Research and Insight from Lane

Hi, I’m Lane McKittrick, co-founder with my husband, Todd, of Hear See Hope. In addition to being the mom to four boys, including Conner and Dalton who have Usher syndrome, I am pursuing my Ph.D. in Special Education at the University of Northern Colorado. My research interests are deafblindness and family-professional partnerships. I hope to use this blog to share updates on my family and my research. My goal is to provide information and support for families living with Usher syndrome. Research into a cure is vitally important, but I know from experience, family support in dealing with day-to-day issues is critical as well. Thanks for reading. For more on my research, visit my academic site.

I’m so grateful for our USH family

I just returned from a trip to New York and New Jersey with Hunter and Dalton, and I have been reflecting on where we are in our journey living with Usher Syndrome.

Rebecca Alexander and Dalton at the baseball game

Dalton was thrilled to meet Usher advocate Rebecca Alexander, who has never let Usher syndrome hold her back.

Dalton has been really struggling this last year with acceptance of Usher syndrome. At age 10, he doesn’t want to be different. He doesn’t want to ask his teachers for help. That resulted in him experiencing a lot of anxiety and he started to get further behind in school. He has attended a private school but he is also dual-enrolled and has been served by an amazing IEP team at our local district. His orientation and mobility specialist has been working with him on self-determination and self-advocacy. I’ve also been teaching him how to actively participate in his IEP meetings. But, the last two years have been rough. Most days he’s so exhausted at the end of the day that he is in tears. Although his hearing is good with his cochlear implants, when he would start his homework, we would realize that he was missing a lot of information at school. He had no idea how to do his homework and it would really upset him. No one at school really knew how to help him.

At the end of the school year, for various reasons, we realized that we were going to need to find a different school for Dalton and his 11-year-old brother, Hunter. They both have such amazing friends at this school and so this makes us all sad. But, unfortunately, the system for student support at this school is not going in the direction that I think it needs to go in. So, we made the decision to move Dalton back to our neighborhood school. We had his first IEP meeting with the new team and I knew we were making the right decision, although change is scary. Dalton and I were surrounded by a room of caring team members who valued our opinions and really listened to our needs and concerns. I felt like a true equal member of the team.

We have had even more change in our lives. Conner is heading to college soon. He’s only going to be home for 2 more weeks this summer before he moves into his dorm. Dalton is sad that his big brother is moving away…his big brother who understands Usher, who understands what he is going through. I am also going through mixed emotions but mostly those emotions now are mostly the same as any parent would feel when their child goes to college. I know he is ready and I know he has the self-determination necessary to be successful.

All this said, it’s been stressful. We tried to figure out how to go to the Usher Syndrome conference in Germany but we just couldn’t make the trip. So, when I heard about the Usher Society’s fundraiser and partnership between Usher advocate Rebecca Alexander and the MLB, I reached out to Carly Fredricks with Ava’s Voice and asked if we could come visit her and ride to the game with her. She has kids the same age as ours and I thought it would be good for Dalton and Hunter to hang out with them.

We had an amazing trip. Not only did we have a great time visiting New York City and doing lots of fun things, being around our USH Family was exactly what we needed. For me, it gave me a renewed sense of purpose to keep helping families. I met so many families that I had only met on Facebook and it was so nice to be around people who understand what we are going through. For Dalton, he gained so much confidence in a short amount of time. He and Hunter both hit it off instantly with all the Fredrick kids.

This all came at the perfect time when we needed our USH family the most. I feel so blessed to be on this journey with so many families who help us when we need it the most. Thank you to our USH family.

Conner shares his journey to acceptance

Being Conner’s mom is such a joy for me. He has overcome huge obstacles and works so hard to achieve his goals. I can’t believe it’s almost time for him to head to college. He will start at the Honors College at Oregon State University in the fall. We are beyond proud, but we know it has not been easy. In an essay for a college-level English class, Conner wrote eloquently and candidly about his journey toward learning to accept and live with Usher and not let it define or limit him. I share some of it here with this permission.

