What to do for children with cortical visual impairment (CVI)Opportunities to use vision should be incorporated into your child’s everyday life. For example, you might use a red bowl or plate for each meal. Adding a red ribbon to a bottle for younger children works well. You could also place a red object on or near the diaper changing table, car seat or wheelchair. The key is to place opportunities for the child to see throughout their daily routine. It becomes easier and easier for kids with cortical visual impairment (CVI) to see these objects as they become familiar with them. It can also be helpful to keep one familiar object with your child throughout the day. This allows the child to learn to recognize the object in different environments. Furthermore, children with CVI may tire easily when engaged in visual tasks, which is another reason to keep vision sessions short and frequent throughout the day.
In order to maximize your child’s ability to use vision throughout the day it is important to provide spaces that are free of distractions and visual clutter. Learning to see can be very taxing and difficult for a child with CVI. If the environment is too visually complex or contains competing sensory input it can be difficult for the child to focus on visual clues. You can reduce visual clutter by providing an all black background against which the shiny, bright, highly saturated colored objects can be placed. Try to eliminate noise to give your child the ability to simply focus on seeing.
Because latency is a common characteristic of CVI, children often need a lot of time to respond visually. When presenting an object remember that you may need to wait several minutes before seeing a response. This is especially true of unfamiliar objects. When we first started working with Little Bear he would look at objects for only a second at a time before looking away. What was important was that he would return to the object repeatedly.
It’s key to keep it simple when introducing objects to CVI children. Initially, objects should be only one highly saturated color, like fire engine red. Moving objects are easier to see, and shiny objects can approximate movement. For many children with CVI the use of light is also helpful. For example, shining a flashlight on the target object can draw a child’s attention to it. Over time, you can introduce two familiar colors at the same time, then simple patterns with those colors and so forth.
It is also important to remember that it will be much easier for your child to see if your child is properly positioned. This means giving a child as much support as possible. For example, a child who has to work to hold up his or her head will be less able to focus on using his or her vision. Little Bear seems to use his vision best when lying on his back or being held in a sitting position.
Learn as much as you can about CVI. There is not a lot written for caregivers or families, but there are books and papers written for academics, ophthalmologists and vision specialists. A book we recommend is Cortical Visual Impairment: An Approach to Assessment and Intervention by Christine Roman-Lantzy. There is also an online class offered by Gordon Dutton, M.D., a pediatric ophthalmologist from Glasgow, Scotland. The American Printing House for the Blind offers research papers on CVI. For links to these and other resources, check out our CVI resources page.
We recommend you find a vision specialist who is familiar with CVI. Often this can be accomplished through Early Intervention, your school system or your local government programs. Regular visits to provide information, education and further intervention ideas are very helpful.

http://www.wonderbaby.org/articles/cvi-educational-toolsBy Penny Duffy
Cortical Visual Impairment (CVI) is a form of blindness that is neurological. In other words, a child with CVI may have perfectly healthy eyes, but their blindness is caused by some form of brain injury or malformation.
Of course, this means that CVI can be both difficult to diagnose and difficult to treat. Babies with CVI often have good days and bad days, seeming to see something one day, and completely ignore it the next. Little Bear Sees has a great explanation of CVI characteristics.
But there are some general rules of thumb for making vision easier for kids with CVI. These kids, for example, often prefer clear, crisp images with little background clutter. They respond well to high contrast, bright colors (especially yellow or red), movement and LIGHTS!
While anything dealing with the brain can be confusing, it’s good to know there are some great educational tools that you can use to help your child learn!


#1. iPad
Price $399 to $799, depending on the model.
The iPad comes in two sizes: the standard size (9.7 inch display) and the mini (7.9 inch display). Which size you should buy would seem like a simple question, but it really depends on your child and how their visual field is affected. The iPad mini, which is more portable, may work for some children, while the larger screen size of the standard iPad Air may work for others.
The decision to have a larger storage size may also be a wise one depending on how the iPad will be used. Will you be downloading a lot of apps and taking lots of photos and videos? Then you may want to consider getting an iPad with 64 or 128GB, which of course raises the price.
The iPad is remarkable because it is a consumer device that has so many benefits and applications for students with CVI and other forms of blindness. The iPad has many accessibility features including VoiceOver, Zoom, font settings and AssistiveTouch that can be a great benefit for many students with CVI.


