Centers - Cortical Visual Impairment The Bridge School

Student Considerations

At the core of every adaption is the student. By looking at the CVI characteristics of our students we determined how best to address their individual vision needs. Which includes:

Complexity – Reducing complexity of the background array (both in the broader environment and for viewing individual targets)
Distance Viewing
Novelty
Light
Movement
Color Preference
Field Preference
Latency

Black fabric has been used in the front of the classroom to cover windows, the under side of a table, and the wires from electronics — Reducing visual clutter in the broader environment.

A black felt tri-fold board standing on a table with a toy hammer, combo wrench, and crescent wrench attached to it, and a white towel with images of flowers draped over the right third of the board — Reducing complexity of background for individual items.

Close up of a red silicone spatula with a clear plastic handle covered in red tape attached to a standing black felt board — Reducing complexity of objects (1-3 colors).

A child looking closely at a transparent image of a red tennis shoe backlit by a light screen — Including color preferences in objects (particularly red, yellow, and/or blue).

Overhead image of an empty wheelchair with a black tray table attached and a yellow toy tow truck sitting on the tray — Presenting novel objects by including color preferences.

Image of a black felt board with a paper cutout of a photo of a cat on it — Talking about the salient features of the item.

An instructor holds a collage of images and text in front of a student in a wheelchair — Presenting materials in the students’ field preference.

An instructor sitting directly behind a student and shining a flashlight onto his hands holding an unidentifiable blue object on top of a black felt board — Using light and movement to attract visual attention.

A student looking closely at a hairbrush being held in front of a light screen by an instructor — Giving students the length of time needed to view the item (latency).

A student looking at a light projected image of a wooly mammoth against a black background — Placing materials at the distance necessary to expect visual fixation.

Environmental Considerations

Classroom space
Desk space
Noise levels
Lighting

With these characteristics in mind we looked at our pretend play and art areas. It was clear we needed to reduce the visual complexity of the areas so that students could more easily find, interpret and know the areas of the classroom as well as the toys, props and objects included in each area as they relate to the theme.

Adaptations included:

Reducing the complexity of the environmental array so that key areas of the classroom could be found and identified.
Reducing complexity by adding black backgrounds to student wheelchair trays.

A corner of the classroom labeled service station with several toy hard hats and road cones on a table behind two ride on sized toy cars and a large toy gas pump — This is what we started with in terms of our pretend play area during service station theme. The play area is a wash of colors and shapes. It is difficult to find and differentiate the toys and props. We needed a way to make at least some of these props visually stand out against a complex background. We needed a way for our students to have visual access to new and familiar toys to engage within a pretend play schema, while also keeping a wide array of toys and objects available for use during play.

A black felt tri-fold board standing on a table with a one dollar bill, a yogurt cup, a box of lemon wafer cookies, and a cloth shopping bag attached to it — Props pulled for the grocery store theme.

Overhead image of an empty wheelchair with a clear tray table attached and a yellow toy tow truck sitting on the tray — Another way in which we reduced environmental complexity was to provide students with black backgrounds on their wheelchair trays. This tray is clear and when the toy car is placed on it the environmental complexity comes through.

A tray table for a wheelchair that has had a black cover placed on it — Other ways to make the tray black include using Velcro to place back material under the tray or, as in this case, where a parent made a black cover to go over the tray.

An instructor helps a student in a wheelchair reach the canvas in front of them — This student uses a bookstand with a light as an easel. The light is clipped to the top of the bookstand and turned on to help draw visual attention to the activity. The stand can be easily adjusted and angled to place materials within a student’s preferred visual field. Given our student’s physical needs some assistance from a teacher may be needed. This teacher provides hand under hand assistance so the student can see and feel the art materials on his hands without her hand interfering in his visual field or experience. Here he is splashing water on his drawing to make the colors run together.

Teacher Considerations

Materials
Instructional strategies
Prompting language
Lesson planning

As a staff we began to understand the importance of having the expectation that a student will look at objects given appropriate adaptations. With this in mind we set about mostly adapting the objects around each Center’s thematic unit and discussed how we would introduce novel objects. We wanted to support the expectation of looking but balance that with the need for a young learner to also just actively do and experience something.

Adaptions included:

Using objects that were 1-3 colors
Using objects that contained at least one preferred color
Labeling objects with their visual salient features so staff consistently describes new objects to students
Black felt boards to present objects against
Flashlights to shine light as needed to attract visual attention towards an object
Providing sufficient quiet wait time to allow the student time to visually orient towards an object
Placing objects within a student’s preferred visual field and within an appropriate distance

Close up image of the handle of a spatula with a label on it that says Spatula: red, long skinny handle, wide bottom — The salient features, or most obvious visual characteristics of the object, were written on a label placed on the back of the object. This helped staff consistently describe novel objects to students as they visually processed the item. Not all objects in our pretend play area had a salient features label, but the ones on the prop board all did. As time progressed we, as a staff, became more consistent in our labeling of salient features even on items that did not have a label.

A student in a wheelchair washes a stuffed dog in a bowl of water held in their lap by an instructor — Once an object is known, for some students the complexity of the visual array can increase. Here the student washes a stuffed dog (which is a single color) in a bowl of water. The overall visual schema continues to be simple, but she does not need a black tray or background to see the different materials.

A student in a wheelchair sits in front of a raised garden bed and scoops up dirt with a highly reflective small shovel — This shovel has reflective properties through its shiny material. This reflective property mimics movement and helps draw the student’s visual attention to the object. Many toys and props needed no adaption to be visually appropriate, it was the job of the teachers to find the right ones that met the students’ visual needs.

An instructor assists a child in a wheelchair in transferring a cup of flour from a glass bowl to a shiny gray bowl — These items are placed within the student’s preferred visual field. With a gray tray to reduce environmental complexity, a single-color measuring cup, and bowl of white flour, the visual scene is simple. The shiny bowl placed in his left visual field attracts his attention with its reflective properties. The student is able to find and hold the cup of flour and put it in the shiny gray bowl.

A student looks closely at a large plastic orange attached to a painting of a tree — The fall tree is placed within the student’s preferred visual field and distance. It contains about 3 colors.

Close up of a bottle of Scholastic school glue — Art tools are presented against a black background with a light as needed to attract a student’s visual attention towards the item before expecting them to hold and utilize the materials.

A student in a wheelchair uses an adaptive marker holder to draw on a paper attached to an easel — A student’s favorite color is incorporated into an art activity. The bookstand art easel was adjusted and angled to match his visual field preference. For students art is not about the final product, but rather the process and the experience of using different art tools. Utilizing vision helps aid in understanding this process.

A student uses an adaptive marker holder to draw on a paper attached to an easel — This student brings his head forward to help come even visually closer to his drawing.

AAC and AT

AAC system development (no-tech, low-tech, high-tech)
Vocabulary
AT tools (switches, seating, mounting, etc.)

In addition to their personalized AAC systems, students are able to express meaningful choices, make comments, ask questions and generally initiate conversations within Center’s activities by utilizing the objects to communicate more information. For some students, we take a picture of the object and incorporate that icon within their AAC system. With the pretend play and art areas more visually highlighted, students can utilize their vision to look towards that area to communicate a choice on where to go, make a comment, ask a question or initiate a conversation.

An instructor pointing across the room while sitting in front of three students in wheelchairs — This student looks towards the car in the pretend play area to initiate a conversation with her teacher. She wanted to pretend to wash the car.

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