literacy for CVI

What Do iPads Do to Support Students

As discussed many, many times, the strategies for CVI must match the assessment results. We never can just randomly apply a strategy because it will not fit the functional visual needs of the child. If it does not fit the functional visual needs, it will not provide visual access and will not foster improvement of cognitive and visual skills.

With that reminder, I was asked about ideas for iPad apps for children who struggle with visual recognition. Just providing a student with an iPad does not guarantee access. We need to assess the child, think about their visual needs and carefully use the iPad as a tool to provide that access.

What can be some general needs for students who struggle with visual recognition?

Impact of Color: The student might benefit from color highlighting to draw visual attention to specific areas on 3D and 2D materials. That color supports visual attention to the specific place.

Light: Backlighting can helps foster access to materials especially in 2D (pictures and text). Some children do not benefit from backlighting and this should be part of the assessment.

Visual Processing Time: There is still a need for increased time for full visual exploration and full visual understanding.

Visual Field: Lower visual fields might be affected in some children. Other children struggle with visual attention in all fields or “hyper attention” if the scene is too complex. (attends to just one part not taking in the whole scene).

Visual Recognition: Presenting new materials in new kinds of presentations might require the verbal narration of visual attributes.

Clutter: Clutter can affects visual understanding of objects, increased display clutter, of faces, and of the sensory environment.

Distance: Near information is more accessible. Distance curiosity is not typical so distance information is missed.

How do we want the iPad to support the student? 

Impact of Color:

  • Tools for color highlighting help support salient feature discussion in pictures and text.

Light:

  • Backlighting helps with understanding and easy of access to prevent fatigue.
  • Moving to 2D: taking pictures of their items in the environment and then providing the 2D on the backlighted iPad.

Visual Processing Time:

  • Provides ability to capture images and videos for longer visual access time.
  • Capturing images can be reviewed as long as needed.

Visual Field:

  • iPad placement is flexible matched to child’s best visual field.

Visual Recognition:

  • Expanded understanding: Example: Here is one kind of mouse in the book but these are all the other kinds of mice.

Visual Clutter and Access:

  • Enlargement: for things at distance, for small items in complexity and for literacy
  • Overall ability to use settings and apps to reduce complexity of images.
  • Studying facial expression in photographs and videos: salient language of faces matched to voice (auditory). There can be instruction about facial expressions that match the auditory information.
  • Visual attributes of items in photographs and as part of texts.
  • Increasing spacing of words and sentences to reduce clutter.
  • Masking: clutter reduction with tools in Photos.

Distance:

  • Videos on the iPad: to bring information about events and concepts that occur at distance: Example: We are reading about giraffes. I think about providing a child with access to where that animal might live and how they move.
  • Access to distance classroom events: Examples: learning song hand movements for circle time.
  • Community access: taking photographs of signs and environmental materials that can be explored on the backlighted, near placed iPad.

“Duckness: How Do We Know?

Look at this series of pictures. (From American Printing House for the Blind website)

How can very young children with intact visual skills understand that these are all ducks?

They understand “Duckness”.

They have a keen understanding of the visual attributes that make up this “Duckness” because of shared visual experiences with others and with access to pictures, TV and movies that feature ducks. This develops effortlessly for children with intact visual skills.  Without direct instruction, they understand that real ducks are different sizes, colors, and ages. They understand that ducks can be seen in different perspectives depending on where and how they are standing. They understand that ducks can be flat in pictures. They understand that ducks can be symbolic in toys, signs, pictures, colored cartoons and in black and white drawings.

Our children with CVI lack this visual access to “duckness”. They lack the expanded and repeated knowledge about ducks. If they have seen a duck, their idea of “duckness” is limited to that one duck. Due to reduced eye contact with people and with reduced eye to object abilities, adults do not explain the shared salient features that all ducks share.

As adults serving children with CVI, we should be aware of this limited access and limited understanding that can occur in 3D and 2D. We must create opportunities to expand children’s access matched to their assessed functional visual skills. We must evaluate all our materials with this visual access limitation considered. We must adjust our own interactions and instructions to include visual attribute language of the same and different visual feature of items.

