literacy for CVI

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 using the CVI Range (Christine Roman-Lantzy 2007)
Color: I use the assessed color preferences that I has discovered in my assessment.
Movement: 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.
Latency: 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 background 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.
Lightgazing: Because the Powerpoint is created on a computer or backlighted device, the child’s need for light is satisfied.
Distance Viewing: The device playing the Powerpoint can be placed at the child’s assessed best visual distance.
Visual Reflexive Responses: No strategy addresses a reflex. This is a characteristic of CVI but not one we program for.
Visual Novelty: 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

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.

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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 Salient Feature

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 visual impairments.  Her preschool provided rich experience based literacy using adapted books matched to her ocular visual needs and matched to her CVI Range Assessment (Roman-Lantzy 2007). 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 salient feature (Roman-Lantzy) 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.


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





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.

Great Video: Perkins School for the Blind Teachable Moments


Marguerite Bilm created a CVI friendly literacy material around the Itsy Bitsy Spider song.

To create a book such as this for a child with CVI, Marguerite or the TVI working in the classroom would need to assess the student using the CVI Range (Christine Roman-Lantzy).  The book would need to match the assessed characteristics.

To use a material such as this, the child would need to

  • Have some visual location abilities
  • Have some sustained gaze
  • Tolerate two items in an array of complexity
  • Be able to visually locate red and white items
  • Have the material presented visually prior to the auditory presentation
  • Have the material presented visually before the tactile page was touched
  • Have the book presented propped up in the best visual field. This propping up would also reduce glare from overhead that reflects off the page. (I have good luck rubbing laminated pages with a fine sandpaper. It takes the glare completely away!)
  • Have the book presented for as long as the child needs to look and to understand what they are looking at.
  • Have the book to be presented at the optimal distance
  • Have the book to be used routinely to build familiarity
  • Have the book be presented against this nice black background

Marguerite used light to draw visual attention. This tells me light is still important for her child, She also moved the light which tells me movement can still help draw this child’s visual attention.

There are some great characteristic considerations for this student!

Salient features: A Strategy for Visual Recognition for Children with CVI

The teaching of salient features begins at birth.  It should be a strategy suggested to parents and teams whether a child is in Phase I, Phase II or Phase III. In Phase I and II, we would be careful to limit the auditory distraction of salient feature discussion to before a child looks at materials and would support again after a child looked at the material due to the issue of complexity.

Incidental Use of Salient Feature Discussion:

Narration of the salient features regarded by the child becomes a philosophy of instruction throughout the day.  This would provide salient language around items that a child can see at near and distance regardless of the CVI Range phase. If the child is looking at materials, these materials are important and often the most familiar to the child. “That’s your Elmo.  He is red with white round eyes.”

Planned Use of Salient Feature Discussion:

I love to use attribute trays to discuss salient qualities. If the child likes balls, I would create a salient feature tray of balls.  This allows discussion of the favorite colored ball and salient language.

  • The first kind of tray would contain all the same colored, favorite balls.  The number presented would depend on how many items in an array a child can tolerate as determined by assessment using the CVI Range. “That’s your favorite red ball.  Its round. It is small and fits into your hand. Its lightweight.  Oh, you dropped it, and it rolled”. There is another one.  It is red too.  You dropped it and it rolled”.
  • The next kind of tray would include several favorite balls and one added item that was very dissimilar in shape, size and color.  Discussion would include: “That is a spoon. It is silver with a long handle.  It is not red. It is not round. It does not roll when you dropped it.  It is not a ball.
  • The next kind of tray would include multiple kinds of balls of various sizes, weights, textures and colors. Discussion could focus on the similarities and differences of the balls.


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 CVI Range assessment results (Christine Roman Lantzy 2007) and applied them to one of her student’s materials.

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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.

Preschool Valentines Book for Children with CVI


Here is the wonderful literacy material created at Concord Area Special Education Collaborative (CASE) by Tess, Speech and Langauge Therapist and Sue, Preschool classroom teacher for the February theme of Hearts.  It presents a clear, red heart as a single image on the page then uses the same salient feature with a variety of textures for each page.

The bumpy heart using bubble wrap


The lacey heary using lacey paper


The googly heart using googy eyes


The rough heart using sandpaper


The bead heart using party beads


The pom-pom heart using pom poms of various sizes.


Each page is presented with predictable text and funny voice for each type of heart.

Heart lacy text

Staff that understand CVI well create fantastic materials based on their firm understanding of the characteristics of CVI and their child’s needs determined after assessment. They then created individual books adapted for each child to share with family.

Evaluate Pictures for Clarity and Perspective

bad contrast hat

When the child with CVI is ready for pictures in Phase II and III, we need to make sure the picture is clear and represents as close to a real perspective as possible.  The above picture of a construction hat is clear but the background provides no contrast and is distracting.  The glare from the overhead light is a problem and the perspective is confusing.  Our brains with perfect vision can understand this is a hat.  Children with CVI do not have the benefit of the visual memory that supports this understanding.

good cvi picture hat

This picture is so much clearer with much better information for the child with CVI.  Supported by seeing this exact same hat in a story box, the child with CVI can build a visual memory and build 2D understanding of this image.

No high tech equipment was needed for this picture.  I covered a tissue box placed up on its end with my black sweater.  I placed a black background behind it.  I used my iPhone to take the photograph.

The shift from 3D real items to 2D images needs to be carefully support by pairing with the exact same real object and presenting clear photographs.