Lack of Visual Access Masks Language/Cognitive Abilities

Young Jack, who has CVI, is in school where the team was using pictures in his communication system. Jack seemed to show no understanding that the picture of the “spoon” represented “snack”. When he wants snack he whines or cries until someone familiar with his limited communication gets him a snack.  It is so hard for Jack to show adults what he knows or understands. His abilities to communicate using symbolic representations seems severely limited.

The new TVI assessed Jack around the well known visual behaviors of CVI.  She determined that 2D pictures were visually inaccessible for this child. She advocated for the change from 2D photographs to 3D symbols for his communication.

With this new 3D symbol system, “snack” is represented as a spoon mounted on a black 5’X7” card.


Jack began to show adults that he indeed understood the new 3D symbol system.

  • Jack smiles when seeing the 3D symbol for “snack”.
  • Jack consistently chooses the “snack” symbol when given a choice of “snack” or a foil. (A foil is a meaningless object or a non-preferred object)

For more about “foils” see under “Implementation” section.

  • Jack pulls people towards the snack table when presented with the 3D “snack” symbol.

Jack also began showing similar understanding of other 3D symbols in his new communication system.

3 imbedded symbols

When using photographs, Jack’s abilities to communicate using 2D symbolic representations seemed severely limited until the assessment determined that these 2D photographs were beyond his visual abilities. Creating symbols in 3D that are accessible allows Jack to truly communicate his wants and needs. This ability shows the team what Jack is capable of.

The collaboration between a TVI who understands CVI and the team puts Jack on the road to building communication. Jack looks more capable as he is now able to show what he understands. The team has higher expectations for his learning. The building successes using the 3D symbol system can later be thoughtfully transitioned to photographic symbols in planned way based on his visual understanding.



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