But the iPad is really only as good as the apps you’ve downloaded for it. So, which apps should you get?



20 iPad Apps for Children with CVIA tip: Before purchasing any app view other apps by the developer to see if they offer a lite (free) version of the app. Since every kid is different, it’s always best to try out an app for free to see if it will work with your child before you buy it.

1. Art Of Glow By Natenai Ariyatrakool
2. Peekaboo Barn By Night & Day Studios (review)
3. Infant Zoo Lite By treebetty
4. My Talking Picture Board by Little Bear Sees (review)
5. Sago Mini Sound Box By Sago Sago (review)
6. iLoveFireworks Lite By Fireworks Games (review)
7. fluidity HD By nebulus design
8. The Cat in the Hat By Oceanhouse Media
9. Sensory Electra By Sensory Apps Ltd
10. Interactive Alphabet By Piikea St
11. Tap-N-See-Now by Little Bear Sees (review)
12. Cause and Effect Sensory Light Box By Cognable (review)
13. Big Bang Pictures By Inclusive Technology
14. Read2Go By Benetech (review)
15. Pocket Pond By TriggerWave LLC
16. Peeping Musicians By Inclusive Technology
17. Bebot – Robot Synth By Normalware (review)
18. Bloom HD By Opal Limited (review)
19. EDA Play By EDA Play (review)
20. Bubbles By Hog Bay Software (review)

#2. Light Box
$135 to $460, depending on the size.
The Light Box is a product sold by American Printing House for the Blind (APH). The Light Box is a common tool used with children with CVI (and other visual impairments). It is a rectangular shaped box with a bright light inside and has a translucent top that allows light to shine through. The light is also adjustable, so you can turn it up or down.
The Light Box comes in two sizes: The standard Light Box is 25 x 15 inches while the Mini-Lite Box is 16 x 12 inches.
What can you do with a Light Box? All sorts of things! APH offers many products to use with the Light Box, including overlays and the Sense of Science program. Sense of Science is a collection of screens you can place on the Light Box that will teach your child about animals, astronomy or plants.
You can also place everyday objects on the Light Box to allow better viewing with the contrast. My daughter loves to place a piece of paper on her Light Box and color over it. She says she can see it so much better.
The possibilities are pretty much endless with it comes to a Light Box and people are always coming up with additional great things to do with this simple but powerful device. For more ideas:

• Fred’s Head Light Boxes: Materials, Activities, and Guides from APH
• Light Boxes & Other Ideas that Glow
• Light Box Ideas

#3. LightAide™

$999
The LightAide™ is a remarkable and innovative educational tool that is perfect for children with CVI. Let’s see…
Simple and clutter free? Check!
Bright colors? Check!
Movement? Check!
Lights? Double check!!
The LightAide combines many of the best features of both the Light Box and the iPad. It’s large and bright like the Light Box, but also includes interactive and motivating games like the iPad. It’s durable and strong like the Light Box, but easy to use to engage kids in social play and hold a child’s attention like the iPad.
The colorful lights, movement and simple graphics really have a lot of benefits for children with CVI. The LightAide has many different educational benefits. There is software available for literacy and math skills while essential skills like turn taking and visual tracking can be facilitated with a LightAide as well.
Want to know more about how you can use the LightAide with your child? Visit 5 Ways the LightAide is Great for Kids with CVI.

