resources

Central Focus for CVI: “How Does This Benefit Kids and Families?”

I have the pleasure of working at Perkins School for the Blind as the CVI Program Manager. My supervisor, Ed Bosso, has one central question for me every time we meet:

“How does this benefit kids and families?”

I try to take that question into consideration for everything I do.

  • How does this statement benefit kids and families?
  • How does this interaction benefit kids and families?
  • How does this idea benefit kids and families?
  • How does this CVI training benefit kids and families?
  • How does this assessment benefit kids and families?
  • How does this collaboration benefit kids and families?

There is certainly increasing understanding of CVI since I first learned about it in 2002. Now our task is to stay focused and to use that building energy and building understanding creatively, scientifically and collaboratively to move this field forward in all ways.

To support the medical field, the educational field and research field in understanding CVI, that central question, “How does this benefit kids and families?”, should be the first question we ask ourselves. Absolutely nothing else matters…

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.

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. Children must have distinctly unique adaptions for their environments and for their learning based on a complete CVI assessment. These distinct needs can only be identified with assessment of the individual child’s CVI.

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 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!

 

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.

Ted Talks: Invaluable Resource

I mentioned Ted Talks in my last post. Many people were unaware of this fabulous resource. Ted Talks stand for Technology, Entertainment and Design.

This explanation is from their website:
“TED is a platform for ideas worth spreading. Started in 1984 as a conference where technology, entertainment and design converged, TED today shares ideas from a broad spectrum — from science to business to global issues — in more than 100 languages. Meanwhile, independent TEDx events help share ideas in communities around the world.”

TED hires specialists in a variety of fields to give 10-20 minute lectures. I watch at least one per day. For my work, I search “vision”, “brain”, “visual processing”, “smell”, “touch”, “developmental learning” and any other topic related to my work with children. I have listened to fascinating lectures with cutting edge information about each of these topics. The search bar is in the upper right of the website home screen. Here is the link:
https://www.ted.com

TEDx is another resource. https://www.ted.com/about/programs-initiatives/tedx-program

A few weeks ago, I shared a TEDx Talk by Lofti Merabet who is studying visual processing in people with blindness. Here is that link: http://tedxtalks.ted.com/video/Blindness-is-Just-Another-Way-o

Reducing Complexity in Board Book

Reading to all young children is important for bonding, academic success, language skills, literacy, logical thinking, auditory skills, experience expansion and concentration. Many times children who are visually impaired or who have multiple disabilities rarely share in those early special reading experiences.

This book was created by the speech therapist in our preschool. She grasped the concepts about CVI, understood the elements of the CVI assessment results and applied them to one of her student’s materials.

IMG_0676 IMG_0675 IMG_0674 IMG_0673

This student loved to listen to the animal sounds games. The speech therapist found a board book to read. The two images were just too much for the child to look at when presented together.

She attached Velcro to the back of each page and attached a black flap on each side. She was then able to lift one flap at a time as she read that page. The flaps were removable as the child was more familiar and able to tolerate more complexity.

This book is a favorite! It matched a preferred auditory event with an adapted literacy material.

List of CVI Resources

Resources for CVI

Ellen Cadigan Mazel, M.Ed., CTVI

CVI:

 

 

  • Cortical Visual Impairment: An Approach to Assessment and Intervention by Christine Roman-Lantzy

 

  • Visual Impairment in Children due to Damage to the Brain by Gordon Dutton (Editor), Martin Bax (Editor) September 14, 2010

 

  • Cerebral Visual Impairment in Children: Visuoperceptive and Visuocognitive Disorders by Josef Zihl (Author), Gordon Dutton

 

 

  • American Printing House website: CVI Section

 

 

  • wordpress.com: my blog

 

  • CVI offered at UMASS Boston Vision Studies Program: 3 graduate credits. Online

 

 

Brain Plasticity:

This is a TED Talk by Pawan Sinha, a Visual neuroscientist at MIT. He and his team research how our brains interpret the visual information that the eyes see. This research helps us understand how the visual system develops. It shatters long held beliefs about the critical periods for vision development and highlights the building understanding of plasticity. Dr. Sinha uses that research to give blind children the gift of sight. Dr. Pawan Sinha details his groundbreaking research into how the brain’s visual system develops. Dr. Sinha and his team provide free vision-restoring treatment to children born blind, and then study how their brains learn to interpret visual data. The work offers insights into neuroscience, engineering and even autism.

 

  • What’s Going on in There? by Lise Eliot. This is a great way to begin to become familiar with brain terminology and the building development of skills for vision and compensatory skills.

 

  • The Brain That Changes Itself by Norman Doidge Doidge discusses the revolution is neuroplasticity: the human brain is as malleable in infancy, as scientists have long believed, but also well into old age.

 

  • The Secret Life of the Brain: PBS Home Video: Includes: Baby’s Brain, Child’s Brain, Teenage Brain, Adult Brain and the Aging Brain.