environments for CVI

Parent Interview, Observation and Direct Assessment: What is Learned?

The CVI Range assessment (Roman-Lantzy) gives us a great idea of functioning across the environments and across people.

  • The parent interview gives up the across the lifetime visual abilities (improvement history), across environments information (home vs grandmother’s house) and across the day abilities (early in the morning and after a long school day).
  • The observations part of the CVI Range gives us the functioning in a less adapted learning environment (for now!).
  • The direct assessment, conducted in a very adapted environment (low complexity, sound, movement etc.) that gives us a look at the visual skills with all the supports in place to support that student’s vision. That direct assessment environment tells us what the child is capable of if the environment is adapted and what adaptations would help.
  • We bring those adaptations into the classroom and home for optimal visual functioning and across the day access.
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Have You Really Controlled the Complexity and Light?

Complexity and access to distracting light and movement can completely overwhelm the student with CVI in the classroom. I have seen teachers work very hard to reduce the complexity of their classrooms. It can be a challenge but well worth every effort for our students with visual impairments due to CVI. Controlling complexity and light effectively creates accessibility to learning.

Take a look at this classroom: (Pinterest)

 

This teacher has covered the shelves that are probably filled with toys and books. The shades are pulled down to control distracting light sources. The floor cover is a nice non-complex background for looking at materials placed on the rug. A nice start!

BUT: look at the shelves in on the left side of the room. The black cover controls the complexity on the shelves but the complexity remains with the many colorful and complex materials stored on top. If those toys were removed, that left side of the room would be a much less complex background against which to learn. (Complexity of Array: Roman-Lantzy). That is, of course, if that is the way the student in facing in the room!

If the student is facing the right side of the room or learning in the middle of the room, that would be completely overwhelming and complex. If the student is facing this way and this is the background, the student would really struggle against this complexity of array. This side of the room is completely inaccessible for learning for the student with CVI.

Here is a challenge for everyone as you return to school from the holiday break. Pick a student in your class who has CVI. Think about every position you place that student throughout the day. Actually sit there. Is the background where the student is facing free of complexity? If not, rethink your adaptations so the whole room is adapted. Would there be a better place to face? Would learning against a wall rather than in the middle of the classroom be best? Accessible learning is from the student’s point of view not from ours.

The What’s the Complexity Framework: Designing a Visually Accessible School Day for the Child with CVI

This is an online CVI related class through Perkins elearning conducted by Matt Tietjen.

October 23rd to December 10th, 2017

It provides educators with 35 ACVREPs, 35 PDPs, 35 CEs, or 3 Graduate Credits

Matt is a passionate and gifted practitioner serving students with CVI in all Phases (Roman-Lantzy). He recently developed this framework to help teachers, TVIs, therapists and parents assess the complexity of visual presentations, learning activities and learning environments for students with CVI. I signed up to learn more about this important new tool for my work with students.

Here it the description:

“We will study the characteristic “Difficulty with Visual Complexity” in-depth, explore its central relationship to the other characteristics, and examine the ways in which it can impact behavior and access to education for a child with CVI. Our study of visual complexity will integrate the literature on cortical and cerebral visual impairment.

Participants will learn how to use The What’s the Complexity Framework in order to evaluate the complexity of school environments, tasks and materials and to guide educational teams in creating more visually accessible, appropriate learning activities for children with CVI.

In addition to learning how to rate the complexity level of a particular environment or education task, we will also emphasize the importance of balancing the complexity of the environment and task in each activity, managing cumulative complexity and visual fatigue throughout the school day, assessing interpretation of two-dimensional images, and providing direct instruction in salient features.”

http://www.perkinselearning.org/earn-credits/online-class/cvi-complexity

Rebecca Davis: Parent blog

Please check out the latest parent blog: CVI Momifesto at

https://cvimomifesto.com/?wref=bif

The subtext of the blog is “Building a Community of Parents of Children with CVI”

Historically, it is the work of parents, organizing and advocating that causes changes in the service to children. I think of the work of parents of children with autism as they organized and advocated for better research, better identification, better funding and more paid services for their children. The parents of children affected with RETT syndrome and related disorders are another wonderful model group for parent advocacy. They came together to advocate for awareness of RETT syndrome, RETT research and funding and they created assessment centers all over the country to serve their children.

Parents with children affected by CVI need to do the same. They need to come together with one voice that will bring the topic of CVI to the forefront. I monitor many Facebook pages that parents have created. They share heartbreaking stories of navigating the misinformation from medical professionals and educators as they seek the best services for their child.

The information about CVI is now decades old and building everyday. Why does it fall on the shoulders of parents with the least free time to organize this effort to help medical professionals and educator understand CVI and how CVI affects learning?  Professionals who understand CVI are out there but they are not sitting at your child’s IEP. That is where the advocacy must begin.