Cortical Visual Impairment Pediatric Visual Diagnosis Fact Sheet™Reprinted with permission from Blind Babies Foundation
DefinitionCortical Visual Impairment (CVI) is a temporary or permanent visual impairment caused by the disturbance of the posterior visual pathways and/or the occipital lobes of the brain. The degree of vision impairment can range from severe visual impairment to total blindness. The degree of neurological damage and visual impairment depends upon the time of onset, as well as the location and intensity of the insult. It is a condition that indicates that the visual systems of the brain do not consistently understand or interpret what the eyes see. The presence of CVI is not an indicator of the child's cognitive ability.
CauseThe major causes of CVI are asphyxia, perinatal hypoxia ischemia ("hypoxia": a lack of sufficient oxygen in the body cells or blood; "ischemia": not enough blood supply to the brain), developmental brain defects, head injury, hydrocephalus, and infections of the central nervous system, such as meningitis, and encephalitis.
CharacteristicsInitially, children with CVI appear blind. However, vision tends to improve. Therefore, Cortical Visual Impairment is a more appropriate term than Cortical Blindness. A great number of neurological disorders can cause CVI, and CVI often coexists with ocular visual loss, so the child should be seen by both a pediatric neurologist and a pediatric ophthalmologist.
The diagnosis of Cortical Visual Impairment is a difficult diagnosis to make. It is diagnosed when a child has poor or no visual response and yet has normal pupillary reactions and a normal eye examination. The child's eye movements are most often normal. The visual functioning will be variable.
The result of an MRI (Magnetic Resonance Imaging) in combination with an evaluation of how the child is functioning visually, provide the basis for diagnosis.
Behavioral/Visual CharacteristicsChildren with CVI have different abilities and needs. The presence of and type of additional handicaps vary. Some children have good language skills and others do not. Spatial confusion is common in children with CVI because of the closeness of the occipital and parietal lobes of the brain.
Habilitation should be carefully planned.
A full evaluation by a number of professionals is essential. The evaluation team could include: teachers (of the visually impaired or severely handicapped), physical therapists (PTs), occupational therapists (OTs), speech therapists, and orientation and mobility specialists.
Common characteristics of visual function demonstrated by children with CVI:

• Vision appears to be variable: sometimes on, sometimes off; changing minute by minute, day by day.
• Many children with CVI may be able to use their peripheral vision more effectively than their central vision.
• One third of children with CVI are photophobic, others are compulsive light gazers.
• Color vision is generally preserved in children with CVI (color perception is represented bilaterally in the brain, and is less susceptible to complete elimination).
• The vision of children with CVI has be described much like looking through a piece of Swiss Cheese.
• Children may exhibit poor depth perception, influencing their ability to reach for a target.
• Vision may be better when either the visual target or the child is moving.

The behaviors of children with CVI reflect their adaptive response to the characteristics of their condition:

• Children with CVI may experience a "crowding phenomenon" when looking at a picture: difficulty differentiating between background and foreground visual information.
• Close viewing is common, to magnify the object or to reduce crowding.
• Rapid horizontal head shaking or eye pressing is not common among children with CVI.
• Overstimulation can result in fading behavior by the child, or in short visual attention span.
• The ability of children with CVI to navigate through cluttered environments without bumping into anything could be attributed to "blindsight", a brain stem visual system.
• Children are often able to see better when told what to look for ahead of time.
• Children with CVI may use their peripheral vision when presented with a visual stimulus, appearing as if they are looking away from the target.
• Some children look at an object momentarily and turn away as they reach for it.

MythsThe following statements are not true, according to current knowledge in the field:

• Children with CVI are visually inattentive and poorly motivated.
• All children with CVI will have cognitive deficits.
• CVI is not a true visual impairment.
• Children with CVI are totally blind.
• Children whose visual cortex is damaged are Cortically Blind.

