picture understanding

Morning Meeting Ideas for Children with Limited Visual Attention

The first place to start in developing a morning meeting routine, of course, is to assess each child to determine their visual needs. 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.

  • Materials in morning meeting must have considerations for color. Best colors are often bright and saturated. Single colored items are most accessible. Your presentations must consider that the child is only seeing color, not shape to discriminate one thing for another. If you have all red things, they can’t do this discrimination. Because this child is very visually impaired, compensatory skills should also be considered.
  • Items presented must be 3D, real, familiar and functional objects NOT PICTURES! 3D objects will provide visual access, tactile input, olfactory input and auditory input and can be seen in all perspectives.
  • 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).
  • Materials in morning meeting must meet any assessed need for motion. Shiny items are considered can seem to move due to reflected light. Movement should be gentle and slow not fast and frantic. Frantic motion can overwhelm the child.
  • 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.
  • Because peripheral fields are stronger than central visual fields, the materials must be presented off center in the best assessed lateral visual field.
  • The lower visual fields are often not functional well 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.
  • The child can only look at items in near space. The exact assessed distance needs to be respected and materials presented within this distance. 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.
  • 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.
  • Provide quieter environments. This can be difficult in a larger group of people. Consider having smaller morning meetings with a smaller number of children. Teaching assistants can be used when designing these multiple morning meeting sessions.
  • 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.
  • Use familiar materials and familiar routines. 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 will have increased processing time for looking 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.

 

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

Inservice about Peripheral Vision

Many of my students with CVI use their peripheral vision for looking. I struggled to help staff and parents understand exactly what this means as far as visual accessibility of learning materials for the child. I devised an inservice for staff and parents that simulates what kids see when they use peripheral vision. Using this, staff and parents can really live that inaccessibility.

I place people into teams of two. One person on the team is “has” CVI with only peripheral vision use. I ask them to focus on a target in the room and not turn to look at any materials their partner will present.

The other team member shows their partner with CVI three kinds of learning materials in their peripheral field:

  • A 3D object
  • Pictures from a book
  • Communication icons
  • Words in large print

I ask the peripheral vision user to tell me what they can see during each presentation. It becomes so clear that using peripheral vision, the child can only see color and vague shape.

This inservice, yet again, gives me an opportunity to talk about the child’s assessed functional vision. I have the opportunity to again stress the possibility of improvement for children with CVI. Working with accessible learning materials with environmental adaptations matched to the child’s CVI assessment, will build visual skills towards that ventral stream use that we all want for the child but for now, these kinds of learning materials are inaccessible.

The inservice provides the experience of inaccessibility.

Understanding Color in the Brain

I always find it so exciting and encouraging when brain research about the visual system continues to unwrap the great mysteries of the brain. This understanding can only move us forward in understanding CVI and in assessing whether interventions are working. I am deeply interested in why my children behave the way they do. Here is a recent article from Spectrum MIT, a publication from Massachusetts Institute of Technology: http://spectrum.mit.edu/fall-2016/color-decoder.

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??

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  • 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.

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  • 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.

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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!

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.

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

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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.

Youtube Lecture: Recovered Sight: Michael May

Understanding Blindness and the Brain (Brian Wandell, Stanford University)

I think you might find this one fascinating! Michael May lost vision as a child and regained it in his 40s. As he regains sight, there are so many CVI characteristics he experiences!

https://www.youtube.com/watch?v=VVgfC_FV2hI

Using Backlighting for Calendar System

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This student with CVI came to our program with a calendar system. The problem was that she wasn’t looking at the photographs or icons at all!  We enlarged the icons and made them translucent. We presented all icons for her calendar system on the lightbox. We standardized our verbal visual attribute language for each presentation so that each icon was described exactly the same by all staff. The student immediately visually located the icon against the backlighting and sustained gaze during the visual attribute language descriptions. This student now has visual access supported by auditory information to build understanding.

(The photograph is modified to protect this student’s identity.)