“I can’t say when it was exactly when I stopped looking at my disability as a limitation. Now I choose to look at it as a way to gain a new perspective on the world and the good that I could do. My disability is the reason I want to become a geneticist, so I can help people who have genetic disorders like me, and possibly help alleviate the symptoms. I also want to be a geneticist to show my younger brother, who has the same disabilities that I do, that he can achieve his dreams if he wants to, and that his disability does not control him. I want him to be and do whatever it is that he desires. I want him to be able to run carefree without worry like I do now. I want him to be able to play sports with other kids, and I want him to live his life without worry about what he can’t do because he can’t see or hear. I want him to be able to choose his own path. I just hope he accepts it earlier than I did.”

You can read his powerful essay here. Thank you, Conner, for everything you do for our family and the example you set for all your brothers, especially Dalton.

Guest podcast with Portland State

As part of my efforts to help more families dealing with Usher syndrome, I was happy to be interviewed by Professor Amy Parker of Portland State University for her Orientation and Mobility On the Go Podcast. In this podcast, I share insights with Amy about the role of the Orientation and Mobility Specialist in supporting the development of self-determination skills from my perspective as a mother and from the perspective of a graduate researcher. I include practical advice for O&M students and practitioners for working with individuals, families and teams. You can listen to the podcast or read a transcript. Thanks, Professor Parker, for the opportunity.

IEP Experiences Podcast

I’m excited to share my podcast about raising two sons with Usher syndrome. In my first episode, I tell you a little about my family, and our experience working with IEP teams. It can be stressful trying to advocate for your child, and I have learned a lot along the way about working with schools to support my sons Conner and Dalton. One of the best things we did was allow our kids to have input into their their IEPs, so I talk about the benefits of student involvement. My hope is to provide support, guidance, and advocacy for other families.

Listen on Anchor. Or you can read the transcript.

Presenting research at the DbI Network of Americas conference

I had the privilege of attending and presenting at the first-ever Network of the Americas Conference sponsored by Deafblind International and Perkins School for the Blind April 16. Leaders in the field of deafblindness from 20 countries in North America, Central America, South America and the Caribbean attended this major conference.

I was part of a team that presented preliminary data from research on Parent-School Collaboration and Conflict: Experiences of Parents with Deafblindness During the IEP Process. This research involved interviewing many families who have been through this difficult journey with their children. I feel so blessed to have talked with so many amazing, strong, families. I remain hopeful that this research helps lead to positive changes regarding family engagement, collaboration, and partnership.

I was joined by my mentors and co-researchers, Dr. Silvia Correa Torres, Dr. Sandy Bowen, and Dr. Tracy Mueller (who could not attend the conference.) I’m so grateful for their knowledge and support, and I look forward to completing this research and making a difference for people who are working with school systems to support their kids.

I also had the opportunity to present my research on Teaching Self-Determination Skills to Elementary Students with Vision Loss at the same conference. This topic is important to me because of my experiences with Conner and Dalton. Conner attended his first IEP meeting at age 16, and until then, we had not thought about transition. I really wanted to understand what was possible for my younger son. Because of what I learned about self-determination, I was able to talk to Dalton’s O&M instructor, who is know working on self-determination skills with him. Last month Dalton attended his first IEP meeting, and at the age of 9, he was able to communicate his needs directly to his IEP team. This has resulted in a much more positive experience for him at school.

 

We were honored to receive the Foresight Award

Todd and I were so honored to receive the Foresight Award from the Usher Syndrome Coalition in 2017. We are gratified by the recognition, mostly because it helps draw attention to the many people like us who are focused on funding research and treatment.

Since we started Hear See Hope in 2004, it has been a journey of learning and growing relationships with others working toward the same goals. Hear See Hope was a founding member of the Coalition, whose mission is to raise awareness and accelerate research into the most common genetic cause of deafblindness. It’s so rewarding to work together with other committed and compassionate people, including families, physicians, researchers, organizations, and funders to find a cure.

Usher Syndrome Awareness Day

Gov. Jay Inslee declared Sept. 16, 2017 Usher Syndrome Awareness Day in Washington. We wrote to the governor and asked him to join other states in making the proclamation to draw attention to Usher and the many families it affects in our state and country. Conner was so proud to hold the proclamation. This is just one step in our advocacy efforts, but it’s an important one.

Many people don’t know about Usher – and that it’s the leading cause of deafblindness in the nation. We hope to make this an annual proclamation. Thanks to Gov. Inslee for his support of our cause.