Teaching Strategies

• A great deal of energy is needed to process information visually. The child might tire easily, when called upon to use his visual sense. Allow for intermittent "break" times.
• Positioning is important. Keep the child comfortable when vision use is the goal in order that "seeing" is the only task.
• Head support should be provided during play or work sessions, to avoid involuntary shifting of the visual field.
• Try many different positions to find the one in which the child feels most secure. Infants and toddlers will demonstrate when and where they see best by their adaptive behaviors.
• If the child needs to use a lot of energy for fine motor tasks, work on fine motor and vision separately, until integration of the modalities is possible.
• The simpler, more constant and more predictable the visual information, the better the child with CVI is likely to deal with it. Keep toys and environment simple and uncluttered. Use books with one clear picture on a contrasting simple background.
• Use familiar/real objects (bottle, bowl, plate, bath toy, diaper, cup, spoon, favorite toy) one at a time. Familiarity and simplicity are very important.
• Since the color system is often intact, use bright fluorescent colors like red, yellow, pink, and orange. Colored mylar tissue seems to evoke visual responses.
• Repetition is very helpful: use the same objects and same process each time to provide familiarity and security for the child. Familiarity breeds response.
• Look for toys and activities that motivate the child.
• Vision is often best stimulated when paired with another sensory system. For example, auditory cues from the handling of mylar may help attract the child's attention.
• Introduce new and old objects via touch and verbal description.
• Try different lighting situations to assess optimal conditions for viewing. Try locating a light source behind, and/or to the side of the child.
• Try moving the target that you want the child to see: try different visual fields.
• Allow lots of time for the child to see and to respond to what is being seen.
• Learn to interpret each child's subtle response cues: such as changes in breathing patterns, shifts of gaze or body position, etc.

"When a child with CVI needs to control his head, use his vision, and perform fine motor tasks, the effort can be compared to a neurologically intact adult learning to knit while walking a tightrope."
Resources1. "Observations on the Habilitation of Children with Cortical Visual Impairment" Groenveld, M.; Jan, J.E.; Leader, P., Journal of Visual Impairment and Blindness, January, 1990.
2. "Visual Behaviors and Adaptations Associated with Cortical and Ocular Impairment in Children," Jan, J.E.; Groenveld, M; Journal of Visual Impairment and Blindness, April 1993, American Foundation for the Blind.
3. Video: "Issues in Pediatric Ophthalmology: Cortical Visual Impairment (1994)," Child Health and Developmental Media, Inc., 5632 Van Nuys Blvd., Suite 286, Van Nuys, CA 91401.
4. "Cortical Visual Impairment in Children," Good, W.; Jan, J.E.; Luis, D. (1994) Surveys of Ophthalmology. 38:4: 351-364.
AcknowledgmentsJulie Bernas-Pierce, Editor
Janice Polizzi
Colette Altmann
Barb Lee
Dr. Creig Hoyt
Home Counselors
Dennak Murphy
Dr. William Good
Ann Silverrain
Off to a Good Start Program
The Pediatric Visual Diagnosis Fact Sheets are sponsored by the Blind Childrens Center and the Hilton/Perkins Program through a grant from the Conrad Hilton Foundation.
Blind Babies Foundation
1200 Gough Street
San Francisco, California 94109
(415) 771-5464
NOTE: Blind Babies Foundation has developed 7 Pediatric Visual Diagnosis Fact SheetsTM on the following topics: Cortical Visual Impairment, Retinopathy of Prematurity, Optic Nerve Hypoplasia, Albinism, Optic Atrophy, Retinal Diseases, and Vision Assessment. One complete set costs $10. Families can get one Fact Sheet free of charge upon request. The Blind Children's Center will soon have the Fact Sheets available on their website at <www.blindcntr.org/bbc>.
Go to Top of Page

Send EMail to SEE / HEAR
Go to Fall 1998 Table of Contents

Encouraging Efficient Use of Vision in Students with CVIEncouraging Efficient Use of Vision in Students with CVI
The following are suggestions to use with infants, young children, and students who have Cortical Visual Impairment (CVI) or who are suspected to have a brain damage related vision loss.  These suggestions are intended to encourage students with CVI to use their vision more efficiently.  These suggestions correlate loosely with functioning levels/Phases described in Dr. Christine Roman’s book, Cortical Visual Impairment – An Approach to Assessment and Intervention. The reader is encouraged to read through all suggestions, as some students functioning in Phase III might still benefit from suggestions in Phase II or even Phase I, students in Phase II might also benefit from suggestions in Phase I and Phase III, etc.  Use the suggestions, especially in Phase I, in conjunction with regularly occurring activities in daily life such as feeding, toileting, grooming and amusement activities.  These are general guidelines; no individual student with CVI will ever fit into any one category.
Students Functioning in Phase I
Students in Phase I are generally functioning at a level where they are just beginning to alert to light and objects with movement. The focus in this phase is the building of visual behaviors.  Environmental complexity and distractions need to be strictly controlled.  Sound can sometimes be used to initiate visual attention, but should be discontinued as soon as the child visually locates the target.  Often, the auditory learning channel is the strongest and if a sound source continues longer than necessary, the child may look away to attend to the sound.  When the child looks away, he/she discontinues learning through the visual channel and discontinues building the neurological pathway that helps the child make sense of what he/she sees.  The same applies to tactual input.  The child at this stage may notice visual targets up to about an arm’s length away (24” to 36”).  Some suggestions offered in Phase II and Phase III may also be applicable to a child functioning in Phase I.
Considerations

