Phase II

Two Interconnected Expanded Core Curriculum Areas for Children with CVI

As a Teacher of Student with Visual Impairments, I am certainly focused on the improvement of visual skills for my students with CVI. I am also interested in how my students understand everything that is easily understood by their sighted peers due to their incidental learning. These intertwined Expanded Core Curriculum (ECC) areas must be considered for that equal access.

These two important areas of the Expanded Core Curriculum must be considered separately and together. These are:

  1. Sensory efficiency skills
  2. Compensatory Skills, Functional Academic Skills (Including Communication Modes)

Sensory Efficiency Skills: This area is especially important for the child with CVI but in a totally different way than that considered for a child with ocular impairments. We are expecting improvement for student with CVI. Functional visual assessment using the CVI Range (Roman-Lantzy 2007) provides the baseline for functional visual skills and sets the stage for this improvement using strategies and objectives matched to the assessed needs.

Compensatory Skills, Functional Academic Skills: This area must be considered to support the
building functional vision of the student with CVI. Vision is the distance sense that supports what is heard, smelled, felt and tasted.

Think about a classroom where someone drops something. The child with typical visual abilities can turn, look and determine what made the sound and determine that the sound is not a threat. The student with CVI hears the item drop and due to lack of visual location abilities or lack of distance abilities, does not turn, does not understand what made the sound and might remain in a state of stress wondering if this sound is a threat or not. We need to build this understanding of environmental sounds by labeling the sound, bringing the child closer to the sound, bringing the sound to them and allowing them to make the sound themselves for complete understanding. If someone drops a tray in the classroom, I make sure to bring a tray to the child and allow them to see it, feel it and push it off the tray to create the sound. Once understood, the sound will not create stress and allow the child to return to the learning. This approach provides the student with the same access to the visual, auditory, tactile, cognitive/language information enjoyed by their sighted peers.

For functional academics, focus needs to consistently be on ways to create and foster the highest level of independence possible to live and work in the future. These are skills that should be worked on from birth! Think of the value of organizational skills for a child with limited visual abilities. Getting objects from a storage place and returning the item to that store place when completed builds independence and understanding of the student’s environment.

For communication the CVI Range can help us determine whether we provide tactile sign language to the student with deafblindness or just visually presented sign. If the child is only using peripheral vision, they could never see and understand the small, distinct visual-only sign that requires central vision use. If a communication device is used, the CVI Range provides information about the accessibility of pictures, the ability to recognize pictures, the number of items that can be seen and recognized at one time (complexity of array), and what size is needed (due to complexity not acuity!). For literacy and communication, the CVI Range provides information about the unique need for color highlighting, spacing and print size (due to complexity not acuity!)

All students with visual impairments need the ECC considered and provided in their educational programming. Students with CVI have the same educational needs but with consideration that CVI is completely different from ocular impairments.

The Expanded Core Curriculum (ECC) for Students with CVI

What is an Expanded Core Curriculum?

Years ago, students with visual impairments were educated in separate schools for the blind. Curriculum needs addressed everything for the student with a visual impairment both academic areas and specialized instruction that provided students with all skills to insure full independence in life. Students often lived at the school and instruction occurred across the day: self-care, moving safely in the environment, using transportation, safety awareness, social skills and recreation opportunities were embedded.

The education model shifted in the 1980s and students with visual impairments increasingly moved to inclusive programs in their communities. These inclusive programs could address the academic needs of students with visual impairments when adapted by a teacher of students with visual impairments. Something was missing. At the inclusive setting, inclusive schools were unprepared to address the other important learning needs for children with visual impairments. They never had to address these important areas because students without vision loss learn these skills incidentally by watching.

The Expand Core Curriculum is an essential consideration for all children with visual impairments including children with CVI. The nine areas of the Expanded Core Curriculum, if they are considered at all, are often mistakenly considered only for the academic child with ocular visual impairments.

Inclusive school settings teach the general education curriculum of math, science, English language arts, foreign language, gym, science, social studies and fine arts to their students. For students with visual impairments, the expanded core curriculum provides those essential independence skills needed for living and working. The expanded core curriculum is meant to level the educational playing field by providing instruction specific to the needs of a child with a visual impairment.

The expanded core curriculum, or ECC, should be used as a framework for first assessing students with visual impairments, then for planning individual goals and objectives.

The nine ECC areas that provide this specific instruction include.

  • Compensatory or functional academic skills, including communication modes
  • Orientation and mobility
  • Social interaction skills
  • Independent living skills
  • Recreation and leisure skills
  • Career education
  • Use of assistive technology
  • Sensory efficiency skills
  • Self-determination

Are these considered on your child’s IEP? We will look at each a bit more in-depth in later posts.

“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 salient features (Roman-Lantzy literacy) 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 measured with the CVI Range (Roman-Lantzy 2007). We must evaluate all our materials with this visual access limitation considered. We must adjust our own interactions and instructions to include salient feature, comparative language (Roman-Lantzy).

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!

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!

 

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”).

Overlooking Children in Phase II and Phase III (Roman-Lantzy)

I hear too often that a child can’t have CVI because they can look and reach or can move through the environment. This is incorrect. Children in Phase I are very visually impaired and appear blind. It is easy to understand their visual impairment even for untrained people. Children in Phase II and Phase III, have some visual abilities. The untrained person sees these visual behaviors and mistakenly believes the child can use their vision effectively to learn. It is essential to have an assessment using the CVI Range (Roman-Lantzy 2007) before deciding whether a child has CVI or not. It is only through rigorous assessment around the 10 characteristics that we can determine a child’s functional vision. It is always the children in Phase II and Phase III that are overlooked and under-assessed. Children in Phase II and Phase III sometimes reach, track and move around well but struggle with visual recognition. This lack of visual recognition is the major roadblock to learning. The lower field is often still a problem well into Phase III. Facial recognition is often strongly effected well into Phase III. Children should certainly see an ophthalmologist to rule out any ocular issue but a trained TVI who understands CVI and how to use the CVI Range must do a functional vision assessment using the CVI Range before dismissing CVI. It is the functional visual assessment to identify visual skills in need of support so learning is optimal.