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 visual behavior of complexity as it is intertwined with other visual behaviors of CVI.

The “What’s the Complexity?” framework takes a close look at the visual behavior of Complexity,  that is most difficult to control and the visual behavior 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.

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 regularly at Perkins elearning to deepen the understanding for using the “What’s the Complexity?” framework. I will certainly be signing up for this!

 

Picture Accessibility for Children with CVI

In my work with children, I am often asked about the accessibility of pictures, icons and line drawings as communication systems for children. I especially struggle to be an effective voice around accessibility when my children with CVI look towards pictures but never use central vision to actually “see” and “understand” those pictures. I try to support my opinions with inservice simulations about peripheral looking, as it only provides visual information about general color and general shape. To understand objects, pictures, ions and line drawings, the child must look directly at the image using central vision and shift to the picture’s elements to understand it. At MIT, there are several labs that study various aspects of visual processing. I found this book and ordered it on Amazon for $10. I am finding it so helpful!

Looking into Pictures: An Interdisciplinary Approach to Pictorial Space by Heiko Hecht

Powerpoint Books: Matching to Assessed Visual Needs

Literacy is so important for every child. I love making Powerpoint books for my students with CVI. You can make these for the class as a whole based on a thematic unit or make individual books tailored to each child’s visual needs and preferences.
Using Powerpoint books allows me to use strategies matched to the child’s assessed visual needs for visual attention and visual recognition
Color: I use the bright, solid colored targets for attention and recognition.
Motion: I can insert slight movement as needed using an inserted film clip. I also like to insert films to build cognitive understanding. If the child will look at a plastic toy fish, I do not want they to believe that “fish” are hard plastic, non-moving things. I want to build understanding of how they move, where they live and to have the child understand that fish come in different colors and shapes. I can insert a film clip of fish in a fish tank. I can talk about how fish are alive, breathe, have different colors, swim in water and how they move. Children with typical vision have this information without direct teaching. I want my students to have the same access.
Processing time: The images on the pages can stay present for as long as a child needs.
Visual Fields: The device using the Powerpoint can be placed in the best visual field. This is often at eye level.
Complexity: Powerpoint books allow me to choose a non-complex target and non-complex backgrounds for each slide page. If I take my own photographs or grab images from Google, I can Edit and erase all complexity before I insert the picture. If I take film, I can make sure that film is non-complex.
Light: Because the Powerpoint is created on a computer or backlighted device, the child’s need for light is satisfied. If there is light sensitivity, I can turn the light down lower.
Distance Viewing: The device playing the Powerpoint can be placed at the child’s assessed best visual distance. It can bring items for learning into the near space.
Visual Recognition: Children will look at familiar items better than non-familiar ones. Using pictures of familiar items and creating books about familiar topics, events or predictable sequences are much more likely to draw a child’s visual attention and interest. Remember that all children like predictable books!
Visual Motor: Visual attention is important for literacy but the ultimate goal is always independence to control the book and choice of books. With the ability to turn to the next page or to indicate a desire for a different book is often visual motor task. To encourage visual motor, there must be an access method that is matched to the child’s assessed visual skills to find and reach.

Here is a Youtube explanation of how to make the Powerpoint book https://www.youtube.com/watch?v=tYQCwowU8sk

Non-Complex Concept/Choice Board

To reduce complexity on a concept/choice board, I used corrugated black plastic to create the board.  I used black Velcro so the Velcro would not become another item in the array. (It disappears against the black plastic).

img_1580

I wanted to be able to notice any visual behaviors so created a window. I was concerned that my eyes and face would become another item in the array. Using black screen like the kind used in window screens, I covered the peek hole. Now this board can be held up at the child’s best distance and at her eye level. I can watch exactly where she is looking and at what she is looking no matter how quickly she looks. I can reach around the board and create movement to draw her visual attention to the described item.

Version 2

This is really helping the team understand whether this child understands the visual information, the concept being discussed and or the choices being made. I can present 1, 2, 3 or 4 icons on this board depending on the child’s assessed presentation needs.