• Interview parent or caretaker; learn about most frequently viewed targets and situations when student most frequently uses his/her vision; knowledge of what the student likes/dislikes should be built into his/her learning activities
• If visual learning occurs away from home, use familiar toys or visual targets from home
• Be aware of prescription medications the student takes; some may cause student to be drowsy or have visual side effects
• Watch for signs of visual fatigue, overstimulation, and/or stress.  Signs include vocalization, eyes closed or sleeping frequently, hand or leg muscle tension/twitching, yawning, and “fading” behavior such as light gazing.
• Allow for intermittent break times
• Plan activities during the time of day when student is alert, ready to learn
• Proper positioning will be crucial.  If the child is not in an aligned or supported body posture, he/she will have difficulty attending to the visual target, focusing, and using efficient vision in general.

Environment

• Reduce auditory distractions when visual learning is taking place – turn off the TV, turn off the radio, move away from neighboring students who are very vocal/loud, turn off cell phones, encourage quiet from other adults/caretakers in the room
• Reduce tactual distractions when visual learning is taking place – resist the temptation to give a rub on the back or a pat on the arm as a “good work” gesture; Care should be taken not to bump into a wheelchair or bed. When there is a need to encourage the student to touch something, use hand-under-hand technique – more information at: “The Language of the Hands:  Hand-Under-Hand Technique” http://nationaldb.org/NCDBProducts.php?prodID=47
• Reduce or eliminate visual distractions that may interfere with visual attending behavior (i.e. sudden movement off to the side) – Use a 3 panel curtain or block from distractions by use of positioning
• Work surface should be free of visual clutter
• Use a white or black cloth to cover distracting background items
• Walls and bulletin boards should be simple and free from clutter
• Carpets should be plain, no pattern
• Turn student away from sunlight streaming through windows or blinds
• Care should be taken that no sparkling jewelry is worn, distracting the student from the visual target
• Reduce or eliminate use of perfume, cologne, or other strong odors/scents
• Maintain a comfortable room temperature

Near Visual Field

• Present visual targets in preferred visual field (usually left field or right field, generally not central and rarely lower)
• Often, students have difficulty detecting targets in lower visual field – raise targets up
• Use of a custom made slant board, reading stand, felt covered tri-fold board or angled dry erase board are helpful in creating contrast in near visual field
• Teacher or caretaker should wear plain colored clothing that creates contrast behind the target being presented; black smock or apron works well
• Use of a black cloth or white cloth also helps to create contrast
• Use a “CVI Den” to help with contrast and to reduce visual distractions

Visual Target

• Use of objects with a single color, especially red or yellow, but sometimes other bright primary colors including orange and purple
• Present visual targets against plain, visually quiet backgrounds (black felt board, white cloth, black cloth) again, attention to contrast will be important
• Place targets no further than an arm’s length away (about 24” to 36”)
• Pair visual target with movement (slinky), especially in the peripheral fields; sometimes moving the object helps the child to see it better
• Use visual targets with light qualities (colorful light or blinking light)
• Use visual targets with reflective qualities (mylar)
• In some cases, pairing visual targets with sound will initiate looking behavior
• In some cases, pairing visual targets with a touch cue will initiate looking behavior
• May turn head to one side or the other when reaching for object; appears as if they are looking away from the visual target, but may be using their peripheral vision
• Use real objects whenever possible.  When using an Anticipation Calendar, use real objects that the child has had a meaningful experience with (see http;//www.tsbvi.edu/Outreach/seehear/archive/Let Me Check My Calendar.htm) For example, use a real cup rather than a picture of a cup.  Relate what is being seen to function, whenever possible
• Present real objects against high color contrast (light colored foods against dark plates with a contrasting background color)
• Watch for subtle response cues to visual targets including; shifts of gaze or body positions, changes in breathing patterns
• Use color
  • Keep color of common objects consistent until association is established (if student is attracted to red, use a red cup during meals; at school and at home)
  • Encourage looking at mom by use of bright colored lipstick
  • A bright yellow colored pom pom might encourage reaching behavior
  • Bright, primary colors are best; red, yellow, purple, and orange work well

