Reading for a Child with CVI

Please watch these important webinars about teaching reading to children with CVI. Pay especially close attention to the fact that the methods are not uniform. They are in consideration of the visual behaviors of CVI of individual children. No reading approach is for every child. That “visual brain” and that “reading brain” are different in every single child.

The first webinar is by a parent of a child with hemianopsia, Monika Jones of the Brain Recovery Project. Although the webinar is not about reading specifically, there are some important considerations for reading presented. Those reading considerations match the visual abilities of the children with CVI impacted by this brain based visual impairment.

https://www.perkinselearning.org/earn-credits/self-paced/vision-after-occipital-lobectomy-and-related-surgeries

The next two webinars are by Judy Endicott. Judy is the grandmother of a child with CVI. Using her expertise in reading and her building understanding of CVI, Judy embarked on a journey to teach her grandson to read. What I love is that Judy was wonderfully diagnostic of her grandson’s abilities and needs.  Her approach to teaching reading followed her grandson’s lead.  She developed each step in the reading journey based on his successes and difficulties. If something didn’t work, she moved on to try something else in partnership with her grandson. Like any great teacher, she has understanding of the different developmental levels of learning, how the child with a neuro-typical brain learns, and that all learners have individual abilities that require instruction matched to those abilities and needs.

Part 1:

https://www.perkinselearning.org/videos/webinar/our-cvi-literacy-journey-phase-iii

Part 2:

https://www.perkinselearning.org/videos/webinar/our-cvi-literacy-journey-phase-iii-part-2

Valuable CVI Awareness of “Mistakes”

Awareness of the unique visual behaviors of CVI can provide teachers, parents and other service providers with context and understanding when learners with CVI make “mistakes”. I put “mistakes” in quotes because the “mistakes” that learners make will always allow us to understand their visual perception of their world if we consider them in the context of CVI. Matt Tietjen’s What’s the Complexity Perkins Elearning online class helped me to think more deeply about these visual “mistakes”.

Images in literacy materials in the community and at school are supposed to add information that supports the text or the situation.

This map symbol confused rather than supported my student’s understanding.

Seeing this icon on a subway wall, my student asked why there was a picture of a purse on the wall. This allowed me to understand the inaccessibility of this highly symbolic image of this map icon. It helped me understand how the student completely missed details in this image. It helped me understand how my student only really understood the shape of this square image and because he visually understands that purses are square shapes, he mistook this for a purse. “Why was a purse on this wall?”  “Am I missing something?” he wondered aloud.

Seeing this icon in a library book, another student identified it as a “flower”

Once again, the highly symbolic image was not understood. The student only perceived the shape not the meaning that the icon was supposed to provide. The “mistake” was made due to the impact of CVI on the student’s functional vision. The “mistake” helped remind me of the inaccessibility of highly symbolic images and helped me to remind me to always ask Matt’s question “What do you see?”

These two students can verbally communicate through their “mistakes” to help me understand how they see the world.

For our students with non-traditional language, we need to also diagnostically consider their “mistakes”.

In an assessment, it was clear that another student who is using a communication device understood the green “yes” symbol and the red “no” symbol when answering questions regardless of where the symbols appeared on the device page of 6 symbols.

I swapped out the red and green symbols for completely different symbols that were also colored green and red. The student continued to answer questions “yes” and “no” by hitting the “wrong” symbols based on color seemly with no awareness of the icon’s details and icon’s shape information.

 

  

 

 

 

 

It was so important for me and for her speech therapist to understand the reliance on color when using the device so color is considered when adding any newer icons.

“Mistakes” are a window into how student understand their world and how they function in their world. Without understanding CVI, these mistakes could be thought of as cognitive lack of understanding rather than the reality of visual inaccessibility.

Troubling Misuse of Promising Practice

When a new approach to teaching learners with CVI is suggested, we need to ask ourselves:

• Does this match our understanding of the unique learner’s visual behaviors?
• Is there scientific research to support the use of this strategy?
• If there is no scientific research, is it a “promising practice” that we can carefully try and carefully apply to each unique student’s situation?
• How do we decide to use this “promising practice”?
• How do we use it as it was meant to be used?
• How do we evaluate its effectiveness since not all inventions will be useful for all learners? (I hope the words collect data popped into your mind here!)

Recently I visited a school to consult for a student who was barely using any central vision to access literacy. The TVI had learned about word bubbling in a conference. Word bubbling is a promising practice suggested by Christine Roman in her book Cortical Visual Impairment: Advanced Principles.

This TVI took the app for word bubbling and suggested that all the child’s literacy materials were bubbled.

• This does not match the student’s visual skills. Central vision use would be essential for this intervention.
• This is not the suggested practice from the text: Cortical Visual Impairment: Advanced Principles.
• This was randomly applied with no diagnostic evaluation of the tool as applied to the student.
• The TVI never partnered with the reading specialist who would be the expert about the teaching of reading. That collaboration would be essential.
• There was no data on the effectiveness of this strategy for this unique learner.

Here is just one example of a sentence this poor student is now struggling visually recognize. I couldn’t quickly read it and I have good reading skills already developed.

 

Please:

• Understand your student’s visual behaviors.
• Try promising practices with careful consideration of those visual behaviors.
• Use the strategy as it was meant to be used.
• Collect data on the effectiveness of your trial. (Baseline data then progress data)
• Random application of any strategy is as inaccessible as doing nothing..

The Neuroscience of Reading

As people suggest methods for our children with CVI to learn to read, I wondered what does the brain need to do in order to learn to read?  I found a local researcher, Maryanne Wolf of Tufts University who wrote extensively about the neuroscience of reading in her book Proust and the Squid.

As it turns out, the brain needs to do quite a lot. It certainly requires a high degree of sustained visual attention, which can be problematic for many of our children with CVI.

Reading requires the whole brain including the occipital lobes, parietal, frontal and temporal lobes. The brain needs activation in both hemispheres and needs the “language areas” of the brain to be engaged and active. There are steps to reading function from decoding to understanding what is read. This reading “thing” is quite complex which is no surprise given how complex the brain is!

When we apply reading methods for our students with CVI, we need to apply methods to the child not decide that all methods work for everyone. We need to be diagnostic. What is working? Why is it working and under what conditions? Is it working at all? What can we do to improve this complex process that includes learning to use vision and to build reading skills?

No one of us serving students with CVI can know everything. We can certainly educate ourselves but will not be experts in everything. We must seek out and collaborate effectively with experts. In this case of reading, we need to partner with reading specialists as we apply any techniques for learning to read.

One size will not fit all because every brain is different and learns differently.