The Happy Little Yellow Box: A Pop-Up Book of Opposites

This looks like such a great book for children with CVI (with some reduction in complexity)! It is by David A. Carter who has several like it. I ordered one for a child who is able to attention to 2D. The concept behind this book creation (non-complex, yellow color, the ability to create movement with the 3D box and movement of the pull tabs) will match many children’s assessed needs around CVI and beginning literacy. I’ll keep you posted but am looking forward to adapting it for my students!

 

How Does This Make Sense?

The child has limited visual attention. He does not look at many items and the looking is very, very brief. The child enters school and icons, that very symbolically represent materials, are chosen to be used for his communication system.  How does this make sense?

  • The child is not looking at 3 dimensional things in their environment therefore can’t build visual recognition of real 3D items. The can’t see the backpack and jacket in real life and recognize them. On the device, these icons appear. They are 2 dimensional and represent these things. How is the child expected to connect the 2D symbol to an 3D item they can’t look at and can’t recognize??

IMG_0505

  • This child is very visually impaired yet pictures are used??
  • The child, if they can locate items, can only tolerate looking at a 3 dimensional item one at a time, yet they are presented with a HUGE amount of symbols on a communication system.

device

  • The child can only look at items that move yet symbols are presented as stable items??
  • The child is constantly told to “look” using central vision, yet it is their peripheral vision which is the most functional.
  • The child is presented with 2 dimensional pictures the represent part of an object (which they can’t recognize in 3 dimensions!). I had to struggle with this one below.

IMG_0504

Teachers of students with visual impairments who understand CVI and how to assess CVI must work hard to help teams understand this disconnect. Without the vital information gained from the CVI assessment of functional vision, the communication device materials and other 2D learning materials are inaccessible. Would we ever do this to a child with an ocular impairment?? I don’t think so!

Building Literacy Around What Children Care About

We all pick up books based on our preferences for topics.  Why should our children with CVI be any different? Parents have a wealth of information about what their children’s passions. These are the favorite and visually familiar things we should build our literacy materials around for our children.

My student is fascinated by cell phones. I grabbed a Google image of a cell phone (actual size) and chose a fairly complex book. I applied Velcro to the back of the cell phone image and to multiple places on each page.

IMG_0420    IMG_0424

IMG_0422

The book became The Ten Ladybugs and the Cell Phone.

Because my student really likes this item and had a firm visual memory for this item, his success was almost immediate. Once he could locate the cell phone picture, he could hand it to me and play with a cell phone for a minute.

With this success, I can go several places with this skill.  I can increase the complexity of the background and/or decrease the size so the cell phone becomes more symbolic (not the exact real cell phone size).

This makes learning interesting for my student and I can work toward my goals. We are both engaged and happy to work together! We move to increase and expand my student’s literacy interests based on their preferences not mine!

Literacy: Searching for a Visual Attribute

My 3 year old student who is non-verbal had no interest in any literacy materials when she arrived in preschool due to ocular and cortical/cerebral visual impairments.  Her preschool provided rich experience based literacy using adapted books matched to her ocular visual needs and matched to her CVI assessment. Each book had an accompanying storybox with 3D materials to support each non-complex picture.

I wanted to check visual recognition of one 2D image.  I choose the book Zoom! Zoom! Zoom! I’m Off to the Moon by Dan Yaccarino. It had a series of images of round pictures.  As a consistent visual feature, I used a shiny, gold, round sticker. I presented this sticker on a white non-complex background. I knew my student loves the Itsy, Bitsy song. With hand under hand support, each time the sticker was presented we would touch the sticker together and I sang part of her favorite song.

IMG_1366

With her success with pointing to this one sticker, I applied the sticker in different places on each page of the Zoom! book.

IMG_1368

 

IMG_1367

 

After a week, she was looking at the pages and finding the shiny sticker each time. She would lean closer to reduce the complexity, isolate her index finger, point and look at me and smile. True recognition! With the increasing interest, she really studies all the classroom adapted books and even chooses books during her free time on the mat.