Lighting

• Provide additional, supplementary light shining on target of interest; 100 LED bright flashlights work well
• Shine light on target of interest without attracting student’s attention to the light source
• Care should be taken to avoid glare
• Do not shine a bright light into the eyes of the student
• Use of plug-in, natural desk lights work well to shine on targets and workspace (but you are restricted to the length of the power cord)
• Use of Light Box (with a Swirly Mat) and other lighted toys/targets are beneficial
• Care should be taken when using blinking or flashing lights (this sometimes sets off a seizure)
• When using a supplementary light shining on a target to encourage visual attending behavior, dim the overhead lights and reduce natural light coming through windows
• A small number of children with CVI experience photophobia (light sensitivity)

Positioning

• Ensure that the student is in a comfortable, secure position when use of vision is the goal
• Do not try a new stander or chair (or other new position) when working on use of vision
• Work closely with the PT or therapist to determine the best position to help student feel secure and comfortable
• When a child’s head rolls to one side, the visual field involuntarily shifts; provide appropriate head support
• Try a variety of positions to determine which one supports visual attending behaviors

Routine

• Repetition, repetition, repetition: use the same objects and the same process each time to provide familiarity, reduce latency period, and shorten “warm up” time
• Same individual working with the child in the same way, again and again
• See, “Steps for Incorporating Activity Routines into Your Practice at:

http://www.tsbvi.edu/Outreach/seehear/fall02/activity-routines.htm

• Repetition and practice is how a child with CVI learns to integrate new knowledge, remember it for a future session, and put it to use

Familiarity

• Use objects that the student is familiar with and uses on a daily basis; use of objects that are familiar often result in increased visual attention
• Objects used in the classroom setting should also be used at home (and vice versa)
• Familiar objects often include bottle, cup, spoon bowl, plate, comb, washcloth, noisy or musical toy, and diaper
• Work with the student in a familiar environment, when possible (this includes when you meet a new student for evaluation; try not to take them to an unfamiliar testing room)

Pacing

• Slow down presentation of visual objects and targets
• Allow student time to process what is being seen and respond to what is being presented

Mobility

• Use lights to encourage reaching behavior/movement
• Use mylar pom poms and other reflective toys with light shining on them to encourage reaching behavior/movement
• Present targets against a contrasting color

Students Functioning in Phase II
A student functioning in Phase II is using his/her vision more consistently, but often not efficiently.  The teacher and caretaker will want to work towards encouraging the child to use their vision during daily routines and activities. Generally, students at this stage are able to visually attend to targets up to about 4 or 5 feet away.   Many of the above considerations may still apply and some suggestions in Phase III may also apply.


Considerations

• Interview parent or caretaker; always the best source of information
• Be aware of the prescription medications the student takes; some may cause student to be drowsy or have visual side effects
• Providing a routine and structure/sameness continues to be important
• Use of cues, signals and symbols might be considered at this stage (see “Non-Verbal Communication: Cues, Signals and Symbols” at; http://www.tsbvi.edu/Education/vmi/nonverbal.htm
• Encourage students to learn by being active (see “An Introduction to Dr. Lilli Nielsen’s Active Learning” at