 

 

Raising Awareness about Usher with our lawmakers

One of the ways Hear See Hope works to raise awareness of Usher syndrome is through our lawmakers. Todd and I met with Sen. Patty Murray in 2015 to educate her about the disease and the many families it affects. We appreciate her meeting with us and asking us about Usher and the work we’ve done through Hear See Hope to support not only Conner and Dalton, but other families who are living with Usher.

HSH co-founder Lane McKittrick presents research at national conference

Lane McKittrick, who founded Hear See Hope with her husband, Todd, continues to expand her efforts to find treatment and a cure for Usher syndrome by pursuing her doctorate in deafblindness at the University of Northern Colorado.

She presented her research at the Council for Exceptional Children Conference in Tampa Feb. 9, 2018. Her presentation, with Dr. Silvia Correa-Torres of UNC, was on Teaching Self-Determination to Elementary Students with Sensory Loss.

She and Todd founded Hear See Hope after their oldest son, Conner, was diagnosed with Usher syndrome. The foundation raises money to find a cure for Usher, the leading cause of deafblindness in the United States.

You can support their work by making a donation or attending the upcoming Laugh for a Cure auction March 24 at the Triple Door.

Visualizing a Cure

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A Proposal for the Hear See Hope Foundation

Understanding Cone Degeneration in Usher Syndrome And Retinitis Pigmentosa
Within the retina, photoreceptors make up one of the most important and most vulnerable cell classes afflicted by retinal degenerative diseases, like those present in Usher syndrome patients. Drs. Jennifer Chao and Ramukar Sabesan, clinical and research faculty at the UW Medicine Eye Institute and Vision Sciences Center, are collaborating on a new approach to visualize what happens to the photoreceptors damaged by retinal degeneration using high-resolution advanced adaptive optics imaging – a next generation technology developed in our labs. This research is critical to advancing our understanding of these diseases and whether potential therapies aimed at preserving and restoring central vision to patients will be successful.

Research Summary

  • The goal of this research project is to better understand the mechanism of how central vision is affected in patients with Usher Syndrome and Retinitis Pigmentosa (RP) using our high-resolution adaptive optics imaging system.
  • Drs. Chao and Sabesan hypothesize that in patients with Usher Syndrome and RP, the cone photoreceptors (those responsible for our central vision) have impaired function early in the disease process — before there is loss of central vision — due to starvation of the cells.
  • At the UW Medicine Vision Sciences Center, we have designed and built an adaptive optics imaging system that can detect, measure, and map the structure and function of cone photoreceptors at an individual cell level in a living human eye.
  • With this new technology, we are now able to detect whether non-functional cone photoreceptors are present, and if they are capable of being stimulated.
  • Ultimately, this study will help us to determine whether potential therapies aimed at preserving and restoring central vision in patients with Usher Syndrome and RP will be successful.

A New Approach For Usher Syndrome
Recent approaches to treating diseases such as Usher Syndrome or RP include the use of stem cell transplants of photoreceptors, gene therapy, and chemical reanimation. However, a fundamental issue in understanding these diseases and translating potential therapies to patients is the ability to visualize their effectiveness at restoring function at the individual cell level. Until recently, the ability to study individual photoreceptor cell function in patients has been a challenge in the field because of the eye’s unique optics and because the retina is constantly moving.

The UW Medicine Eye Institute and Vision Sciences Center is one of only a few institutions in the United States to have designed and built an adaptive optics imaging system capable of imaging the human retina at a singular cellular level. Furthermore, our adaptive optics equipment has the ability to fix an image on the retina, allowing scientists to study cells that are not functioning properly and explore opportunities to stimulate those cells and measure the effects of any treatment with extreme precision.

Figure 1: Human foveal cone mosaic imaged with adaptive optics imaging system in the Sabesan lab. A) and B) are reflectance images with illumination centered at 543nm and 840nm respectively. Each spot denotes a cone photoreceptor and is about 2-4 microns in diameter. The scale bar is 20 microns.

Drs. Chao and Sabesan theorize that in patients with Usher Syndrome and RP, the central cones show signs of disruption in their structure and function before it is clinically noticeable. Several recent studies have shown that the loss of central cone function may be caused by the “starvation” of the cells following the loss of their rod photoreceptor counterparts. Using animal models with RP, researchers have shown that they can reverse some of the damage seen in cones and even restore their functionality with an injection of glucose into the subretinal space (4) (5) (6).