As parents and professionals who understand CVI, let’s begin to build the documented evidence for the IEP process that fosters the diagnosis of CVI. Let’s make sure the students are assessed using the correct tools such as the CVI Range (Roman-Lantzy). Let’s make the CVI Endorsement (through Perkins School for the Blind) mandatory for professionals working with each child. Let’s make sure there is not “vision time” but consideration of visual needs around the day and across the curriculum.

Check out Rebecca’s blog!

 

Adapting Classrooms for Children with CVI

It can be a real challenge to adapt learning environments for our students with CVI. Of course, one adaptation suggestion is never the answer. The environment must match the child’s assessed functional needs around CVI. The functional visual assessment for children with CVI must be the CVI Range (Roman-Lantzy 2007). Even children in the same Phase of CVI, must have distinctly unique adaptions for their environments and for their learning. These distinct needs can only be identified with assessment of the individual child.

For a child with an ocular impairment like retinopathy of prematurity (ROP), we would never say “Oh, this child has ROP? Here are the environmental needs and the learning material needs.” We would assess functional vision to identify the unique visual needs of that individual child. Our children with CVI deserve the same respectful and accurate assessment of their functional vision. They deserve accurate environmental supports and adaptations to learning that match that assessment.

In several classrooms where I serve children, the reduction of visual and auditory complexity and controlling access to light are the most challenging environmental adaptations. The solution we have used was to create learning centers in the classroom using cubicles.

 

These cubicles were donated by a business that was renovating their offices. The donation was a free and effective environmental support for many of my students. The cubicle walls are large and sound reducing. They tend to be tall which blocks distracting light. Perfect for so many children. Call your local Chamber of Commence or contact your local Rotary Club. I’m sure businesses would be so happy to help and to see these cubicles recycled and put to good use!

Visual Experience, Experience, Experience

For science nerds like me!

“Neuroscientists Reveal How the Brain Learns to Recognize Objects”

https://www.sciencedaily.com/releases/2010/09/100922121937.htm

This article comes from work being conducted at Massachusetts Institute of Technology (MIT). They are studying how humans process visual information for recognition so they can design artificial visual systems. It seems vision is such a complex process! I think parents and teacher have understood this for years!

This great article that drives home the brain’s need for repeated experience to build visual understanding. The brain must have repeated experiences with objects in different kinds of positions, perspectives, lighting, size and distance. It reminds me to provide my students with real objects in repeated, predictable routines to build familiarity. It reminds me not it only present iPad visual targets that can’t be manipulated. The child builds visual recognition from the presentation of objects in multiple positions to view multiple perspectives. If the child is not able to manipulate material themselves, we must provide that varying visual perspective.

This is a reaffirmation of the characteristic of Novelty that Dr. Christine Roman-Lantzy discusses (Roman-Lantzy CVI Range 2007)

 

 

What’s the Complexity? Workshop

This month I attended a full day workshop titled: “What’s the Complexity?” with creator, Matt Tietjen, M.Ed. CTVI. This assessment tool was developed to look at the characteristic of complexity as described in the work of Christine Roman-Lantzy in the CVI Range 2007.

The “What’s the Complexity?” framework takes a close look at the characteristic, Complexity,  that is most difficult to control and the characteristic that seems to effect children’s visual functioning to the greatest degree. It provides a way for parents and educational teams to assess complexity in all forms. It helps parents and teams choose appropriate materials, design appropriate environments matched to appropriate tasks and then to plan across the complete learning day for the student with CVI.

It focuses on all Phases of CVI (Christine Roman-Lantzy) but I believe is most valuable for the students functioning in Phase II and Phase III as they try to access pictures. The “What’s the Complexity?” framework also provides us with a well thought out system to assess the student’s interpretation of images. We evaluate the child’s understanding of photographs of their real items (my spoon), colored photographs of other classes of items (the class of spoons), understanding of realistic or abstract cartoon icons of items (spoons in cartoon form), colored icons (Mayer Johnson spoon) and black and white line drawings (black and white drawing of a spoon).

This is an important new tool for us as we serve our children with CVI. It will help support our recommendations for children’s accessible media. Fantastic!

I understand that a graduate class will be offered in September at Perkins elearning to deepen the understanding for using the “What’s the Complexity?” framework. I will certainly be signing up for this!

 

Morning Meeting Ideas for Children in Phase I

I had a request for some morning meeting ideas for children in Phase I as measured on the CVI Range (Christine Roman-Lantzy 2007). The concepts and vocabulary around “Characteristics” and “Phases” come from Dr. Roman-Lantzy’s work.

The first place to start, of course, is to assess the child using the CVI Range. This is the only functional vision assessment for children with CVI. Understanding the child’s functional visual skills allows you to create goals and objectives and to provide across-the-day accommodations and methodologies to meet those needs.

Phase I:  Goal: Building Visual Behaviors. Providing access to use visual skills around the 10 characteristics.

The child has a favorite color and will only look at simple one colored items. (Color)

  • Materials in morning meeting must meet the color preference. This is not always red o yellow. Your assessment will tell you the preferred color. Because this child is very visually impaired, compensatory skills should also be considered. Items presented must be 3D, real objects NOT PICTURES! 3D objects will provide visual access, tactile input, olfactory input and auditory input.

