The ultimate goals of Bridge to Life include:

  • serving individuals with physical and/or communication impairments from birth through adulthood, locally, nationally and globally 
  • providing professional development opportunities in our areas of expertise 
  • contracting with families, agencies and school districts to offer direct services to students with severe physical impairments and complex communication needs

Save the Dates for Spring 2025!
Conversation Series on CVI and AAC with Dr. Christine Roman Lantzy

Browse Programs @The Bridge School

Webinar 9: Effective Interaction Strategies for Children with CVI and CCN

CVI@The Bridge School

Adapted AAC-CVI Framework – Adapted from work at Penn State University

Latest Events CVI@The Bridge School

2023 Summer Workshop – Addressing the Needs of Students with Cortical Visual Impairment (CVI) and Complex Communication Needs (CCN) in the Classroom Setting.

The Bridge School is excited to announce the AAC-CVI Framework, adapted from work at Penn State University.

Music, Storytime, and Morning Circle are all teacher-directed routines that incorporate many of the same accommodations for vision needs due to CVI.

Student Considerations

At the core of these accommodations is the student.  In order for students to visually access the instructional materials (that includes objects and 2-dimensional materials) the following characteristics were considered across these activities:

  • Complexity
  • Novelty
  • Light
  • Movement
  • Color Preference
  • Field Preference
  • Latency

Environmental Considerations

  • Classroom space
  • Desk space
  • Noise levels
  • Lighting

Most teacher-directed activities in the preschool classroom occur in the same “blue rug” area.  After careful consideration, it was clear we needed to reduce the visual complexity of the area and think about what to include on the wall displays and what objects to include in the instructional space to meaningfully support vision.

Adaptations included:

  • Adding black felt to walls
  • Reducing the amount of icons posted on the wall
  • Reducing the amount of instructional objects stored in the space
  • Use of the computer screen to attract visual attention towards the space
This is what the blue rug area looked like before adaptations were made. There are lots of things on the walls and around the teacher. It is difficult for students to know what to visually fixate on in this environment.
The walls in the blue rug area are covered in black felt to help those essential items visually pop out. The book being read at Storytime for the week is prominently displayed so that students can easily find it across the day. Everything presented visually here serves a purpose and the students can find and use these items across teacher-led sessions and other activities throughout the day. Instructional objects presented in various teacher-directed activities can be easily displayed and visually found by students to support extended participation with the content.
When the blue rug area moved in order to have access to the big computer screen mounted on the wall during instruction, the same considerations were carried over (black background on the walls, reduced objects within the space). Now we turn on the computer screen with a bright yellow desktop background as students move towards the group. The color and backlighting help attract visual attention towards the space and give students a reference point as they navigate the classroom to the group. Once everyone arrives to the group the screen is turned off until needed later to avoid visually distracting the students.
During teacher-directed activities much of the environmental space can be controlled. This includes turning off overhead lights as needed and reducing background noise during instruction. In this photo the lights have been lowered and the teacher shines a light on the icons while the student helps take attendance.

Teacher Considerations

  • Materials
  • Instructional strategies
  • Prompting language
  • Lesson planning

During teacher-directed activities we needed to consider how to best adapt instructional materials to help students recruit their vision and how and where to present the materials during the lesson.

Adaptions included:

  • Reducing the background clutter of 2-dimensional materials
  • Black felt boards to present objects against
  • Using objects with 1-3 colors
  • Using light as needed to recruit visual attention
  • Use of the computer screen to attract visual attention within lessons to present materials as appropriate
  • Labeling objects and pictures with their visual salient features
  • 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
This student looks at an image of a teacher during Morning Circle for attendance. The image is presented on an iPad, which provides backlighting to attract visual attention. The overhead lights have been dimmed to help the backlighting pop out. The image background clutter was eliminated by first editing the image in Microsoft Office PowerPoint using the “remove background” tool and then placed on a slide with a black background. This student looks at the image presented on the iPad and then visually finds the actual person within the group. Ms. Katie is here!
During Morning Circle students reposition themselves to find friends during attendance. They like to get close to each other and reach out to touch a friend to say hi. This close proximity and ability to reach out and physically find a friend helps many students to activate their vision and orient to the people in the space both tactilely and visually.
During the Music lesson students sing a song that relates to the current thematic unit. Objects with 1-3 colors are pulled from the pretend play area to help act out the song and support extended participation with the content. Here the speech language pathologist presents the object against a black felt board. She places the object within this student’s preferred visual field and gives her enough time to find and look at the object. Then the student puts the fish in the tub of water.
The teachers often use Microsoft Office PowerPoint to present lesson materials and concepts and to support participation and understanding during the activity. By using slide transition or animation found within the PowerPoint program, the movement it creates helps some students find and orient towards the lesson materials. This slide used the “vortex” transition during a song about rainbows.
Teachers use as many real objects as possible during teacher-directed activities. While singing “Peanut Butter and Jelly” during Music the speech language pathologist had students look at, touch, smell, and make peanut butter and jelly sandwiches. This student said, “Yuck!” to the peanut butter!
During Storytime, illustrations in a book may be simplified to help students find and interpret the image. The teacher searched for images on the internet to match the content of the book and used the Microsoft Office PowerPoint tool “remove background” to remove any visual clutter. The teacher explains the 2 to 3 visual salient features of the image to help the student interpret an unfamiliar picture.
Original book illustration
This illustration was color copied from the book, cut out, and then mounted on a plain background. It is easily presented on a lightbox if light is needed to attract and maintain visual attention.
Original book illustration
Dr. Roman-Lantzy shared with us a much faster way to reduce illustration complexity that needs to be done on the fly. These black felt overlays have different size squares cut out in them. By placing the cut out over the illustration much of the complexity is eliminated.
Second example of the black felt overlay. By placing the cut out over the illustration much of the complexity is eliminated.
Symbols used for participation and comprehension of the book’s content are reduced in visual complexity.

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 topics within teacher-directed activities by utilizing the objects and 2-dimensional materials to communicate more information.  Symbols used in teacher-directed activities can be meaningfully incorporated within individual AAC systems based on interest and need using the same adaptations presented to the whole group.

Symbols of people in the classroom were made for this student’s “word book” so that she could use the words across sessions and time.