Using our adaptive optics imaging equipment, we propose to map the progression of cone photoreceptor dysfunction in patients with Usher syndrome and RP in order to gain a more complete picture of disease etiology, progression, and possibilities for clinical intervention. In addition, we also seek to demonstrate that cone photoreceptors are only dormant in Usher and RP patients and not completely lost. This finding in patients would confirm what has been observed in animal models and open up new avenues of research for the therapeutic reanimation of cones. The presence of dormant cones would that mean either preserving or restoring central vision in patients with late stage Usher Syndrome or RP is possible.

This new collaboration between the Chao and Sabesan Labs is an opportunity to test the feasibility of conducting these imaging studies in patients with a broad array of retinal diseases, such as will be possible in our new Retina Center at UW Medicine opening in 2018. This proposal is fundamentally distinct from the current efforts of both labs and is a natural next step in our pursuit to translate new therapies developed in the lab to new cures that can be administered clinically. With the results of this research, we intend to apply for federal NIH funding and other private grants in order to support continuing research in this new and promising area of study.

Budget
We have received initial funding support for this project from a Latham Vision Research Innovation Award, which was granted by the UW Medicine Department of Ophthalmology in August 2017.

 

With additional pilot funding of $25,000 or more from the Hear See Hope Foundation, we will be able to fund a portion of a salary for a research assistant for one year to aid in patient enrollment, image acquisition, analysis and interpretation of the data, and manuscript preparation. Additionally, these funds will be used towards the purchase of two new detectors that will allow us to acquire images of cone photoreceptors inner segments in Usher and RP patients.

We estimate that the full study will take three years to complete, with a total cost of $225,000. We envision this project as the beginning of a new field of research that will be ongoing at the UW Eye Institute and Retina Center. This funding will support the salary for a full-time research assistant ($60,000, including benefits) for three years, as well as provide partial salary for a clinical trials coordinator. It will also completely equip our current adaptive optics imaging equipment with the hardware needed to acquire images of cone inner segments or dormant cones ($30,000).

Thank You!
We are grateful for the past support of the Hear See Hope Foundation and we look forward to discussing this new proposal with you. Please feel free to contact Abbey Norris, director for philanthropy, at 206.221.8274 or abbeyn@uw.edu with any questions.

Thank you for your consideration of this request.

REFERENCES

  1. Sabesan R, Schmidt BP, Tuten WS, & Roorda A (2016) The elementary representation of spatial and color vision in the human retina. Sci Adv 2(9):e1600797.
  2. Wang Q, et al. (2015) Adaptive optics microperimetry and OCT images show preserved function and recovery of cone visibility in macular telangiectasia type 2 retinal lesions. Invest Ophthalmol Vis Sci 56(2):778-786.
  3. Tu JH, et al. (2017) Dysflective cones: Visual function and cone reflectivity in long-term follow-up of acute bilateral foveolitis. American Journal of Ophthalmology Case Reports 7:14-19.
  4. Du J, et al. (2016) Phototransduction Influences Metabolic Flux and Nucleotide Metabolism in Mouse Retina. J Biol Chem 291(9):4698-4710.
  5. Punzo C, Kornacker K, & Cepko CL (2009) Stimulation of the insulin/mTOR pathway delays cone death in a mouse model of retinitis pigmentosa. Nat Neurosci 12(1):44-52.
  6. Wang W, et al. (2016) Two-Step Reactivation of Dormant Cones in Retinitis Pigmentosa. Cell Rep 15(2):372-385.

UW Medicine Eye Institute and the Hear See Hope Foundation

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Restoring Vision Loss Caused by Usher Syndrome

It is estimated that between 30,000 and 50,000 people in the United States suffer from Usher syndrome, a genetic disorder that causes deafness and blindness. Children with Usher syndrome are born with, or may develop, hearing loss. Then, as these children get older, they develop night blindness and their visual field narrows, creating “tunnel vision.” There are currently no treatments for Usher syndrome, but stem cell therapy holds great promise for restoring sight and benefiting patients worldwide.