Pictures are completely inaccessible for this child who is not using central vision   effectively. (Central vision is essential for children to understand any 2D materials).

The child looks at movement or shiny items but does not seem interested in stable objects. (Movement)

  • Materials in morning meeting must meet this assessed need for movement of the presented materials to foster visual use. Shiny items are considered under the Movement characteristic since the reflected light from the surface looks like movement. Movement should be gentle and slow not fast and frantic.

There is no or little reaction to visual threat or touch between the eyes. (Visual Reflexive Responses)

  • Reflexes are reflexes and cannot be taught. There are no accommodations for visual reflexes.

The child fixates briefly but likes light, ceiling fans and movement. (Light gazing and Movement)

  • To foster looking at the presented morning meeting materials, light must be controlled, limiting the child’s lightgazing.
  • Because light is important to encourage looking, light the materials that are presented or use materials that light up.
  • Because fixation is brief, the material must be presented for longer so the child has another opportunity to visually locate.

The child sees things in the peripheral fields but does not react to items in central vision positions. (Visual Fields)

  • Because peripheral fields are stronger than central visual fields, the materials must be presented off center in the best assessed lateral visual field. (The child in Phase I will have a distinct preference for one lateral visual field).
  • The lower visual fields are often not functional well into Phase III so eye level is recommended. Upper fields can also be inaccessible.
  • Make sure the “action” of morning meeting is within their best assessed visual field.

There is visual attention in near space only within 2 feet. (Distance and Complexity)

  • The child can only look at items in near space. The exact assessed distance needs to be respected and materials presented within this distance. At this Phase, this is typically within 18”-24” of the child’s eyes.
  • Give the child a copy of the material being used with other child in turn. This provides visual access for the child even when materials are being presented to other children at greater distances.

The child rarely looks to faces (Complexity).

  • Faces are very complex. This child will have difficulty looking at faces. Be mindful that the child may be attending but not able to make eye contact or even look towards your face if you are talking. Greet them with your name and tell them what you will be doing with them. Call their name before delivering a message or asking a question. Research shows that adults often do not talk as much or as long to children without eye contact. Adults should be aware of this and monitor their behavior with children.

The child sees best in uncluttered, quiet places. (Complexity)

  • Provide quieter environments
  • Create morning meetings of less children so the movement, visual complexity and auditory complexity is more controllable. There is no rule that morning meeting needs to be all the children in one morning meeting. Have several smaller meetings.
  • Provide non-complex backgrounds for all learning materials.
  • Where non-complex shirts. You are the the visual background!
  • Seat yourself in the same position as the child to see what the child sees. You will be surprised how much visual complexity you will notice and need to control.
  • Position this child solidly for best visual skill use.

The child only looks at familiar and favorite toys. (Novelty)

  • Use familiar materials.
  • Use consistent materials to build visual familiarity.
  • Predictable routines in morning meeting will support visual recognition of materials and help children predict the sequences.

The child has a long delay before they turn to look. (Latency)

  • The child will have latency for looking and latency for understanding what is seen. Using the assessment and taking data will help identify how long the child requires for visual attention, which visual field is faster and which visual field has the most sustained visual attention abilities. The material needs to be where the learning is accessible and for as long as the child requires.

 

Toys for the Holidays

As we think about gifts for our children with CVI, we want to pick toys and materials for fun and learning. First and foremost, children with CVI are children. All children benefit from play as the basis of their learning. It is essential that our children have those opportunities carefully created and frequently available. Think about a child with typical vision. They have access all the time. Wouldn’t it be great to have teams look across the child’s day and make sure our children with CVI have visual and play access all the time?
These play opportunities need to be matched to children’s assessment results from the CVI Range (Roman-Lantzy).
Certainly for children in Phase I and Phase II, as measured on the CVI Range (Christine Roman-Lantzy 2007), toys and materials that would be best would include:
• A toy that includes the child’s favorite color as a component in a less complex toy surface.
• Lighted toys
• Movement that is predictable, not too frantic.
For the play environment:
• We want fewer toys to look at matched to their assessed tolerance.
• We want non-complex backgrounds so the toy really stands out.
• We want the toy to be in the child’s best visual field at eye level.
• We want toys close matched to their visual abilities for distance.
• We want an activation method for the toy. This might be a switch that the child can accidentally hit, learn and then purposefully hit. It might be a toy that makes a visual change or a toy that makes a noise when it is hit. Children in Phase I might not be reaching much yet but we need to present the opportunity to activate to build reaching. Far too many toys for children with CVI rely on passive looking and no expanded access ability for the improving vision and visual motor skills.
• We want toys within the child’s arms’ length and arm movement abilities. If the child has limited arm movement, we must place the activation method near the hand/arm and have another part of the toy within their visual field (“I move my arm and I see this visual event”).