the road. Then getting to smaller targets such as reading the words on signs. Here the client is putting into practice as a passenger those things taught in the car park on foot training.

 

Students/clients get to experience the effect of the benefits and limitations of using the bioptic and how to compensate.For example, the “jack in the box” effect. In the parking lot exercise above, a chosen person walks across the paths of a student(s) instructed to view through the telescopic portion of their bioptic lens system. The bioptic lens user experiences a sudden nearness illusion (where if driving, may cause the untrained user to quickly move their foot from the accelerator to their brake pedal, resulting in a sudden brake reaction and potential rear end collision with another road user, that may be tailgating from behind the bioptic user. Personally, I have experienced this on many separate accessions over the years of my driving. Such as when seeing in the far distance crossing my path; a kangaroo, a car crossing my road, cyclists. Instinctively I exited my telescopic lens unit to see how far the actual distance was. I then determined whether I needed to look again through the bioptic or stay in the carrier. To me this is by far the best use of the bioptic to let me see hazards in the distance and give me time to respond if needed as I approach while driving.

 

      1. Passenger in Car - Awareness acuity

2. Passenger in car - Traffic lights

3. Passenger in car - square off, reference point, curves

The above is only the introductory. Over the WV 6-week program these skills are reinforced in varying settings similar design how an Orientation and Mobility Specialists teaches route travel from simple environments to more complex incorporating low vision view skills.

 

Here are some sample passenger-in-car exercises, reinforcing basic vertical spotting abilities):

Practice:

·       squaring off with single lane of traffic or roadway, adjacent lane of traffic, multiple lanes, large size road users, large size guidance signs along secondary highways and interstate roadway systems, etc.

·       Practice squaring off with single lane of city traffic, adjacent lane of traffic, multiple lanes of traffic, large and smaller in size road users, road signs, traffic control devices

·       Practice approach to stop sign controlled intersections; have student practice vertically spotting stop signs in the following order: near right corner, far left corner (back side of sign), near left corner (if needed) and lastly far right corner (if visible).

·       Practice detecting and identifying distant color, detail or activity (i.e. traffic light, speed limit sign, vehicle maneuvers down the roadway). 

·       Hazard Perception Skills.

 

Once the novice driver candidate becomes proficient with distance viewing skills, critical object or condition awareness skills, and proper and appropriate use of their dispensed bioptic lens system, it is an appropriate time to introduce and reinforce basic hazard perception skills. The latter include situations where the novice driver candidate learns how to detect when other road users fail to see you, become distracted, execute a driving maneuver incorrectly, or become confused.

 

Outdoors (sample passenger-in-car hazard perception skill exercises):

·       Practice detecting and identifying situations where novice driver’s line of sight to other road users and theirs to them is restricted or hidden (due to fixed hazards such as buildings, utility poles, slope of land, weeds, and crops).

·       Practice detecting and identifying situations where other road users become distracted in-car due to cell phone use, eating, personal management practices, talking to other passengers, reading or texting, other road users outside their vehicle, etc.

·       Practice detecting and identifying situations where other road users become confused due to: turning the wrong way on a one way street or roadway, turning the wrong way onto an interchange leading to a controlled access roadway, turning from the wrong lane of one street onto another roadway, etc.

·       Practice detecting and identifying situations where other road users execute a driving maneuver incorrectly or unsafely (i.e. related to lane changing, passing, tailgating, blocking an intersection so that cross traffic cannot enter, rolling stops, etc.)

Chuck is available for consultation so please reach out:

Chuck Huss, COMS

Driver Rehabilitation Specialist

 

Dunbar, WV 25064

TEL: (304) 767-1497 (cell)

E-MAIL: chuck_huss@hotmail.com (h)

 

 

To learn about the reasons for this blog, go to my Churchill Trust Australia webpage to read about the fellowship I was awarded being "The NRMA - ACT Road Safety Trust Churchill Fellowship to identify success factors and barriers for low vision and telescopic glasses driving" The page is here:  https://www.churchilltrust.com.au/fellow/belinda-oconnor-act-2022/