The UW Medicine Eye Institute, the only academic Eye Institute in the five-state WWAMI region (Washington, Wyoming, Alaska, Montana and Idaho), is at the frontier of developing new techniques to restore vision loss utilizing stem cell therapy. Building on a depth of research expertise, clinicians and scientists at our institute have partnered with the Hear See Hope Foundation to develop treatments for vision loss caused by Usher syndrome. We welcome your partnership to advance this innovative research.

Advancing Stem Cell Therapy
Jennifer Chao, M.D., Ph.D., assistant professor in UW Medicine’s Department of Ophthalmology, utilizes a special technique to create undifferentiated stem cells from a patient’s own skin or blood cells. These stem cells, called induced pluripotent stem cells (iPSCs), contain a person’s entire genome and can be programmed to become almost any other cell in the body. Dr. Chao, in collaboration with Tom Reh, Ph.D., professor in the Department of Biological Structure, converts these iPSCs into retinal cells that are genetically identical to those found in the patient’s eye. Once the iPSCs have been grown into millions of copies of patient-specific retinal cells, high-throughput screening technology tests thousands of compounds on the cells in an effort to determine which of these compounds help the cells to survive. This process, called “cell rescue,” is a groundbreaking technique that could help identify already FDA-approved drugs capable of stopping or slowing the progression of vision loss in patients with Usher syndrome or other retinal degenerative diseases. While animal models exist for many other degenerative retinal diseases, this is not the case for Usher syndrome. This means that traditional basic research techniques used to test hypotheses in animal models cannot be performed for Usher syndrome. However, new techniques are being developed at UW Medicine to produce improved patient-derived cell culture models of Usher syndrome and other degenerative diseases to accelerate research. With UW Medicine’s streamlined approach, and our strong partnership with the Hear See Hope Foundation, we believe an effective cure will soon be made available to patients.

The Potential of Cell Rescue — From Concept to Cure
In 2013, the Chao Lab performed the first high-throughput screening of stem cells from patients with age-related macular degeneration (AMD). This proof-of-concept study demonstrated promising results: multiple compounds were found to have therapeutic effects, facilitating cell rescue. We are now in the process of understanding the biological mechanisms of the cell rescue, as well as the dosing of potential therapeutic compounds. In 2015, with support from the Hear See Hope Foundation, the UW Medicine Eye Institute will begin using this same method to test stem cells derived from Usher syndrome patients.

Opportunities to Invest
We can accelerate the pace of research aimed at slowing or stopping vision loss in Usher syndrome patients with your philanthropic investment. Support of the UW Medicine Eye Institute will advance:

  • Research associated with collecting and growing millions of Usher syndrome patient-specific stem cells, as well as use of the high-throughput screening equipment to test potential treatments. $500,000
  • New studies of the mechanisms, dosing and bio-availability of potentially therapeutic compounds identified through high-throughput screening. $500,000
  • Implementation of advanced imaging technology — available only at UW Medicine — for understanding the retinal degeneration caused by Usher syndrome and assessing the effectiveness of new treatments. $150,000
  • Devoted Usher syndrome research support via part-time or full-time post-doctorate fellows. $40,000 to 60,000 per year

Join Us
By investing in our partnership, you can advance groundbreaking research that will bring hope for a cure to the thousands of children and individuals suffering from Usher syndrome worldwide.

To learn more, please contact Abbey Norris, director for philanthropy at UW Medicine, at 206.221.8274 or abbeyn@uw.edu. Thank you for your interest.

More Hope than Ever!

Breaking research news – Gene Therapy provides vision to nearly blind young adults” Three young adults with virtually no vision can now read several lines on an eye chart and see better in dimly lit settings thanks to an innovative gene therapy aiming to reverse blindness in a severe form of retinitis pigmentosa known as Leber congenital amaurosis or LCA. One person was even able to better navigate an obstacle course several weeks after receiving the therapy.

The three individuals are participating in a Phase I clinical trial at The Children’s Hospital of Philadelphia.

This is an incredible milestone in curing blindness, and this advancement will help pave the way for the development of gene therapies to treat and cure a variety of retinal diseases including Usher syndrome.

Doctors working on Usher syndrome research are working to extend this incredible breakthrough to Usher syndrome. There is great hope that clinical trials for similar gene therapy for Usher syndrome is right around the corner. Future funding is needed for this important research to continue.