http://www.tsbvi.edu/Outreach/seehear/summer99/nielsonintro.htm
Environment

• Reduce auditory distractions – turn off the TV, turn off the radio, move away from neighboring students who are vocal/loud, turn off cell phones, encourage quiet from other adults/caretakers in the room
• When an auditory cue is used/needed to encourage looking behavior (and develop language), use the following suggestions
  • Explaining what to look for and where to look often helps a child with CVI see better
  • Use descriptive words about the object or visual situation
  • Use voice intonation that matches the word used
  • Use “Verbal Cuing” (the ball is by the light)
  • Use an interesting noise or a few words of praise, along with a visual target, to increase looking behavior (crunchy/scratchy noise when you shake a mylar pom pom)
  • If possible, try to establish looking behavior first, then give verbal praise or description; make sound a “reward” for looking behavior
  • Reduce tactual distractions when visual learning is taking place
    • Resist the temptation to give a rub on the back or a pat on the arm as a “good work” gesture
    • Avoid grabbing a hand to help student touch something
    • When a tactual cue is needed to encourage looking behavior, use the following suggestions
      • Touch the object of interest to the child’s hand to direct visual attention
      • Run the object of interest down the side of the child’s arm to his/her hand, to direct visual attention
      • Reduce visual distractions when visual learning is taking place
        • Sunlight through the window or light from a lamp may be a distracter
        • A moving ceiling fan may be a distracter
          

https://cvi.aphtech.org/?page_id=1713

light box resources and plans
felt boards
tactile activity kits

Click heGeneral Materials Used to Adapt Books for Children with CVI

 from Paths to Literacy

• Literacy for Children with CVI:...
• Guidelines for Modifying Books for...
• Adapting Books and Literacy for...

By Diane Sheline, TVI, CLVT
Please begin by reading:

• Literacy for Children with CVI: Overview and Implications for Different Phases
• Guidelines for Modifying Books for Students in Phases I, II, and III
• Adapting Books and Literacy for Students with CVI

 
The following items are general materials that can be used when adapting books for children with cortical visual impairment (CVI):

• 11 X 17 inch flat, black heavy weight paper (I use Neenah, 80 lb. Astrobrights Cover Eclipse Black)
• 8.5 X 11 inch flat, black heavy weight paper (I use Neenah, 80 lb. Astrobrights Cover Eclipse Black)
• Tru Bind Small Office Binding Machine (TB-S20A)
• Tru Bind Black Coil Bindings 3/8”
• Tru Bind Black Coil Bindings 9/16”
• Coil Cutting and Crimping Tool (Watch the YouTube Video for how to use the Crimping Tool:  How to Use Coil Crimping Pliers for Spiral Coil Binding)
• Pro-Click Covers (rather than the Neenah paper noted above, I have also used these covers as pages, using the flat, black side of the cover, not the shiny side)
• Pro-Click Spines (these spines go along with the Covers above, and can be clicked open and closed, again and again, for easy removal of just one page or two pages to present)
• Clear, round, self-adhesive rubber pad bumpers, to use as “Page Fluffers”
• Variety of adhesives, including (but not limited to); glue stick, glue gun, 3M Scotch-Weld Instant Adhesive, Velcro, Contact Strips and Stick-it Dots
• Medium Binder Clips
• Black clothespins with Velcro on one edge for attaching to an Invisiboard or All-In-One Board to hang individual pages from.  Use a flat, black spray paint on natural wood colored clothes pins. When the clothes pins are spray painted black, they “disappear” into the black background and do not cause additional “visual clutter”
• All-in-One-Board and/or Invisiboard (available through APH)

 Materials to Create Specific BooksIn addition to the above General Materials, you will need the following specific materials to create the books below:
“Where is the Red Gift Bag?”

• Red Mylar Gift Bags (I use 4” X 6” size); these often come in a set of 3 at The Dollar Store
• Red chenille stems or pipe cleaners OR strip of yellow paper 

Cover of "Where is the Red Mylar Gift Bag?"
“Three Silver Pie Tins and One Red Puff”

• Disposable 3” Aluminum Foil Tart/Pie Pans Mold; these can be ordered on Amazon and come in a package of 250 pieces
• Red Puff Balls, use 1” or 2” size; these are often called “Pom Poms” at the craft stores, but should not be confused with the mylar cheerleader-like pom poms used in another book and noted below

Page of Three Silver Pie Tins and One Red Puff
“Three Bright Red Pom Poms Lined Up in a Row”

• Red inexpensive mylar pom poms that can be taken apart and modified in size; you can often find these at the Dollar Store or you can cut apart and modify a metallic red foil fringe curtain/doorway to create mini pom poms (find at Amazon)
• Scrunchy pony tail holders, to bind and create the mini pom poms (2 per pom pom)  

Cover of Red Pom Pom book
“One Yellow Slinky Bouncing Up and Down”

• Yellow Slinky Jr., by Poof; cut one Slinky apart into smaller sections (I made mine into 7 smaller sections)

Page of Yellow Slinky book
“Five Little Lights”

• Leorx LED Party Lights; these are small, LED lights which are designed to go in paper lanterns, can be ordered from Amazon and come in a package of 30.  Note: I often place one or more of these inside of a balloon to light it up!  ALTERNATELY, you can use LED Finger Lights. The advantage of using the Finger Lights is the color; they come in either red, green, blue or white. They can be ordered from Amazon as well and often come in a package of 10 to 40.  

 Page of Five Little Lights
“My Favorite Things”

• Five to ten, 5” X 7” matte finish, color photographs of your student’s favorite toys or objects.  This might include favorite toys such as an O’Ball, or an Elmo doll, or it might include objects he/she encounters during familiar routines such as a favorite cup or lighted spoon

Page of My Favorite Things


“Clifford’s Family” (Modified, progressive version)

• Clifford’s Family, by Norman Bridwell, paperback version available on Amazon (Note: you will need 3 copies of the same book to make the modified, progressive version I show in the sample)
• Red, mylar-like ribbon and glittery craft tape, to highlight Clifford's collar; it will be used both as a salient feature and to draw visual attention
  
  

Materials for Clifford's Family
“Get Ready for School” Pegboard Book:

• Black, round elastic
• Black retractable badge holder
• 1/4th inch thick pegboard
• 2” X 2” hardwood board
• 1” X 2” hardwood board
• ½” doweling, 3 feet
• Active Learning materials to put on the pages
• A very complete Tutorial on how to make and assemble this book can be found in the DIY section of my website at strategytosee.com.

Pegboard book


re to edit.

https://www.rnib.org.uk/insight-online/teach-cvi-resource

This site offers teaching strategies for lesson planning for  stimulating growth in vision and attending.

http://www.perkinselearning.org/cvi/educators
this web site offers resources for teachers and families, professional development, and teaching strategies.

http://www.perkinselearning.org/scout/topics/cvi

Resources include an 80 page  instructional manual written by an Occupational Therapist that has great ideas for increasing sensory responses.   Active Learning
A project developed between Penrickton Center for the Blind in Michigan, Perkins School for the Blind, and the Texas School for the Blind and Visually Impaired provides resources and a community of practice around the work of Dr. Lilli Nielsen and Active Learning. The site includes discussion of Active Learning principles, assessment, implementation, materials, equipment, and other events and resources. Active Learning is most effective for those with significant multiple disabilities and in the 0-48 month developmental level. 

CVI Hub
Information and resources on CVI, including videos, online classes, and information on the CVI Endorsement.
Source: Perkins eLearning
CVI Web Exercise
This three-part multimedia presentation covers an introduction to CVI, case studies, and intervention strategies.
Source: Texas School for the Blind and Visually Impaired
CVI Website
Information on all aspects of cortical visual impairment (CVI), including introductory materials, CVI products, research, and resources.
Source: American Printing House for the Blind (APH)
National Center on Deaf-Blindness (NCDB)
NCDB is a national technical assistance and dissemination center for information about deafblindness. While most resources focus on the needs of children and youth, there is wealth of information here in the Adult Services section.

Strategies for Promoting Literacy Skills and Students with CVI
Numerous tips, activities, and resources to adapt books and literacy materials for children with CVI.
Source: Paths to Literacy
The Laboratory for Visual Neuroplasticity Research
This research lab focuses on issues of vision impairment and neuroplasticity. Check out the site for reports on current research done by the lab on topics including visual impairment, CVI, spatial cognition, and related topics. 
Source: The Laboratory for Visual Neuroplasticity